Absolute Clinical Radiation Oncology Review

Description

This book provides a quick reference guide for clinicians in radiation oncology. It is designed to be an intuitive and easily reviewed study guide for board or maintenance of certification examinations, as well as a quick reference for residents and established radiation oncologists who need a refresher. The text begins with a general pearls chapter that radiation oncologists should consider in all aspects of their practice, including cancer visibility, dosing, counseling recommendations, and toxicity management. The subsequent chapters then delve into different cancer disease sites, including pediatrics, central nervous system, head and neck, thoracic, breast, gastrointestinal, gynecologic, genitourinary, hematologic, soft tissue, palliative, and radiophysics/radiobiology. Within each chapter, each disease and its recommended approach is then summarized in only a few pages, allowing a focus on the most essential information. Bullet points, figures, tables, and images make for an intuitive reader experience. The text includes the 7th and 8th editions staging from the American Joint Committee on Cancer (AJCC). Recommendations are taken from the American Society for Radiation Oncology (ASTRO), the European Society for Radiation Oncology (ESTRO), and the National Comprehensive Cancer Network (NCCN). Planning guides for imaging, diagnosis, and staging offer readers a starting point in approaching each patient based on disease origin, and dosing guidelines then detail consideration for treatment methods. Each chapter additionally includes disease-specific pearls and key points to test the knowledge reviewed in the chapters. Experts in the disease sites from the United States serve as senior authors on each chapter. The authors include all diseases associated with radiation oncology training to ensure a comprehensive resource for exam studying and clinical care. Residents, trainees, and established radiation oncologists find this an ideal study resource for both board and certification exams, as well as an easily accessible aid during practice. Contents......Page 5 Contributors......Page 7 Abbreviations......Page 8 1: General Principles of Radiation Oncology......Page 17 Blood Vessel Radiosensitivity......Page 23 Palliative Care......Page 24 KPS vs ECOG......Page 25 Nausea/Vomiting......Page 26 Pituitary hormones......Page 27 Disorders, Syndromes, and Genetics......Page 28 High-Yield Neoadjuvant RT and pCR Rates......Page 29 CTCAE v4.0 Grading [6]......Page 30 Dose Constraints......Page 32 QUANTEC Dose Constraints......Page 33 References......Page 43 DDx Suprasellar Mass......Page 45 Molecular Markers......Page 46 Protons......Page 47 Second Neoplasm......Page 48 Treatment Comparison for Pediatric Tumors......Page 49 Pediatric Leukemia (T-ALL, B-ALL) [2, 3]......Page 55 Rhabdomyosarcoma (RMS) [4–15]......Page 57 High-Yield Cases......Page 62 Non Rhabdoid Soft Tissue Sarcoma (NRSTS)......Page 63 Ewing Sarcoma [4–8, 16–21]......Page 64 Nephroblastoma (Wilms’ Tumor/WT) [4–8, 22–29]......Page 67 Neuroblastoma [4–8, 30–35]......Page 72 Retinoblastoma [4–8, 36–38]......Page 76 Langerhans Cell Histiocytosis (LCH)......Page 78 Medulloblastoma (and Supratentorial PNET, Pineoblastoma) [4–8, 36, 39–44]......Page 79 COG Approach......Page 82 Atypical Teratoid Rhabdoid Tumor (ATRT)......Page 83 Ependymoma [4–8, 45–47]......Page 84 Germ Cell and Non-Germ Cell Tumors (GCT/NGGCT/Germinoma) and Pineal Tumors [4–8, 48–50]......Page 86 Craniopharyngioma [4–8, 51–53]......Page 89 Hemangioblastoma......Page 90 Optic Pathway Glioma (OPG)......Page 91 Low-Grade Gliomas (LGG)......Page 92 High-Grade Glioma (HGG)......Page 93 Diffuse Intrinsic Pontine Glioma (DIPG)/Midline Glioma/Brainstem Glioma [4–8, 51, 54–62]......Page 94 References......Page 95 3: Central Nervous System Cancers......Page 98 CNS Pearls [1–10]......Page 102 Intradural Intramedullary Spinal Cord Tumors......Page 103 Radionecrosis......Page 104 Molecular Pathways