Head and Neck Cancer

Contouring and Plan Evaluation Curriculum Overview

Open to radiation oncology residents and consultants, as well as medical physicists interested in bettering their anatomy and contouring.

 

Goal: improve ability to contour accurately, confidently, and critically evaluate structures and plans (coverage, conformality, heterogeneity, gradient, and DVH)

 

  • While directly improving ability to provide high quality care to patients

  • Easy to participate and opportunities to ask any questions with passionate experts

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  • Curriculum Design:

Benjamin Li, MD, MBA

Parag Sanghvi, MD, MSPH

  • Supporting Educators: 10

  • Sessions: 16

Curriculum Outline
Wave

1. Introduction and overview of H&N Contouring, importance, and clinical significance (impact on outcomes, toxicities, and economics)

 

2. Contouring the GTV (gross tumor volume) – with Radiation Oncologist expert

  • If you are going to treat the patient with the intent for cure, make sure that you prescribe the dose correctly! Or else the patient will receive a treatment with no actual benefit and that only causes significant harm and toxicity.

  • Resources for CTV expansions

 

3. Contouring the LN (lymph node) stations – with Radiation Oncologist expert

  • Session a – LN I and II, any relevant OARs (organs at risk) and disease site tips

  • Session b – LN III and IV, any relevant OARs, and disease site tips

  • Session c – LN Va and Vb, any relevant OARs, and disease site tips

  • Session d– LN VI and VII, any relevant OARs, and disease site tips

 

4. Contouring cranial nerves (e.g. for perineural invasion)

  • Show atlases

 

5. Contouring OARs (organs at risk) – with Dosimetrist and Radiation Oncologist

  • Explanations for the clinical importance of each OAR

  • Review of dose constraints

  • Review of supporting literature

 

6. Plan evaluation – with Dosimetrist and Radiation Oncologist experts

  • Session a – Overview of a perfect method for plan evaluation, with an example

  • Session b – Practice plan evaluations of participants’ submitted cases

  • Session c – More practice plan evaluations of participants’ submitted cases

  • Dosimetrists will also provide advice and techniques to participating medical physicists to help achieve planning goals (e.g. in 2D, in 3D-CRT, and in IMRT)

 

7. Final Evaluation

  • Each participant will be given the same standardized case to contour

  • They will bring this case to the session, completed beforehand.

  • They will receive real-time feedback on each plan during the session! Participants will be asked to provide their commentary before the expert provides his/her own. The expert can show his gold-standard plan.

Gradient

Videos

Introduction to ProKnow and instructions for pre-curriculum case

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Ben Li, MD

Radiation Oncologist

Becky Lee

Radiation Oncologist

Loma Linda University

University of California, San Francisco

Introduction and overview of H&N Contouring (Part 1)

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Parag Sanghvi, MD, MSPH

Radiation Oncologist

University of California San Diego

Contouring the GTV (Case-Based Learning a.k.a. "CBL")

Radiation Oncologist

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Jason Chan, MD

University of California San Francisco

Introduction and overview of H&N Contouring (Part 1)

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Parag Sanghvi, MD, MSPH

Radiation Oncologist

University of California San Diego

Plan evaluation: Part 1 Establishing a Perfect Method

Dosimetrist

Kiran Hudka

University of California San Francisco

Contouring - Level I & II lymph nodes + OARs (CBL) talk about importance in the context of which disease sites these are relevant for

Radiation Oncologist

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Kenneth Hu, MD

New York University

Contouring - Level III and IV lymph nodes + OARs (CBL)

Radiation Oncologist

Samir Patel,  MD

Mayo Clinic

Contouring- Level V lymph nodes + OARs (CBL)

Radiation Oncologist

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Lisa McGee, MD

Mayo Clinic

Contouring- Level VI and VII lymph nodes + OARs (CBL)

Radiation Oncologist

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JAna Kiess, MD

Johns Hopkins University

Contouring cranial nerves (e.g. for perineural invasion) (CBL)

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Parag Sanghvi, MD, MSPH

Radiation Oncologist

University of California San Diego

Organs at risk, clinical relevance, and dose considerations - library of plans, doses, and functional outcomes

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Parag Sanghvi,

MD, MSPH

Radiation Oncologist

University of California,

San Diego

Adenike Olanrewaju

Dosimetrist

The University of Texas

MD Anderson Cancer Center

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Introduction to Radiation Oncology in the Philippines

Jickson Flores, MD

Radiation Oncologist

Plan evaluation: Part 2 Practice (CBL)

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Jay Reddy, MD

Radiation Oncologist

The University of Texas

MD Anderson Cancer Center

Plan evaluation: Part 3 More Practice (CBL)

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Amy Moreno, MD

Radiation Oncologist

The University of Texas

MD Anderson Cancer Center

Opportunity for Next Directions: RCC in Asia (presentation to SEAROG)

Jickson Flores, MD

Radiation Oncologist

Contouring Level VIII, IX, and X nodes

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Parag Sanghvi, MD, MSPH

Radiation Oncologist

University of California San Diego

Challenging H&N cases: Contouring

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Parag Sanghvi, MD, MSPH

Radiation Oncologist

University of California San Diego