RadOnc Smart Review

Welcome back to Rad Onc Smart Review: Thoracic Oncology Edition. Episode 10 builds a coherent curative strategy for resectable stage II through III non-small cell lung cancer. We show why a stage label alone cannot define medical operability, anatomic resectability, the required operation, the meaning of a PET-avid mediastinal node, or the best perioperative sequence. The episode keeps radiation o...

Welcome back to Rad Onc Smart Review: Thoracic Oncology Edition. Episode 9 addresses one of the hardest surveillance problems after lung stereotactic body radiation therapy: distinguishing expected evolving fibrosis and inflammation from true local recurrence. We integrate time from treatment, serial morphology, metabolic behavior, symptoms, physiology, original dose geometry, restaging, and the f...

Welcome back to Rad Onc Smart Review: Thoracic Oncology Edition. Episode 8 explores the modifiers that can turn apparently early-stage non-small cell lung cancer into a high-risk radiation problem: central or ultracentral anatomy, endobronchial extension, large tumor size, and fibrotic interstitial lung disease. These features can change candidacy, fractionation, target priorities, image guidance,...

Welcome back to Rad Onc Smart Review: Thoracic Oncology Edition. Episode 7 is a practical workshop in peripheral lung stereotactic body radiation therapy. We move from candidacy and respiratory-motion data to target construction, fractionation, chest-wall risk, intermediate-dose falloff, image guidance, and the question that matters at every fraction: can the team reproduce the geometry that made...

Welcome back to Rad Onc Smart Review: Thoracic Oncology Edition. Episode 6 tackles early-stage non-small cell lung cancer as a treatment-selection problem, not a reflex comparison of surgery versus stereotactic body radiation therapy. We begin by confirming localized, node-negative disease, pursuing tissue when safely feasible, separating medical operability from anatomic resectability, and defini...

Welcome back to Rad Onc Smart Review: Thoracic Oncology Edition. Episode 5 moves thoracic radiation from the planning scan to the reality of treating a breathing patient. We examine how simulation, respiratory-motion assessment, treatment position, image registration, beam delivery, and image guidance must describe the same physical situation for the plan to remain trustworthy. The episode provide...

Welcome back to Rad Onc Smart Review: Thoracic Oncology Edition. Episode 4 separates three questions that are too often collapsed into the phrase surgical candidate: Can the patient tolerate the proposed operation? Can the cancer be completely removed by a reasonable operation? And even if both are possible, is surgery the right oncologic strategy for this patient? We apply those distinctions to p...

Welcome back to Rad Onc Smart Review: Thoracic Oncology Edition. Episode 3 connects thoracic nodal anatomy to the decisions it changes: imaging probability, procedural access, specimen adequacy, stage, and treatment intent. The goal is not simply to memorize station numbers, but to know whether a suspicious node was named correctly, could be reached by the chosen procedure, and was truly represent...

Welcome back to Rad Onc Smart Review: Thoracic Oncology Edition. Episode 2 turns thoracic imaging and TNM staging into a clinical reasoning exercise rather than a table-lookup task. We work through how to integrate imperfect studies, separate radiographic suspicion from pathologic proof, and assign a transparent, version-correct anatomic stage without treating missing information as negative infor...

Welcome back to Rad Onc Smart Review: Thoracic Oncology Edition. Episode 1 follows the clinical chain from lung-cancer screening and pulmonary-nodule evaluation to a tissue diagnosis that can actually guide treatment. We focus on the decisions that prevent downstream staging and planning errors: whether an abnormality belongs on a screening or diagnostic pathway, what to sample, how to judge tissu...

Welcome back to Rad Onc Smart Review: Genitourinary Oncology Edition. In Episode 32, we conclude our distal GU module with a deep dive into Mock Oral Boards—focusing on Penile and Urethral Cancer, including node-positive presentations and organ-preservation strategies. These rare malignancies are prime targets for board examinations because they require a disciplined, structured approach to stagin...

Welcome back to Rad Onc Smart Review, Genitourinary Oncology edition. In Episode 27, we tackle a mock oral exam focused on Renal Cell Carcinoma (RCC), covering clinical scenarios involving a solitary kidney, IVC involvement, and oligoprogression. In this session, I present two primary case blocks, each paired with a contrasting clinical twist. To get the most out of this episode, I encourage you t...

