Médico Especialista en Radio-oncología Certificado por el Consejo Mexicano de Certificación en Radioterapia. Maestro en Ciencias de la Salud.
Benito Juárez, Distrito Federa
Joined February 2015
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Gerardo CM retweeted
💚 Hoy, 13 de octubre, Día Mundial del Cáncer de Mama Metastásico.
Desde la SESPM, trabajamos para avanzar en el conocimiento, la prevención, el diagnóstico y el tratamiento de las enfermedades de la mama.
#SESPM #CáncerDeMamaMetastásico
Gerardo CM retweeted
DCIS Management in 2026: A Practical NCCN-Based Algorithm for Clinicians
(AI-assisted infographic. Content reviewed)
Gerardo CM retweeted
Original Article: Perioperative Apalutamide in High-Risk Localized Prostate Cancer (phase 3 PROTEUS trial) nej.md/3RuNe00
Editorial: A Watershed Moment in the Perioperative Treatment of Prostate Cancer nej.md/4dLeiiW
#Oncology #Urology
ALT This image contains four graphs showing the key secondary end points. Graph A shows event-free survival over time in months since randomization comparing ADT plus apalutamide and ADT plus placebo. Graph B presents the first subsequent local or systemic therapy occurrence, with the same treatment comparison. Graph C illustrates distant metastasis or conventional imaging or PSMA PET. Graph D compares freedom from disease at four years with percentages for both treatment groups. Each graph includes shaded confidence intervals and hazard ratios with confidence intervals.
Gerardo CM retweeted
Really useful app for estimating OAR cumulative dose & dose reserve for re-irradiation planning by @jryckman3!
We are going to record a video going through some case examples.
Let us know if any specific qs.
radonc.org/reirradiation
ReRT planning is hard.
So we built a free EQD2-based D0.1cc calculator to help estimate remaining OAR reserve across prior RT courses, with both no-forgiveness and time-forgiveness options.
Decision support only. Use judgment. Verify independently.
#RadOnc #OncTwitter
Gerardo CM retweeted
I am so grateful to share that I passed oral boards and am officially boarding certified in #radonc! Huge thank you to @radoncresidency & my study group. While residency is still fresh in my mind, I look forward to sharing some advice to any residents that may find this useful.
Gerardo CM retweeted
listos 2° sesión 25 de abril 9 am CDMX #ASTROJOURNALCLUBLATAMEIBERICA avalado @ASTRO_org revisaremos #INTERLACE #LATAM #cancercervicouterino acompañados #braquiterapia @AndrewFarach & #Colombia Dra. Valentina Coronado link us02web.zoom.us/meeting/regi… #youtube @astrojournalclubconn
Gerardo CM retweeted
Just released! Volume 2 of SBRT: From Clinical Trials to your Clinic in @IJROBP
Truly amazing papers from end to end. Have a look at the issue highlights here.
redjournal.org/issue/S0360-3…
Gerardo CM retweeted
📌 Top 10 Tips for Stereotactic Body Radiation Therapy Contouring and Planning in Oligometastatic Disease: Lessons Learned From the UK SBRT QA Program ☢️
🔗 sciencedirect.com/science/ar… @OncoAlert #OncoAlertAF @IJROBP @fifimcdrmh @royalmarsdenNHS
🔹Standardize definitions.
🔸 Optimize use of supporting imaging.
🔹 Motion management.
🔸 Optimize patient preparation.
🔹 Use all available TPS tools to optimize contouring.
🔸 Check auto-contouring output.
🔹 Appropriate use of OAR dose-volume constraints.
🔸 Maximize PTV coverage.
🔹 Conform tightly to the PTV.
🔸 Managing multiple lesions.
Gerardo CM retweeted
Imagínate buscar aprobación en un mundo que crucificó a un hombre totalmente perfecto.
Gerardo CM retweeted
More lesions ≠ WBRT anymore? 🤯
Phase 3 data just changed how we think about 5–20 brain metastases.
