Radiation Oncology

Gastrointestinal Cancers   

Questions discussed in this category

Would the presence of diverticulosis change your dose constraint for large bowel?
Is diverticulosis in large bowel adjacent to a target a contraindication for SBRT? How would you manage?
1 Answer available
What chemotherapy regimen do you recommend with radiation therapy for cervical esophageal squamous cell carcinoma?
The upfront plan is to use a definitive radiation dose of 66 Gy. My reading supports the use of 5FU + cisplatin but another doctor is recommending FOL...
2 Answers available
What dose-fractionation would you utilize to palliate a symptomatic distal rectal cancer in an inoperable elderly gentleman with previous prostate bed radiation therapy 30 years prior?
Would your recommendation change if the patient had prior radiation proctitis and cystitis (now resolved)? Previous treatment records limited, but pre...
1 Answer available
Do you offer radiation therapy for locally advanced, node positive rectal adenocarcinoma in patients with Li-Fraumeni syndrome?
Would you omit radiation therapy for some patients with Li-Fraumeni syndrome who would normally receive it?
1 Answer available
What surveillance do you recommend for a patient with locally advanced rectal adenocarcinoma who had a complete clinical response to total neoadjuvant therapy and declines to undergo surgery?
MRI? Endoscopy? Physical exam?
1 Answer available
How do you manage patients with pancreatic adenocarcinoma who progress during neoadjuvant FOLFIRINOX, such that borderline resectable disease is now unresectable but still localized?
Is there evidence for radiation therapy in this setting? 
3 Answers available
Are there circumstances where you would recommend every 6 week dosing schedule for pembrolizumab monotherapy?
I am considering every 6 week pembrolizumab dosing in patients >70 years old in whom I want to reduce clinic visits for, especially in the context ...
2 Answers available
Does p16 negative status of anal squamous cell carcinomas affect your treatment approach?
1 Answer available
What is your treatment algorithm for solitary hepatocellular carcinoma, 3-5 cm, non-operative candidate but Child-Turcotte Pugh A/B?
Do you recommend TACE, RFA, radioembolization, systemic therapy or SBRT?  What if the size is >5 cm?
1 Answer available
How do you manage patients with low-lying rectal adenocarcinoma who refuse surgery?
Should these patients be managed with high dose chemoradiation similar to the Danish study (Lancet in July 2015)? To what dose would you take the prim...
1 Answer available
Should special precautions be taken patients with Ehlers-Danlos syndrome receiving radiation therapy?
Would you have reservations in treating patients with breast, GI, or pelvic malignancies with radiation alone or concurrent chemoradiation?
2 Answers available
In rectal cancer patients receiving total neoadjuvant therapy, do you prefer chemotherapy followed by long-course chemoradiation, or short-course RT followed by chemotherapy?
1 Answer available
Should adjuvant CRT be considered in gastric cancer patients who received pre-op chemo based on the recent results of the CRITICS trial?
The CRITICS trial showed there was no OS or PFS benefit with adj chemo vs CRT. Is there potentially still a role for CRT to reduce heme toxicity and p...
1 Answer available
What is your approach to a patient with GE junction or esophageal cancer with oligomestatic disease at presentation?
Would you offer definitive or neo-adjuvant chemo-RT in the setting of a single lung or bone metastasis?
1 Answer available
What is a safe dose to deliver to a gastric bed recurrence adjacent to the duodenal stump post total gastrectomy for gastric carcinoma?
What is the duodenal stump dose constraint?
2 Answers available
In which clinical situations is there a good rationale for the use of proton therapy for GI cancers?
Should we give concurrent capecitabine?
1 Answer available
What dose constraints do you use for 15-25 fraction hypofractionated RT for cholangiocarcinoma?
Higher radiation dose was shown to be associated with longer survival in Tao et al., JCO 2016. What dose constraints do you use when using these ...
2 Answers available
Is there any advantage to proton beam therapy in a locally recurrent anal carcinoma, which has already been treated with concurrent chemo RT as well as APR for relapse?
Would you consider the addition of chemotherapy to proton beam therapy?
2 Answers available
Which patients with rectal cancer who have not received neoadjuvant treatment, do you offer adjuvant radiation to?
Is there a subset of patients you would avoid neoadjuvant CRT and operate first?
1 Answer available
What is your treatment paradigm for rectal cancer in the setting of COVID-19?
Are you doing more TNT to prolong time to surgery? If so, do are you starting with CRT or chemotherapy?
3 Answers available
Is it acceptable to deliver ablative hypofractionated radiation therapy for unresectable intrahepatic cholangiocarcoma in conjunction with concurrent checkpoint inhibitor?
Would you be concerned with more and higher grade hepatobiliary toxicity with concurrent use of checkpoint inhibitors (i.e. Keytruda)?
1 Answer available
How do you sequence short course radiation for locally advanced rectal cancer when using the total neoadjuvant approach?
When using short course RT, the NCCN guidelines currently recommend short course RT followed by chemotherapy, followed by surgery. Many surgeons are h...
4 Answers available
How would you treat a T4 rectal cancer invading the uterus that is causing rectal and vaginal bleeding?
What is your preferred combination and order of therapy for a T4 rectal tumor invading the uterus leading to both rectal and vaginal bleeding?  ...
1 Answer available
Would you offer radiation therapy to a patient with sigmoid colon cancer that is medically inoperable?
What dose and volumes of radiation would you use?
1 Answer available
Would you consider short course RT for rectal cancer in the post-op setting given COVID-19?
2 Answers available
Are there scenarios that new visits/consults with patients can be done virtually amidst the COVID-19 outbreak?
6 Answers available
For T2-T3 N+ rectal patients with large (2+ cm) bilateral sidewall nodes outside the TME volume, should you extend elective nodal volumes anteriorly to include external iliacs?
1 Answer available
When treating locally advanced/borderline resectable pancreatic cancer with SBRT, what are the typical duodenal dose constraints you utilize?
2 Answers available
What form of surveillance do you recommend for esophageal adenocarcinoma s/p NACRT and resection at what frequency?
1 Answer available
Do your post-operative rectal fields differ from pre-operative fields?
For those that tend to contour rather than set fields based on bony anatomy, how do you draw your CTVs? 
1 Answer available
For a patient with a solitary kidney, what dose constraints would you use for SBRT to a nearby site?
2 Answers available
How would you treat an early-stage gastric adenocarcinoma in a patient who is medically inoperable and not fit enough for chemotherapy?
Is there such thing a definitive radiotherapy in this setting, or would this be a purely palliative approach? If you would treat, what would your targ...
3 Answers available
Do you recommend definitive chemoradiation for unresectable gastric adenocarcinoma in a medically unfit patient?
If so, what dose-fractionation regimen do you utilize? What are your target volumes?
2 Answers available
How do you manage unresectable esophageal cancer involving both the thoracic esophagus and GE junction?
In the case of multiple skip lesions in the thoracic esophagus and GE junction, the PTV may encompass nearly the entire esophagus, including the supra...
3 Answers available
Do you hold pelvic radiation for patient with clostridium difficile-associated diarrhea?
Would your recommendations change if you were treating a GI primary (e.g. rectal or anal cancer) vs non-GI primary? 
1 Answer available
What dose and fractionation would you recommend for anal melanoma that is localized but refusing surgery?
2 Answers available
Do you recommend post-operative radiation therapy for gastric cancer after pre-operative chemotherapy when there is no pathologic response to chemotherapy?
Do factors such as large tumor size and/or node positivity affect the decision?
1 Answer available
If colostomy is indicated prior to Nigro for locally advanced anal SCC, would you wait to simulate after this procedure or do you feel pelvic anatomy will not be distorted?
1 Answer available
Are there circumstances when you would consider re-irradiation of the esophagus in a patient who is not a surgical candidate or declines surgery?
2 Answers available
Do you offer liver SBRT for metastatic colorectal cancer after local recurrence following previous treatments such as radiofrequency ablation (RFA), radioembolization, and chemoembolization?
If so, what dose fractionation do you prefer?
1 Answer available
What techniques do you use to address fertility preservation in young female patients being treated with chemoradiation therapy for cancer in the pelvis?
How do you prevent early menopause in women? Please comment on freezing of eggs, oophopexy, supine vs prone position, vaginal dialator. 
4 Answers available
What small bowel dose constraints do you utilize when treating resected pancreatic cancer?
When indicated as in the setting of positive margins and/or positive lymph nodes, do you use V45 <195cc (QUANTEC), or V45 <15% (RTOG 0848), and ...
1 Answer available
Do you electively cover the celiac axis in a patient with node negative middle third to distal, and GEJ esophageal carcinoma?
What factors do you use in deciding whether or not to electively cover the celiac axis?
2 Answers available
Is prior radioembolization with Yttrium-90 microspheres for a primary liver cancer a contra-indication to external beam radiation therapy with either stereotactic body radiation therapy (SBRT) or proton beam therapy?
3 Answers available
How do you choose between SBRT and RFA for CRC metastases to the liver?
*What dose and fractionation do you recommend for metastases >4cm in favorable positions (ie. not abutting mucosal tissue)? 
1 Answer available
Is there a role for a post-operative boost in a patient with rectal cancer who has a positive margin after total neoadjuvant chemo and chemoradiation therapy?
Total neoadjuvant therapy consisted of with FOLFOX and chemoradiation therapy with Xeloda and 50.4 Gy. Would you deliver a boost to the area and if s...
1 Answer available
Would you treat rectal squamous cell carcinoma the same as rectal adenocarcinoma, stage for stage?
Any adjustments in terms of elective nodal coverage?
4 Answers available
What dose constraint do you use for the ostomy site when treating a patient with close/adjacent disease?
1 Answer available
What proton dose regimen would you use for locally recurrent esophageal cancer previously treated with chemoRT?
For a patient with an access to proton beam therapy, what dose regimen would you use in the context of a locally recurrent esophageal cancer, previous...
3 Answers available
Would you offer adjuvant chemoRT for node positive high rectal cancer above the peritoneal reflection?
3 Answers available
How would you treat a patient with adenocarcinoma of the GE junction in the setting of interstitial lung disease?
Is neoadjuvant chemoradiation or perioperative chemotherapy preferred?
1 Answer available
How do you treat duodenal adenocarcinoma when using primary chemoradiation therapy?
What dose/fractionation do you use and what elective nodal areas do you cover? What studies do you order to aide in treatment planning (PET/CT? MRI?) ...
1 Answer available
Would you offer SBRT in a patient with history of CRC, subsequently found to have a solitary liver metastasis treated with chemotherapy followed metastasectomy with positive margins?
1 Answer available
For borderline resectable pancreas treated with induction chemo therapy and minimal radiographic response, if unable to do SBRT, do you prefer 36/15 or 50.4/28 (given that is where we have more data)?
The concern being that if patient does not go to surgery, you have delivered lower BED with 36/15.
1 Answer available
In what situations would you treat with adjuvant radiation for resected gallbladder cancer?
If you were to treat, what do you include in your treatment?  
1 Answer available
Is there a role for dose escalation beyond 50.4 Gy in neoadjuvant chemoradiation therapy for rectal cancer?
1 Answer available
Do you treat rectosigmoid/upper rectal cancers with neoadjuvant chemoradiation?
The German trial included patients with tumors up to 16cm from the anal verge, while the Swedish trial update found no local control benefit for tumor...
5 Answers available
What dose do you use for postoperative rectum boost?
NCCN allows a range from 5.4-9 Gy for adjuvant boost and German trial used 55.8 Gy. What factors might sway you to give a higher / lower dose? Is mor...
4 Answers available
Would you recommend chemoradiation to the pelvis for a patient with squamous cell carcinoma of the anus metastatic to the liver who has had a complete response to chemotherapy in the pelvis and a liver resection?
2 Answers available
In patients undergoing pre-operative chemoradiation for rectal adenocarcinoma with clinically positive pelvic sidewall nodes that may not be surgically accessible, do you boost these nodes above 50.4 Gy?
If so, what dose do you boost these nodes to?
