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Our meta-analysis comparing EBRT & TACE for HCC is here in ACS Journal Cancer ! (Spoiler: RT benefits patients in LC and PFS) Thank you so much Neil Newman for being such an incredible mentor and guiding me every step of the way on the project! acsjournals.onlinelibrary.wiley.com/doi/10.1002/cn…

Patients can benefit from SBRT / PBT over TACE in HCC (ineligible for upfront surgery/transplant) ! 🚨 Local Control HR 0.16 (0.08, 0.34) 🚨 💥 PFS HR 0.37 (0.23, 0.60) 💥 OS RR 0.79 (0.51, 1.22) Toxicity RR 0.86 (0.31, 2.37)

Beau Bosko Toskich, MD FSIR Mersiha Hadziahmetovic Yakup Ergün ACS Journal Cancer Completely agree! The key is selecting the best LC modality per patient through multiD decision-making. Dual IR/RO approaches are some of my favorite across any disease site. When total consolidation runs like a well-oiled machine & both hands work together, patients can achieve

Could ensuring a minimum dose to the entire tumor be just as, or even more, critical than ≥ 400 Gy in some areas, especially for larger tumors? Also, is there a way to prospectively guarantee full shoulder coverage, and is this coverage routinely quantified with Y-90? 🧩 #HCC

Until we get clear data - the story for larger tumors and especially MVI is that min dose does matter … I have seen tumor thrombus progress into confluence for example Until dosimetry is clear to interpret ( such as EYE90) along with positive phase 3 trial - onus is on y90

radoncreview_org HCC-LIVE Conference Thanks Jeff, I think it highlights a good pt that Riad touches upon. Y90 and SBRT dose are measured differently though both in Gy...you don't need 400 Gy to whole tumor in HCC - it's a radiosensitive histology.

Dr. Nina Niu Sanford radoncreview_org HCC-LIVE Conference Nope. You need 10% of that, in five fractions. ALARA.

Is this the most important question? HCC-LIVE Conference #HCC 🧩

Math checks out with absolute dose! HCC is a rather radiosensitive tumor. Interesting aside: A BED10 of >80 Gy with EBRT yields 80–90% local control. For context, 400 Gy in a single fraction equates to a BED10 of 16,400 Gy—yet the X-axis of this chart maxes out at 150 Gy. Of

Dr. Nina Niu Sanford radoncreview_org HCC-LIVE Conference I've never understood Y90 dosimetry. The prescription dose in Gy is so high, ~10x EBRT and ~3x LDR Brachy, despite Y90's half-life being much shorter than prostate LDR isotopes. Why does intravascular therapy require such a massive dose? Does any biologically relevant volume

Dr. Nina Niu Sanford Freddy E Escorcia (@freddyeescorcia elsewhere) Also, radiotherapy can improve Child-Pugh scores from B ➡️ A. Lasley et al. Such a great paper! This fact tends to leave surgeons, IR, and med oncs equally jaw-dropped. Try dropping this fun fact at a GI tumor board near you! pubmed.ncbi.nlm.nih.gov/25899219/

Seeing some logical fallacies in this debate. It not logically sound to assume that patients who progress on NAC-ICI wouldn’t have responded to upfront chemoradiotherapy.

Rituximab does not decrease transformation to DLBCL. Adding targeted, modern radiotherapy may decreases this ~20% long term risk by an order of magnitude. DLBCL-free survival is a meaningful endpoint for patients. Teamwork is key! 🤝 #LYMSM sciencedirect.com/science/articl…

Here is a provocative paper for stage III. This data is suggestive of Rituximab + RT being curative treatment, with none of the 11 patients who received peri-radiation Rituximab experiencing relapse. DLBCL-free survival is a patient-centric endpoint! ncbi.nlm.nih.gov/pubmed/32316464