🧠 Trial: SRT vs HA-WBRT (JAMA 2026)
👥 Population:
• 5–20 brain mets
• Good PS, expected survival ≥4 months
• Mean ~14 lesions
⚡ Arms:
• 🎯 SRT (1–5 fractions)
• 🧠 HA-WBRT (30 Gy/10 fx ± memantine)
📊 Key Results:
• ↓ Symptom burden with SRT (MDASI-BT Δ −1.06, P<.001)
• Better neurocognition at 12 months
• Better performance status early & sustained
• Similar survival & grade ≥3 toxicity
⚠️ Trade-offs:
• ↑ New brain mets with SRT
45.4% vs 24.2%
• ↑ Radiation necrosis (mostly asymptomatic)
• More salvage WBRT needed
🎯 Takeaway:
Even with up to 20 brain mets, SRT offers better QoL + functional outcomes
👉 At the cost of higher intracranial relapse risk
🔖 Think beyond lesion count. Think patient-centered outcomes.
📖 Full paper in comment ⬇️
#OncoTwitter #MedTwitter #RadiationOncology #BrainMetastases
@oncoalert
Gerardo CM retweeted
📣 DON'T FORGET: The next #ISRSWebinar
The Role of the Biological Effective Dose (BED) in SRS
🗓️ April 1, 2026 | 2pm CET
🥼 Ian Paddick, MSc, MIPEM, CSci
Consultant Physicist Past-President of the BRSS Co-Chair of the ISRS Certification Committee Honorary Research Fellow at UCL
The role of the Biological Effective Dose (BED) was developed to account for sub-lethal DNA repair effects during exposure and the resulting decrease in the clinical effect of the radiation. In conventional radiotherapy, where treatment times are short (≤10 minutes), sub-lethal repair is minimal. However, in radiosurgery, where treatments can take tens of minutes to deliver, the overall treatment time can reduce the BED of a treatment by a significant amount. This effect, evidenced originally in clonogenic cell survival studies, then animal models, has now been shown to have an important influence in clinical outcomes of SRS. The rationale for prescribing according to the Biological Effective Dose will be explored.
👉 REGISTER: isrsy.org/webinars/the-role-…
Gerardo CM retweeted
What is the rate of sacral fracture (SF) after short course pelvic ☢️ for rectal cancer?
In this single institution series (n=171), pts w/ rectal adeno received short course RT (25 Gy in 5 fx), consolidative chemo, and surgery (or non-operative management). From mFU 2.2yrs:
🔘 Crude incidence SF = 7.6%
🔘 2yr cumulative incidence SF = 8.8%
🔘 Median time to SF = 1.64 yrs
🔘 Most (84.6%) SF were asymptomatic
🔘 On MVA, 🔼 SF risk if ♀️ (aHR 6.01) and hx of osteoporosis (aHR 7.37)
🔗 - tinyurl.com/348w4s5b
@JHMRadOnc @ASTRO_org #radonc
Gerardo CM retweeted
FREE for ASTRO members-in-training!
Join us on Thursday, April 2 at 1:00 p.m. ET for a Live Webinar:
"eContouring for Functional Radiation Medicine - Osteoarthritis & Fibromatosis," with speaker Jessica Schuster, MD, from the University of Wisconsin-Madison.
Supported by Speed of Light - The ASTRO Foundation's Juan A. del Regato Fund
Register now: ow.ly/l8Uw50YlZwo
@ARRO_org @RadOncPDs @UW_RadoncDHO
Gerardo CM retweeted
NICE 2026 guideline for the diagnosis and management of #kidneycancer :
👉doi.org/10.1016/S1470-2045(2…
@OncoAlert #cancer #oncology @DrYukselUrun @urotoday @AUC3_Official
Gerardo CM retweeted
🎯 Gastroesophageal Cancer: ITE/BOARDS Pearls
(Follow ASCO/NCCN guidelines for latest updates)
🧭 1) First sort by SITE + HISTOLOGY
1. Esophageal SCC → upper/mid esophagus, very radiosensitive → radiation must be involved.
2. True esophageal adenocarcinoma → distal, Barrett, still ->esophageal pathway.
3. GEJ adenocarcinoma → distal esophagus/GEJ/cardia; behaves like esophageal (Siewert I–II) or gastric (III), but boards accept either CROSS or FLOT.
