Radiation Oncology

NCI-CCC Tumor Board Question   

These are questions being discussed by academics at NCI-Cancer Centers

Questions discussed in this category


For example, a large iliac or sacral plasmacytoma causing symptoms. Both medical oncologists and radiation oncologists get nervous about RT-related cy...

If CCRT is pursued, would you move forward with durvalumab consolidation? Assume the patient with ECOG PS 0 and no co-morbidities. How might this chan...

Young healthy patient, ER/PR positive HER2 negative right breast cancer with a synchronous single site of oligometastatic disease in the right 4th rib...

Patients are understandably concerned about the risks and benefits of radiation to an oozing, bleeding, and ulcerated breast.

Would you treat this as a locally advanced breast cancer and offer surgery, radiation, and systemic therapy? Does your management change depending on ...

NGS without any actionable mutations and PD-L1 TPS 15%. Would you offer chemotherapy, radiation, or immunotherapy and, if so, in what order?

Do you routinely offer post-operative adjuvant radiation in addition to chemotherapy? Are the results of the recently published negative phase II...

Would you use it for initial staging or at time of biochemical recurrence?

GS 4+4. PSA low (1-2). CT and bone scan negative for lymphadenopathy or metastatic disease.  Prostate MRI pending. 

Colleagues in surgery have raised concerns about post radiation effects in the pelvis with the ordering of short course RT->chemo ->surgery.

Is there any role for denosumab? How do you counsel patients regarding the benefit of bisphosphonates on breast cancer outcomes?

Does patient age effect your approach? Would you consider RPLND for any patients in light of the phase II SEMS trial presented at the 2021 ASCO GU Ca...

History of CDH1 mutation and prophylactic gastrectomy in 2017 - no other primary site found beyond vagina at diagnosis. Vaginal tumor completely resp...

What clinicopathological features would need to be present for you to recommend adjuvant chemotherapy? Would you treat pT3 disease? Any specific histo...

Specifically, would you offer salvage radiation to a patient who underwent a prostatectomy with PLND and had a post-op PSA of 12 with pathology reveal...

Specifically, for cT2N0M0 small cell bladder cancer without response to neoadjuvant cisplatin and etoposide on imaging, would you proceed with cystect...

Tumor felt to be technically unresectable due to extensive cervical/parametrial involvement. ER/PR and HER2 testing are pending.

The patient went straight to gastrectomy for clinical T1 gastric adenocarcinoma, but post-op was up-graded to T4 disease.   Both ARTIST and Inte...

Should staging and treatment decisions be made based on imaging alone?

Most trials establishing CRT as standard of care for IIIB NSCLC excluded patients with separate ipsilateral lung nodules given that they were categori...

In clinical practice, consolidation chemotherapy is sometimes used, though this was not implemented in the PACIFIC trial.Antonia et al., PMID 28885881...

No other site of metastatic disease. It is unclear if this situation should be managed as two separate primaries or metastatic disease.

Do your recommendations differ if patients are pre or postmenopausal given the data?

When would you favor delivering local therapy (e.g. SBRT) prior to systemic therapy?

These patients have been largely excluded from these trials.  What if the infection is well controlled?

This is in regards to the risk of secondary cancers after radiation therapy or cytotoxic chemotherapy (such as anthracyclines) in an immunosuppre...

How would the new data presented at ASCO GI 2021 from from Alliance A021501 influence your answer?


