Head and Neck Cancer Contouring and Plan Evaluation
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)
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While directly improving ability to provide high quality care to patients
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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
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Supporting Educators: 10
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Sessions: 16
Curriculum Outline
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
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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.
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Resources for CTV expansions
3. Contouring the LN (lymph node) stations – with Radiation Oncologist expert
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Session a – LN I and II, any relevant OARs (organs at risk) and disease site tips
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Session b – LN III and IV, any relevant OARs, and disease site tips
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Session c – LN Va and Vb, any relevant OARs, and disease site tips
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Session d– LN VI and VII, any relevant OARs, and disease site tips
4. Contouring cranial nerves (e.g. for perineural invasion)
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Show atlases
5. Contouring OARs (organs at risk) – with Dosimetrist and Radiation Oncologist
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Explanations for the clinical importance of each OAR
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Review of dose constraints
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Review of supporting literature
6. Plan evaluation – with Dosimetrist and Radiation Oncologist experts
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Session a – Overview of a perfect method for plan evaluation, with an example
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Session b – Practice plan evaluations of participants’ submitted cases
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Session c – More practice plan evaluations of participants’ submitted cases
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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
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Each participant will be given the same standardized case to contour
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They will bring this case to the session, completed beforehand.
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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.
Videos
Introduction to ProKnow and instructions for pre-curriculum case
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)
Parag Sanghvi, MD, MSPH
Radiation Oncologist
University of California San Diego
Contouring the GTV (Case-Based Learning a.k.a. "CBL")
Radiation Oncologist
Jason Chan, MD
Introduction and overview of H&N Contouring (Part 1)
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
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
Lisa McGee, MD
Mayo Clinic
Contouring- Level VI and VII lymph nodes + OARs (CBL)
Radiation Oncologist
JAna Kiess, MD
Johns Hopkins University
Contouring cranial nerves (e.g. for perineural invasion) (CBL)
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
Parag Sanghvi,
MD, MSPH
Radiation Oncologist
University of California,
San Diego
Adenike Olanrewaju
Dosimetrist
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The University of Texas
MD Anderson Cancer Center
Introduction to Radiation Oncology in the Philippines
Jickson Flores, MD
Radiation Oncologist
Plan evaluation: Part 2 Practice (CBL)
Jay Reddy, MD
Radiation Oncologist
The University of Texas
MD Anderson Cancer Center
Plan evaluation: Part 3 More Practice (CBL)
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
Parag Sanghvi, MD, MSPH
Radiation Oncologist
University of California San Diego
Challenging H&N cases: Contouring
Parag Sanghvi, MD, MSPH
Radiation Oncologist
University of California San Diego