
Radiation Oncologist at @COH_RadOnc serving the lovely communities of South Pasadena & Glendale
South Pasadena, CA
Joined August 2020
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ROAM (phase 3, n=157): After complete resection of grade 2 meningioma, 5-year DFS was 79.9% with RT vs 64.3% with observation (HR 0.51). Grade 2/3 radiation-related serious AEs occurred in 8% treated. Who would you still observe?
pubmed.ncbi.nlm.nih.gov/4279…
7.4% vs 22.7%: acute grade ≥2 oral mucositis with protons vs IMRT in a randomized phase 2 trial of unilateral postoperative head and neck RT (n=98). Dysgeusia was also lower; dysphagia and 3-year local control were similar.
pubmed.ncbi.nlm.nih.gov/4269…
RT CHARM, published Oct 12: 16 vs 25 fractions of PMRT had 2-year reconstruction complications of 12.3% vs 10.2% (n=825), meeting noninferiority. The prespecified margin was 10 percentage points; 3-year locoregional recurrence was 1.5% vs 2.2%.
pubmed.ncbi.nlm.nih.gov/4286…
NeoORB: breast pCR was 52% with preop RT vs 27% with postop RT. But pCR was assessed before control patients received RT. Interim n=60; breast-conserving surgery was 26% in both arms. Which endpoint would justify moving RT before surgery?
amportal.astro.org/sessions/…
For ≤2 cm HCC eligible for either approach, SBRT met noninferiority to RFA for 2-year local PFS: 91.5% vs 87.0% (n=93). This is a single-center interim result, not proof SBRT is superior. Would a perivascular location tip your choice?
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SOAR-HN: 2-year grade ≥3 treatment-related toxicity was 6.7% with SBRT reirradiation vs 23.9% with conventional RT (P=.073). Among 59 evaluable patients, 59% assigned to conventional RT crossed over to SBRT. That makes survival comparisons difficult.
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More immunotherapy was not better in early NSCLC. Phase 3 S1914 (n=402) added atezolizumab to SBRT: 2-year OS was 82% in both arms, while grade 3+ AEs rose from 3% to 12%. The trial stopped early for futility.
pubmed.ncbi.nlm.nih.gov/4270…
i-STOP randomized 60 men with PSMA PET-only oligometastatic prostate cancer: 3-year biochemical progression was 21% with SBRT plus intermittent ADT vs 60% with iADT alone. Feasibility was the primary endpoint, so larger efficacy trials are needed.
amportal.astro.org/sessions/…
Five fractions vs 28: randomized phase 2 SOFT Preop (n=102) found no difference in nodal positivity (41% vs 38%), resection, PFS or OS after chemotherapy for PDAC. SBRT better preserved QOL. Is that enough to favor the shorter course?
amportal.astro.org/sessions/…
Jason Liu, MD retweeted
What's the role of supervision in #radonc and canaccreditation play a role
Examining the Case for Accreditation Standards to Require Direct Supervision in Radiation Oncology - International Journal of Radiation Oncology, Biology, Physics
@MWeismanMD @A_CT_SimMDJD @JasonRLiuMD
Phase 3 NRG-CC009 (n=151): SRS did not improve neurocognitive failure vs HA-WBRT + memantine in SCLC brain metastases (HR 0.83), but median OS was 17.4 vs 8.6 months (HR 0.60). The OS signal is secondary; median follow-up among survivors was 9.5 months.
amportal.astro.org/sessions/…
Long-term phase 3 NRG/RTOG 0815: 6 months of ADT with dose-escalated RT reduced distant metastases from 40 to 14 events and prostate cancer deaths from 19 to 5, but 14-year OS was 58% vs 53% (p=.13). Which endpoint matters most in your ADT discussion?
amportal.astro.org/sessions/…
Low-dose RT for knee OA was associated with a 67% lower adjusted disability hazard in a 292-patient randomized trial with 11.9-year follow-up. In grade 2 disease, knee replacement was 14% vs 36%. Caveat: single-center, unblinded; median age 38.
amportal.astro.org/sessions/…
Jason Liu, MD retweeted
Nick Saban says he had lived his entire life like he was in a hurry and didn’t even realize it
“When I retired, and I don’t know if I ever shared this with anybody, I spent 50 years of my life being in a hurry and didn’t know it.”
“I retired and the cars are backed up on the bridge and it goes down to one lane. In the old days, I would be the guy that passed all the cars up and cut in at the last minute in front of somebody.”
“I sat there with Miss Terry in the car. She says, ‘You mean you’re not going to pass everybody illegally and cut in?’ I said, ‘We’re not in a hurry.’”
“But it’s the first time when I retired that I realized that I wasn’t in a hurry. And I was in a hurry for 50 years and didn’t know it.”
“I was always hurrying up to the next thing. Solve the next problem, go to the next thing. And you talk about relieving stress, that relieves stress better than anything. I just noticed it in that circumstance. Not cutting into traffic and waiting my turn.”
Phase 3: in limited-stage DLBCL after CR to chemotherapy, 30 Gy was noninferior to 40 Gy. Five-year PFS was 90.5% vs 87.2% (n=425 ITT); OS, locoregional recurrence and toxicity were similar. Is there still a reason to use 40 Gy?
amportal.astro.org/sessions/…
STELLAR II (n=588): adding sintilimab to SCRT-based TNT raised complete response in pMMR rectal cancer from 26.8% to 51.9%. Grade 3-4 toxicity rose from 19.9% to 27.7%; 3-year DFS is pending. Is CR enough to change organ-preservation discussions?
amportal.astro.org/sessions/…
Weekly cisplatin did not reduce grade 3-4 toxicity vs q3-week cisplatin with 70 Gy RT in randomized p16-negative NRG-HN009 (n=234): T-score ratio 1.11, p=.77. Six-month locoregional failure was 9.6% vs 4.6%; this cohort did not advance to phase 3.
amportal.astro.org/sessions/…
INTREPId tested darolutamide instead of ADT with RT. Good erectile function at 3 months was 72% vs 44%, while early PSA suppression was 90.8% vs 99.1% and failed noninferiority. Would you wait for 3-year PSA control before using this outside a trial?
amportal.astro.org/sessions/…
70% vs 56%: 6-year OS with SABR plus four nivolumab doses vs SABR alone in randomized phase 2 I-SABR (n=141). EFS was 53% vs 32%. The OS HR was 0.55, but its 95% CI reached 1.00. This is not yet phase 3 evidence.
amportal.astro.org/sessions/…
At 5 years, phase 3 NRG-GU003: 25-fraction post-prostatectomy RT had similar biochemical failure to 37 fractions (21% vs 18%), but more grade 3 GU events (13% vs 3%). Only 56% completed EPIC, limiting confidence in the patient-reported comparison.
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