Rahul Tendulkar, MD
@RTendulkarMD
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Clinical director, Vice Chair of education, Professor of Radiation Oncology @ Cleveland Clinic. Tweets mine.
Cleveland, OH
Joined September 2015
Burnout & moral injury in medicine have affected so many health care workers. As a mid-career physician, here’s what I’ve learned to combat it - I hope others find it to be helpful. In Search of Joy and Meaning in Modern Medicine @JCOOP_ASCO
https://t.co/NnR5cSbtPT
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The first modern review on the treatment of tendinopathies with low-dose radiotherapy (LDRT) has now been published and is available online. This work represents a truly international collaboration, bringing together expertise from across disciplines and continents.
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Congratulations to super ⭐️ @CleClinicMD #radonc PGY-3 resident @ElizabethEObi for receiving the Women in Neuro-Oncology (WiN) scholarship award at @NeuroOnc #SNO2025!
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ASTRO Experts Comment on the Results of the SUPREMO Trial - The ASCO Post
ascopost.com
While the headlines following its publication suggested that “radiotherapy can be avoided” in some patients with early-stage breast cancer, experts from the American Society for Radiation Oncology...
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Just got my favorite textbook! It feels extra special because I had the privilege of learning from the brilliant minds who wrote it. Grateful for such an invaluable resource! @RTendulkarMD
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The best protocol to eliminate filler words (ummms etc.) These are otherwise very difficult to eliminate b/c they happen reflexively. Matt Abrahams on the Huberman Lab podcast out now all about how to speak clearly and with confidence.
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Pleased to share the primary endpoint analysis of the LUNAR trial out in @JCO_ASCO
https://t.co/AFHiHssZCi. The addition of 177Lu-PNT2002 to SBRT improved PFS and HT-FS over SBRT alone, without a significant increase in toxicity, in men with oligometastatic prostate cancer
ascopubs.org
PURPOSEProgression after metastasis-directed therapy via stereotactic body radiotherapy (SBRT) for oligorecurrent hormone-sensitive prostate cancer (orHSPC) is common. We aimed to assess whether the...
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🌕✨ “This trial didn’t just shine - it LUNAR-eclipsed SBRT alone.” 🧬 LUNAR Trial | JCO 2025 Lu-177 PNT2002 ×2 → SBRT in oligorecurrent HSPC 🔥 Nearly doubled PFS with no added toxicity. 🎯 Study Essentials 🏥 Phase II | UCLA | n = 87 🔍 PSMA-PET–defined oligorecurrence (1–5
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A quiet shift is happening in breast cancer care for women over 70 — shorter radiation, fewer pills, same long-term control. Here’s why short-course radiotherapy alone may be enough for some low-risk patients. 👇
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November 10, 1975 — 50 years ago today, The SS Edmund Fitzgerald sank in Lake Superior with 29 crew members aboard during a storm. Today we honor their memory. "The legend lives on from the Chippewa on down Of the big lake, they called Gitche Gumee The lake, it is said, never
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When the 729-foot-long SS Edmund Fitzgerald sank in Lake Superior on Nov. 10, 1975, it took its entire 29-member crew with it. The men were connected to dozens of families and a number of comrades in the shipping and freight industry. We remember and honor them 50 years later.
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Had our 30th med school class reunion this weekend. To say that medical school was a phenomenal experience would be a gross understatement- mostly because of my classmates. One thing I couldn’t help but notice - how many people had transitioned or were looking to transition out
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Need to clarify the above post about the role of post-mastectomy RT here:
Unlike previous post-mastectomy RT trials which included regional nodal irradiation (BC, Danish, etc), SUPREMO primarily tested chest wall RT only. Let’s compare to 4 other studies which found that RNI for LN+ after ALND can reduce DM. 1/
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@BLawenda Of course, each decision should be individualized based on patients' goals & risks, e.g. impact on breast reconstruction. But with SUPREMO we have to be careful to not throw the proverbial baby out with the bath water. 13/end
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@BLawenda Of course, as ALND is increasingly abandoned in favor of SLNB alone, the role of RNI becomes more important as >30% of SLN+ have additional ALN+ that would go untreated. https://t.co/v0bE0p0OzS 12/
Patients on SUPREMO had median 14 lymph nodes removed, so PMRT adds little value for pT1-2N1 after ALND. If ALND not done for SLN+, PMRT still indicated since >30% have risk of additional LN+ per AMAROS & SENOMAC. ASCO guidelines summarize nicely:
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@BLawenda I particularly favor PMRT (CW + RNI) for pN1 (after ALND) with medial location or those not receiving optimal systemic therapy. The risk calculator by Sittenfeld et al can help estimate individual risk: https://t.co/dnmZMuBQYW 11/
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@BLawenda The SUPREMO results should NOT spell the end of PMRT for pN1 breast cancer after ALND. PMRT (if used) should include comprehensive RNI - CW only RT likely insufficient. But exactly WHICH patients need PMRT remains unclear. 10/
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@BLawenda Other data corroborate the role of RNI in breast cancer: EORTC 22922: better DFS and DM with RNI to SCV/IMNs. Korean KROG 08-06: medial tumors w/ LN+ had better DFS & DMFS with IMNI. Danish DBCG-IMN1 and IMN2: better OS, DM & BCM with IMNI. 9/
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@BLawenda MA.20 suggests that the impact of RNI is to sterilize microscopic nodal mets which act as nidus for DM, i.e. DM are not simply a downstream consequence of LRR. So in this modern population, LRR and DM events appear to be "decoupled" - contrary to older data. 8/
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@BLawenda But MA.20 found 5% improvement in DFS with RNI, though LRR was reduced by only 2.5%. So RNI with WBI had small impact on LRR, but bigger impact on preventing DM. 7/
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@BLawenda Both SUPREMO & MA.20 were recent trials with modern chemo, in similarly stages of patients (N0 25% & 10%, N1 75% & 85%, resp). SUPREMO found no DFS or DM benefit to CW RT, with just a small reduction in LRR (1.4%). 6/
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