Papers discussed in this category


International journal of radiation oncology, biology, physics, 2013-03-15

International journal of radiation oncology, biology, physics, 2011-05-01

International journal of radiation oncology, biology, physics, 2011-11-01

Lancet, 2017-09-09

Journal of the National Cancer Institute, 2006-12-20

Medicine and science in sports and exercise, 2010-07

J Clin Oncol, 2016 Feb 20

Curr Breast Cancer Rep, 2016-01-01

Crit Rev Food Sci Nutr, 2018 Apr 19

JAMA, 2018-02-20

JAMA Oncol,

Int J Radiat Oncol Biol Phys, 2023 Mar 01

Breast Cancer, 2012 Apr 25

Annals of surgical oncology, 2018-10

Lancet Oncol., 2015 Sep 09

J Clin Oncol, 2022 Jan 07

JAMA oncology, 2019-06-01

Lancet Oncol, 2021 Jun 11

The New England journal of medicine, 2018-12-13

N Engl J Med, 2017 Nov 16

Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2008-12-10

The Lancet. Oncology, 2012-07

Annu. Rev. Med., 2015 Aug 28

Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2017-06-20

Lancet,

Lancet Oncol, 2019 Feb 19

Lancet Oncol, 2019 Dec 02

Lancet Oncol, 2017 Oct 13

JNCI Cancer Spectr, 2021 May 28

Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2017-01

Arch Surg,

Lancet, 1998 Jul 25

Int. J. Radiat. Oncol. Biol. Phys., 2008-11-01

JAMA Oncol,

Lancet Oncol, 2021 Dec 15

J. Clin. Oncol., 2020 Feb 27

Lancet Oncol., 2020 Feb 14

International journal of radiation oncology, biology, physics, 2005-07-15

Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2012-07-01

The New England journal of medicine, 2001-09-06

Lancet Oncol, 2020 Dec 07

Ann Oncol,

Lancet Oncol, 2021 Apr 13

Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2014-12-10

N. Engl. J. Med., 2017-07-27

Ann. Oncol.,

Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2005-02-01

JAMA Oncol,

Urology, 2001-08

Gynecologic oncology, 2014-11

Practical radiation oncology, 2019

The New England journal of medicine, 2017-07-27

JAMA Oncol, 2021 Feb 18

Clinical genitourinary cancer, 2017-06

The Journal of urology, 2014-02

International journal of radiation oncology, biology, physics, 2018-10-01

Urology, 2000-11-01

Abdom Radiol (NY), 2019 Aug 29

Lancet, 2021 May 07

N. Engl. J. Med., 2016-10-13

Lancet, 2020 Sep 28

Lancet Oncol,

Lancet Oncol,

J Urol, 2020 Apr 13

Eur J Nucl Med Mol Imaging, 2020 Aug 12

J Urol,

Gynecologic oncology, 2019-06

Gynecol Oncol, 2021 Mar 05

J Urol, 2021 Feb 26

N. Engl. J. Med., 2012-04-19

European urology, 2017-07

Prostate, 2022 Jun 08

Ann Surg,

Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2019-06-20

BMC Cancer, 2019 Aug 19

Breast Cancer Res Treat, 2009 Jun

The Journal of community and supportive oncology, 2014-10

Journal of the National Cancer Institute, 1996-10-16

The oncologist, 2019-03

Breast cancer research and treatment, 2019-04

Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology, 2020 Apr 22

Annals of oncology : official journal of the European Society for Medical Oncology, 2020 Sep 23

Annals of surgical oncology, 2020 Oct 30

JAMA oncology, 2021 Jan 01

Annals of oncology : official journal of the European Society for Medical Oncology, 2021 Oct 19

Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2023 May 26

Journal of the National Comprehensive Cancer Network : JNCCN, 2020 Sep

Radiology, 2012 Dec 06

Annals of oncology : official journal of the European Society for Medical Oncology, 2019-08-01

J Thorac Oncol, 2023 Feb 23

J Clin Oncol, 2023 Jan 31

Cancer journal (Sudbury, Mass.), 2020 Nov/Dec

Journal of thoracic oncology : official publication of the International Association for the Study of Lung Cancer, 2021 Feb 12

Journal for immunotherapy of cancer, 2021 Aug

International journal of cancer, 2019 Feb 19

The Lancet. Respiratory medicine, 2023 May 05

N Engl J Med, 2022 Apr 11

Blood, 2023 Nov 30

Cancer, 2011-10-01

BMC Cancer, 2006 May 05

International journal of radiation oncology, biology, physics, 1998-07-15

International journal of radiation oncology, biology, physics, 2006-01-01

Blood, 2014 May 29

Blood, 2014 Jun 17

International journal of radiation oncology, biology, physics, 2011 Jan 27

International journal of radiation oncology, biology, physics, 2024 Oct 27

Scientific reports, 2022 Nov 29

Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2009-12-10

Blood, 2015 Jun 24

Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2009 Oct 05