1. Radiotherapy targeting only para-aortic nodes is insufficient for testicular seminoma patients with a history of pelvic or scrotal surgery, as the primary lymphatic drainage pattern may have been altered. 2. For these cases, the treatment plan should include ipsilateral iliac and inguinal nodes in classic dog-leg AP-PA fields. 3. Prophylactic irradiation of the contralateral iliac, inguinal, or scrotal region may also be indicated for prior maldescensus testis, inguinal or scrotal violation, or pT3/4 primary tumors.

1. DR KANHU CHARAN PATRO
M.D, D.N.B[RT], FAROI, MBA, PDCR, CEPC
APRIL 2021 ISSUE/61st VOLUME
FACE BOOK PAGE
ONCOLOGY CARTOON
PHOTOS
CHAPTER WISE

4. THE MAIN ONCOLOGY JOURNALS
16th MARCH 2021/HISTORY
WIKI
AROI
Dr Kishore Singh
Impact factor-0.791
ESTRO
Michael Baumann
Impact Factor:4.856
ASCO
Jonathan W. Friedberg
Impact Factor: 32.956
LANCET GROUP
David Collingridge
Impact Factor: 33.752
ASTRO
JAMES D. COX
Impact Factor: 5.859
J. E. Tepper
Impact Factor: 4.076
ABS
Michael Zelefsky
Impact Factor: 1.853
IBS/PBS
Adam Chicheł
Impact Factor: 1.627

5. SOME RADIOTHERAPY DISCOVERIES & INVENTIONS
17th MARCH 2020/HISTORY
Joel E. Gray/Radiology/2000

7. KNOW YOUR ONCOLOGY AUTHORS
19th MARCH 2021/HISTORY
WIKI
AROI
Dr Kishore Singh
Impact factor-0.791
ESTRO
Michael Baumann
Impact Factor:4.856
LANCET GROUP
David Collingridge
Impact Factor: 33.752
ASTRO
JAMES D. COX
Impact Factor: 5.859
ABS
Michael Zelefsky
Impact Factor: 1.853
IBS/PBS
Adam Chicheł
Impact Factor: 1.627 Eric J. Hall
Faiz M Khan
Carlos A. Perez
Vincent T. DeVita, Jr,

8. IMPORTANT ICRU REPORTS
20th MARCH 2021/PHYSICS
ICRU WEB SITE
ICRU 29 Dose Specification for. Reporting External Beam. Therapy with Photons & Electrons
ICRU 38 Dose and Volume Specification for Reporting Intracavitary Therapy in Gynecology
ICRU 50 Prescribing, Recording, and Reporting Photon Beam Therapy
ICRU 58 Dose and Volume Specification for Reporting Interstitial Therapy
ICRU 60 Fundamental Quantities and Units for Ionizing Radiation
ICRU 62 Prescribing, Recording and Reporting Photon Beam Therapy Supplement to ICRU 50
ICRU 71 Prescribing, Recording, and Reporting Electron Beam Therapy
ICRU 78 Prescribing, Recording, and Reporting Proton-Beam Therapy
ICRU 83 Prescribing, Recording, and Reporting (IMRT)
ICRU 89 Prescribing, Recording, and Reporting Brachytherapy for Cancer of the Cervix
ICRU 91 Prescribing, Recording, and Reporting of Stereotactic Treatments
LATEST
ICRU 95 Operational Quantities for External Radiation Exposure

9. THE MAIN ONCOLOGY HOSPITALS USA
21st MARCH 2021/HISTORY
WIKI
MD Anderson Cancer Center
(Texas)
Mayo Clinic
(Rochester, Minn.)
MSKCC
(New York City)
Massachusetts hospital
(Boston)
Moffitt cancer center
(Florida)

10. THE MAIN ONCOLOGY HOSPITALS EUROPE
22nd MARCH 2021/HISTORY
WIKI
CHRISTIE HOSPITAL
(Manchester)
Institut Gustave Roussy
Villejuif, France
Netherlands Cancer Institute
Amsterdam, Netherlands
German Cancer Research
Center
Heidelberg
Clatterbridge cancer centre
Bebington & Liverpool