1 Answer available
How do you sequence antiviral therapy and cancer-directed therapy in a newly diagnosed patient with hepatocellular carcinoma and incidentally found hepatitis C?
Is there a "best" way to approach treatment of the viral infection i.e concurrently with therapy, prior to therapy, delayed or post therapy? Does this...
1 Answer available
How would you manage a patient with T3N0 rectal cancer status post transanal excision, who is not a surgical candidate, and who received pelvic radiation for prostate cancer 20 years ago?
Would you be confortable to give full dose CRT? 
1 Answer available
Is it common to have atypical squamous cells on pap smear s/p chemoradiation for anal cancer in a female?
1 Answer available
What radiation dose, fractionation and volume would you use in an elderly patient with localized extensive anorectal malignant melanoma status post laparoscopic APR?
Would your recommendation change with the following aggressive features: 8 cm, pericolic extension, positive radial margin, perineural invasion presen...
1 Answer available
How would you manage an elderly patient with GE junction adenocarcinoma who is not interested in surgery and who has ulcerative colitis (not currently on medication or symptomatic)?
Would you be concerned about toxicity given that he has ulcerative colitis?
1 Answer available
In rectal cancer in patients receiving total neoadjuvant therapy of FOLFOX followed by 5FU-radiation, is there a role for additional adjuvant chemotherapy based on significant residual disease at time of surgery?
1 Answer available
How would you approach potential SBRT to liver metastases in a patient on a VEGF inhibitor?
Would you alter your SBRT dose? How long would you hold the VEGF inhibitor before and after? Does the primary matter (e.g. NSCLC vs. colorectal)?
1 Answer available
For a patient with terminal ileal Crohns disease who requires chemoRT for distal rectal cancer, can mercaptopurine (6MP) be continued during that phase of treatment?
1 Answer available
Is there evidence to support routine use of adjuvant chemotherapy for resected rectal cancer treated with pre-operative chemoradiation?
The NCCN seems to make its recommendation based on extrapolation from colon cancer, but those patients are not treated with pre-op chemoRT.
3 Answers available
Do you offer definitive chemoradiation for a primary duodenal adenocarcinoma?
If so, what dose-fractionation regimen do you utilize? What are your target volumes? Would you first recommend induction chemotherapy followed by rest...
1 Answer available
Would you consider upfront chemoradiation therapy for a patient with metastatic anal squamous cell carcinoma if they have a large burden of disease at the anus?
Would you treat with definitive doses? 
2 Answers available
If tumor is stradling the peritoneal reflection how do you decide whether to treat with neoadjuvant chemo/RT vs just surgery?
1 Answer available
Should neoadjuvant chemoradiation ever be considered in the a patient with high risk rectal cancer in the setting of active ulcerative colitis?
If the patient will be having a total colectomy, would up-front surgery be a better consideration? 
1 Answer available
Is there a role for consolidative definitive radiation therapy for metastatic rectal adenocarcinoma with good response to systemic therapy (patient is not symptomatic)?
1 Answer available
In a patient with distal esophageal cancer with a single non-regional neck lymph node, would you offer chemoradiation therapy or surgery to the primary site if the lymph node has a complete radiographic response after chemotherapy? 
Would your answer depend on the response of the primary site? 
1 Answer available
How would you manage a patient who received neoadjuvant CRT per the CROSS trial for esophageal cancer, but refuses surgery after imaging shows a good radiographic response?
Is there a role for additional treatment?
2 Answers available
How would you manage a patient with oligometastatic colon cancer status post resection of the primary whose single unresectable liver lesion has had a complete response to FOLFOX chemotherapy by PET?
Would you offer local therapy to the liver?
1 Answer available
In patients with rectal cancer receiving neoadjuvant chemoradiation, how does possible seminal vesicle involvement on MRI affect the contours of your target?
Do you include the whole seminal vesicles and prostate, or just the whole seminal vesicles? Do you add external iliac lymph node coverage in this scen...
1 Answer available
How would you approach a small mucinous adenocarcinoma of the anal verge (without anal canal involvement) with positive margins after resection?
Further surgery is not possible.
2 Answers available
How would you manage a patient with Lynch syndrome who is s/p surgery and pelvic RT 20+ years ago for endometrial carcinoma with a new T3N0M0 squamous cell carcinoma of the anus?
The patient refuses surgery.
2 Answers available
Do you use a metal biliary stent as a fiducial marker for cholangiocarcinoma?
Do you worry about migration or scatter dose from the metal?
2 Answers available
What dose/fractionation would you choose for resected tail of pancreas adeno with positive margin, node negative?
Plan to give adjuvant chemotherapy.
1 Answer available
Would you consider chemoradiation to the primary in a patient with resectable pancreatic cancer s/p neoadjuvant chemotherapy found to have single liver metastasis on re-staging?
If so, what dose and fractionation? 
1 Answer available
How would you approach a mucinous adenocarcinoma of the anal verge without anal canal involvement, status post excision with positive margins but without the possibility of additional surgery?
Given this rare histology, would you treat this patient as a skin cancer or as an anal adenocarcinoma with inguinal nodal coverage? 
1 Answer available
Should anal cancer patients undergoing definitive chemoradiation be put on a treatment break for neutropenic status?
Is this practice still relevant to the modern IMRT approach where skin toxicity is much lower?
1 Answer available
Is there a role for pre-operative RT (+/-chemo) for a borderline resectable Klatskin tumor as an attempt to try to get them to surgery?
1 Answer available
How do you treat unresectable pancreatic adenocarcinoma invading into the duodenum?
Would you consider "neoadjuvant" RT to 45-50.4 Gy followed by a resimulation and a boost to a "definitive" dose of 54+ Gy depending upon disease respo...
1 Answer available
What constraints do you use for the gallbladder when giving liver SBRT to lesions close to the gallbladder?
1 Answer available
How soon after ChemoRT for a head and neck cancer can you safely initiate esophageal dilation?
3 Answers available
When is SBRT or hypofractionated radiation appropriate as adjuvant treatment for pancreatic cancer?
What are the targets (tumor bed, positive margin, nodes etc.)?
4 Answers available
In what situations can short course RT (5Gy x 5fx) be used instead of chemoRT for rectal cancer?
6 Answers available
What is the appropriate radiation dose/volume for perianal basal cell carcinoma?
Should concurrent chemotherapy be given? How would you modify the regimen in elderly/frail patients?
1 Answer available
Would you offer liver SBRT to a patient with a history of a liver transplant?
Assuming good liver function currently, without evidence for recurrent cirrhosis? Would your decision be affected if it was a primary HCC vs Liver me...
1 Answer available
If a patient has distal esophageal adenocarcinoma and a PET+ left supraclavicular lymph node, and nothing in between, would you cover the entire esophagus? Both supraclavicular fields?
1 Answer available
What role, if any, is there for Y90 in metastatic gallbladder cancer to the liver?
1 Answer available
Can total neoadjuvant therapy be considered an option equivalent to standard of care treatment for patients with T3N0 or T3N1 rectal adenocarcinoma?
Or should total neoadjuvant therapy be reserved for bulkier disease (T4N2)?
2 Answers available
What adjuvant therapy do you give after surgery to patients with gastric CA who undergo 3 cycles of FLOT with no tumor effect on pathology and maintain good PS?
I understand the perioperative trials are not based on tumor regression in cancer cells.
5 Answers available
How do you approach rectal cancer with a solitary bone metastasis that is biopsy proven?
Do you recommend definitive therapy? Would your approach change if there are more than 1 site of bone metastases, such as 2-3?
1 Answer available
Do you recommend neoadjuvant radiation or chemoradiation for patients with T1-2 N0 adenocarcinoma of the anal canal prior to APR?
2 Answers available
What anal squamous cell carcinoma patients, if any, do you take to 59.4 Gy?
1 Answer available
What dose do you use for squamous cell carcinoma of the cervical esophagus?
2 Answers available
When treating node positive anal squamous cell carcinoma, dose your lymph node boost include only gross disease with margin or do you boost the entire nodal region?
1 Answer available
Would you still offer adjuvant chemoradiation therapy to a patient with pT3 pN1a rectal cancer who did not receive any neoadjuvant treatment, and whose adjuvant treatment is delayed by 4 months due to post-operative complications?
Is there any data to support delayed treatment? 
1 Answer available
In what situations do you obtain both a pelvic MRI and EUS for rectal cancer staging and treatment planning?
For instance, in borderline cases for neoadjuvant therapy (e.g. T2N1 disease), should both be obtained to increase accuracy?
1 Answer available
Is it appropriate to treat unresectable secretory insulinoma of tail of the pancreas with radiation therapy?
What dose would you recommend? Any role for systemtic therapy?
1 Answer available
In a patient with gastric adenocarcinoma with +peritoneal cytology status post an R1 resection, would you consider post operative chemoradiation?
2 Answers available
Would you consider prone SBRT (with solid image guidance techniques) if bowel is lying on a target, for instance bowel surrounding an oligometastatic lymph node or next to a kidney tumor?
1 Answer available
Would you recommend adjuvant radiation therapy to a T4N0 colon cancer with invasion into other organs or the abdominal wall status post R1 resection?
Would you cover elective lymph nodes?
3 Answers available
Do you have any specific bowel constraints when treating patients with palliative radiation 3000/10?
Do you look at max dose or are there specific volumetric constraints you use for the small or large bowel? 
1 Answer available
In patients receiving neoadjuvant CRT for cN+ rectal cancer, do you expand your elective nodal volumes to include the external iliac chain or to extend more superiorly along the common iliac chain?
Do you boost the positive nodes beyond your standard pelvic dose?
4 Answers available
What is the role of liver SBRT in the setting of an excellent interventional radiology program?
Our hospital has an aggressive and talented interventional radiology group. We have wanted to start a stereotactic liver radiotherapy program but are ...
3 Answers available
When do you consider total neoadjuvant therapy (chemotherapy and chemoradiation) for rectal cancer?
1 Answer available
For gastric cancer receiving FLOT perioperatively with negative margins but multiple positive nodes, do you offer postoperative chemoRT?
1 Answer available
How do you manage an anal SCC status post a non-oncologic excision of a 2-3 cm primary and positive excisional biopsy of an inguinal node with pathology revealing LVSI, positive surgical margins, and more regional lymph nodes on PET?
What dose do you take the primary to?
1 Answer available
How do you decide what elective lymph node stations to include in your treatment volume for cervical and upper and middle thoracic esophagus cancer?
1 Answer available
In patients witih locally advanced pancreatic cancer, how long would you wait after 1st line induction chemotherapy with FOLFIRINOX before you image for assessment of response and deciding about 2nd-line therapy?
1 Answer available
What is your general approach to treating bleeding gastric masses with palliative RT?
Do you have any preferred dose fractionation schedules? What kind of margins do you use?
3 Answers available
Would you offer radiation therapy for pleural- or peritoneal-based pseudomyxoma peritonei?
If so, how would you approach your radiotherapeutic plan and what dose-fractionation would you utilize?
1 Answer available
Would you offer adjuvant chemoRT to a patient with pancreatic adenocarcinoma who underwent neoadjuvant therapy with FOLFIRINOX and SBRT but had a positive (neck) margin on resection and is now s/p adjuvant chemotherapy?
1 Answer available
Would you recommend SBRT for locally advanced pancreatic adenocarcinoma invading the stomach s/p multiple rounds of chemotherapy?
1 Answer available
In light of the 2015 ASTRO plenary session presentation about involved-field radiation vs elective nodal radiation therapy, are you including elective nodal fields (celiac, mediastinal, supraclavicular) in the treatment of locally advanced esophageal cancer?
1 Answer available
How long after pancreatic SBRT do you wait to re-image?
This will influence the decision to operate or not, so you want to give it enough time to see a response, but given that it's a disease predisposed to...
1 Answer available
How would you approach a patient with locally recurrent esophageal carcinoma who is s/p previous chemoRT and refuses salvage surgery?
1 Answer available
Would you offer additional radiation therapy in a medically inoperable patient with rectal adenocarcinoma who has a persistently palpable tumor after definitive chemoradiation therapy?
