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News and Publications

The Gray Zone

The ultimate goal of radiation oncology research is to improve clinical care. As a specialty, we tackle diverse research questions, addressing every type of cancer and encompassing cancer biology and radiation physics. But despite our best efforts, evidence-based medicine cannot provide one clear answer to every clinical problem. In many patient scenarios, the best management approach remains uncertain, leaving room for differences of opinion and constructive debate. In the Gray Zone, we present difficult or controversial clinical cases. For example, the controversy could involve optimal workup, clinical or radiologic interpretation, sequencing or choice of therapies, or technical considerations in surgical or radiotherapy approaches. After each case, you will be able to read the management plans favored by a few specialists in that particular field. Be sure to keep up with our new cases and follow the conversation on Twitter at #gyzone.

Please share this page with friends and colleagues who may also be interested in participating in the Gray Zone.

Submit a Case Proposal:

Submitting a proposal allows the Red Journal to identify ideal Gray Zone cases and to alert authors prior to submission if a similar case has already been submitted or published. This process is informal and is not a commitment to submit the case to the Red Journal, nor does it constitute a guarantee of acceptance following submission. All proposals will be treated as confidential. Authors should expect a reply within a week.

Submit your proposal

Submit a Case:

Please see the full author instructions when ready to formally submit a Gray Zone case for review. Of note, authors submitting cases are expected to have arranged for at least two sets of expert responses to be submitted simultaneously at the time of case submission. Please list the corresponding authors’ names of the responses to be expected in the appropriate field of the online submission form  If the responses are not submitted within two weeks of the initial case submission date, the case will be removed from further consideration. A maximum of five responses may be submitted with a case; responses that include surgical, medical, or physics-based perspectives are of interest. 

Become one of our Experts:

The Gray Zone is an excellent opportunity to participate in the discourse around some of the most challenging cases in the field. Our experts who provide opinions on these cases are an invaluable part of the Gray Zone. 

We hope to expand our pool of experts and identify those with an enthusiasm for addressing these difficult or unusual cases. Oncologists of all disciplines and physicists who engage in the care of oncology patients are potential candidates. If you submit your information through the form linked below, you will be placed on a list for early consideration when soliciting expert opinions. In order to be invited, experts must already have an author account with the Red Journal Submission Site. Filling out this form does not guarantee that you will be invited to respond to a case, but it does increase the likelihood of being asked. 

Join the Expert Opinion Roster

Those invited to write an opinion will be asked to adhere to the following constraints:
  • Authors ≤ 2
  • Text ≤ 250 words
  • Tables and figures ≤ 2
  • References ≤ 2
  • Submitted through the website within two weeks of accepting the invitation

Any questions can be sent to redjournal@astro.org