11. KNOW YOUR ONCOLOGY RESEARCH GROUPS
23rd MARCH 2021/HISTORY
WIKI
ASTRO American Society for Radiation Oncology
ESTRO European Society for Radiotherapy & Oncology
RTOG Radiation Therapy Oncology Group
ASCO American Society of Clinical Oncology
ABS American Brachytherapy Society
GOG Gynecologic Oncology Group
NSABP National Surgical Adjuvant Breast and Bowel Project
TROG Trans Tasman Radiation Oncology Group
EORTC European Organization for Research and Treatment of Cancer
ESMO European Society for Medical Oncology
FIGO International Federation of Gynecology and Obstetrics
AROI Association of Radiation oncologists' of India
ICON Indian Cooperative Oncology Network
ISNO Indian Society of Neuro-Oncology
COG Children Oncology Group
POG Paedriatic Oncology Group
IASLC International Association for the Study of Lung Cancer
ILROG International Lymphoma Radiation Oncology Group
WFNOS World Federation of Neuro-Oncology Societies
COGNo The Cooperative Trials Group for Neuro-Oncology
NRG NSABP + RTOG + GOG
SIOP International Society of Paediatric Oncology
ECOG Eastern Cooperative Oncology Group
MRC Medical Research Council
ISEH Society for Hematology and Stem Cells
MSTS Musculoskeletal Tumor Society
AHNS American Head and Neck Society
BIG Breast International Group
NCI National Cancer Institute
ISRS International Stereotactic Radiosurgery Society
AAPM American Association of Physicists in Medicine
ICRU International Commission on Radiation Units & Measurements
ICRP International Commission on Radiological Protection
RSS The Radiosurgery Society
IAEA International Atomic Energy Agency
AERB Atomic Energy Regulatory Board
EANO European Association of Neuro-Oncology
IRSA International Radiosurgery Association
IBS Indian Brachytherapy Society
SWOG Southwest Oncology Group

12. KNOW YOUR ONCOLOGY GUIDELINE GROUPS
24th MARCH 2021/HISTORY
WIKI
GROUP FULL FORM ABOUT LINK
ASTRO AMERICAN SOCIETY FOR RADIATION ONCOLOGY RADIOTHERAPY https://www.astro.org/Patient-Care-and-
Research/Clinical-Practice-Statements
ESTRO EUROPEAN SOCIETY FOR RADIOTHERAPY & ONCOLOGY RADIOTHERAPY https://www.estro.org/Science/Guidelines
RTOG RADIATION THERAPY ONCOLOGY GROUP RADIOTHERAPY https://www.rtog.org/
ASCO AMERICAN SOCIETY OF CLINICAL ONCOLOGY ONCOLOGY https://www.asco.org/
ABS AMERICAN BRACHYTHERAPY SOCIETY BRACHYTHERAPY https://www.americanbrachytherapy.org/
NCCN NATIONAL COMPRESSIVE CANCER NETWORK ONCOLOGY https://www.nccn.org/professionals/physician_
gls/default.aspx#site
TROG TRANS TASMAN RADIATION ONCOLOGY GROUP RADIOTHERAPY https://www.trog.com.au/
ESMO EUROPEAN SOCIETY FOR MEDICAL ONCOLOGY ONCOLOGY https://www.esmo.org/guidelines
ISNO INDIAN SOCIETY OF NEURO-ONCOLOGY BRAIN TUMORS http://isno.in/
ILROG INTERNATIONAL LYMPHOMA RADIATION ONCOLOGY
GROUP
LYMPHOMA https://www.ilrog.org/
NICE NATIONAL INSTITUTE OF HEALTH AND CARE
EXCELLENCE
ONCOLOGY https://www.nice.org.uk/guidance/conditions-
and-diseases/cancer
DEGRO ARBEITSGRUPPE RADIOCHIRURJI/STEREOTAXIE RADIOTHERAPY https://www.degro.org/ag-stereotaxie/practice-
guidelines-of-the-degro-working-group-
stereotactic-radiotherapy-radiosurgery/

