RT @FadenLab: @DavidSherMD Re: impact of more sensitive NGS assays. We agree. Preliminary results from our Clear-HPVca Trial (NCT NCT067304….

RT @FadenLab: @DavidSherMD See our commentary on Routman et al here: . @JAMAOto.

RT @DanielMaMD: DART 2, which was based upon this work, should finish accrual Q2 2026, so more data on ctDNA-personalized de-escalation wi….

This is very nice work and has important implications for the use of NavDX (ctHPVDNA by ddPCR) to determine postoperative treatment. During the Mayo DART trial, ctDNA was drawn a median of 22 days after surgery, with 17/140 (12.1%) positive. ALL of these patients then received.

Very thoughtful take in this article. One additional comment: if there is any one discipline in US radiation oncology that is disappearing over the next 5 years, it is the dosimetrist/treatment planner. Auto-planning will essentially render this position close to obsolete, with.

RT @giuliani_luiza: Excited to share our latest work in Advances in Radiation Oncology! 🚀. We compared outcomes of 5-fraction adaptive MRI-….

RT @JJCaudell: Rising PGY-5s and anyone interested, we have a 5th HN rad onc position @MoffittNews. If interested in joining a busy team,….

Excellent work here, with successful results consistent with the published literature on 40 Gy (or less) to the elective neck.

These results are obviously just hypothesis-generating with potential confounding, but I think it’s worth exploring these systemic effects of H&N radiation, and ENI in particular. Incredible work here by the first author Alston Mickel, one of our @UTSW_RadOnc residents. Much of.

When diving into the anatomy, both ipsilateral and contralateral carotid doses were associated with lymphopenia, and the cervical spine dose was particularly influential. We looked at both mean dose and V40 of these structures, and both were significantly associated with grade.

We compared grade 3 and grade 4 lymphopenia in three cohorts. One trial studied ENI dose (40 Gy) and volume reduction trial (INFIELD), one study investigated INRT (INRT-AIR), and one cohort of patients treated with standard ENI (mid-50 Gy). The risk of severe lymphopenia was.

Lymphopenia and ENI. It has been long established that H&N radiation leads to lymphopenia, which can last several months. The adverse prognostic impact of lymphopenia has also been shown. However, specific predictors of lymphopenia are poorly understood. Our experience of.

We have proposed something similar, replacing the PTV with an adaptive target volume (ATV). The ATV is a combination of contour uncertainty under adaptive conditions plus an adjustment for residual intra-fractional motion. Personally, I favor an adaptive target volume, because.

Eliminating the PTV as a concept is a provocative idea. This editorial is worth a read.

RT @DoctorJSpicer: Is anyone surprised that CM816 is the only pure neoadjuvant phase 3 trial for resectable solid organ disease?!? Now that….

RT @StephenVLiu: This is a major story from #ASCO25. Randomized phase 3 trial of time of day of immunotherapy infusion. Randomized to infus….

5. I don't entirely understand why there wasn't a statistical DM benefit in NIVOPOSTOP, although perhaps the competing risk of LRR was just too high to see a distant benefit (more than in KN-689). 6. The relative ratio of distant:locoregional recurrences was quite high in the.

4. RTOG 0920 showed that HPV-negative patients with intermediate-risk path factors benefit substantially with concurrent cetux. So there may have been inadequate locoregional therapy in both arms (versus NIVOPOSTOP). Plus, there was downstaging with pembro and less concurrent.

Here are a few observations on failure patterns, recognizing we don't have the full data to examine. 1. In KN-689, the patients in the control arm did quite poorly. In the control arm, the EFS was only 62.5% at 1 year. Contrast that with a DFS of ~55% in the RT-only arm of RTOG.

The difference in patterns-of-failure is odd (to say the least) and should make us take a step back in understanding the mechanism of potential benefit for I/O in these studies.