Would you consider a re-biopsy after chemoRT to confirm viable tumor and if so, how long would you wait after chemoRT before biopsy?  If you did ...
3 Answers available
When would you offer adjuvant RT after R0 resection for a distal esophageal adenocarcinoma?
If so, what would your target encompass? 
1 Answer available
What dose-fractionation would you utilize when treating an elderly patient with local-only pancreatic cancer who is not eligible for systemic therapy or surgery?
1 Answer available
Would you recommend pre operative (chemo)radiotherapy for a patient with a T3 N0 low rectal cancer in a patient with active Crohn's disease?
Colonoscopy reveals inflammation in the colon and rectum due to Crohn's and patient also has perianal fistula due to Crohn's.
1 Answer available
Do you treat elective nodes in unresectable pancreas when treating with 15fx?
Do you use concurrent Xeloda?
1 Answer available
Is there any data comparing neoadjuvant pancreatic SBRT vs standard fractionation in terms of its ability to convert unresectable tumors to resectable tumors?
What percentage of unresectable T4N0 pancreatic body adenocarcinomas with celiac axis involvement and no response to 6c chemo, will convert to resecta...
1 Answer available
Do you use any dose constraints for the spleen while delivering abdominal radiation therapy?
1 Answer available
How do you time same-day chemotherapy and radiation for patients undergoing concurrent chemoRT?
For the first treatment day (during combined chemo/XRT courses), is it ok to give XRT first then send the patient for chemo or should the chemo be giv...
3 Answers available
Would you treat the supraclavicular nodes electively for a patient with esophageal adenocarcinoma originating in the mid-esophagus but extending above the carina?
2 Answers available
What is the most appropriate radiation dose and volume for elderly and/or frail patients with advanced SCC of the anal canal not receiving chemotherapy to attain durable local control?
5 Answers available
When a large malignant appearing GI mass is encountered on endoscopy but biopsies show dysplasia or carcinoma in situ, would you recommend additional biopsies or proceed with treatment for invasive cancer?
I am currently managing two patients (one esophageal and one anal) with this scenario and the referring physicians and patients are reluctant to under...
4 Answers available
Do you consider adjuvant radiation for low grade T1bN0 gallbladder adenocarcinoma with negative margins after oncologic resection?
The data is scarce- do you recommend chemotherapy only or would you consider RT for local control? 
1 Answer available
How would you approach oligometastatic (solitary) recurrence with previously resected pancreatic adenocarcinoma and adjuvant chemotherapy with a prolonged disease-free interval?
Is there a role for SBRT with or without the addition of systemic therapy?
3 Answers available
How do you manage a patient who presents with a tracheoesophageal fistula from a lung or esophageal primary that is non-metastatic?
As a for instance, a centrally located primary tumor with mediastinal adenopathy that results in a TE fistula? Currently we would recommend esophagea...
4 Answers available
What image guidance do you use when treating rectal and anal cancers?
3 Answers available
When using oral contrast for simulation, how much prior to simulation do you have patients drink the contrast?
Does this vary depending on the site you are treating, i.e. abdomen vs pelvis?
3 Answers available
What neoadjuvant approach is best for an adenocarcinma of the GE junction (arising in Barret's) with a large hiatal hernia?
Would you recommend neoadjuvant chemotherapy to spare the stomach?
1 Answer available
Would you recommend adjuvant chemoradiation after adjuvant chemotherapy for a patient with pancreatic adenocarcinoma s/p a whipple resection with negative margins?
What pathologic factors would you use to make your recommendation?
1 Answer available
Should definitive concurrent chemoRT be offered to patients with anal canal SCCa with common iliac nodal involvement (by definition M1 disease) without evidence for other distant disease?
2 Answers available
How would you treat a patient with locally and distant recurrent rectal cancer who has previously received chemoradiation but now presents with pain and bleeding from the site of local recurrence?
1 Answer available
How do you approach treatment planning for preoperative radiation therapy in gastric cancer?
If considering that it is not gastroesophageal junction, what margin do you place on the clipped GTV to formulate CTV? Is there any role for SIB to PE...
1 Answer available
When treating rectal cancer with conventional neoadjuvant chemoradiation (45 Gy to pelvis with boost to 50.4 Gy), what volume do you use for the boost?
There is no RTOG consensus on boost volume, except to say that it should include the entire mesorectum/presacral region at involved levels + 2 cm in c...
2 Answers available
In patients with oligometastatic disease, would you offer SBRT to a metastatic lymph node abutting the trachea and/or esophagus?
If so, what dose and dose constraints would you consider? How would you counsel the patient about risk of trachesophageal fistula?
1 Answer available
How do you create an ITV for liver SBRT (metastatic lesions) when you don't have a 4D-CT or fiducials?
Is it sufficient to use fluoroscopy to assess total motion, fuse MRI and PET to create an ITV, and use abdominal compression to limit motion?
3 Answers available
In the case of a thoracic esophageal cancer that will require extensive volume coverage, >2/3 of the esophagus, do you prophalactically prescribe a feeding tube or observe?
3 Answers available
Would you recommend adjuvant chemoradiation for a resected ampullary adenocarcinoma?
What features would make you more likely to recommend radiation therapy with chemotherapy?
1 Answer available
What would you recommend for a patient with a new or locally recurrent anal cancer s/p chemoRT for anal cancer 15 years ago?
1 Answer available
What treatment would you recommend for a 3 cm basal cell carcinoma of the perianal skin with anal canal involvement?
The patient has no evidence of lymph node involvement.
1 Answer available
How would you treat oligoprogressive metastatic GIST to the liver with a single enlarging liver lesion while on imatinib and no other evidence of active disease, where surgery and RFA are not possible?
If you would recommend radiation therapy, what dose-fractionation would you utilize? 
1 Answer available
How would you recommend treating locally recurrent pancreatic cancer?
In a patient who has undergone resection and adjuvant chemotherapy who then recurs locally, how would you recommend treating?  Would you treat ju...
1 Answer available
For postoperative gastric patients status post total gastrectomy, how do you approach anastamotic coverage?
Detailed instructions regarding lymph node coverage have been published, but how do you think about coverage of the anastamoses from the gastrectomy?
1 Answer available
Do you regularly utilize antiemetic or GI prophylaxis when treating abdominal sites with SBRT?
What timing do you recommend? What drug and what dose do you use?
1 Answer available
How would you approach a young patient with metastatic rectal cancer and a painful local recurrence who underwent chemoRT to 50.4 Gy two years ago and declined surgery?
1 Answer available
How would you mange true anal margin squamous cell carcinoma (with no involvement of anal canal) if wide local excision cannot be done and chemoradiation therapy is being used instead?
Anal cancer guidelines mostly refer to anal canal tumors with less information about tumors of skin in perianal area (ie true anal margin). Would IMR...
2 Answers available
How would you manage a male with a prior history of localized prostate cancer s/p radiation to prostate only (two years ago), who now presents with a T1N0 squamous cell carcinoma of the anus?
Would your management change if the prostate and lymph nodes were treated with radiation two years ago?
2 Answers available
How would you treat very locally aggressive rectal cancer extending into muscle and causing internal iliac tumor thrombus, in a patient who is not a surgical candidate?
What volumes and doses of radiation would you recommend? To what dose would you limit the rectum, especially in a patient with no salvage surgical opt...
1 Answer available
How do you approach patients with squamous cell carcinoma of anal canal with ano-vaginal fistula?
Do you consider diversion colostomy, or abdominoperineal resection up front?
4 Answers available
Do you ever treat patients with rectal or anal cancer with IMRT in the prone position?
1 Answer available
What is the best treatment approach for locally advanced (T3+ and/or N+) rectal cancer status post low anterior resection in a patient who has a remote history of seed implant for low risk prostate cancer?
What are your thoughts on dose, avoidance structures, re-tx risk, etc?
1 Answer available
Should inoperable squamous cell carcinoma of the esophagus be treated to doses > 60 Gy?
Should the recent publication of Chen et al. dose escalation study for inoperable SCC esophageal cancer patients treated with CCRT, showing an 8% 5-ye...
2 Answers available
How do you manage grade 3 dermatitis during chemoradiation therapy for anal cancer?
Aquaphor, barrier cream, sitz baths, domboro, silvadene, foam dressings?
8 Answers available
In what situations do you recommend preoperative chemoradiation for gastric cancer?
1 Answer available
Should patients who received pelvic radiation get colonoscopy screenings more often than what is recommended for the general population?
In view of higher risks of rectal cancer after pelvic radiation, is more frequent screening warranted?
1 Answer available
Do you routinely use any type of motion management or breathing techniques when treating a lower esophageal cancer?
3 Answers available
How do you manage gastroesophageal junction cancer after resection with a positive circumferential surgical margin when no neoadjuvant treatment has been given?
1 Answer available
Would you recommend adjuvant chemoradiation for T1N0 gastric adenocarcinoma status post R0 resection but no D2 lymph node dissection?
Does the lack of D2 dissection automatically necessitate adjuvant chemoradiation therapy (ie <5 LN obtained)? Would the presence of high risk facto...
1 Answer available
Would you use standard neoadjuvant chemoradiation for a patient with advanced rectal cancer and a history of previous pelvic RT for another cancer?
For a patient with cT3-4N0 rectal cancer, does the dose of the previous RT affect your decision making (for example, 45 Gy to the pelvis with boo...
2 Answers available
When would you consider initial induction chemotherapy (e.g. FOLFOX) followed by neoadjuvant chemoradiation, over neoadjuvant chemoradiation alone, in patients with locally advanced rectal cancer?
2 Answers available
How do you manage unresctable thoracic esophageal cancer invading the trachea?
What chemotherapy and radiation doses/fractionation would you use once the airway has been stabilized to provide reasonably safe and effective palliat...
1 Answer available
What is your preferred palliative regimen for pancreatic cancer with pain related to celiac plexus involvement?
Do you consider palliative SBRT 25Gy in 5 fractions? I often find that these patients are in severe pain and my typical regimen is 30 Gy in 10 fractio...
2 Answers available
When treating adenocarinoma of the pancreas to 75 Gy in 25 fractions, what dose constraints do you use for small bowel, large bowel, and stomach?
What are your fields? Do you treat nodes electively?
1 Answer available
When treating an inoperable patient with squamous cell carcinoma of the thoracic esophagus, do you ever dose escalate beyond 50.4Gy?
What doses do you use?
1 Answer available
When treating a patient with anal cancer with a vaginal dilator, do you routinely simulate the patient with and without the dilator in place?
How often do patients become unable to tolerate the dilator during the treatment course secondary to discomfort related to acute toxicity?
3 Answers available
How would you treat a p16+ small cell neuroendocine tumor of the anal canal with or without metastatic inguinal lymph node metastasis?
Would the radiation dose and fields be the same as for squamous cell carcinoma? What chemotherapy would you recommend? 
2 Answers available
When treating recurrent rectal cancer with re-irradiation using accelerated hyperfractionation (39-45 Gy at 1.2 or 1.5 Gy BID), what normal tissue constraints would you recommend for the bladder and bowel?
1 Answer available
What dose of radiation do you use for neoadjuvant chemoradiation in esophageal cancer?
The CROSS trial showed a survival benefit with 4140cGy and concurrent carbo/taxol, but I was always trained to treat to 5040cGy. Is anyone de-escalati...
5 Answers available
In a thin patient with anal cancer, do you use bolus over the inguinal nodal volume when treating with an IMRT technique?
2 Answers available
What positioning and immobilization technqiues do you use for anal canal carcinoma radiotherapy in the era of IMRT?
On the heels of the discussions regarding skin toxicity prophylaxis and treatment, I am interested in your thoughts and current practice regarding pat...
1 Answer available
What dose do you typically prescribe to the primary tumor for definitive treatment of squamous cell carcinoma of the anal canal (given concurrently with chemotherapy)?
Do you have different preferences based on T-stage?
6 Answers available
What approach have you found works best in treating persistent acute radiation proctitis in patients undergoing pelvic EBRT?