13. DR SUBIR NAG
25th MARCH 2021/HISTORY
WIKI
• Dr. Subir Nag, MD is a radiation
oncology specialist in Santa Clara,
CA.
• Dr. Nag completed a residency at
Montefiore Medical Center - Moses
Division.
• He currently practices at Kaiser
Santa Clara Cancer Treatment
Center and is affiliated with Kaiser
Permanente Santa Clara Medical
Center.
• He authored the principles and
practice of brachytherapy book.
• Credited with may articles on
brachytherapy in various journals
• Radiation oncology from AIIMS
Delhi alumni

14. PROF B D GUPTA
26th MARCH 2021/HISTORY
B K MOHANTI/JCRT/2018
• Prof BD Gupta was born in Uttar Pradesh
on March 8, 1934. After graduating from
Medical College, Agra, he did his post
graduation in radiology (combined radio-
diagnosis and radiotherapy) under Dr PK
Haldar.
• He obtained the FRCR degree from
London and returned to India to
exclusively practice radiotherapy and
oncology
• BD Gupta died in his sleep in his home at
Panchkula, on the outskirt of Chandigarh,
on the night of September 17, 2017
• He was a founder member of Association
of Radiation Oncologists of India, Atomic
Energy Regulatory Board, and the
National Cancer Control Program (NCCP),
India

15. Professor Minesh Mehta
27th MARCH 2021/HISTORY
WIKI
• Professor Minesh P Mehta, MD, FASTRO, is an
American radiation oncologist and physician-
scientist of Indian origin, Ugandan birth, Zambian
Schooling and American Training, who
contributed to the field of oncology for more than
two and half decades
• A well-respected clinician and researcher, Dr.
Mehta has over a thousand publications,
including medical journal manuscripts, book
chapters, and professional abstracts, and serves
on the editorial board of several peer-reviewed
journals.
• Additionally, through his work in the RTOG and
other clinical trial mechanisms he was
instrumental in setting new standards in clinical
research on Brain Metastases through a series of
well-conducted multicenter, international,
randomized trials, incorporating both traditional
and novel endpoints, resulting in the most robust
neurologic and neurocognitive dataset collection
and evaluation for this condition

16. PROF. MICHAEL BRADA
28th MARCH 2021/HISTORY
Google
• Professor Brada was the President of ESTRO
(2003-2005) and President of EANO
(European Association of Neuro-oncology)
nurtured a young organisation towards the
principal European force it is now.
• He has been a leader in the development of
radiotherapy in neuro-oncology, with
benchmark studies of technical aspects and
clinical outcome of stereotactic radiotherapy
and key studies of late toxicity of cranial
irradiation.
• He has also made a major contribution to
chemotherapy and radiotherapy in glial
tumours and brain metastases.
• In lung cancer he developed and tested
novel technologies including motion
management techniques and high precision
irradiation.
• Throughout his career has been a passionate
believer in evidence based medicine

17. Guideline on Diet and Physical Activity for Cancer Prevention
29th March 2021/PREVENTION
Cheryl L. Rock/ CA CANCER J CLIN 2020

18. RISK FACTORS FOR BRAIN METASTASIS IN BREAST CANCER
30th March 2021/BREAST
Bernardo Cacho-Díaz/CANCER /2020
Look at p value and analyze

19. STEMMER'S SIGN IN POST OP LYMPHEDEMA
31st MARCH 2021/BREAST
Google- Courtesy –Dr Priyasha
1. Stemmer's Sign, a thickened skin fold
at the base of the second toe or second
finger that is a diagnostic sign for
lymphedema.
2. Stemmer Sign is positive when this
tissue cannot be lifted but can only be
grasped as a lump of tissue; it is
negative when it is possible to lift the
tissue normally

20. A. Pseudo‐chilblains lesions on
toes of a 17‐year‐old patient.
B. Erythemato‐purpuric
macules with undefined
limits on the heel of a
COVID‐19 suspected patient.
C. Palpable purpura lesions on
the lower extremities of a
patient with COVID‐19
pneumonia.
D. Polymorphic papulovesicular
eruption on a patient
presenting simultaneously
with palpable purpura on
the lower extremities.
E. Targetoid lesions at a
delayed phase of COVID‐19
pneumonia.
F. Maculopapular exanthem on
a patient recovered from
pneumonia; RT‐PCR test
persisted positive.
DERMATOLOGICAL MANIFESTATION OF COVID-19
Jour. of Euro.Academy of Dermato & Venereology, /June 2020 1st APRIL 2021/COVID

