RadOnc Smart Review

Today is a hands-on planning workshop. We’ll simulate, contour, and plan adjuvant pelvic IMRT. Then we’ll master vaginal cuff HDR brachytherapy—from choosing the cylinder to writing the prescription and optimizing dwell times. You’ll also get two short “oral boards canned speeches” you can deliver verbatim on exam day.

Welcome back to Rad Onc Smart Review, Gyn cancer series. This is a special topics episode focused on three areas that trip people up on consults and in orals: uterine sarcomas, carcinosarcoma, and how to cure medically inoperable endometrial cancer with radiation.

This is Episode ten: Endometrial Cancer, Part three — high-risk histologies and Stage three through four-A disease, plus what to do when cancer comes back. Last time we mastered adjuvant therapy for early stage. Today we zoom in on who truly benefits from chemo-radiation, how to reconcile Portec-three with G.O.G. two fifty-eight, how molecular subtype changes the plan, and what first-line therapy...

Last time, we mastered modern staging and SLN mapping. Today, we answer the question you get every week in clinic: Who needs observation, who gets VBT, and who still needs pelvic EBRT? We’ll build the algorithm from GOG 99, PORTEC-1, PORTEC-2, and key updates, and we’ll start with a quick Surgical Corner so we’re crystal-clear on what operation and pathology we’re planning around.

Today we pivot from cervical to endometrial cancer, the most common gynecologic malignancy in the U.S. While many patients present early, outcomes hinge on understanding the biology and the new 2023 FIGO staging that integrates molecular data. We’ll differentiate classic and molecular subtypes, walk the new staging system, and review why sentinel lymph node biopsy (SLNB) is now the standard for no...

For two decades, concurrent cisplatin-based chemoradiation was the uncontested standard for locally advanced cervix cancer. That foundation still stands—but 2023–2024 ushered in real upgrades. Today, we’ll cover what to add (and when) for definitive therapy, and how first-line systemic therapy has changed for metastatic and recurrent disease.

In our last episode, we established why brachytherapy is a mandatory, life-saving component of definitive cervical cancer treatment. Today, we get practical. This is a hands-on workshop covering the "how-to" of brachytherapy. We will walk through the key steps of a tandem and ovoids procedure, learn how to decide when to add interstitial needles, and most importantly, master the dose constraints—t...

In our last episode, we mastered the modern techniques for planning pelvic external beam radiation. But for the definitive treatment of cervical cancer, EBRT is only the first half of the story. The second, non-negotiable component for achieving a cure is brachytherapy. Today, we’re going to build the case for why brachytherapy is mandatory. We’ll review the powerful evidence demonstrating its sur...

In our last few episodes, we’ve focused on the “why” and “when” of treating cervical cancer. Today, we shift to the “how.” This is a practical, hands-on workshop: how to simulate, contour pelvic and para-aortic nodes with modern atlases, justify IMRT over 3D, choose an SIB for nodal disease, execute IGRT correctly, and manage toxicities proactively.

Today, we are tackling one of the most significant paradigm shifts in the history of radiation oncology: the establishment of concurrent chemoradiation as the definitive standard of care for locally advanced cervical cancer. This isn't just an incremental improvement; it was a revolution that dramatically improved survival for our patients. Understanding the key trials that drove this change is ab...

In our last episode, we established the framework for managing newly diagnosed, early-stage cervical cancer. But what happens when the surgeon calls you for a post-op consult? This is one of the most common and highest-yield scenarios you will face. Today, we're going to master the post-operative decision framework, learning exactly when to recommend observation, when to give adjuvant radiation, a...

Welcome back to Rad Onc Smart Review, Gyn cancer series. This is Episode 1: Cervix Cancer Part 1: Staging, Workup, and Early-Stage Evidence. Today, we're laying the foundation for our entire cervical cancer curriculum. We're going to tackle the critical first steps in managing a new diagnosis: understanding the disease's background, how to properly stage a patient using the modern FIGO system, wha...

This is our final episode in the C.N.S. block, Episode 20C: a comprehensive Case-Based Review of Benign C.N.S. Tumors and Stereotactic Radiosurgery cases. Over the last several episodes, we've systematically dissected the evidence that defines modern C.N.S. oncology, from malignant gliomas to a wide range of benign tumors. Let's continue to put that knowledge to the test. This episode is a mock or...

Welcome back to Rad Onc Smart Review, C.N.S. Cancer series. Over the last several episodes, we've systematically dissected the evidence that defines modern C.N.S. oncology. We are continuing our mock oral style review of CNS oncology. I will present comprehensive case blocks, covering different clinical scenarios and then pose a series of questions designed to test your knowledge across all core c...

Over the last several episodes, we've systematically dissected the evidence that defines modern CNS oncology. Today, we put that knowledge to the test. These episodes will follow a mock oral board examination. I will present comprehensive case blocks, covering different clinical scenarios and then pose a series of questions designed to test your knowledge across all core competencies. Pause after...

Episode 19D: Benign P3d: Rare Benign Rapid Review. Needs editing

This is Episode 19c: Benign P3c: Trigeminal Neuralgia – SRS for Functional Pain. Needs editing

This is Episode 19b: Benign P3b: AVM Part 2 - SRS Technique, Doses & Toxicity. Needs editing

This is Episode 19a, the first in our new two-part series on a fascinating and challenging benign condition: Arteriovenous Malformations, or AVMs. To build a foundational understanding of arteriovenous malformations (AVMs) by covering their biology and risk factors, applying the Spetzler-Martin scale to assess surgical risk, calculating annual hemorrhage risk, and critically dissecting the controv...

In our last episode, we mastered the management of non-functioning pituitary adenomas, where the primary goal of radiation is long-term tumor control. Today, we tackle the more complex world of functional, or secreting, pituitary adenomas. Here, the clinical challenge is entirely different. Our goal is not just to control the size of the tumor, but to achieve biochemical control—to shut down the h...

In our last two episodes, we mastered the management of vestibular schwannomas. Today, we shift our focus to another common sellar region tumor: the pituitary adenoma. While often discovered incidentally, these tumors can cause significant morbidity through mass effect. In this episode, we will focus specifically on non-functioning pituitary adenomas, covering their comprehensive workup, surgical...

In our last episode, we established the foundational framework for managing vestibular schwannomas. We worked up our patient, a 55-year-old man with a Koos Grade II tumor and serviceable hearing, and after reviewing the options, decided that stereotactic radiosurgery offered him the best balance of tumor control and functional preservation. Today, we take him to the treatment planning system. This...

Today we're tackling one of the most common non-malignant brain tumors you will treat: the vestibular schwannoma, also known as an acoustic neuroma. While histologically benign, these tumors can cause significant, life-altering morbidity by affecting hearing, balance, and facial function. The management is a masterclass in shared decision-making, balancing excellent tumor control rates against the...

This is Episode 17b: Non-Glioma Part 2: Atypical & Anaplastic Meningiomas & Future Directions. In Episode 17a, we built the essential foundation for understanding meningiomas, covering their epidemiology, detailed WHO grading, and the management of WHO Grade I tumors. Today, we confront the more challenging and clinically critical aspects: the complex management of Atypical (Grade II) and...

This is Episode 17a: Non-Glioma Part 1: Meningioma Foundations & Grade I Management. While gliomas often take the spotlight, the single most common primary intracranial tumor you will encounter is the meningioma. But don't let its often-benign histology fool you; the management of meningiomas is deceptively complex, nuanced, and surprisingly lacking in high-level randomized evidence. Today, we...