Great reference! Though sad to me that in 2024 our only 2 standard RT regimens are still just long v short course w large fields - regimens created decades ago before any appreciation of molecular dif, non-op, MRI-staging, etc. So much room to individualize RT in rectal cancer.

Very much agree - we’ve got so much work to do in rectal cancer #radonc: adjusting fields & target volumes to stage, optimising dose and fractionation to intent & systemic Tx (rather than just use what worked in the pre-op, no TNT setting), finding the right OARs, etc

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If you’re bored/looking to procrastinate…feel free to read this interview where I talk about radiation oncology w some advice for trainees…plus fashion, reading & grocery stores 😃

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This study is investigating the survival impact of aggressive local therapy in oligometastatic H&N cancer. Important question, and we need as many sites as possible. Please contact me if interested in opening in your center!

I applied to medical school in 2002. And all I’m gonna say is: Every now and again, I see certain things and say to myself, “Yeah, that person was definitely in the 63.3%.”

New NCCN guidelines recommend total neoadj therapy for all pMMR T3+/N+ rectal ca. What about upfront surgery for “lower risk” tumors? Several series show low LR rates w surgery 1st, & both ASTRO & ESMO rec for tumors fitting criteria. TNT makes sense for many but not all IMO.

Dr. Nina Niu Sanford Krishan Jethwa Neil Newman Hyun Kim Completely agree. I worry we already over-treat many patients in the US, especially low risk upper rectal, and these recs will not help discourage that…. This seems like a significant over-generalization to me.

Dr. Nina Niu Sanford Dr. Foxpaws Fauxpas Yakup Ergün Journal of the @NCCN Anant Ramaswamy Lot of data for neoa adjuvant IO for MSI high colo rectal cancer . Most of it it phase 2 data. Below is summary table for all trials in this setting .

Yes, NCDB also doesn’t capture 2nd opinions which could confuse the picture here. If patient gets 2nd opinion at academic center and is recommended treatment for their prostate cancer, they may be more likely to do that closer to home (at community practice). Versus if academic

Is there a female version of derek guy? Anyone know?

Dr. Nina Niu Sanford Krishan Jethwa Neil Newman Hyun Kim Curious the way PROSPECT incorporated to NCCN by only specifying non-T4: -Trial criteria did not include N2 -Required MRF margin of at least 3 mm -More formal guidelines on measuring “20%” would be helpful -No mention in NCCN of adjuvant chemo most received

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Letter to editor from Laura Dawson Jordan Kharofa Dr. Nina Niu Sanford Ali Hosni Mamen Rubio Rodriguez Regarding 1.5 T MRL pancreas planning protocol manuscript (PMID 38831754) Elective coverage should be routine It impacts planning authors.elsevier.com/sd/article/S24…

Michael Chuong Krishan Jethwa Susannah Ellsworth DocDaviesMD Thomas P. Kole, M.D., Ph.D Todd Scarbrough James Good Austin Sim, MD JD Neil Newman Hyun Kim Cliff Robinson Freddy E Escorcia (@freddyeescorcia elsewhere) Matt Spraker Lauren Henke, MD, MSCI Updated the 5 and 15 fraction dose-escalated templates with recent feedback from upcoming contouring and prescription guidelines. Given the aggressive large bowel metrics, a range has been provided. Open to all feedback. #PancSM #Radonc Dr. Nina Niu Sanford Krishan Jethwa

Neil Newman, MD, a radiation oncologist UT Health San Antonio MD Anderson, is part of a national study using low-dose radiation to treat osteoarthritis. Unlike cancer treatment, this therapy uses lower doses to target pain directly at the joint. Neil Newman Learn more: bit.ly/47h55eD

Big congrats to Laura Dawson & team for completing this symptom-based, palliative radiotherapy RCT! 8Gy x 1 ~whole liver RT improves pain in 67% Agree that all patients fitting study criteria should be offered this simple, convenient, safe & cost-effective treatment.