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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…
RadOncReview ftw again. Thank you @jryckman3 🙏. Incredible resource. GI highlights below. #ASTRO25
Our “Best Of” #ASTRO25 abstract summary is out! 🦾🎯 Featuring plenaries, late-breaking abstracts, and select scientific highlights. I'm sure we missed plenty of gems - what would you add? 👇 bit.ly/BestOfASTRO25
The latest #ASTRO25 study dump now brings us to over 2,000 studies logged since May 2020. Happy studying and treating, and thank you for being part of this community! 🔗 bit.ly/RoROnDeck
Our “Best Of” #ASTRO25 abstract summary is out! 🦾🎯 Featuring plenaries, late-breaking abstracts, and select scientific highlights. I'm sure we missed plenty of gems - what would you add? 👇 bit.ly/BestOfASTRO25
Our “Best Of” #ASTRO25 abstract summary is out! 🦾🎯 Featuring plenaries, late-breaking abstracts, and select scientific highlights. I'm sure we missed plenty of gems - what would you add? 👇 bit.ly/BestOfASTRO25
Check out the new updates to #RadOncCalc and @RadoncTables available now on all platforms (iOS, Android, web) Rad Onc Tables IOS ➡️ is.gd/tnqpTT Android ➡️ is.gd/dzc9xH Rad Onc Calc IOS ➡️ is.gd/txHOue Android ➡️ is.gd/HzIP5x
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
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…
15-yr F/U of my fav study by Ardeshna et al.: W&W v Rx4 low tumor burden FL - median TTNT: NR in R maint, 14.8 yrs (!!!) in Rx4, 5.6 yrs in W&W - 34% of W&W cohort with no tx at 15 yrs! - women: shorter TTNT w/ W&W & longer TTNT with R maint (biological diff?) 1/2 #lymsm
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.
Some intriguing data and personal reflections to contribute to this fantastic discussion. Around 10-20% of patients shuttled down NAC-ICI pathway didn’t proceed to resection or had R1+ margins highlight room for improvement. Many of these patients might have completed CCRT if…
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/
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…
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…
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
Is this the most important question? @HCCLIVEConf #HCC 🧩
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…
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
Nope. You need 10% of that, in five fractions. ALARA.
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.
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