Head & Neck Rad/Onc Textbook

[AlphaBetaRatio]

Hey everyone,

I was thinking of adding a dedicated Head & Neck textbook to my library. Has anyone checked out the following book by Dr. Ang & Dr. Garden?

http://www.amazon.com/Radiotherapy-...8-1&keywords=head+and+neck+radiation+oncology

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[Gfunk6]

I bought it and used it to study for oral boards. I also found it invaluable during my first post-residency year.

 

[AlphaBetaRatio]

Awesome, thanks Gfunk. I think I may be treating a fair amount of Head and Neck cases as an attending next year so it looks like a no-brainer purchase.

Did you ever make a thread of what books/study materials were useful for oral boards?

 

[Gfunk6]

I've never made a thread like that. The problem is you only need texts in areas of perceived weakness which will depend on your individual/institutional weaknesses.

In general I think you're better off studying with a group for oral boards rather than reading a textbook.

 

[medgator]

I've never made a thread like that. The problem is you only need texts in areas of perceived weakness which will depend on your individual/institutional weaknesses.

In general I think you're better off studying with a group for oral boards rather than reading a textbook.

Preferably from different institutions. Solid advice.

 

[Seldon1985]

Garden and Ang book is invaluable. Definitely go for it...

 

[Scatter]

Did anyone get Dr. Harrison's book? I heard it's pretty RadOnc-centric. Pls share your impressions.

 

[medgator]

Did anyone get Dr. Harrison's book? I heard it's pretty RadOnc-centric. Pls share your impressions.

I have an old version from several years ago. I mainly bought it (on the cheap) to learn about some of the stuff that hasn't changed (anatomy, description of the various oncologic surgeries etc.) It was pretty comprehensive in that regard.

 

[Pewl]

This Ang & Garden head and neck book is excellent. It's actually very, very useful and practical. The best part is that it has a lot of sample cases with images.

 

[deleted4401]

Hmm. I got the book. Wasn't so thrilled on first go-thru. Read intro, and the description of IMRT was sort of muddled, and claims that IMRT is always Simultaneous Integrated Boost. And, was hoping for some good atlas type stuff - like Nasopharynx - showing how to contour the CTV, etc. Anyway, I'll give it another read through next few days.

 

[Seldon1985]

Personally, I found the cases in each of the chapters to be golden. Many include sample contours of representative slices and isodose curves. from me...

 

[Scatter]

Re: KK Ang & A. Garden's book --- what's the latest edition? I heard the 3rd edition is mostly 2D. :-/

Re: CTV for nasopharynx, SimulD, I always go to RTOG 0225 protocol -- it's never failed me. My H&N attending, who's bril btw, practically declared it catechism:

"CTV70 includes the gross tumor volume seen on MRI. CTV59.4 includes the entire

nasopharynx, retropharyngeal lymph nodal regions, clivus, skull base, pterygoid fossae,parapharyngeal space, inferior sphenoid sinus and posterior third of the nasal cavity andmaxillary sinuses. Whenever possible, fusion of the diagnostic MRI images and thetreatment planning CT images should be performed to accurately delineate the GTV and the surrounding critical normal structures."​

 

[Gfunk6]

I have the 3rd edition (2005) which I believe is the latest. While studying for oral boards, my H&N attending convinced me to memorize 2D fields in response to the question, "you are working in a center without IMRT, what do you do?"

Fortunately, I was never asked about 2D H&N fields . . .

 

[Scatter]

I have the 3rd edition (2005) which I believe is the latest. While studying for oral boards, my H&N attending convinced me to memorize 2D fields in response to the question, "you are working in a center without IMRT, what do you do?"

Fortunately, I was never asked about 2D H&N fields . . .

I was told that 2D is def not asked anymore. Gosh, I hope that's the truth.

 

[deleted4401]

Yeah, the protocol has text, but there isn't an easily accessible atlas that I've found.

No, they won't ask 2D. It's not standard of care. Even if you do 3D-CRT, you should still be using GTV-CTV-PTV, and not using bony landmarks. If they said no IMRT, you could say you'd contour GTV-CTV-PTV, and develop a multifield 3D-CRT plan, usually 6-7 fields, and do your best to meet constraints. Learned all that 2D crap for nothing. It was the equivalent of asking "Well, your patient has an MI, but there are no longer beta blockers and aspirin and statins in the clinic? What do you do?"

S

 

[medgator]

I have the 3rd edition (2005) which I believe is the latest. While studying for oral boards, my H&N attending convinced me to memorize 2D fields in response to the question, "you are working in a center without IMRT, what do you do?"

Fortunately, I was never asked about 2D H&N fields . . .

Yeah, the protocol has text, but there isn't an easily accessible atlas that I've found.

No, they won't ask 2D. It's not standard of care. Even if you do 3D-CRT, you should still be using GTV-CTV-PTV, and not using bony landmarks. If they said no IMRT, you could say you'd contour GTV-CTV-PTV, and develop a multifield 3D-CRT plan, usually 6-7 fields, and do your best to meet constraints. Learned all that 2D crap for nothing. It was the equivalent of asking "Well, your patient has an MI, but there are no longer beta blockers and aspirin and statins in the clinic? What do you do?"

S

Pretty much. They will ask you.... "Well what would YOU do?" When I studied for orals with other residents from other institutions, some of them still did 3-field for post-op H&N. I answered IMRT because that's what I felt comfortable with. They answered 3-field. We both passed.

 

[Scatter]

Pretty much. They will ask you.... "Well what would YOU do?" When I studied for orals with other residents from other institutions, some of them still did 3-field for post-op H&N. I answered IMRT because that's what I felt comfortable with. They answered 3-field. We both passed.

Awesome. I'm gonna IMRT my way through it, I hope.

@ SimulD: I'd say leeches, just for kicks!

 

[deleted4401]

The only hitch arises when it is node + on both sides. The old school examiners will say "Well, what are you sparing then?" Can't get flustered. Just say that's what we used institutionally, and multiple institutions have reported favorable results using IMRT in these patients.

 

[medgator]

The only hitch arises when it is node + on both sides. The old school examiners will say "Well, what are you sparing then?" Can't get flustered. Just say that's what we used institutionally, and multiple institutions have reported favorable results using IMRT in these patients.

Yup. Ditto for node-negative supraglottic larynx. Technically, you don't need IMRT.