Welcome back to Rad Onc Smart Review, GYN Series. This is Episode 16: GYN Brachytherapy — The Oral Boards Performance Guide. Today is a mock oral. I’ll ask; you answer. Then I’ll give teaching pearls. Focus on applicator selection, polished procedural scripts, hybrid escalation, plan read-outs, troubleshooting, and complications. Pause after each question to formulate your answer.

Ovarian cancer is dominated by surgery and systemic therapy. As radiation oncologists, we’re expert consultants who step in at critical junctures: to clarify staging and risk, to advise on maintenance systemic strategies that shape recurrence patterns, and to deliver highly conformal radiation for palliation or carefully selected oligometastatic disease. Today we’ll cover surgical staging and cytoreduction goals, the modern systemic landscape (including PARP inhibitors and HRD), and radiation’s niche roles—palliative EBRT and SBRT for oligometastatic or oligoprogressive disease.

Today we will master primary vaginal cancer from first principles to planning. We will start with epidemiology, pathophysiology, and the anatomy that dictates nodal targets. We will explain why definitive radiation is the backbone of curative therapy for most stages. Then we will design a complete plan that combines pelvic EBRT with a brachytherapy boost, including when to choose an interstitial implant rather than a cylinder. By the end, you will be able to choose the correct nodal basins based on tumor location, justify definitive radiation over morbid surgery, and construct a curative EBRT and brachy plan to seventy to eighty-five gray with the right applicator for the residual tumor thickness.

Last time we built the algorithm for early vulvar cancer—who needs nodes, how sentinel mapping changes the plan, and when to radiate the vulvar bed and groins. Today we turn to the hard one: locally advanced, unresectable disease. We’ll start by defining “unresectable,” walk through the neoadjuvant chemoradiation evidence, and then do a planning workshop you can take straight to clinic: how to contour the inguinofemoral basins without the classic medial miss, how to set doses for elective versus high-risk volumes, and why you should not “midline-block” the vulva when you’re treating positive nodes. We’ll reinforce, repeat where it helps, and keep it board-ready.

This is Episode twelve: Vulvar Cancer Part one—Foundations and evidence for surgery and adjuvant radiation. Today we build from first principles—epidemiology, pathophysiology, anatomy, workup, and staging—and then walk the decision tree for surgery, nodes, and radiation using four anchor studies: the depth-of-invasion rule from the GOG era, the GROINSS-V pathway for sentinel nodes, the Heaps margin criteria for the primary, and GOG-thirty-seven for node-positive adjuvant radiation. By the end, you’ll know when to observe, when to re-operate, and when—exactly—to radiate the vulva, groins, and pelvis.

Today is a hands-on planning workshop. We’ll simulate, contour, and plan adjuvant pelvic IMRT. Then we’ll master vaginal cuff HDR brachytherapy—from choosing the cylinder to writing the prescription and optimizing dwell times. You’ll also get two short “oral boards canned speeches” you can deliver verbatim on exam day.

Welcome back to Rad Onc Smart Review, Gyn cancer series. This is a special topics episode focused on three areas that trip people up on consults and in orals: uterine sarcomas, carcinosarcoma, and how to cure medically inoperable endometrial cancer with radiation.

This is Episode ten: Endometrial Cancer, Part three — high-risk histologies and Stage three through four-A disease, plus what to do when cancer comes back.Last time we mastered adjuvant therapy for early stage. Today we zoom in on who truly benefits from chemo-radiation, how to reconcile Portec-three with G.O.G. two fifty-eight, how molecular subtype changes the plan, and what first-line therapy looks like now for advanced or recurrent disease.

Last time, we mastered modern staging and SLN mapping. Today, we answer the question you get every week in clinic: Who needs observation, who gets VBT, and who still needs pelvic EBRT? We’ll build the algorithm from GOG 99, PORTEC-1, PORTEC-2, and key updates, and we’ll start with a quick Surgical Corner so we’re crystal-clear on what operation and pathology we’re planning around.

Today we pivot from cervical to endometrial cancer, the most common gynecologic malignancy in the U.S. While many patients present early, outcomes hinge on understanding the biology and the new 2023 FIGO staging that integrates molecular data. We’ll differentiate classic and molecular subtypes, walk the new staging system, and review why sentinel lymph node biopsy (SLNB) is now the standard for nodal staging.