Was there ever a more dreaded rad onc oral boards case than a post-op pancreas? A secondary analysis of RTOG 0848, a multi-center prospective trial of +/- the addition of radiation to adjuvant chemo for resected pancreatic adenocarcinoma, reveals one-third of radiation treatment plans (n=160) were rejected on initial trial-mandated pre-treatment quality assurance checks. The most common reasons for rejection were unacceptable pre-operative gross tumor volumes (61%) and/or pancreaticojejunostomy volumes (48%), highlighting both the difficulty of identifying patient-specific at-risk regions in the postoperative setting as well as the importance of pre-treatment peer review of volumes for such uniquely challenging cases. | Tchelebi, Int J Radiat
