Insurance denial-standard fx low risk prostate
Wondering if this has happened to others...insurance denied 45 IMRT for low risk prostate CA. Only approving 28 fractions...Is breast next? (Source: Student Doctor Network)
Source: Student Doctor Network - March 4, 2018 Category: Universities & Medical Training Authors: Reaganite Source Type: forums

Direct supervision vs personal supervision SRS/SBRT
Question for the group. I understand that “direct supervision” is a gray area in some centers. But, I think we all can agree that the safest way to absolutely avoid fraud charges from CMS is to have a rad/Onc on-site (AKA in the department) while the beam is on. My question concerns Radiosurgery. The provider is in the department and immediately “interruptible for direct supervision” rules to oversee the procedure (just like is typical for IMRT/CBCTs). Do you need to be literally at the... Direct supervision vs personal supervision SRS/SBRT (Source: Student Doctor Network)
Source: Student Doctor Network - February 12, 2018 Category: Universities & Medical Training Authors: firewicket Source Type: forums

Prostate cancer IMRT - no difference between daily IGRT and weekly KV
http://www.thegreenjournal.com/article/S0167-8140(17)32680-4/fulltext Interesting Phase 3 study. All patients received dose escalated IMRT to prostate (78 Gy in 39 fractions) with either daily CBCT (7 mm margins) or weekly orthogs (15 mm! margins). No difference in patient reported toxicity. (Source: Student Doctor Network)
Source: Student Doctor Network - February 11, 2018 Category: Universities & Medical Training Authors: Gfunk6 Source Type: forums

Tomo better than RapidArc
Clinical Outcomes of Several IMRT Techniques for Patients With Head and Neck Cancer: A Propensity Score–Weighted Analysis Filed under "How'd I Miss This." You know you wonder about these things. In your mind you think every IMRT/VMAT treatment machine is just a scalpel: a blade is a blade is a blade. Maybe not? I don't know. The study can't answer the question definitively. But still. Pretty interesting result I... Tomo better than RapidArc (Source: Student Doctor Network)
Source: Student Doctor Network - January 19, 2018 Category: Universities & Medical Training Authors: scarbrtj Source Type: forums

todays wsj
While we beat ourselves up over IMRT/fractionation, it has nothing on the robot: Robot-Assisted Surgery Costs More But May Not Be Better and well written editorial on robotic prostatectomy: Robotic-Assisted Radical Prostatectomy: Who Is Benefiting? | Cancer Network | The... todays wsj (Source: Student Doctor Network)
Source: Student Doctor Network - November 1, 2017 Category: Universities & Medical Training Authors: nkmiami Source Type: forums

PSMA and treatment of micromets
My urologists have started sending like everyone with a rising PSA for PSMA testing. Today I got a referral for these teeny tiny retroperitoneal nodes. Technically, would be amenable to a small IMRT field. I got another referral today for two super small but avid lung nodules. I have no idea what to do with this. Would you guys be SBRTing the lung nodules and treating the LN's?! (Source: Student Doctor Network)
Source: Student Doctor Network - June 17, 2017 Category: Universities & Medical Training Authors: napoleondynamite Source Type: forums

Reirradiation for recurrent glottic cancer
Dear collegues, Your opinion is needed plz. 70 yo male, smoker may 2016: radiochemotherapy for T3N1 supraglottic squamous cell carcinoma He received 70Gy in 35 fractions to the GTV,60Gy to the intermediate risk regions and 50 Gy to the low risk PTV, 3DRT +IGRT ( could not afford IMRT. In my country VMAT is not covered) He kept smoking and drinking Good response to CRT March 2017: he relapsed with 2cm transglottic lesion and underwent total laryngectomy with bilateral neck dissection... Reirradiation for recurrent glottic cancer (Source: Student Doctor Network)
Source: Student Doctor Network - May 16, 2017 Category: Universities & Medical Training Authors: Kroll2013 Source Type: forums

Head & Neck IMRT & AP Scv
When doing head and neck IMRT, if matching an upper neck IMRT field to a lower neck supraclav field, do you have to feather every so often? (Source: Student Doctor Network Forums)
Source: Student Doctor Network Forums - September 17, 2013 Category: Universities & Medical Training Authors: jb2 Tags: Radiation Oncology Source Type: forums