Radiation Oncology
Expert insights on radiation treatment planning, techniques, toxicity management, and multimodal cancer care.
Recent Discussions
What fields would you treat for a postmastectomy patient with a single suspected small IMN node on MRI but no other criteria for PMRT and a negative SNB?
If treating based on suspected IMN, I favor treating the chest wall with comprehensive RNI.
How would you treat grade 3 cauda equina meningioma status post biopsy only with a history of prior prostate/whole pelvis radiation?
This question is anything but routine. WHO grade 3 spinal meningiomas are exceedingly rare. I’ve been treating meningioma patients my entire career, now beyond 3 decades, and have never seen one. If this patient’s prostate cancer radiation therapy (RT) were many years ago and if his meningioma were ...
Do you offer APBI to patients who do not have surgical clips but a visible seroma?
Yes, if open cavity surgery, we don’t place clips and define CTV based on seroma. If type 1 oncoplastic then need clips to help define CTV.
How would you optimally manage a small solitary plasmacytoma of the alveolar ridge, including minimizing the risk of dental toxicity?
The alveolar ridge is an osseous structure (extension of the mandible and maxilla) that houses the sockets of the teeth. Assuming an appropriate work-up demonstrates no evidence of multiple myeloma (bone marrow biopsy, PET-CT/MRI, laboratory work, etc.), a plasmacytoma arising in this region would b...
Is it safe to give spine SBRT after recent cryoablation?
There is a small randomized trial (CROME) of SBRT vs Cryo + SBRT open at MD Anderson addressing this question. In this trial, SBRT is done within a few weeks of cryotx. The trial is still accruing and results are not available. In lieu of randomized data, I think it would be reasonable to consider S...
For a small (<5 mm) hard/soft palate junctional primary with DOI <2 mm status post limited excision with negative but close deep margin, how would you approach neck management in the adjuvant RT setting?
Postop RT to primary plus elective neck RT.