RadOnc Smart Review

Welcome back to Rad Onc Smart Review, Head and Neck edition. This is Episode 3: Foundations III — Workup Masterclass: Scope, PET, Pan endo, and Biomarkers. Today is about the discipline of diagnosis. On oral boards, there is a specific way to fail a head and neck case before you ever draw a contour: you jump to treatment before you have established the diagnosis and stage. That signals immaturity....

This is Episode 2: Foundations II — Cranial Nerves, PNI Highways, and the Skull Base.**Last episode, we mapped lymphatics. Today, we map nerves. Because in head and neck oncology, **perineural invasion is not just a pathology word. It is geography.** It is a route problem. When tumor gets into a nerve, it can travel **from a peripheral skin site or gland to the skull base foramina**, and from ther...

This is Episode 1: Foundations I — Neck Levels and Spaces That Change Volumes. We are starting this season with anatomy because in head and neck oncology, anatomy is destiny. If you do not understand the drainage pathways, you cannot draw the target. And if you cannot draw the target, you cannot cure the patient—or worse, you cure them but leave them with avoidable, life-altering toxicity. Today,...

This is Episode 18: *Mock Oral Boards 2 – Vulvar, Vaginal, and Complex Recurrence Cases*. This is our **final episode in the GYN series**. In the **next series, we’ll move on to Breast cancer** and build a new mock oral framework there.**Examiner:** In Episode 17, we focused on cervical and endometrial cancer fundamentals and brachytherapy technique. Today we escalate to the “exam-separating” scen...

Today, we're not just reviewing content; we're practicing the *performance* of the oral boards. I will act as your examiner, providing board-style prompts for eight comprehensive cases, each with a contrasting twist. When you hear the pause, answer out loud, practicing a crisp, structured, and confident response. After each pause, I’ll give you a model answer—a polished performance script—followed...

Welcome back to Rad Onc Smart Review, GYN Series. This is Episode 16: GYN Brachytherapy — The Oral Boards Performance Guide. Today is a mock oral. I’ll ask; you answer. Then I’ll give teaching pearls. Focus on applicator selection, polished procedural scripts, hybrid escalation, plan read-outs, troubleshooting, and complications. Pause after each question to formulate your answer.

Ovarian cancer is dominated by surgery and systemic therapy. As radiation oncologists, we’re expert consultants who step in at critical junctures: to clarify staging and risk, to advise on maintenance systemic strategies that shape recurrence patterns, and to deliver highly conformal radiation for palliation or carefully selected oligometastatic disease. Today we’ll cover surgical staging and cyto...

Today we will master primary vaginal cancer from first principles to planning. We will start with epidemiology, pathophysiology, and the anatomy that dictates nodal targets. We will explain why definitive radiation is the backbone of curative therapy for most stages. Then we will design a complete plan that combines pelvic EBRT with a brachytherapy boost, including when to choose an interstitial i...

Last time we built the algorithm for early vulvar cancer—who needs nodes, how sentinel mapping changes the plan, and when to radiate the vulvar bed and groins. Today we turn to the hard one: locally advanced, unresectable disease. We’ll start by defining “unresectable,” walk through the neoadjuvant chemoradiation evidence, and then do a planning workshop you can take straight to clinic: how to con...

This is Episode twelve: Vulvar Cancer Part one—Foundations and evidence for surgery and adjuvant radiation. Today we build from first principles—epidemiology, pathophysiology, anatomy, workup, and staging—and then walk the decision tree for surgery, nodes, and radiation using four anchor studies: the depth-of-invasion rule from the GOG era, the GROINSS-V pathway for sentinel nodes, the Heaps margi...

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...