Killing me. Trying to study for oral boards and there have literally been 2 or 3 major revisions in past year. When I looked 1 year ago, interim PET/CT recommended for HD. Few months ago, rec is changed to "CT scan through region of interest" for early stage. Look today, now back to interim PET with Deauville criteria. Jesus Christ, can you wait till after June?
nccn lymphoma guidelines
- Thread starter Reaganite
- Start date
D
deleted4401
That's crazy, man.
As a survivor (of boards, not lymphoma), I recommend not killing yourself in the details. You won't fail because you said CT, instead. You will fail if you recommend a full mantle for someone without a CI for chemotherapy.
As a survivor (of boards, not lymphoma), I recommend not killing yourself in the details. You won't fail because you said CT, instead. You will fail if you recommend a full mantle for someone without a CI for chemotherapy.
Last edited by a moderator:
- Joined
- Feb 11, 2005
- Messages
- 593
- Reaction score
- 475
agree with SimulD. The examiner is not going to ask you NCCN guidelines, but rather what you would do to work-up and treat the patient. As long as you dont deviate so for from the standard of care that you harm the patient you should be OK.
Agree with the above. I actually said CT for early stage HDz (to eval response to chemo) last year only because that is what was in NCCN guidelines at the time. My examiner actually said something along the lines of "what is this 1990?"
Thank you for the responses! Going through the usual pre-exam jitters so probably seriously overreacting!
D
deleted4401
I think lymphoma used to be a real killer, but now it's swung the other way. I walked into just having been reamed without KY by Zietman, and Lynn Wilson could tell I was shaken up. He basically told me the answers 🙂
- Joined
- Sep 20, 2004
- Messages
- 12,368
- Reaction score
- 12,849
Speak for yourself 🙂 Got reamed a plenty for mentioning IFRT and waffling on using HD10 data for early-favorable HD the year of its publication 😀
When I got on my flight out of Louisville, I was almost sure the return trip would be because of that section.....
- Joined
- Nov 28, 2005
- Messages
- 844
- Reaction score
- 77
Holy crap guys this is such a nerve-wracking process. It's gonna be so damn nice to have this exam behind you.
Is it normal that after you study one section you feel like a rock star in that section, then you move on to GU and you're like, "what's a prostate?" It's not so bad to tackle each section one at a time..but crud, I can't believe how hard it is to keep all of it in your head at once for every section..
Is it normal that after you study one section you feel like a rock star in that section, then you move on to GU and you're like, "what's a prostate?" It's not so bad to tackle each section one at a time..but crud, I can't believe how hard it is to keep all of it in your head at once for every section..
D
deleted4401
I saw that. They say ISRT, but it's undefined. Maybe use the Vancouver group's involved nodal margins?
Prostate/GU is indeed rough. I mean, it's stinking prostate cancer. If they were reasonable and tested actual prostate cancer cases, it would be super easy since that's bread and butter (which they should do, the point is to make sure we're practicing medicine safely in the community). Instead, the guy spent 10 minutes on prostate MRI anatomy (which was my own fault, I wasn't completely prepared for it, make sure you know what median lobe hypertrophy looks like!), another 5 minutes on CT anatomy, and then 5 minutes on what time frame it would be appropriate to start adjuvant RT for prostate (based on this symptom and that symptom). Started a bladder case, but it was something completely unusual and didn't even get to discuss management.
We didn't do one dose, didn't discuss any constraints, didn't talk about hormones or not hormones. We didn't discuss GTV/CTV/PTV. We didn't talk about pelvis vs prostate only. We didn't go through a seeds case. We didn't go through the bladder preservation regime. We didn't go through the observation scheme for testicular cancer. We didn't draw a PA strip field. The whole experience was a waste of my time, and probably a waste of his. He passed me.
Any one of you Harvard residents want to ask him what the point of this was?
Prostate/GU is indeed rough. I mean, it's stinking prostate cancer. If they were reasonable and tested actual prostate cancer cases, it would be super easy since that's bread and butter (which they should do, the point is to make sure we're practicing medicine safely in the community). Instead, the guy spent 10 minutes on prostate MRI anatomy (which was my own fault, I wasn't completely prepared for it, make sure you know what median lobe hypertrophy looks like!), another 5 minutes on CT anatomy, and then 5 minutes on what time frame it would be appropriate to start adjuvant RT for prostate (based on this symptom and that symptom). Started a bladder case, but it was something completely unusual and didn't even get to discuss management.
We didn't do one dose, didn't discuss any constraints, didn't talk about hormones or not hormones. We didn't discuss GTV/CTV/PTV. We didn't talk about pelvis vs prostate only. We didn't go through a seeds case. We didn't go through the bladder preservation regime. We didn't go through the observation scheme for testicular cancer. We didn't draw a PA strip field. The whole experience was a waste of my time, and probably a waste of his. He passed me.
Any one of you Harvard residents want to ask him what the point of this was?
- Joined
- Apr 16, 2004
- Messages
- 4,902
- Reaction score
- 6,042
I feel your pain having gone through this process myself. However, I do think you need to cut these guys a little bit of slack. Faculty volunteer for oral boards testing and they test dozens of candidates over a 72 hour period. I imagine that it is very easy to get bored and therefore asking the same 'bread and butter' cases over over would be monotonous. I think sites like GU and Breast, where treatment is straightforward, lend themselves to 'unconventional' lines of questioning.
I'd say for most of my sites we ran through a lot of standard stuff quickly. H&N was a section I was particularly freaked out about, but it went fine. I think we must've ripped through 11 cases or so.
D
deleted4401
- Joined
- Dec 17, 2007
- Messages
- 3,704
- Reaction score
- 5,215
I found these INRT-guidelines of the EORTC quite helpful.
http://groups.eortc.be/lymphoma/inrt_radiother_oncol.pdf
The German Hodgkin's Lymphoma trial group just activated the HD17-trial in our institution. I am quite anxious to see how to do INRT according to protocol. 😕
http://groups.eortc.be/lymphoma/inrt_radiother_oncol.pdf
The German Hodgkin's Lymphoma trial group just activated the HD17-trial in our institution. I am quite anxious to see how to do INRT according to protocol. 😕
Cool...I found these same guidelines and was planning to use them as well...at least for lymphomas where the patient gets chemo first. Follicular lymphoma, NLPHD, etc. where patients don't get chemo was still planning to do IFRT, although looking at NCCN, the whole NHL section says "ISRT."
- Joined
- Nov 28, 2005
- Messages
- 844
- Reaction score
- 77
My answer will be "a generous involved nodal which respects/includes the nodal tissue of the involved site"