for Adult Gliomas in 2018......Page 105 General Glioma Treatment Paradigms in 2018......Page 106 Low-Grade Glioma (WHO Grades I–II, Oligo, Astro, and Mixed Oligo-Astro) [11–25]......Page 107 High-Grade Glioma (WHO Grades III–IV) [11–15, 26–86]......Page 110 Bevacizumab in Up-Front GBM......Page 112 Response Assessment in Neuro-Oncology (RANO) Criteria for GBM Recurrence......Page 113 Grade III Glioma (AA, AO, AOA) management......Page 114 Primary CNS Lymphoma (PCNSL) [11–15, 87–103]......Page 115 Primary Ocular DLBCL......Page 117 Meningioma [11–15, 96, 104–127]......Page 118 Optic Nerve Sheath Meningioma......Page 121 Brain Metastases [11–15, 128–161]......Page 122 Clinical Data......Page 123 Intradural Spinal Cord Astrocytoma......Page 126 Pituitary Tumors [11–15, 162–173]......Page 127 Vestibular Schwannoma (VS)/Acoustic Neuroma (AN) [9, 174–207]......Page 130 Trigeminal Neuralgia (TN) [208–214]......Page 133 Arteriovenous Malformation (AVM) [215–223]......Page 134 Hemangiopericytoma (HPC) [224–227]......Page 136 Thyroid Ophthalmopathy (TO) [228–232]......Page 137 References......Page 138 4: Head and Neck Cancers......Page 147 Differential Diagnosis......Page 148 Types of Neck Dissections......Page 149 PET-CT......Page 153 Contouring Normal Structures......Page 154 Dose Constraints (Guidelines Vary Depending on Proximity/Importance of PTV Coverage)......Page 155 Nodal Stations and Boundaries of the HN [10, 11]......Page 156 HN Toxicity Management [12–18]......Page 159 Brachial Plexopathy......Page 160 Ocular/Uveal Melanoma [19–29]......Page 163 Nasopharyngeal (NPX) Cancer [19–23, 30–41]......Page 164 Maxillary Sinus Cancer [19–23, 42–44]......Page 167 Esthesioneuroblastoma, Kadish Staging......Page 168 Nasal NK/T-cell Lymphoma/Lethal Midline Granuloma [47, 48]......Page 170 Oral Cavity (OC) Cancer [19–23, 49–66]......Page 171 General Oral Cavity......Page 173 Oral Tongue......Page 174 Oropharyngeal (OPX) Cancer [19–23, 49–61, 67–73]......Page 175 Squamous Cell Cancer Metastatic to Cervical Nodes from Unknown Primary (SCCUP) [19–23, 78–85]......Page 180 Salivary Gland Cancer [19–23, 86–93]......Page 183 Laryngeal (LX) and Hypopharyngeal (HPX) Cancer [19–23, 94–111]......Page 186 Studies......Page 187 Surgery Types......Page 188 Treatment for Glottic Larynx......Page 189 Indications for Treating Stoma (“No ESCAPE”)......Page 190 Thyroid Cancer: PTC, FTC, MTC, and ATC [19–23, 112–120]......Page 193 Melanoma [19–23, 121–139]......Page 195 Mucosal Melanoma......Page 197 Skin Squamous Cell and Basal Cell Carcinoma (SCC/BCC) [19–23, 140–144]......Page 198 Standard Skin SCC, NCCN......Page 199 Medial Canthus SCC......Page 201 Merkel Cell Carcinoma (MCC) [19–23, 145–148]......Page 202 Graves ophthalmopathy......Page 203 References......Page 205 5: Lung Cancer......Page 211 AJCC 7th Edition Staging......Page 213 Mediastinal Staging......Page 214 Simulation......Page 216 Chemo for Advanced/Metastatic Disease......Page 217 Toxicity of RT......Page 218 Dose Constraints in Gy (RTOG 0618, 0813, 0915; QUANTEC) [3–5]......Page 219 Early-Stage Non-Small Cell Lung Cancer (NSCLC) [6–32]......Page 220 SBRT Eligibility......Page 221 NSCLC: Post-op Therapy [22, 33, 34]......Page 223 Locally Advanced Non-Small Cell Lung Cancer [3, 6–11, 35–62]......Page 225 Superior Sulcus Tumors (Pancoast) [63]......Page 228 Metastatic Lung Cancer......Page 230 Tracheal Cancer [64, 65]......Page 231 Carcinoid......Page 232 Small Cell Lung Cancer (SCLC) [6–10, 66–81, 82]......Page 233 Thymoma and Thymic Carcinoma [6–10, 83–89]......Page 237 Pleural Mesothelioma [6–10, 90–94]......Page 240 SVC Syndrome [95, 96]......Page 242 References......Page 243 6: Breast Cancer......Page 247 Breast Pearls [1–17]......Page 248 Anatomy......Page 250 Biopsy......Page 251 MRI......Page 252 Oncotype DX......Page 254 Surgical Margins (Moran, 2014; Morrow, 2016)......Page 255 Tamoxifen......Page 256 Aromatase Inhibitors (AIs)......Page 257 Agents Used and Schedule......Page 258 To Ensure Post-NACT SLNBx FNR