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ASTRO/ILROG Joint Session - When Every Centigray Counts: Expert Panelists on Approaching and Optimizing the Most Challenging Lymphoma Plans
Ongoing advances in technology have allowed for the shrinkage of target volumes and lowering of doses in the treatment of lymphomas with radiation. Nonetheless, given that the disease distribution and anatomy of each patient with lymphoma is unique, lymphoma cases can be some of the more challenging cases for radiation oncologists in the community. In this educational activity, we hope to provide radiation oncologists, both community based and those specializing in the treatment of hematologic malignancies, with a shared set of tools that can be used to approach and optimize the most challenging lymphoma plans. We survey lymphoma radiation oncology experts to obtain their most challenging treatment planning cases as well as common challenging scenarios in order to provide a variety of tools to troubleshoot these cases to 1) maximize coverage while meeting OAR constraints, 2) choose the correct modality (IMRT, proton, VMAT, limited beam angles), 3) consider omitting certain pre-chemo areas of involvement. Finally, due to the different volume and anatomy of every case as well as unique OAR concerns, lymphoma does not have fixed OAR constraints as many other tumor sites do, thus requiring the RO to make “trade-off” decisions with every case. However, in 2022, the NCCN did publish a radiation section within each lymphoma guideline with published citations and these will be highlighted and reviewed within each topic.
Topics:
- Challenging Dosimetric Cases in Abdominal and Pelvic Lymphomas
John P. Plastaras, MD, PhD - Mediastinal/Axillary Locations
Rachna Malani, MD - Challenging Dosimetric Cases in Extranodal Lymphomas
David Hodgson, MD, FASTRO - Additional Cases and Comments
Full Panel
This activity is available from March 19, 2024, through 11:59 p.m. Eastern time on March 18, 2026.
This activity was originally recorded at the 2023 ASTRO Annual Meeting.
Target Audience
The activity is designed to meet the interests of medical oncologists, radiation oncologists, physicists, radiation therapists, dosimetrists and residents.
Learning Objectives
Upon completion of this activity, participants should be able to:
- Describe when specialized planning modalities should be used to treat lymphomas of the mediastinum.
- Assess when OAR sparing should be prioritized over target coverage as well as describe lymphoma OAR constraints.
- Lena Specht, MD, DMSc., is employed by Rigshospitalet, University of Copenhagen. Dr. Specht serves on the Advisory Board of Takeda and Kyowa Kirin. She receives royalties from Springer Verlag and Munksgaard Publishing. She receives research grant funding from Varian, ViewRay, and the Danish Cancer Society. She serves in leadership roles with the International Lymphoma Radiation Oncology Group (ILROG) as Vice-Chairman and the Danish Lymphoma Group as a Board Member and Chairman of the Radiotherapy Committee.
- Jillian Rebecca Gunther, MD, PhD, is employed by University of Texas MD Anderson Cancer Center. Dr. Gunther receives honoraria from Osler. She serves in leadership roles with ROECSG as a Board Member and ILROG as Vice Chair of the Educational Steering Committee.
- John P. Plastaras, MD, PhD, is employed by Hospital of the University of Pennsylvania. Dr. Plastaras is a member of the Proton Therapy Advisory Committee (IBA) and his spouse serves on the ASTRO Board.
- Bouthaina Dabaja, MD, FASTRO, is employed by The University of Texas MD Anderson Cancer Center. Dr. Dabaja receives research funding from Seattle Genetics and KITE. She serves on the Advisory Board of ONO-Pharma.
- David Hodgson, MD, FASTRO, is employed by Princess Margaret Cancer Centre, University Health Network. Dr. Hodgson also serves as Medical Director of the Pediatric Oncology Group of Ontario.
The person(s) above served as the developer(s) of this activity. Additionally, the Education Committee had control over the content of this activity. All relevant relationships have been mitigated.
The American Society for Radiation Oncology (ASTRO) is accredited by the Accreditation Council of Continuing Medical Education to provide continuing education to physicians.
ASTRO is awarded Deemed Status by the American Board of Radiology to provide SA-CME as part of Part II Maintenance of Certification.
Available Credit
- 1.25 AMA PRA Category 1 Credit™The American Society for Radiation Oncology (ASTRO) is accredited by the Accreditation Council for Continuing Medical Education for physicians. ASTRO designates this Enduring material for a maximum of 1.25 AMA PRA Category 1 Credit™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
- 1.25 Certificate of AttendanceThis activity was designated for 1.25 AMA PRA Category 1 Credit™.
Price
Course Fees:
ASTRO members must log in to the ASTRO website to view and receive the member rate.
Nonmember: $149
Member: $99
Member-in-training: $49
Student/Grad Student/PGY: $49
Postdoctoral Fellow: $49
Policies:
No refunds, extensions, or substitutions will be made for those participants who, for any reason, have not completed the course by the end of the qualification date. The qualification date for each course is listed in the course catalog on the ASTRO website under availability.
Participants using ASTRO's online courses to satisfy the requirement of a Maintenance of Certification (MOC) program should verify the number, type and availability dates of any course before making a purchase. No refunds, extensions, or substitutions will be made for participants who have purchased courses that do not align with their MOC requirement.
The course and its materials will only be available on the ASTRO website until March 18, 2026, regardless of purchase date. At the expiration of the qualification, participants will no longer have access to the course or its materials. ASTRO reserves the right to remove a course before the end of its qualification period.
Required Hardware/software
One of the two latest versions of Google Chrome, Mozilla Firefox, Internet Explorer or Safari.