Radiation Oncology
Expert insights on radiation treatment planning, techniques, toxicity management, and multimodal cancer care.
Recent Discussions
When is postmastectomy radiation therapy indicated for a de-novo occurrence of cancer in the chest wall after mastectomy without prior malignancy, such as in a patient who had prophylactic mastectomy?
This is such a rare occurrence and I may have done this a few times. I have usually limited to CW only if SNLN is done as part of surgery and is negative. That being said, feel local excision alone with adjuvant systemic treatment as indicated may be an option.
How do you manage real-time release of pathology and radiology results to oncology patients following enaction of the CURES act?
Even prior to the Cures Act, I worked in a place where lab and imaging results were immediately available to patients through their smartphone app. A few memorable encounters: Patient 1 - told me his favorable PSA result when I walked in the room and basically told me the plan going forward, (which ...
What additional benefit does radiation offer for a patient <65 years old with T1aN0 ER+ invasive carcinoma (tubular histology) of the breast?
Most of these have low genomic scores and are part of the DEBRA trial and up until that, based on available evidence, would favor adjuvant RT (APBI preferred).
How do you manage new brain mets in a patient with a history of RT necrosis after prior SRS?
The short answer is “yes”. For brain mets over 2 cm in maximum diameter, we and others have found that 3-5 fraction stereotactic radiation therapy has produced equivalent or better local control and lower incidence of radionecrosis than single fraction stereotactic radiosurgery. It would be good if ...
How would you sequence treatment for HPV (+) concurrent advanced oropharynx and anal SCC?
Treat concomitantly.
When contouring pelvic lymph nodes in rectal and anal carcinoma, do you exclude bowel from your CTV?
Certainly, the expected clinical difference is so small that I personally think we will never have data to tell us whether one strategy is better than the other. Another point to consider is that unless your bowel constraints are very strict, your planning process is going to allow a considerable am...
Would you recommend XRT to post-cystectomy bladder cancer patient with metastatic PA and mesenteric nodes?
I would not as this would have outcome like metastatic disease and need systemic treatment as the mainstay of treatment.