2 Answers available
How do you manage patients with history of multiple perianal condylomas who develop focal high grade squamous intraepithelial lesions in the anal margin?
What would be your preferred management, surgical resection or radiation? If radiation is contemplated, what dose would be appropriate and would HPV s...
2 Answers available
What factors determine the choice of treatment in the management of intermediate (BCLC stage B) hepatocellular carcinoma?
What features would help you decide between TACE vs. TARE vs. external beam radiation therapy?
1 Answer available
What are your preferred target doses for bulky T4 rectal adenocarcinomas with extensive GU and anal sphincter involvement as well as common illiac and inguinal adenopathy, as part of total neoadjuvant therapy when future APR is planned?
In particular, many guidelines suggest a max point dose of 50Gy for small bowel but in cases of extensive disease how do you reconcile loops of bowel ...
1 Answer available
What volumes and prescription doses do you use when treating patients with unresectable cholangiocarcinoma?
Do you electively treat nodes and how does your approach change with intra- or extra-hepatic primaries?
1 Answer available
In locally advanced rectal cancer treated with total neoadjuvant therapy, do you adjust boost volumes to only include post-chemo gross disease/nodes plus a margin?
1 Answer available
What types of sexual side effects do you discuss with men undergoing radiation therapy for rectal and/or anal cancer?
Is there a risk for anejaculation?
2 Answers available
Can you skip elective inguinal treatment in PET negative squamous cell carcinoma of anal canal?
2 Answers available
Which patients would you offer a watch-and-wait approach versus surgical resection after chemoradiotherapy for patients with rectal cancer?
Based on the UK OnCoRe matched cohort analysis, would you offer a watch-and-wait approach off protocol or are you uncomfortable treatin...
5 Answers available
How would you approach treatment in recurrent, localized rectal mucinous adenocarcinoma?
Would you consider repeating neoadjuvant chemo/RT? Does this, occurring in the context of Lynch Syndrome, change the treatment approach?
1 Answer available
How do you manage early stage anal or anal margin cancer that is locally excised with negative but close margins when going back for wider margins would require an APR?
4 Answers available
How would you treat a synchronous anal and oropharyngeal squamous cell carcinoma?
If the oropharyngeal cancer is operable (ex T1N1), would would your preference be upfront surgery?   Would you use chemoradiation therapy to bo...
1 Answer available
How would you approach a low-lying rectal cancer wtih para-aortic lymphadenopathy?
Would you recommend only chemotherapy or would you offer chemotherapy followed by restaging and possible definitive CRT and surgery?
3 Answers available
How do you manage a patient with a 3.5 cm squamous cell carcinoma of the perianus (with no involvement of the anal canal) with a positive inguinal node?
Are the treatment volumes the same as those for squamous cell carcinoma of the anal canal?
1 Answer available
When treating younger men with anal cancer do you consider dose to the prostate?
Given risk of secondary malignancies do you make an effort to avoid/spare the prostate or give any specific dose constraints when treating young men w...
1 Answer available
How would you manage a patient with a very large adenocarcinoma of the rectum (10 cm) that extends to the anal verge with positive peri-rectal and inguinal lymph nodes, but no distant organ involvement?
Is this patient considered to have metastatic disease? Should definitive surgery be considered?
1 Answer available
How would you manage a patient who presented with synchronous squamous cell carcinoma of the anus (cT2N0) and adenocarcinoma of the rectum (cT3N0) at 7cm from the anal verge?
1 Answer available
For rectal cancer with solitary liver metastasis, do you recommend neoadjuvant chemoradiation?
Are these patients better candidates for preop chemotherapy alone?
2 Answers available
Would you consider PCI for a patient with neuroendocrine carcinoma of the esophagus?
1 Answer available
What are your treatment volumes for patients with gastric cancer receiving adjuvant chemoRT for a positive margin following gastrectomy and D2 nodal dissection?
Will you treat only the anastamosis and remnant stomach without elective nodal RT, or will you include elective nodal RT in your treatment fields, ass...
1 Answer available
Would you ever recommend radiation alone for a T1N0 anal cancer?
1 Answer available
How do you treat localized esophageal carcinoma in patients who are unwilling or unable to undergo chemotherapy or surgery?
If a patient is unable or unwillling to undergo dual or tri-modality therapy with chemotherapy or surgery, would you use a palliative radiation treatm...
1 Answer available
When would you add an extra radiation dose to compensate for treatment breaks?
Apart from H&N SCC, are there times where adding an extra dose of radiation due to a tx break is appropriate?  Is there a decent equatio...
1 Answer available
What dose fractionation would you recommend for large (>5 cm) perianal Bowen's disease (squamous cell CIS)?
1 Answer available
What dose constraint(s) would you use for a patient with a pelvic kidney transplant getting pelvic RT?
1 Answer available
Is extensive abutment of the duodenum without invasion a contraindication to SBRT for pancreatic tumors?
If so, how do you quantify this when making a decision about who may or may not be a candidate for SBRT?
1 Answer available
What methods do you use to decrease genital skin reaction when delivering pelvic radiation to patients in the prone position?
1 Answer available
How would you manage a patient with synchronous locally advanced H&N (p16+) and locally advanced rectal adenocarcinoma?
If treating the H&N first, would you anticipate some effect of chemo on the rectal cancer?  Would you include 5FU in the H&N chemo for be...
2 Answers available
Would you consider post operative boost radiation for positive margin in a patient with rectal cancer who underwent short course RT(25 Gy in 5 fractions) prior to TME?
What fractionation would you use?
2 Answers available
Would you consider induction chemotherapy prior to starting chemoradiation therapy in squamous cell carcinoma of the esophagus?
If the patient has large, bulky nodes would you consider starting after chemotherapy for cytoreduction? Or otherwise consider replanning mid-treatment...
2 Answers available
What treatment do you recommend for patients with Siewert III gastroesophageal junction cancer with periesophageal or mediastinal lymph node involvement beyond what is considered regional for gastric cancer?
Would you recommend chemoradiation therapy or chemotherapy upfront? 
1 Answer available
How would you manage an inguinal-only recurrence of a previously treated low lying rectal cancer?
Any role for surgery?  What radiation volumes would be used?
2 Answers available
How do you manage urgency and frequency of bowel movements secondary to radiation proctitis?
1 Answer available
Which chemotherapy regimen do you prefer for concurrent treatment with radiation therapy for anal squamous cell carcinoma?
5FU/mitomycin C or 5FU/cisplatin? Is there any benefit of cisplatin in terms of skin toxicity?  
2 Answers available
How would you treat an excised T1N0M0 anal canal well-differentiated squamous cell carcinoma with positive microscopic margin?
Do you recommend 5FU/mitomycin chemoradiotherapy or radiotherapy alone? What evidence is there for efficacy and toxicity differences between the two ...
3 Answers available
Do you prefer to treat patients prone (on a belly board) or supine when treating rectal cancers?
Is there any evidence to show that treating with a bellyboard is preferred? 
3 Answers available
How would you manage locally advanced anal cancer patients with PET positive para-aortic lymph nodes?
2 Answers available
Does external iliac coverage, such as in a T4 primary, justify IMRT for rectal cancer?
2 Answers available
Do you offer adjuvant radiation therapy for patients with hepatocellular carcinoma status post partial hepatectomy with positive parenchymal margins?
What dose and volumes would you use?  
2 Answers available
Would you consider observation instead of a Whipple in a borderline resectable pancreatic cancer patient treated with neoadj CRT who has a radiographic CR?
If the patient received neoadjuvant FOLFOX for 4 cycles then 50.4 Gy with concurrent capecitabine, is that enough treatment to omit surgery?
1 Answer available
How would you manage a patient with distal rectal adenocarcinoma involving the anal canal and a single non-bulky inguinal nodal metastasis?
Is curative intent surgery off the table?  
4 Answers available
Would you give post-operative radiation therapy and/or chemotherapy after an APR for anal cancer if inguinal lymph nodes were involved but margins were negative?
Surgery showed 1/5 and 1/4 LNs involved in the groins. What areas would you cover and with what corresponding doses?
1 Answer available
Would you boost a positive margin (R1 resection or R2 resection) in a GEJ esophageal carcinoma that completed neoadjuvant chemoradiation?
What if the patient was not a candidate for additional chemotherapy?  Would your answer change if the patient received the CROSS regimen with <...
1 Answer available
Has SBRT shown to improve OS or PFS in patients with localized pancreatic cancer who are not a eligible for surgery due to other comorbidities?
2 Answers available
How do you treat anal adenocarcinoma?
Is the approach chemoradiotherapy (Mitomycin-5FU) as for squamous carcinoma with surgery only for salvage or do you always perform surgery after neo-a...
1 Answer available
Can short course radiation therapy (5 Gy x 5 fractions) be given for low lying rectal tumors, near the sphincter but not involving it?
Is there a risk of increased sphincter tone issues in these patients?
2 Answers available
What SBRT dose and tissue constraints would you choose for a presacral rectal recurrence status post preoperative chemoradiation to 50.4 Gy followed by surgical resection in a patient who is not a candidate for surgical re-resection?
1 Answer available
For liver metastases, what criteria do you use to decide between SBRT vs Y90?
Is there a benefit of SBRT over Y90 or vice versa?
1 Answer available
Would irreversible elctroporation (IRE) performed at the time of Whipple affect your plans or dose for radiation in the setting of adjuvant treatment for pancreatic adenocarcinoma?
1 Answer available
What is the appropriate follow up after chemoradiotherapy for patients with anal SCC?
Is obtaining serial MRIs or other imaging appropriate?
1 Answer available
Would you consider maintenance therapy for patients who achieve complete response after palliative chemoradiation for metastatic distal esophageal adenocarcinoma?
If so, what regimen would you consider?
1 Answer available
What is the role of radiation in regionally recurrent gastric cancer?
In a patient who received upfront surgery and chemotherapy who later recurred in the regional nodes, s/p lymphadenectomy, would you offer RT?  If...
1 Answer available
How would you approach isolated inguinal lymph node squamous cell carcinoma of occult primary?
If workup is negative for a primary lesion, would you consider prophylaxis of potential primary sites (anus/vulva?), and would you treat bilateral ing...
1 Answer available
What is the preferred palliative regimen for elderly patients with rectal cancer who elect to forego surgery?
Is concurrent chemoradiation reasonable or excessive in a patient with life expectancy <5 yrs? Should the standard be 5 Gy x 5, and will this provi...
2 Answers available
What target volumes do you use for rectosigmoid / very superior rectal cancers?
Does it ever differ from a standard rectal field? For example, do you always treat the entire rectum, mesorectum, and entire length of internal iliac ...
2 Answers available
What techniques do you use to minimize gas artifacts on cone beam CT when treating upper abdominal lesions?
Antacids? Anti-motlity agents? Dietary changes? Combination?
1 Answer available
In what situations do you recommend adjuvant radiotherapy for colon cancer?
How do you deliver it safely? Even when there is adherence to other organs (T4) or positive margins, I'm hesitant to offer RT because the volumes are ...
2 Answers available
What cumulative dose constraints would you use for the normal liver when repeating SBRT for liver metastases with a longer time interval (i.e. 2-3 years)?
Do you factor in the time interval when deciding cumulative dose constraints?
1 Answer available
Would you consider BID treatment for a patient with a pelvic SCC (e.g. cervix or anal) if a significant amount of treatment days have been missed?
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...
1 Answer available
When is radiation indicated in the treatment of perianal paget's disease?
A nuimber of options for treatment but not a lot of great data for this rare disease.
1 Answer available
Do you treat inguinal lymph nodes for rectal cancers involving the anal canal?
The RTOG contouring atlas doesn't give a consensus on this issue.
4 Answers available
How do you do immobilization for liver SBRT?
What method provides the best reproducibility? Abdominal compression? Inhale breath hold? Exhale breath hold? 
1 Answer available
How do you manage a patient with gastric/GE junction carcinoma who has positive lymph nodes at resection after neoadjuvant chemotherapy?
If you would elect for adjuvant therapy, which study helps guide your choice of regimen?