21. BRAIN METASTASIS CAVITY DYNAMICS- WHEN TO START SRS?
Majed Alghamdi/ Jour. of Radiosurgery and SBRT/2018 2nd APRIL 2021/STEREOTAXY
Caution must be taken when treating cavities in the early(<21 days) interval after surgery as
it may lead to irradiating more normal tissue especially in small tumors

22. OPTIC NERVE SHEATH MENINGIOMA RT GUIDELINE
Jeffrey V./PRO/2013 3rd APRIL 2021/BRAIN

23. SABR-COMET STUDY- LONG TERM RESULTS
David A. Palma/JCO/2020
1. Between 2012 and 2016, 99 patients
were randomly assigned at 10
centers internationally.
2. The most common primary tumor
types were breast (n =18), lung (n
=18), colorectal (n = 18), and
prostate (n = 16).
3. Median follow-up was 51 months.
4. The 5-yr OS rate was 17.7% in pall
arm versus 42.3% in SABR arm ( P=
.006).
5. The 5-year PFS rate was not reached
in pall arm(3.2%; 95% CI, 0% to 14%
at 4 years with last patient
censored) and 17.3% in SABR arm P
.001).
6. There were no new grade 2-5
adverse events and no differences in
QOL between arms.
4th APRIL 2021/HCC

24. RADIOLOGY OF BUCCAL SPACE
Google 5th APR 2021/RADIOLOGY
The boundaries
1. The angle of the mouth anteriorly
2. The masseter muscle posteriorly
3. The zygomatic process of the maxilla and
the zygomaticus muscles superiorly,
4. The depressor anguli oris muscle and the
attachment of the deep fascia to the
mandible inferiorly,
5. The buccinator muscle medially (the buccal
space is superficial to the buccinator)
6. The platysma muscle, subcutaneous tissue
and skin laterally (the space is deep to
platysma)
Content
1. The buccal fat pad
2. The parotid duct (stenson's duct)
3. The anterior facial artery and vein
4. The transverse facial artery and vein

25. RADIOLOGY OF PARAPHARYNGEAL SPACE
6th APRIL 2021/RADIOLOGY
Google

26. RADIOLOGY OF RETROSTYLOID SPACE
7th APR 2021/RADIOLOGY
Google

27. RADIOLOGY OF PAROTID SPACE
8th APR 2021/RADIOLOGY
Google
Contents
1. Parotid Glands
2. Intraparotid Lymph Nodes
3. Intraparotid Facial Nerve
4. External Carotid Artery
5. Retromandibular Vein
Boundaries
1. Medially: the parapharyngeal space
2. Laterally: superficial space and
subcutaneous tissue
3. Posteriorly: the carotid space
▪ Posterior belly of the digastric muscle
forms a variable portion of the
posteromedial border of the parotid
space and separate the parotid space
lesion from the carotid space
4. Anteriorly: masticator space
5. Superiorly: external auditory canal;
apex of the mastoid process
6. Inferiorly: inferior mandibular margin
(although the parotid tail can extend
further inferiorly below the angle of the
mandible)

28. SRS DOSES FOR BRAIN LESIONS
BOOK-CLINICAL APPLICATION OF SRS AND SBRT 9th APR 2021/STEREOTAXY

29. TARGET IN SEMINOMA TESTIS WITH SCROTAL VIOLATION
Richard B. Wilder/2012/IJROBP 10th APR 2021/TESTIS
1. Radiotherapy directed to the para-
aortic nodes alone is not sufficient in
patients with a history of pelvic or
scrotal surgery because the pattern of
primary lymphatic drainage has been
altered and may no longer be confined
to the para-aortic region.
2. In these cases, inclusion of ipsilateral
iliac and inguinal nodes in classic dog-
leg AP-PA fields is indicated
3. Prophylactic irradiation of the contra
lateral iliac, inguinal, or scrotal region
for prior maldescensus testis, inguinal
or scrotal violation, or pT3/4 primary
tumors is not indicated.
4. Avoid testicular FNAC/BIOPSY and
SURGERY in suspected testicular mass

