Oral boards: IMRT or standard fields?

[napoleondynamite]

For which subsites did people use IMRT vs 3D fields? As recent as just a couple of years ago most of the examinees I spoke with said to do 3D for everything except H&N. Has the pendulum sufficiently swung to IMRT?

Most of us are familiar with traditional fields, but in reality don't use them as much as IMRT for something like say pancreas. Is it more difficult to prepare for 3D when you aren't used to doing it or for IMRT where you have to memorize a zillion dose constraints?

Would love some feedback on what people think on this issue.

Gracias.

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[Brim]

The best advice is to do on boards what you really do in practice.

 

[medgator]

The best advice is to do on boards what you really do in practice.

Correct. Some of the examines will flat out tell you this before the session. "If you do IMRT, answer IMRT. If you do 3D/2D, answer 3D/2D"

Nothing will look worse than trying to wing it during your orals with a technique/method that you've never done before but you've read about on recalls or in books.

 

[Gfunk6]

From talking to folks at other institutions, IMRT is now more or less standard for: H&N, prostate, anal, and post-op Gyn whole pelvis.

IMRT can be justified for lung, esophagus, rectal, lymphoma (if using INRT), pre-op Gyn and complex CNS if you have appropriate experience/training.

But the best advice was given by Brim above. It is unwise to memorize something that you don't routinely do in practice.

 

[napoleondynamite]

Great, thanks guys

 

[CNphair]

I did not learn a single 2D field for the oral boards. In head and neck, I did everything IMRT except a 3D parotid (wedge pair) and larynx. I got 7 or 8 cases. There is absolutely no reason to pretend you treat a nasopharynx or BOT with anything other than IMRT. Assuming you are a recent residency grad.

The one piece of advice I will give is be prepared to draw those IMRT volumes. Know what your CTV/PTV margins will be, where exactly you will anatomically constrain, and what specific nodal groups you want to cover. You can't just get away with "I would use IMRT."

All that being said, I had Nancy Lee and left the exam knowing I had failed that section (I didn't). I will never be able to see her at a conference without heading in the opposite direction. Seriously terrifying.