1 Answer available
How would you manage dysphagia and odynophagia in an otherwise healthy patient with newly diagnosed metastatic esophageal cancer with a large primary in the mid to distal esophagus?
Would you send the patient for a stent or do palliative RT?
4 Answers available
When giving hypofractionated ablative doses of radiation for cholangiocarcinoma, do you give concurrent Xeloda or hold chemo during radiation?
http://ascopubs.org/doi/full/10.1200/JCO.2015.64.2710
1 Answer available
Would you recommend repeat radiation therapy for a painful perineal recurrence in a patient who failed definitive CRT, and recurred again after salvage abdominoperineal resection (APR)?
What would be the RT dose and what percentages would you quote for toxicities? Would you recommend consideration of surgery instead?
2 Answers available
When is it appropriate to recommend a diverting colostomy for treatment of anal cancer or low lying rectal cancer?
Fecal incontinence can be one indication. What are others?
2 Answers available
What is the appropriate role for radiation therapy in patients with HCC or intrahepatic cholangiocarcinoma who are transplant candidates?
Should radiation be offered as a bridge to transplant? Should this depend on whether SBRT is feasible (i.e. is fractionated IMRT an appropriate option...
1 Answer available
What is the appropriate dose and volume for adjuvant treatment of a sigmoid colon adenocarcinoma adherent to the L5 vertebral body with a positive radial margin?
2 Answers available
Do you offer adjuvant radiotherapy for pancreatic adenocarcinoma following surgical resection?
Given lack of strong evidence supporting the benefits of adjvuant RT in resected pancreatic adenocarcinoma (with results of the ongoing RTOG 0848 unav...
1 Answer available
Do you ever offer repeat radiation for hepatobiliary cancers in cases of local recurrence after definitive external beam or SBRT?
If so, what constraints would you use for central biliary and other normal structures and what dose/fractionation would you use?
1 Answer available
Can pre-op chemoRT be used to potentially downstage an early stage rectal cancer (i.e. T2 N0) for a sphincter sparing operation?
4 Answers available
In a male patient with a single inguinal node containing SCC, with no identifiable anal or penile lesions, what areas would you cover and to what dose?
Would you treat the node alone, unilateral/bilateral inguinal nodal basins, or cover any possible primary locations such as the anal mucosa?
1 Answer available
For patients receiving concurrent chemoradiation for anal cancer, what is your ANC threshold for holding radiation or switching to a boost plan to limit myelotoxicity?
1 Answer available
Have the results of LAP07 caused your institution to pursue more aggressive systemic therapy before radiotherapy in the treatment of pancreatic cancer?
Is better systemic control needed to make radiation therapy beneficial?
1 Answer available
When treating prostate or other pelvic malignancies, what dose constraints do you use for the sigmoid colon?
Do you use the same constraints that you would for the rectum? Or perhaps employ a lower dose limit, such as not exceeding 65Gy to a small volume of t...
1 Answer available
Would you recommend an inguinal node dissection as part of definitive treatment for adenocarcinoma of the anus with suspicious inguinal nodes?
What about bulky nodal disease?
1 Answer available
How do you treat hiccups in cancer patients?
Does your management differ if the hiccups are felt to be related to chemotherapy as opposed to the disease itself?
1 Answer available
What dose constraint, if any, do you use for the diaphragm when treating liver or lung tumors with SBRT?
Have you ever seen toxicity related to diaphragm dose with conventional fractionation?  
4 Answers available
In patients with newly diagnosed cervical esophageal cancer with limited metastatic disease, do you treat the primary with chemoradiation?
1 Answer available
What treatment volume is appropriate when treating postoperatively for esophageal carcinoma?
In what situation, if ever, do you include mediastinal nodes?
1 Answer available
How do you optimize nutrition for patients experiencing dysphagia while undergoing chemoradiation therapy for esophageal cancer?
Is there a preferred method and should any of the following be avoided: esophageal stent, nasogastric tube, PEG, J-tube, or TPN?
1 Answer available
How do you approach bowel constraints in the setting of reirradiation?
Do you assume some recovery since the prior course of RT? If so, how much over what time period?
1 Answer available
In light of the recently published LAP07 trial, what is the role of radiation in unresectable pancreatic cancer?
In LAP07's second randomization (capecitabine+54 Gy vs maintenance gemcitabine +/- erlotinib), 60% of unresectable pancreatic cancer patients who did ...
3 Answers available
What GTV to CTV margin do you typically use for the primary lesion in anal cancer?
RTOG 0529 guidelines were 2.5cm margin from GTVA to CTVA (except bone or air), do you still follow this practice?
1 Answer available
How would you treat locoregionally recurrent anal CA?
If a patient developed locoregional recurrence after initial chemoradiation, would resection of known disease followed by observation be preferred?
1 Answer available
Are there situations in which elective nodal volumes may be reduced for T1/T2N0 anal SCC?
Is inguinal coverage always required?
3 Answers available
Do you recommend neoadjuvant chemotherapy or induction chemo + chemoRT for borderline resectable pancreatic cancer?
With the current data, I'm struggling to justify addition of radiation for potentially resectable disease.  If in favor of RT, do you recommend s...
3 Answers available
For esophageal and gastroesophageal junction cancers, which lymph nodes are metastatic versus regional?
Specifically, are hilar nodes metastatic?
1 Answer available
Is acute pancreatitis a contraindication to radiotherapy for patients with pancreatic cancer?
Does treatment of the pancreas with radiotherapy during an episode of acute pancreatitis increase the risk of acute and late side effects? Should one ...
2 Answers available
Given the significant risk of recurrence after chemoradiation for locally advanced anal carcinoma, should resection be considered (with or without neoadjuvant treatment) in select cases?
At other sites we consider locally advanced disease and high risk of recurrence a contraindication for organ preservation. Would surgery improve likel...
1 Answer available
How do you treat anal margin tumors?
Per NCCN, only well-differentiated T1 lesions (with 1cm surgical margins) should be excised (with no other treatment). Do you follow this at your inst...
1 Answer available
Is it safe and appropriate to palliatively treat abdominal or thoracic tumors with concurrent chemotherapy when using fractions of 250-300 cGy?
For example, there is a retrospective series out of MD Anderson (Kim, Acta Oncologica 2008) wherein 37 patients with gastric cancer were treated with ...
2 Answers available
What is the optimal dose fractionation for treating liver metastases in the central liver causing obstruction of biliary flow?
Will higher doses per fraction increase the risk of fibrosis and cause permanent impediment to biliary flow?
1 Answer available
Are there any special considerations when treating a patient with anal cancer who has poorly managed HIV/AIDS?
2 Answers available
Is there an advantage in treating with a SIB (simultaneous integrated boost) over sequential boost for anal cancer?
1 Answer available
In what situations, if any, do you offer postoperative radiation or chemoradiation for patients with squamous cell carcinoma of the esophagus?
Would your recommendation change if the histology was adenocarcinoma (excluding GE junction tumors)?
2 Answers available
How do you interpret the results of the ACT II trial in terms of the choice between cisplatin and mitomycin in the treatment of anal cancers?
Reference: https://www.ncbi.nlm.nih.gov/pubmed/23578724
1 Answer available
Do you base liver SBRT dose fractionation on size, volume, or proximity of normal tissue?
For example, would you use a cutoff such as PTV of 25cc, or 4cm diameter, or simply use nearby normal tissue constraints to alter your fractionation f...
3 Answers available
When treating borderline resectable pancreatic adenocarcinoma patients with neoadjuvant chemoradiation, do you treat the elective nodal regions or the primary alone?
 Is your approach similar in unresectable disease? Is there evidence to support one approach over the other? 
2 Answers available
In a patient with a small cell of the esophagus in which trimodality therapy is planned what dose of preoperative radiation would you use and would you utilize BID fractionation?
1 Answer available
How do you approach disease monitoring in patients with localized rectal cancer who have received treatment with chemoradiation?
Is MRI being considered the primary mode of imaging in multidisciplinary tumor boards, especially in light of the results of the MERCURY trial (JCO 20...
1 Answer available
In a patient with a large condyloma adjacent to a squamous cell carcinoma of the anal canal being treated with chemoradiation how would you incorporate the condyloma in the target volume if it is PET negative and would it receive a different dose?
2 Answers available
What maximum volume (in cc's) of small bowel would you allow to receive 45 Gy in a patient with node positive squamous cell carcinoma of the anal canal receiving concurrent chemoradiation with 5-FU/MMC being treated with IMRT?
What if a large portion of small bowel is located within PTV45?
1 Answer available
When treating a high grade neuroendocrine tumor of the rectum with involved pelvic lymph nodes, do you use the same approach (dose, fractionation, concurrent chemotherapies) as you would for a small cell lung cancer?
Would you use platinum/etoposide concurrent with radiation or would you opt for platinum only during radiation?  Would you use BID fractionation...
1 Answer available
Should capecitabine be administered at a specific time prior to RT in pre-op chemoradiation treatment for rectal cancer?
Would taking the drug at a specific time point prior to their radiation appointment time to maximize blood levels of the drug be clinically beneficial...
1 Answer available
Is it feasible to treat central liver tumors +/- portal vein thrombus with SBRT while minding central hepatobiliary tract constraints?
The Stanford report (Osmundson, IJROBP 2015) on central hepatobiliary tract toxicity recommended dose constraints to the cHBT that would limit dose to...
2 Answers available
Would you advocate for sphincter preserving chemoradiation therapy for a patient with a diagnosis of anal canal carcinoma who has previously been treated with pelvic radiation such as EBRT or brachytherapy?
How would your radiation treatment approach change in terms of dose and target definition? Would the time interval between diagnosis affect the optio...
2 Answers available
Is there any role for adjuvant radiation for a low grade, intraductal papillary mucinous neoplasm (IPMN) of the pancreas after resection with a positive pancreatic margin?
1 Answer available
What is your typical target/field when treating a patient with 5 Gy x 5 fractions pre-operatively for rectal cancer?
Do you target the whole pelvis or a smaller "boost-like" field?
2 Answers available
What would you include in the radiation field for a patient with T2 N0 M0 adenocarcinoma of the distal 1/3 of the esophagus?
In a patient who is not a surgical candidate and has a negative PET/CT and EUS, would you include celiac lymph nodes in the radiation field?
1 Answer available
Is it acceptable for a medical oncologist to use Xeloda in place of 5FU when treating GI sites other than rectal?
Specifically - anus, pancreas, gastric?
2 Answers available
Is it appropriate to use SBRT on unresectable pancreatic tumors invading the duodenum?
Do you use any age limit to determine whether pancreatic SBRT is appropriate?  
1 Answer available
Should patients with anal canal SCC undergo an FNA biopsy of any palpable inguinal LN that is also FDG avid on PET/CT or should these nodes be assumed to be positive and treated to a higher dose?
How do you manage a patient a with a PET positive inguinal lymph node who has a typical anal cancer? If a biopsy is done and it is negative, is it is ...
1 Answer available
What adjuvant therapy recommendations would you make for a patient with pT3N0M0 duodenal cancer?
In a case with negative margins, would you consider chemotherapy alone or sequence with chemoradiation?
1 Answer available
Is chemoradiation the preferred treatment for T2 SCC of the anal canal in a patient with IBD?
Does the presense of ulcerative colitis, now in remission, affect your dose and fields?
1 Answer available
How do you use a 4D CT to account for hepatocellular carcinoma tumor motion?
When planning SBRT cases for primary liver cancers, it is very difficult to see the tumor on the non-contrast 4D scan. How do you use information from...
2 Answers available
Is there an "ideal" method for abdominal motion control when treating upper abdomen malignancies?
In my training, we used an abdominal compression paddle, but in my current practice, my physicist says that we cannot treat through multiple parts of ...
1 Answer available
Are special precautions necessary for esophageal cancer with tracheal invasion prior to chemoradiation?
Are there any precautions to prevent formation of a TE fistula? 
1 Answer available
What is your preferred dose for definitive radiation of squamous cell cancer of the thoracic esophagus that will be combined with chemothererapy?
