Advances, an ASTRO Journal

The biggest day of the year for medical students & residencies is upon us... Match Day! ?? Program "signaling," which has evolved since 2021, can be complex, but a group of powerhouse residents & their mentors make it simple in this new Brief Opinion on geographic preferences/signaling. As the average number of residency applications per applicant increases ?? leading to "application inflation," how do programs know who is truly interested? Enter... Signaling! Per the Association of American Medical Colleges (AAMC), signals through ERAS offer the opportunity 1?? for candidates to express interest in programs at the time of application 2?? for programs to gather more data points about applicants prior to deciding whom to invite to interview. So what did this team think about geographic signaling/preferences in particular? ?? Signaling may seem like a great way to gauge an applicant's true interest BUT ?? it may also serve as an unintended way to unequally benefit (or hurt!) some candidates. Check out their article & good luck on Match Day! ?? https://lnkd.in/ggExNTPT

Advances in RT technology has enabled highly effective treatment of brain metastasis, including gamma knife or LINAC SRS. In-silico study: photon VMAT SRS vs. spot scanning particle arc therapy (SHarc) Demonstrates ?? low-dose conformality and ?? brain V12 in select cases Incremental advances lead to incremental improvement for our patients! This may evolve as another "tool in the toolbox" that can be used in select patients. Read more here! https://lnkd.in/gfz-DJj3

5fx adjuvant whole breast RT is an evidence based and increasingly utilized regimen Study of 436 pts treated w/ 26 Gy in 5 fx +/- boost further supports use of this regimen: ? 97.7% excellent/good cosmesis ? Favorable acute/late toxicity profile ?< 1% locoregional recurrence ?? Supports continued use of this safe, effective, and highly convenient treatment schedule for appropriate patients with breast cancer! https://lnkd.in/gTW26V2n

??Your questions answered!?? Here's the first-ever ? prospective trial assessing the safety and dose distribution of sequential Y90 (a form of selective internal radiation therapy (SIRT)) ? SBRT for liver tumors! In this trial of 15 patients: ?post-SIRT dosimetry was performed using Y90 PET/CT to calculate mean absorbed dose (check out the photo below!) ?lesions that received < 290 Gy SIRT then received SBRT (30-50 Gy) ?toxicity was assessed by change in Child Pugh (CP) score Of the 10 who received the SIRT?SBRT combo, only 1 experienced CP +2 worsening in liver function. Stay tuned for the final trial results, but in the meantime, see their planning steps ? https://lnkd.in/gc8Pm4sf

?? BNCT shows promise for recurrent clival chordoma! A case study reports significant tumor reduction & minimal early side effects after traditional treatments failed. Could BNCT be a game-changer? More research needed! #RadOnc #BNCT https://lnkd.in/gXDtTNAE

??ctDNA in NSCLC receiving CRT: A Prospective Study?? n=25 ?? 76% had >/= 1 genomic alteration, most common driver mut= KRAS ?? Pre-tx ctDNA-detection associated with pre-tx PET metrics and PFS ??ctDNA + vs ctDNA- PFS, 23.4 m vs. not reached, HR 4.54 https://lnkd.in/g8MVAgGP

With NRG ONCOLOGY BN003 still enrolling (adjuvant RT vs active suveillance), adjuvant RT for resected G2 meningioma remains a debatable Study compared adjuvant vs early salvage RT for G2 meningioma, demonstrating increased toxicity with adjuvant RT: ?? Acute 90% vs 69% ?? Late 57% vs 33% ?? Radionecrosis 18% vs 8% When comparing adjuvant RT vs. active surveillance, adjuvant RT associated with: ?? Overall toxicity, 31% vs 15% ?? Trend towards grade 3-4 toxicities 8% vs 3% Learn more here!! https://lnkd.in/g8GgtaJQ

MALT lymphoma is curable with radiotherapy and treatment approaches are optimized to reduce side effects of treatment, including both dose/fraction and target volume reduction. However, day-to-day stomach variation combined with respiratory motion often mandate large PTV volumes to reduce marginal miss. This study from UTSW utilized breath-hold and CT-based adaptive technique to facilitate use of 0.5-0.7 cm PTV margins They demonstrated: -??????Improved target coverage and stable OAR sparing with daily adaptation compared with the scheduled plan -??????Feasibility with about 20-25 min tx time per fraction https://lnkd.in/g9TcgRD8

Proton craniospinal irradiation (pCSI) for leptomeningeal metastases (LM) is a buzzword these days! Check out this recently published paper by Keng Lam, et al on their institution's retrospective pCSI for LM! https://lnkd.in/gSS3cM8V

?? Secondary analysis of the ROMAN Trial?? Patients with HNSCC randomized to Cisplatin-CRT + SOD inhibitor avasopasem (AVA) vs placebo ?? AVA demonstrates significant net treatment benefit with reduction in: ?Severe oral mucositis (SOM) incidence ?Days of SOM ?Days to SOM onset https://lnkd.in/eYH8j2RY