Welcome back to Rad Onc Smart Review, Genitourinary Oncology edition. This is Episode 23: Testicular Mock Oral - Stage I, Stage IIA, and NSGCT Variants. Today we cap our testicular block with a full mock oral boards session. I will present three case blocks. Each block includes a main case and a contrasting twist that forces a different management decision. Pause after each question to formulate y...

Welcome back to Rad Onc Smart Review, Genitourinary Oncology edition. This is Episode 18: Bladder Mock Oral - trimodality therapy, post-cystectomy radiation, and local recurrence. This is the capstone of the bladder block. The goal today is not just to know doses. The goal is to answer the way an examiner wants to hear it: first define candidacy, then frame the multidisciplinary options, then give...

Welcome back to Rad Onc Smart Review: Genitourinary Oncology Edition. In Episode 12, we’re putting your knowledge to the test with a Case-Based Review: Prostate Cancer Mock Oral Boards. In this episode, I walk through three distinct case blocks covering intact localized disease, post-prostatectomy salvage, and oligometastatic recurrence. Each block features a primary case followed by a contrasting...

This is Episode 31: Penile and Urethral Planning Workshop. These are rare, high-stakes plans. The anatomy is mobile, the setup can be awkward, the evidence base is limited, and sloppy field design can have major consequences. This workstation episode covers simulation, bolus, immobilization, penile brachytherapy, inguinal and pelvic nodal contouring using the InPACT framework, and key principles o...

This is Episode 30: Penile Cancer Primary Management, Nodes, and Organ Preservation. Penile cancer is rare, but it is very fair game on boards because it tests whether you can keep anatomy, staging, nodal logic, and quality-of-life tradeoffs straight in a disease most residents will see only rarely.

Today we will build a practical framework for workup, staging, histology, and multimodality management. We will also cover where radiation fits, including selected use of brachytherapy for early-stage female disease and definitive chemoradiation for selected locally advanced squamous tumors.

This is Episode 28: Upper Tract Urothelial Carcinoma perioperative therapy, patterns of failure, and where radiation enters the conversation. UTUC is one of those diseases that residents do not see often, but oral examiners love it because it looks familiar and then punishes shortcut thinking. The histology overlaps with bladder urothelial carcinoma, but the risk stratification, the surgical plann...

This is the workstation episode. This is the planning episode. The big idea is simple: kidney SBRT is usually a motion-management problem and an organ-at-risk problem before it becomes a dose problem. Your bowel, your duodenum, your stomach, and the remaining uninvolved renal parenchyma often decide the regimen.

This is one of the highest-yield modern RCC topics because it sits right where three practice changes collide. First, RCC was long treated as a disease that did not respond well to conventional radiation, but modern ablative radiation changed that conversation. Second, cytoreductive nephrectomy went from reflex dogma to a selective, risk-adapted decision. Third, immune checkpoint inhibitor–based c...

This is Episode 24: Renal Cell Carcinoma Localized Disease, Surgery, Ablation, and Primary SBRT. Here is the modern frame. Localized RCC is still primarily a surgical disease. Conventional fractionation never established a curative or adjuvant role in this setting. But stereotactic ablative body radiotherapy has changed the conversation for selected patients who are medically inoperable, technical...

This episode is about what happens after cure. Testicular cancer is one of the great success stories in oncology, but that success creates a second job: taking care of survivors for decades. These are often young men with excellent cure rates and long life expectancy. So the real question is not just whether you cured the cancer. It is whether you protected fertility, recognized relapse on the rig...

This is the episode where testicular cancer stops being mostly about stage I and stage II decision trees and starts becoming a sequencing problem. The questions are no longer just surveillance versus adjuvant therapy. Now the important questions are: how do you classify risk correctly, which chemotherapy backbone belongs to which group, when does PET help, when does it not help at all, who needs s...

This is Episode 20: Testicular Stage II Seminoma, NSGCT, and Field Design. Last episode, we built the foundation: markers, orchiectomy, staging, and why surveillance is preferred for most stage I seminoma. Today we move into stage II disease, where the question is no longer just whether you know the basics. The question is whether you can choose treatment, explain why, and, if needed, describe a r...