Would your approach change if the histology were adenocarcinoma? 
1 Answer available
Would you treat the inguinal nodes in a patient who had an adenocarcinoma excised from the anal canal?
In a lesion <2.5 cm from anal verge arising in a tubulovillous adenoma, does the data from Taylor, et. al. Red Journal 2001 apply? 
2 Answers available
What is the evidence that there is a benefit to giving doses higher than 3060 cGy-3600 cGy in the elective treatment of uninvolved lymph nodes in the treatment of SCC of anal canal with chemoradiation?
3 Answers available
How do you treat locally advanced, operable, Siewert 3 GE junction adenocarcinomas?
1 Answer available
Is liver radiotherapy contraindicated in patients with Child-Pugh C liver function?
Would you avoid any RT in these patients, including palliation for a portal vein thrombus? Or would you consider a short course of RT (like 20Gy/5fx)?
4 Answers available
For elderly patients with locally advanced rectal cancer who are not candidates for surgery or chemotherapy, what would be an appropriate palliative regimen?
1 Answer available
Do you recommend adjuvant chemoradiation for T2N0 gastric adenocarcinoma?
In a patient with an R0 resection, would you routinely recommend postop chemoradiation, since these patients were included in the MacDo...
1 Answer available
When treating pancreatic cancer with adjuvant chemoradiation, do you treat the initial field to 50 Gy, as per RTOG 0848, or to 45 Gy?
For cases with positive margins, do you boost to 54 Gy? If so, do you boost the entire tumor bed or only the area of the positive margin? 
2 Answers available
In what setting do you omit adjuvant radiation therapy in a T3N0 rectal cancer?
The NCCN guidelines categorically recommend adjuvant XRT for a cT1-2N0 rectal adenocarcinoma upstaged to a pT3N0, yet there are multipl...
1 Answer available
What dose and upper field border would you use following transanal excision for rectal cancer found to be T2 by final pathology but without LVSI or perineural invasion?
Should standard post operative radiation fields be used, treating up to the L5-S1 interspace? Or is it acceptable to treat a lower field, for ins...
1 Answer available
Following transanal excision with positive margins for for T1 or T2 rectal cancer, is it more appropriate to proceed with APR or attempt sphincter preservation with RT/Chemo?
If RT/chemo is preferred, what is an acceptable final boost dose?
1 Answer available
What is the appropriate treatment for a low lying rectal cancer in the setting of prior definitive prostate IMRT?
Fore example for a T3N0 rectal cancer on EUS?
1 Answer available
What dose and volume would be recommended for a medically inoperable patient with a T4 rectal adenocarcinoma?
Would you boost to >54Gy? 60Gy? Is there relevant literature/evidence for supporting a higher dose?
1 Answer available
When treating rectal cancer with neoadjuvant chemoRT, is it appropriate to employ IMRT planning, rather than 3D conformal, for all cases, or should IMRT be reserved for special circumstances?
1 Answer available
Is it possible to palliate presacral recurrences of rectal cancer in patients who previously received neoadjuvant chemoradiation to the rectum?
In the past, I haven't seen great results in palliating the presacral area. The pain is excruciating for many patients. Is there an effective option f...
1 Answer available
For a GE junction tumor with a lymph node distant from the primary site, would the treatment volume be contiguous?
I.e. Would you treat most of the normal esophagus to include a mediastinal lymph node? 
1 Answer available
How do you manage squamous cell carcinoma in situ of the anus?
While the Nigro/Wayne state regimen consisting of Mito C &  5FU is well stablished for squamous cell carcinoma of the anus/perianal tissue, a...
1 Answer available
For a patient who has undergone preoperative chemoradiation to 50Gy for locally advanced rectal cancer followed by LAR or APR, would you treat a positive margin with radiation therapy?
If so, what dose? 
2 Answers available
How do you contour distal esophageal cancer in the postop setting after Ivor-Lewis pT3N3 (perigastric and periesophageal LN)?
What regional lymph nodes do you include perigastric, portahepatic, periesophageal, celiac, splenic, pancreaticoduodenal, sup. mesenteric, paraesophag...
1 Answer available
Has pelvic MRI replaced EUS as the standard of care for rectal cancer staging?
Are there any indications to choose one over the other?
1 Answer available
What is the likelihood of a successful pregnancy following pelvic irradiation?
How should we counsel young women who are receiving treatment for GI/GYN malignancies?
1 Answer available
How do you treat synchronous rectal cancer and prostate cancer?
I have a healthy 70+ year old man recently diagnosed with cT3N1M0 rectal adenoCA and GS 3+4=7 prostate cancer in 1/6 cores with a PSA of 25.
2 Answers available
Which regimen is better for gastric adenocarcinoma- neoadjuvant chemotherapy or adjuvant chemoradiation?
Is there a consensus on the MAGIC v. MacDonald debate?
2 Answers available
Is there a role for PET/CT in pancreatic cancer staging or treatment planning?
I recently had a patient with unresectable disease ask for a PET before starting RT but I’m not sure there is a benefit. 
1 Answer available
How do you justify adjuvant radiotherapy in pancreatic cancer?
I can't convince the surgeons to refer their patients for adjuvant RT because the prospective data is messy and doesn’t seem to indicate a benef...
1 Answer available
Should I use PET/CT for GE junction treatment planning?
We use PET for esophageal, but not gastric cancer. GE junction seems like a grey area. 
1 Answer available
Do you stage and treat GE junction tumors like gastric or esophageal cancer?
Does the advent of FLOT in gastric cancers, change your approach to GE adeno's? Would anyone consider FLOT followed by chemoradition followed by surge...
1 Answer available
Do you ever give postoperative chemoradiation in patients who underwent preoperative chemotherapy for gastric adencocarcinoma?
1 Answer available
How do you control for organ motion when treating pancreatic cancer?
What techniques work best?
2 Answers available


Papers discussed in this category

N. Engl. J. Med., 2012-05-31
Preoperative chemoradiotherapy for esophageal or junctional cancer.
Lancet Oncol., 2015-09-01
Neoadjuvant chemoradiotherapy plus surgery versus surgery alone for oesophageal or junctional cancer (CROSS): long-term results of a randomised controlled trial.
Cancer, 2007-11-15
Radiation therapy is associated with improved survival in patients with pancreatic adenocarcinoma: results of a study from the Surveillance, Epidemiology, and End Results (SEER) registry data.
Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2008-07-20
Analysis of fluorouracil-based adjuvant chemotherapy and radiation after pancreaticoduodenectomy for ductal adenocarcinoma of the pancreas: results of a large, prospectively collected database at the Johns Hopkins Hospital.
Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2008-07-20
Adjuvant radiotherapy and chemotherapy for pancreatic carcinoma: the Mayo Clinic experience (1975-2005).
Cancer, 1987 Jun 15
Further evidence of effective adjuvant combined radiation and chemotherapy following curative resection of pancreatic cancer. Gastrointestinal Tumor Study Group.
Ann Surg, 2007 Nov
Long-term survival and metastatic pattern of pancreatic and periampullary cancer after adjuvant chemoradiation or observation: long-term results of EORTC trial 40891.
N Engl J Med, 2006 Jul 6
Perioperative chemotherapy versus surgery alone for resectable gastroesophageal cancer.
The New England journal of medicine, 2001-09-06
Chemoradiotherapy after surgery compared with surgery alone for adenocarcinoma of the stomach or gastroesophageal junction.
BMC Cancer, 2015-07-21
TOPGEAR: a randomised phase III trial of perioperative ECF chemotherapy versus preoperative chemoradiation plus perioperative ECF chemotherapy for resectable gastric cancer (an international, intergroup trial of the AGITG/TROG/EORTC/NCIC CTG).
J. Clin. Oncol., 2009-02-20
Phase III comparison of preoperative chemotherapy compared with chemoradiotherapy in patients with locally advanced adenocarcinoma of the esophagogastric junction.
Nature clinical practice. Oncology, 2005-05
Multidisciplinary treatment of synchronous primary rectal and prostate cancers.
Practical radiation oncology, 2012
Neoadjuvant chemoradiation followed by interstitial prostate brachytherapy for synchronous prostate and rectal cancer.
Urology, 1999-10
Combined radical retropubic prostatectomy and rectal resection.
Urology, 2001-04
External beam radiotherapy for synchronous rectal and prostatic tumors.
Int J Colorectal Dis, 2012-11-01
Management of synchronous rectal and prostate cancer.
International journal of radiation oncology, biology, physics, 2001-11-01
Elective groin irradiation is not indicated for patients with adenocarcinoma of the rectum extending to the anal canal.
Radiat Oncol, 2014-12-23
Is elective inguinal radiotherapy necessary for locally advanced rectal adenocarcinoma invading anal canal?
Lancet (London, England), 2009-03-07
Preoperative radiotherapy versus selective postoperative chemoradiotherapy in patients with rectal cancer (MRC CR07 and NCIC-CTG C016): a multicentre, randomised trial.
J. Clin. Oncol., 2012-06-01
Preoperative versus postoperative chemoradiotherapy for locally advanced rectal cancer: results of the German CAO/ARO/AIO-94 randomized phase III trial after a median follow-up of 11 years.
Br J Surg, 2006-10-01
Long-term results of a randomized trial comparing preoperative short-course radiotherapy with preoperative conventionally fractionated chemoradiation for rectal cancer.
Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2012-11-01
Randomized trial of short-course radiotherapy versus long-course chemoradiation comparing rates of local recurrence in patients with T3 rectal cancer: Trans-Tasman Radiation Oncology Group trial 01.04.
International journal of radiation oncology, biology, physics, 2014-03-15
Five fractions of radiation therapy followed by 4 cycles of FOLFOX chemotherapy as preoperative treatment for rectal cancer.
Ann. Surg. Oncol., 2017 May 30
Short-Course Radiotherapy Followed by Neoadjuvant Bevacizumab, Capecitabine, and Oxaliplatin and Subsequent Radical Treatment in Primary Stage IV Rectal Cancer: Long-Term Results of a Phase II Study.
Ann. Oncol., 2019 Jun 13
Long-course preoperative chemoradiation vs. 5 x 5 Gy and consolidation chemotherapy for clinical T4 and fixed clinical T3 rectal cancer: Long-term results of the randomized Polish II study.
Ann. Surg., 2007-11-01
The TME trial after a median follow-up of 6 years: increased local control but no survival benefit in irradiated patients with resectable rectal carcinoma.
Int. J. Radiat. Oncol. Biol. Phys., 2008-02-01
Involved-field, low-dose chemoradiotherapy for early-stage anal carcinoma.
Cancer, 1983-05-15
Combined preoperative radiation and chemotherapy for squamous cell carcinoma of the anal canal.
Cancer, 2010-02-15
Long-term quality of life after radiotherapy for the treatment of anal cancer.
International journal of radiation oncology, biology, physics, 2013-05-01
RTOG 0529: a phase 2 evaluation of dose-painted intensity modulated radiation therapy in combination with 5-fluorouracil and mitomycin-C for the reduction of acute morbidity in carcinoma of the anal canal.
International journal of radiation oncology, biology, physics, 2007-02-01
Pathological analysis of clinical target volume margin for radiotherapy in patients with esophageal and gastroesophageal junction carcinoma.
Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2004-08-15
Phase III study of adjuvant chemotherapy and radiation therapy compared with chemotherapy alone in the surgical adjuvant treatment of colon cancer: results of intergroup protocol 0130.
Journal of cancer research and therapeutics, 2011
Stereotactic body radiotherapy for the treatment of presacral recurrences from rectal cancers.
Cancer, 2015-04-01
Phase 2 multi-institutional trial evaluating gemcitabine and stereotactic body radiotherapy for patients with locally advanced unresectable pancreatic adenocarcinoma.
JAMA, 2012 Jul 11
Effect of adjuvant chemotherapy with fluorouracil plus folinic acid or gemcitabine vs observation on survival in patients with resected periampullary adenocarcinoma: the ESPAC-3 periampullary cancer randomized trial.
