What after neoadjuvant CT-RT for Lung Ca that remained inoperable?
Dear Colleagues, I hope you are safe. I need your advice concerning my patient 65 years old, who initially presented (at another institution) for a left lung para-hilar mass, 5cm, involving the left lingular bronchi, N2 on Pet, M0. Biopsy: Poorly differentiated NSCLC, EGFR neg, ALK neg, PD-L1 90% He received neo-adjuvant CT (CDDP-Navelbine) + RT 45Gy/25fr. He had a partial response but still inoperable. Last RT session was on october 26/10/20. What to do ? Do you recommend SBRT to the... Read more (Source: Student Doctor Network)
Source: Student Doctor Network - January 28, 2021 Category: Universities & Medical Training Authors: Kroll2013 Tags: Radiation Oncology Source Type: forums

Triple Neg with residual post neoadjuvant....
.... med onc wants to give Xeloda during radiation. Are you hypofractionating or standard fractionation? (Source: Student Doctor Network)
Source: Student Doctor Network - January 28, 2021 Category: Universities & Medical Training Authors: Mandelin Rain Tags: Radiation Oncology Source Type: forums

Nodal ITC after neoadjuvant chemotherapy
Dear colleagues, I would greatly appreciate your input on this situation. cT2N0 triple positive breast cancer. Mastectomy and axillary clearance after neoadjuvant chemotherapy shows pCR in the breast and sentinel node biopsy shows ITC. RT? Leave alone? Thanks (Source: Student Doctor Network)
Source: Student Doctor Network - October 5, 2020 Category: Universities & Medical Training Authors: Treat Tags: Radiation Oncology Source Type: forums

Breast Case
41 y/o female, 6cm IDC, 2 enlarged axillary lymph nodes on preop imaging (2cm and 1.5cm respectively), IDC, ER 10%, PR/HER-2-negative. 2cm axillary node core biopsy negative (clip placed at time of biopsy). BRCA-negative. Received neoadjuvant ACT with imaging showing complete resolution of breast mass and "normalization" of both enlarged nodes. (Per imaging, the 1.5 cm node initially showed thickened cortex but now normalized with fatty hilum). Got simple mastectomy + SLNB + immediate... Breast Case (Source: Student Doctor Network)
Source: Student Doctor Network - May 29, 2020 Category: Universities & Medical Training Authors: Reaganite Tags: Radiation Oncology Source Type: forums

Locally-Advanced Duodenal Cancers
I know these are rare, but curious how other people are practicing. Just saw a guy who presented with a proximal tumor and multiple positive nodes. They gave him upfront FOLFOX and he actually progressed clinically (no radiographic response but worsening clinical symptoms though not even close to obstructed). I was honestly surprised how "controversial" this case was at our tumor board and I am curious what everyone would recommend? I (successfully) argued for neoadjuvant chemorads. Some of... Locally-Advanced Duodenal Cancers (Source: Student Doctor Network)
Source: Student Doctor Network - April 30, 2020 Category: Universities & Medical Training Authors: ramsesthenice Tags: Radiation Oncology Source Type: forums

Is PMRT needed for this patient?
59 yo female patient, that presented with multifocal right breast lesions in the upper-lower outer quadrants: T1 26.5*21 mm - T2 23*19mm cN0 on the initial MRI. staging Pet: N0 M0 she underwent neoadjuvant chemotherapy. MRI showed a good radiological response she had total mastectomy and LND: bifocal residual carcinoma, T1: ILC, 3.7 cm T2: IDC, grade 2 negative margins, lVSI neg, skin free, nipple free, 0/21 negative nodes with no signs of... Is PMRT needed for this patient? (Source: Student Doctor Network)
Source: Student Doctor Network - August 16, 2019 Category: Universities & Medical Training Authors: Kroll2013 Tags: Radiation Oncology Source Type: forums

Who wants another Great Breast Cancer Debate?
71 yo, history of single-lung transplant with T1N1 triple negative breast cancer. immediate surgery (ie no neoadjuvant therapy). s/p full ax dissection (11 nodes) - final path with single positive node and associated ECE. Would anyone treat axilla in this situation? If it matters the transplanted lung is on the right and the cancer was on the left. (Source: Student Doctor Network)
Source: Student Doctor Network - July 19, 2019 Category: Universities & Medical Training Authors: pikachu Tags: Radiation Oncology Source Type: forums

Breast boost after complete response to neoadjCT
39 y/o with triple-negative breast cancer, 1.9 cm in size, had lumpectomy after neoadjuvant chemo which showed complete response. I'm treating whole breast to 42.6/16. Would anyone omit boost? Thanks. (Source: Student Doctor Network)
Source: Student Doctor Network - July 17, 2019 Category: Universities & Medical Training Authors: seper Tags: Radiation Oncology Source Type: forums

PMRT for this patient?
Dear colleagues, i need your opinion concerning this patient: 44 yo patient diagnosed of a bifocal mass of the right breast 5*2*3 cm , UOQ, cN0 , no suspiscious nodes on MRI biopsy showed a poorly differentiated IDC with extensive high grade DCIS, HR neg, Her2 positive she received neoadjuvant chemotherapy with complete response. pathology of the radical right mastectomy with sentinel node showed: no residual tumor, 0/1 LN, LVSI was not specified. do you give PMRT taking into... PMRT for this patient? (Source: Student Doctor Network)
Source: Student Doctor Network - May 30, 2019 Category: Universities & Medical Training Authors: Kroll2013 Tags: Radiation Oncology Source Type: forums

micromets axillary radiation
Hi All, I'm an M3 currently on an RO elective. I saw the following case and there was looked like there was some disagreement over it at the tumor board. 50 y.o female, (edit: right sided) ILC, initial lumpectomy attempted with sentinel lymph node dissection, 2.5 cm tumor (ER/PR +, grade II, prosigna score intermediate- high risk of recurrence) removed, but positive margins, 0.8mm micromets found in sentinel node. 4 rounds of neoadjuvant tc chemo before mastectomy for clear margins. It... micromets axillary radiation (Source: Student Doctor Network)
Source: Student Doctor Network - May 14, 2018 Category: Universities & Medical Training Authors: dellort and 57 others Source Type: forums