30. RADIATION DOSE SEMINOMA-IA/IB/IS
Jones WG/2005/JCO 11th APR 2021/TESTIS
1. Medical Research Council Trial TE18 showed that 20Gy in 10 daily 2.0Gy
fractions is not inferior to 30Gy in 15 daily 2.0Gy fractions .
2. 625 patients were randomly assigned to treatment
3. Like 25.5Gy in 15 daily 1.7Gy fractions over 3 weeks, 20Gy in 10 daily 2.0-Gy
fractions over 2 weeks results in excellent survival and freedom from relapse.
4. In conclusion, this study has shown that, compared with 30Gy given in 15
fractions during 3 weeks, 20Gy given in 10 fractions during 2 wks produces
excellent results, with less inconvenience to the patient in terms of the numbers
of hospital visits and severity of adverse effects, allowing a speedier resumption
of normal living.

31. FIELD AND DOSE IN SEMINOMA IA or IB
Richard B. Wilder/2012/IJROBP 12th APR 2021/TESTIS
1. Patients with no history of pelvic or scrotal surgery
before inguinal orchiectomy have traditionally been
treated with opposed AP-PA fields from the top of the
T11 vertebral body to the bottom of the L5 vertebral
body.
2. Para-aortic fields based on bony anatomy are
approximately 9 to11 cm wide.
3. Lateral borders have traditionally been placed at the
tips of the transverse processes.
4. Several groups advocate inclusion of the left renal hilum
in AP-PA fields for left sided testicular seminoma.
5. Left renal hilar nodes are commonly included in AP-PA
fields when the left lateral border is placed at the most
lateral tips of the transverse processes of the T12-L5
vertebrae.
6. Typically, the L5 vertebra has transverse processes that
extend the farthest laterally.
7. Nodal mapping studies suggest that inclusion of left
renal hilar nodes in a nodal CTV may be optional in a
patient with a relatively lateral left kidney

32. FIELD AND DOSE IN SEMINOMA IIA or IIB
13th APR 2021/TESTIS
Clinical Stage IIA or IIB
1. UPPER BORDER- 2CM BELOW KIDNEY
2. LOWER BOREDR –UPPER BORDER ACETABULUM
3. LATERAL BORDER- for the lower part of modified
dog-leg fields is defined by a line from the tip of
the ipsilateral transverse process of the fifth
lumbar vertebra to the superolateral border of
the ipsilateral Acetabulum
4. MEDIAL BORDER -May be drawn from the tip of
the contra lateral transverse process of the fifth
lumbar vertebra toward the medial border of the
ipsilateral obturator foramen.
5. BOOST-2-cm margin on the retroperitoneal
adenopathy
6. PTV1-20Gy/10FRACTION
7. PTV2 BOOST- 10 Gy in 5 fractions over for
clinical Stage IIA disease and 16 Gy in 8 fractions
Richard B. Wilder/2012/IJROBP

33. PA NODE IN SEMINOMA TESTIS BASED ON CTV
Richard B. Wilder/2012/IJROBP 14th APR 2021/TESTIS
1. Nodal CTV should include the paracaval, precaval,
and interaortocaval lymph nodes for right-sided
testicular seminomas and at least the lateroaortic
and preaortic lymph nodes for left-sided testicular
seminomas.
2. Others have suggested inclusion of similar lymph
node groups in a nodal CTV .
3. One should contour the inferior vena cava and
aorta separately from 2 cm below the top of the
kidneys down to the point where these blood
vessels end.
4. One may provide a 1.2-cm expansion on the
inferior vena cava and a larger, 1.9cm expansion on
the aorta to include the Later-aortic nodes,
thereby creating a nodal CTV1.
5. Bone and bowel should be excluded from CTV1.
6. A uniform 0.5-cm margin should be provided on
CTV1 to create a planning target volume (PTV1)
that accounts for treatment setup errors

34. ABCDE APPROACH FOR LIFESTYLE MODIFICATION
A FOR AWARENESS B FOR BP CONTROL C FOR CIGARETTE STOP
D FOR DIABETES CONTROL AND DIET MODIFICATION
GOOGLE 15th APR 2021/PUBLIC