Questions discussed in this category
How would you factor in a patient with profound thrombocytopenia?
Paraaortic nodes positive to left renal vein
Would PET-positive pelvic or paraaortic lymph nodes change this recommendation?
Margins negative, no LVSI, PET/CT negative.
Currently 7 weeks pregnant, diagnosis based on CKC
ex. in a patient with pulmonary micronodules, inguinal, pelvic, PA nodes
Patient is currently 7 weeks GA with 1.5cm visible lesion. MFM recommends 13wk CKC vs LEEP with cerclage at that time.
Particularly with IMRT when delineating volumes.
Lesion measures 2cm and PET is otherwise negative.
Could EBRT lead to rupture of the cyst?
Patient with stage IIB cervical cancer treated 8 years ago, now with large (>10cm), isolated, symptomatic recurrence involving the left SCL and med...
Would you consider SBRT or brachytherapy?
Small bowel is usually the dose limiting OAR while planning cervical HDR brachytherapy. Having the bladder empty during treatment planning and deliver...
Would you consider additional EBRT or vaginal cuff HDR in a patient with previous tx with EBRT (45Gy) + HDR (30Gy) for a R1 resection with a radial ma...
This is not the standard of care in the USA.
This has been a common practice in the community. Is there a benefit for certain patients?
What dose/fractionation would you recommend?
Patient being treated for cervical cancer noted to have a < 1 cm posterior vaginal fornix defect with a small focus epiploclia herniating into the ...
The limited data on MDA (minimum deviation adenocarcinoma) suggests it has a worse prognosis, but it is hard to disentangle this from stage, as it is ...
Would there be a substanital increase in the risk of toxicity using such a scheme?
We frequently have patients who have to travel long distance...
Would you be more or less likely to use a cisplatin-containing regimen if a patient had previously responded to chemoradiation with concurrent cisplat...
Could you discuss how you decide between IMRT or SBRT boost for a patient who is not able to receive intracavitary or interstitial HDR or LDR brachyth...
What chemotherapy and sequencing with radiation therapy would you recommend? IS surgery a component of the treatment?
Does the phase II KN-158 provide sufficient evidence to change management?
Should this be done at the time of recurrence or after failure of 1st line therapy for recurrence?
Do you have an SUV cutoff for physiologic activity of the ovary?
Do you cover common iliac nodes (L3/L4) or keep field edge at L4/L5 to reduce bone marrow toxicity?
If so, what indications would you use other than Peters criteria?
Do you use a trimmed 10 mm expansion on HR-CTV? Do you also include the entire initial extent of disease? How much does your IR-CTV coverage affect yo...
A literature search indicates that most port site recurrences are managed fairly aggressively with chemoRT or RT doses 45-66 Gy. This is understandabl...
Sequentially or do you integrate the cuff brachy with the EBRT and if so what schedule, BIW, weekly, etc?
For example, a patient with cervical or anal SCC who has missed many treatments due to side effects, low blood counts, hospitalizations, or non-compli...
Do you recommend upfront diversion? Are there unique planning considerations such as the inability to use bladder filling? How do you boost? What are ...
Do you add an IMRT boost with possibly vaginal brachytherapy?
What are your specific protocols for monitoring and for dosing narcotics and sedatives?
If so, what dose/ volume is prescribed? How do you account for motion?
What dose and technique do you use and how do you integrate the subsequent definitive treatment plan?
Close but negative radial margins? LVSI? What fractionation/dose do you use for your vaginal cuff boost if used?
In the setting of a negative lymph node sampling, would you treat a full pelvis or mini-pelvis to compensate for lack of the appropriate surgery? Is a...
In patients who don't meet traditional criteria for adjuvant chemoradiation from Peters (GOG 109) and < 2 high risk factors from Rotman (GOG 92) fo...
What exactly do you contour and what is your dose constraint to that volume?
Does using something like a vienna applicator allow you to avoid dose escalation with more external beam? How do you recommend doing a classic pa...
Some classic references recommend the coverage of the entirety of the sacrum but the volume delineation guidelines for both seem to only cover the mos...
Do you try to keep Hb> 10 or 12? Or somewhere in between?
The most recent ABS guidelines don't discuss a dose constraint for the small bowel.
Does your strategy change if bladder invasion is present?
Do you treat PAs if pelvic nodes are positive? If common iliacs are involved? Only if there are positive PA nodes?
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Papers discussed in this category
International journal of radiation oncology, biology, physics, 2011-02-01
Int J Radiat Oncol Biol Phys, 2013 Jul 9
Int. J. Radiat. Oncol. Biol. Phys., 2014-05-01
Cancer Nurs, 2017-04-21
Cochrane Database Syst Rev, 2010 Sep 08
International journal of radiation oncology, biology, physics, 2019-05-01
Cochrane Database Syst Rev, 2012 May 16
Int. J. Gynecol. Cancer,
Seminars in radiation oncology, 2019-04
International journal of radiation oncology, biology, physics, 2006-08-01
Gynecologic oncology, 2005-11
Clinical cancer research : an official journal of the American Association for Cancer Research, 2015-12-15
Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2000-04
Lancet,
Gynecol. Oncol., 2005 Nov 21
J. Clin. Oncol., 2011 Mar 28
BMC Cancer, 2017 Apr 28
N. Engl. J. Med.,
Obstet Gynecol,
Gynecologic oncology, 2014-01
Cancer, 2000-04-15
Lancet Oncol.,
International journal of gynecological cancer : official journal of the International Gynecological Cancer Society, 2019-01
Gynecologic oncology, 2004-04
J Obstet Gynaecol Res, 2019 Sep 09
The New England journal of medicine, 2018-11-15
International journal of radiation oncology, biology, physics, 1991-07
Cancer,
The Lancet. Oncology, 2017-03
International journal of gynecological cancer : official journal of the International Gynecological Cancer Society, 2019-01-23
Ann Oncol,
Gynecol Oncol, 2018 May 24
Int J Gynecol Cancer,
Gynecologic oncology, 2011-07
BMC Cancer, 2018 May 04
J Gynecol Oncol,