JAMA, 2008-03-05
Fluorouracil vs gemcitabine chemotherapy before and after fluorouracil-based chemoradiation following resection of pancreatic adenocarcinoma: a randomized controlled trial.
Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2011-08-01
Phase II trial of cetuximab, gemcitabine, and oxaliplatin followed by chemoradiation with cetuximab for locally advanced (T4) pancreatic adenocarcinoma: correlation of Smad4(Dpc4) immunostaining with pattern of disease progression.
International journal of radiation oncology, biology, physics, 2011-09-01
Single-fraction stereotactic body radiation therapy and sequential gemcitabine for the treatment of locally advanced pancreatic cancer.
American journal of clinical oncology, 2011-02
Stereotactic body radiotherapy in the treatment of advanced adenocarcinoma of the pancreas.
International journal of radiation oncology, biology, physics, 2013-12-01
Mapping patterns of local recurrence after pancreaticoduodenectomy for pancreatic adenocarcinoma: a new approach to adjuvant radiation field design.
JAMA, 2007 Jan 17
Adjuvant chemotherapy with gemcitabine vs observation in patients undergoing curative-intent resection of pancreatic cancer: a randomized controlled trial.
J Can Assoc Radiol, 1975-09-01
The 1975 Gordon Richards Memorial Lecture. Is the Miles operation really necessary for the treatment of rectal cancer?
Int. J. Radiat. Oncol. Biol. Phys., 1995-01-15
Adenocarcinoma of the rectum treated by radical external radiation therapy.
Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2004-05-15
Impact of T and N stage and treatment on survival and relapse in adjuvant rectal cancer: a pooled analysis.
Diseases of the colon and rectum, 2008-08
Local excision of distal rectal cancer: an update of cancer and leukemia group B 8984.
Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2012-07-01
Updated analysis of SWOG-directed intergroup study 0116: a phase III trial of adjuvant radiochemotherapy versus observation after curative gastric cancer resection.
Journal of thoracic oncology : official publication of the International Association for the Study of Lung Cancer, 2006-03
Esophageal cancer located at the neck and upper thorax treated with concurrent chemoradiation: a single-institution experience.
Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2002-03-01
INT 0123 (Radiation Therapy Oncology Group 94-05) phase III trial of combined-modality therapy for esophageal cancer: high-dose versus standard-dose radiation therapy.
J Clin Oncol, 2007 Apr 1
Chemoradiation followed by surgery compared with chemoradiation alone in squamous cancer of the esophagus: FFCD 9102.
J Clin Oncol, 2005 Apr 1
Chemoradiation with and without surgery in patients with locally advanced squamous cell carcinoma of the esophagus.
Current oncology reports, 2019-04-04
Cervical Esophageal Cancers: Challenges and Opportunities.
Int. J. Radiat. Oncol. Biol. Phys., 2016 Sep 03
Multicenter Phase 2 Study of Cisplatin and 5-Fluorouracil With Concurrent Radiation Therapy as an Organ Preservation Approach in Patients With Squamous Cell Carcinoma of the Cervical Esophagus.
Int. J. Radiat. Oncol. Biol. Phys., 2017 Jan 09
Effect of Intensity Modulated Radiation Therapy With Concurrent Chemotherapy on Survival for Patients With Cervical Esophageal Carcinoma.
Dis. Esophagus,
Dose escalation of definitive radiation is not associated with improved survival for cervical esophageal cancer: a National Cancer Data Base (NCDB) analysis.
Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2016-01-20
Ablative Radiotherapy Doses Lead to a Substantial Prolongation of Survival in Patients With Inoperable Intrahepatic Cholangiocarcinoma: A Retrospective Dose Response Analysis.
Technology in cancer research & treatment, 2014-06
The effectiveness of a pneumatic compression belt in reducing respiratory motion of abdominal tumors in patients undergoing stereotactic body radiotherapy.
International journal of radiation oncology, biology, physics, 2015-07-15
Expert Consensus Contouring Guidelines for Intensity Modulated Radiation Therapy in Esophageal and Gastroesophageal Junction Cancer.
Practical radiation oncology, 2015
Treatment variables related to liver toxicity in patients with hepatocellular carcinoma, Child-Pugh class A and B enrolled in a phase 1-2 trial of stereotactic body radiation therapy.
International journal of radiation oncology, biology, physics, 2013-10-01
Safety of 90Y radioembolization in patients who have undergone previous external beam radiation therapy.
Int. J. Radiat. Oncol. Biol. Phys., 2019 Sep 16
Safety and Efficacy of Liver Stereotactic Body Radiation Therapy for Hepatocellular Carcinoma After Segmental Transarterial Radioembolization.
Lancet Oncol., 2015 Dec 16
Watch-and-wait approach versus surgical resection after chemoradiotherapy for patients with rectal cancer (the OnCoRe project): a propensity-score matched cohort analysis.
Lancet,
Long-term outcomes of clinical complete responders after neoadjuvant treatment for rectal cancer in the International Watch & Wait Database (IWWD): an international multicentre registry study.
Int. J. Radiat. Oncol. Biol. Phys., 2014 Feb 01
Local recurrence after complete clinical response and watch and wait in rectal cancer after neoadjuvant chemoradiation: impact of salvage therapy on local disease control.
Cancer, 1999-10-15
Concurrent chemoradiotherapy for esophageal carcinoma patients with malignant fistulae.
Int. J. Radiat. Oncol. Biol. Phys., 2002-05-01
Prospective trial of concurrent chemoradiotherapy with protracted infusion of 5-fluorouracil and cisplatin for T4 esophageal cancer with or without fistula.
The Annals of thoracic surgery, 2001-05
Evolving management and outcome of esophageal cancer with airway involvement.
JAMA oncology, 2018-06-14
Adoption of Total Neoadjuvant Therapy for Locally Advanced Rectal Cancer.
J. Clin. Oncol., 2019 Oct 08
Oxaliplatin-Based Adjuvant Chemotherapy for Rectal Cancer After Preoperative Chemoradiotherapy (ADORE): Long-Term Results of a Randomized Controlled Trial.
The New England journal of medicine, 1985-06-06
Prolongation of the disease-free interval in surgically treated rectal carcinoma.
Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2011-11-01
Gemcitabine alone versus gemcitabine plus radiotherapy in patients with locally advanced pancreatic cancer: an Eastern Cooperative Oncology Group trial.
J Can Assoc Radiol, 1981-09-01
Multi-drug chemotherapy with and without radiation for carcinoma of the stomach and pancreas: a prospective randomized trial.
J. Clin. Oncol., 1985-03-01
Treatment of locally unresectable cancer of the stomach and pancreas: a randomized comparison of 5-fluorouracil alone with radiation plus concurrent and maintenance 5-fluorouracil--an Eastern Cooperative Oncology Group study.
J. Natl. Cancer Inst., 1988-07-20
Treatment of locally unresectable carcinoma of the pancreas: comparison of combined-modality therapy (chemotherapy plus radiotherapy) to chemotherapy alone. Gastrointestinal Tumor Study Group.
Ann. Oncol., 2008-09-01
Phase III trial comparing intensive induction chemoradiotherapy (60 Gy, infusional 5-FU and intermittent cisplatin) followed by maintenance gemcitabine with gemcitabine alone for locally advanced unresectable pancreatic cancer. Definitive results of the 2000-01 FFCD/SFRO study.
Gastrointestinal cancer research : GCR, 2007-03
Capecitabine and timing of radiotherapy during preoperative chemoradiation for rectal cancer.
J Clin Oncol, 2012 Jan 20
Phase III trial comparing capecitabine plus cisplatin versus capecitabine plus cisplatin with concurrent capecitabine radiotherapy in completely resected gastric cancer with D2 lymph node dissection: the ARTIST trial.
Lancet Oncol., 2018 Apr 09
Chemotherapy versus chemoradiotherapy after surgery and preoperative chemotherapy for resectable gastric cancer (CRITICS): an international, open-label, randomised phase 3 trial.
Ann. Surg. Oncol., 2017 Mar 23
TOPGEAR: A Randomized, Phase III Trial of Perioperative ECF Chemotherapy with or Without Preoperative Chemoradiation for Resectable Gastric Cancer: Interim Results from an International, Intergroup Trial of the AGITG, TROG, EORTC and CCTG.
International journal of radiation oncology, biology, physics, 2010-05-01
Hyperfractionated accelerated radiotherapy for rectal cancer in patients with prior pelvic irradiation.
Med Dosim, 2016-01-01
Urethral dose sparing in squamous cell carcinoma of anal canal using proton therapy matching electrons with prior brachytherapy for prostate cancer: A case study.
International journal of radiation oncology, biology, physics, 2008-11-01
Gemcitabine chemotherapy and single-fraction stereotactic body radiotherapy for locally advanced pancreatic cancer.
International journal of radiation oncology, biology, physics, 2013-07-01
Stereotactic body radiation therapy for locally advanced and borderline resectable pancreatic cancer is effective and well tolerated.
Br. J. Cancer, 2005-04-11
Effective treatment of anal cancer in the elderly with low-dose chemoradiotherapy.
Cancer, 1993-03-01
External radiation therapy without chemotherapy in the management of anal cancer.
Diseases of the colon and rectum, 2018-07
A Population-Based Cohort Analysis of Chemoradiation Versus Radiation Alone for Definitive Treatment of Stage I Anal Cancer in Older Patients.
International journal of radiation oncology, biology, physics, 2015-04-01
Predictors of toxicity associated with stereotactic body radiation therapy to the central hepatobiliary tract.
Practical radiation oncology, 2016
Practical implementation of quality improvement for high-dose-rate brachytherapy.
Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2016-02-10
Multi-Institutional Phase II Study of High-Dose Hypofractionated Proton Beam Therapy in Patients With Localized, Unresectable Hepatocellular Carcinoma and Intrahepatic Cholangiocarcinoma.
Seminars in oncology, 2001-06
Combining gemcitabine with radiation in pancreatic cancer: understanding important variables influencing the therapeutic index.
J. Clin. Oncol., 2018 Nov 07
Neoadjuvant (Chemo)radiotherapy With Total Mesorectal Excision Only Is Not Sufficient to Prevent Lateral Local Recurrence in Enlarged Nodes: Results of the Multicenter Lateral Node Study of Patients With Low cT3/4 Rectal Cancer.
JAMA, 1999-05-05
Chemoradiotherapy of locally advanced esophageal cancer: long-term follow-up of a prospective randomized trial (RTOG 85-01). Radiation Therapy Oncology Group.
Cancer, 2000-01-15
Small cell carcinoma of the esophagus: the University of Texas M. D. Anderson Cancer Center experience and literature review.
Annals of oncology : official journal of the European Society for Medical Oncology, 2008-03
Small-cell carcinoma of the esophagus and gastroesophageal junction: review of the Memorial Sloan-Kettering experience.
International journal of radiation oncology, biology, physics, 2012-06-01
Celiac node failure patterns after definitive chemoradiation for esophageal cancer in the modern era.
J Thorac Dis,
Lymph node metastases near the celiac trunk should be considered separately from other nodal metastases in patients with cancer of the esophagus or gastroesophageal junction after neoadjuvant treatment and surgery.
Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology, 2014-10
Neoadjuvant chemoradiation with IMRT in resectable and borderline resectable pancreatic cancer.
Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2012-12-10
Long-term update of US GI intergroup RTOG 98-11 phase III trial for anal carcinoma: survival, relapse, and colostomy failure with concurrent chemoradiation involving fluorouracil/mitomycin versus fluorouracil/cisplatin.
Lancet Oncol., 2013-05-01
Mitomycin or cisplatin chemoradiation with or without maintenance chemotherapy for treatment of squamous-cell carcinoma of the anus (ACT II): a randomised, phase 3, open-label, 2 × 2 factorial trial.
Medical physics, 2003-03
How should we describe the radioblologic effect of extracranial stereotactic radlosurgery: equivalent uniform dose or tumor control probability?
Cancer, 2009-12-01
Proton beam therapy for hepatocellular carcinoma: the University of Tsukuba experience.
