Brian D. Kavanagh, MD, MPH

In this edition of our ongoing series, the authors present two cases involving renal cell carcinoma patients treated with SBRT for pancreatic metastases.

Fifteen years from now, graduate business school students seeking a PhD in medical economics will write dissertations on the topic of proton therapy and its place in the health care reform efforts of the 2010s

Stereotatic body radiation therapy (SBRT) is a rapidly evolving cancertreatment method in which concepts and techniques previously developedfor brain tumor radiosurgery are adapted to eradicate tumorselsewhere in the body. The spatial accuracy, conformality, and steepradiation dose gradients of radiosurgery, which have been critical to itssuccess in the treatment of intracranial tumors, are applied in SBRT totreat a variety of extracranial tumors. Early results demonstrate excellentresponse rates and low toxicity with a variety of hypofractionateddose regimens and localization/immobilization techniques. This articleprovides an overview of the rationale and results of SBRT for specificindications, descriptions of some methods of treatment delivery, anddiscussion of potential areas of future investigation.

While in Denmark under an ASTRO/ESTRO fellowship travel grant, Dr. Brian Kavanagh spoke with a number of oncologists at the University of Aarhus about their research and the practice of oncology in Denmark. In this essay, he skillfully weaves Danish history, philosophy, customs, and landscape into his interviews with four eminent Danish physicians.

The patient’s medical history is remarkable only for asthma and mild emphysema. The family history included a grandmother with gastric cancer. The patient had been taking estrogen replacement therapy since menopause 3 years earlier, and she was