Radiation Oncology
Expert insights on radiation treatment planning, techniques, toxicity management, and multimodal cancer care.
Recent Discussions
How long can a patient with newly diagnosed merkel cell carcinoma wait for wide local excision with sentinel node biopsy?
A recent study I read on this same question regarding sentinel node biopsy (SNB) performed after melanoma wide excision found that the sentinel node could still be found just fine. And I have found that in practice a number of times when I wide-excised obvious melanomas at first presentation visit. ...
Would you use SBRT to treat a lipoma of the spine that recurred twice after surgery?
Interesting question for an infrequent clinical matter. SBRT for recurring Lipoma of the spine, maybe - in my humble opinion.Related clinical questions -->>:1) Are the lesion(s) becoming more aggressive histologically?2) Are the lesion(s) becoming difficult anatomically for more surgery resections? ...
What are your current recommendations for treatment of symptomatic splenomegaly in the setting of myelofibrosis when splenectomy is not an option?
I use low dose, typically 50cGy per fraction for 4-6 fractions, done in 2 fractions per week; need to check platelets each week during course.
What is your experience with Gelclair for oral mucositis during head & neck radiotherapy?
I used Gelclair for my patients regularly till a few years ago. However, I did not find a significant difference in the rates of mucositis among those who did and did not use this product. That is my anecdotal experience and I would be curious to hear other thoughts from those who are routinely reco...
How would you treat a patient with a granular cell tumor of the breast with positive margins following excision?
I would recommend a re-excision to widely negative margins. I would not radiate.
How do you treat SNUC?
There’s no standard treatment. Suitable for gross total resection: surgery and postop RT and concomitant chemo.Not suitable for GTR: chemo RT or induction chemo and reevaluate for surgery and postop RT chemo.
Is FAST-Forward/ultra-hypofractionation suitable for an early-stage breast patient after a lumpectomy with oncoplastic reduction?
Yes, FAST-Forward is fine after oncoplastic reduction as long as dose homogeneity criteria can be met (V105 < 5%).
What dose and OAR constraints do you use for boost with IMRT or SBRT when a patient with cancer of the cervix is not a candidate for brachytherapy?
Concurrent chemoradiotherapy plus brachytherapy boost (intracavitary or interstitial) is the standard of care in patients with locally advanced cervical cancer. In light of published data suggesting inferior survival if brachytherapy is omitted from definitive treatment, we do not recommend utilizin...
For locally advanced adenocarcinoma of the maxillary sinus, how should the neck be managed?
ENI if high grade
Would you add a brachytheray boost to a locally advanced cervical cancer after surgical resection and pelvic RT?
In general, a brachytherapy boost following external radiation is not standard when treating women for locally advanced cervical cancer post hysterectomy. Neither of the 2 major adjuvant GOG trials (92 and 109) allowed a brachytherapy boost, and even the currently open GOG trial, GOG 263, does not i...