Ann. Surg., 2016-07-01
A Propensity-matched Analysis Comparing Survival After Esophagectomy Followed by Adjuvant Chemoradiation to Surgery Alone for Esophageal Squamous Cell Carcinoma.
Dis. Colon Rectum, 2014-04-01
Long-term effects of chemoradiotherapy for anal cancer in patients with HIV infection: oncological outcomes, immunological status, and the clinical course of the HIV disease.
Clin Oncol (R Coll Radiol), 2017-04-01
Are there HIV-specific Differences for Anal Cancer Patients Treated with Standard Chemoradiotherapy in the Era of Combined Antiretroviral Therapy?
Can Fam Physician,
Managing hiccups.
Journal of the National Comprehensive Cancer Network : JNCCN, 2014-04
Neoadjuvant chemotherapy first, followed by chemoradiation and then surgery, in the management of locally advanced rectal cancer.
The British journal of surgery, 2002-11
Salvage abdominoperineal resection in anal epidermoid cancer.
Cochrane Database Syst Rev, 2015-05-22
Percutaneous endoscopic gastrostomy versus nasogastric tube feeding for adults with swallowing disturbances.
The Annals of thoracic surgery, 2003-11
Percutaneous endoscopic gastrostomy before multimodality therapy in patients with esophageal cancer.
Eur J Surg, 2001-11-01
Percutaneous endoscopic gastrostomy for nutrition in patients with oesophageal cancer.
American journal of surgery, 2014-03
Esophagectomy in patients with prior percutaneous endoscopic gastrostomy tube placement.
J. Am. Coll. Surg., 2015-03-01
Self-expanding covered metallic stent as a bridge to surgery in esophageal cancer: impact on oncologic outcomes.
Gynecol. Oncol., 1991-07-01
Changing concepts in the management of vulvar cancer.
International journal of radiation oncology, biology, physics, 2017-02-01
Hematologic Nadirs During Chemoradiation for Anal Cancer: Temporal Characterization and Dosimetric Predictors.
Cancer, 2010-09-01
Gabapentin for the treatment of pain syndrome related to radiation-induced mucositis in patients with head and neck cancer treated with concurrent chemoradiotherapy.
J. Clin. Oncol., 2004-04-15
Phase III randomized trial of Calendula officinalis compared with trolamine for the prevention of acute dermatitis during irradiation for breast cancer.
International journal of radiation oncology, biology, physics, 2016-03-15
Focal Radiation Therapy Dose Escalation Improves Overall Survival in Locally Advanced Pancreatic Cancer Patients Receiving Induction Chemotherapy and Consolidative Chemoradiation.
International journal of radiation oncology, biology, physics, 2005-12-01
Prevention of acute radiation-induced proctosigmoiditis by balsalazide: a randomized, double-blind, placebo controlled trial in prostate cancer patients.
N. Engl. J. Med., 2004-10-21
Preoperative versus postoperative chemoradiotherapy for rectal cancer.
Lancet Oncol., 2015-08-01
High-dose chemoradiotherapy and watchful waiting for distal rectal cancer: a prospective observational study.
J. Natl. Cancer Inst., 2016-12-01
Long-term Outcome of an Organ Preservation Program After Neoadjuvant Treatment for Rectal Cancer.
Lancet, 2017-07-29
Organ preservation for rectal cancer (GRECCAR 2): a prospective, randomised, open-label, multicentre, phase 3 trial.
Pract Radiat Oncol, 2012 Oct-Dec
Palliative radiotherapy in patients with esophageal carcinoma: A retrospective review.
Curr Oncol, 2012-04-01
What is the optimal management of dysphagia in metastatic esophageal cancer?
Int. J. Radiat. Oncol. Biol. Phys., 2013-03-15
Acceptable toxicity after stereotactic body radiation therapy for liver tumors adjacent to the central biliary system.
Practical radiation oncology, 2017
Gallbladder toxicity and high-dose ablative-intent radiation for liver tumors: Should we constrain the dose?
Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2005-12-01
Phase II trial of high-dose conformal radiation therapy with concurrent hepatic artery floxuridine for unresectable intrahepatic malignancies.
Liver transplantation : official publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society, 2014-01
Neoadjuvant stereotactic body radiation therapy, capecitabine, and liver transplantation for unresectable hilar cholangiocarcinoma.
Advances in radiation oncology, 2016
Stereotactic body radiotherapy (SBRT) for locally advanced extrahepatic and intrahepatic cholangiocarcinoma.
J. Hepatol., 2017-07-01
Stereotactic body radiotherapy vs. TACE or RFA as a bridge to transplant in patients with hepatocellular carcinoma. An intention-to-treat analysis.
Liver transplantation : official publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society, 2012-08
Long-term outcomes of stereotactic body radiation therapy in the treatment of hepatocellular cancer as a bridge to transplantation.
Advances in radiation oncology, 2016
Comparison of outcomes between SBRT, yttrium-90 radioembolization, transarterial chemoembolization, and radiofrequency ablation as bridge to transplant for hepatocellular carcinoma.
Liver Transpl., 2013-10-01
Down-staging of hepatocellular carcinoma via external-beam radiotherapy with subsequent liver transplantation: a case report.
Future Oncol, 2016-07-01
Conformal radiotherapy as a bridge to liver transplantation for hepatocellular carcinoma: is it safe?
Cancer medicine, 2016-12
Comparison of outcomes between rectal squamous cell carcinoma and adenocarcinoma.
American journal of clinical oncology, 2018-07
Hyperfractionated Accelerated Reirradiation for Patients With Recurrent Anal Cancer Previously Treated With Definitive Chemoradiation.
Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology, 2017-01
Hyperfractionated accelerated reirradiation for rectal cancer: An analysis of outcomes and toxicity.
J. Clin. Oncol., 2016-08-10
Effect of Pathologic Tumor Response and Nodal Status on Survival in the Medical Research Council Adjuvant Gastric Infusional Chemotherapy Trial.
Lancet Oncol., 2014-07-01
Sequential paclitaxel followed by tegafur and uracil (UFT) or S-1 versus UFT or S-1 monotherapy as adjuvant chemotherapy for T4a/b gastric cancer (SAMIT): a phase 3 factorial randomised controlled trial.
Ann. Oncol., 2014-07-01
Randomized trial on adjuvant treatment with FOLFIRI followed by docetaxel and cisplatin versus 5-fluorouracil and folinic acid for radically resected gastric cancer.
J. Clin. Oncol., 2015-10-01
Phase III Trial to Compare Adjuvant Chemotherapy With Capecitabine and Cisplatin Versus Concurrent Chemoradiotherapy in Gastric Cancer: Final Report of the Adjuvant Chemoradiotherapy in Stomach Tumors Trial, Including Survival and Subset Analyses.
Radiat Oncol, 2014 May 29
Chemoradiation with capecitabine and mitomycin-C for stage I-III anal squamous cell carcinoma.
Br. J. Cancer, 2014 Aug 28
Chemoradiotherapy with capecitabine for locally advanced anal carcinoma: an alternative treatment option.
J Gastrointest Cancer,
Phase II Study of Capecitabine in Substitution of 5-FU in the Chemoradiotherapy Regimen for Patients with Localized Squamous Cell Carcinoma of the Anal Canal.
Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2009-04-01
Multi-institutional phase I/II trial of stereotactic body radiation therapy for liver metastases.
Acta Oncol, 2006-01-01
Phase II study on stereotactic body radiotherapy of colorectal metastases.
J. Cancer Res. Clin. Oncol., 2015-07-01
The challenge of inoperable hepatocellular carcinoma (HCC): results of a single-institutional experience on stereotactic body radiation therapy (SBRT).
Semin Radiat Oncol, 2017-07-01
Stereotactic Body Radiotherapy for Liver Metastases.
Int. J. Radiat. Oncol. Biol. Phys., 1988-05-01
Reflections in rectosigmoid: retro-peritoneal vs. intra-peritoneal.
Int J Radiat Oncol Biol Phys, 2016 Jul 15
Palliative Short-Course Radiation Therapy in Rectal Cancer: A Phase 2 Study.
Journal of geriatric oncology, 2018-03
Use of frailty to predict survival in elderly patients with early stage non-small-cell lung cancer treated with stereotactic body radiation therapy.
International journal of radiation oncology, biology, physics, 2001-01-01
Effective pelvic symptom control using initial chemoradiation without colostomy in metastatic rectal cancer.
Lancet Gastroenterol Hepatol, 2017-07-01
A watch-and-wait approach for locally advanced rectal cancer after a clinical complete response following neoadjuvant chemoradiation: a systematic review and meta-analysis.
Dis. Colon Rectum, 2017-10-01
Quality of Life in Rectal Cancer Patients After Chemoradiation: Watch-and-Wait Policy Versus Standard Resection - A Matched-Controlled Study.
Ann. Oncol., 2016-05-01
Long-course oxaliplatin-based preoperative chemoradiation versus 5 × 5 Gy and consolidation chemotherapy for cT4 or fixed cT3 rectal cancer: results of a randomized phase III study.
International journal of radiation oncology, biology, physics, 2017-10-01
Improved Metastasis- and Disease-Free Survival With Preoperative Sequential Short-Course Radiation Therapy and FOLFOX Chemotherapy for Rectal Cancer Compared With Neoadjuvant Long-Course Chemoradiotherapy: Results of a Matched Pair Analysis.
Ann. Surg., 2015-09-01
Treatment of 200 locally advanced (stage III) pancreatic adenocarcinoma patients with irreversible electroporation: safety and efficacy.
Journal of vascular and interventional radiology : JVIR, 2017-03
Percutaneous Image-Guided Irreversible Electroporation for the Treatment of Unresectable, Locally Advanced Pancreatic Adenocarcinoma.
N. Engl. J. Med., 2001-08-30
Preoperative radiotherapy combined with total mesorectal excision for resectable rectal cancer.
J. Clin. Oncol., 2005-09-01
Late side effects of short-course preoperative radiotherapy combined with total mesorectal excision for rectal cancer: increased bowel dysfunction in irradiated patients--a Dutch colorectal cancer group study.
Lancet Oncol., 2017-03-01
Optimal fractionation of preoperative radiotherapy and timing to surgery for rectal cancer (Stockholm III): a multicentre, randomised, non-blinded, phase 3, non-inferiority trial.
International journal of radiation oncology, biology, physics, 2003-03-01
Chemoradiation for adenocarcinoma of the anus.
Int J Radiat Oncol Biol Phys, 2006 Dec 1
Update of human spinal cord reirradiation tolerance based on additional data from 38 patients.
Practical radiation oncology, 2018
Reirradiation of thoracic cancers with intensity modulated proton therapy.
Int. J. Radiat. Oncol. Biol. Phys., 2012 Aug 14
Curative chemoradiotherapy in patients with stage IVB cervical cancer presenting with paraortic and left supraclavicular lymph node metastases.
Practical radiation oncology, 2017
Impact of treatment year on survival and adverse effects in patients with cervical cancer and paraortic lymph node metastases treated with definitive extended-field radiation therapy.
Radiother Oncol, 2012 Feb 22
Systematic review of the role of a belly board device in radiotherapy delivery in patients with pelvic malignancies.
Radiother Oncol, 2011 Jun 30
Bowel exposure in rectal cancer IMRT using prone, supine, or a belly board.
Br J Surg,
Epidermoid cancer of the anus.
Proc. R. Soc. Med.,
Results of surgical treatment of squamous cell carcinoma of the anal canal and anal margin seen at St. Mark's Hospital 1928-66.
Lancet Oncol., 2011 May 17
Preoperative radiotherapy combined with total mesorectal excision for resectable rectal cancer: 12-year follow-up of the multicentre, randomised controlled TME trial.
Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2008-03-20
Effects of chemoradiation on tumor-host interactions: the immunologic side.
J. Clin. Oncol.,
Neoadjuvant cisplatin chemotherapy before chemoradiation: a flawed paradigm?
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Effect of high-dose stereotactic body radiation therapy on liver function in the treatment of primary and metastatic liver malignancies using the Child-Pugh score classification system.
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