4. Gastric adenocarcinoma (subcardia/body/antrum)→ intestinal/diffuse; no routine neoadjuvant RT.
🩻 2) Classic staging steps
1. Dysphagia → EGD/biopsy.
2. PET/CT to rule out mets.
3. If M0 → EUS for T/N; malignant node = round, hypoechoic, >1 cm.
- Add-ons:
- Bronchoscopy if tumor at/above carina.
- Staging laparoscopy: standard for gastric (≥cT1b), optional for GEJ.
-->Celiac nodes = regional for distal esophagus/GEJ
-->Below celiac = distant.
🎯 3) Four management buckets
1. Very early (T1a N0)- Mucosa only → endoscopic resection (EMR-Endoscopic mucosal resection /ESD-Endoscopic submucosal disection) ± Barrett ablation
2. Resectable, locally advanced (T1b+ or any N+)
- T1b(submucosa) → surgery standard.
- T2+ → needs systemic therapy (micromets).
- Options:
- Neoadjuvant CRT → surgery (CROSS)
- Perioperative chemo (FLOT preferred over MAGIC)
3. Locally advanced unresectable (T4b / medically inoperable)
- Definitive CRT(cis/5-FU or FOLFOX + RT).
- Cervical esophagus (almost always SCC) → definitive CRT, no surgery.
4. Metastatic (any distant organ or non‑regional nodes
->Systemic therapy ± local palliation.
💉 4) SCC vs Adeno: which regimen?
- Esophageal SCC- Radiosensitive; periop chemo alone not standard (INT 0113 negative).
Neoadjuvant CRT (CROSS) if resectable; definitive CRT if not surgical.
- Esophageal / GEJ adenocarcinoma
- Higher distant relapse; less radiosensitive.
- Boards: CROSS OR FLOT acceptable (ESOPEC favors FLOT but exams may lag).
- Gastric adenocarcinoma- Perioperative FLOT for fit patients.
- Upfront RT only in post‑op D1 setting (see below), not routine neoadjuvant.
🧪 Immunotherapy pearls (exam-simplified)
- After CROSS + surgery with residual disease → adjuvant nivolumab x 1 year.
- Metastatic adenocarcinoma:
- Test HER2, PD‑L1 (CPS), dMMR/MSI‑H
1. HER2– → platinum/FP + PD‑1 inhibitor (e.g., nivolumab).
2.HER2+→ trastuzumab + platinum/FP + pembrolizumab.
3. MSI‑H/dMMR** → IO-(IO is king)
- Metastatic SCC:
- Platinum/FP + PD‑1 inhibitor; no HER2 drugs.
FP=Flouro pyrimidine/5-FU
->No HER2 targeting in SCC
->do not continue trastuzumab beyond progression.
🍽 Gastric surgery: D1 vs D2 = dictates adjuvant
- D1 (N1 only) → adjuvant chemoradiation (MacDonald/INT 0116; 5‑FU based).
- D2 (N1+N2)→ adjuvant chemo only (CAPOX, etc.; CLASSIC).
- Adding RT after good D2 (ARTIST) → no clear benefit.
🧠 Board one‑liners
->T1a N0 → EMR/ESD.
->T1b+ or N+ → surgery + periop systemic (CRT or FLOT).
->T4a- resectable; T4b → definitive CRT.
->Celiac nodes are regional for distal esophagus/GEJ.
->Gastric ≥cT1b → staging lap.
->Cervical esophagus→ definitive CRT (even if technically resectable).
-> Residual disease after neoadjuvant CRT + surgery → adjuvant nivolumab
->FLOT > MAGIC; periop chemo only for true gastric.
->Celiac nodes = Regional for distal esophagus/GEJ.
->p16is NOT used here (that's Head & Neck).
->Trastuzumab deruxtecan (T-DXd) = 2nd line for HER2+ disease.
->Ramucirumab = Adenocarcinoma only; not for SCC.
#OncTwitter #HemOnc #MedOnc #Oncology #Cancer #ITE #Boards #ABIM #MedEd #FOAMed #gcsm
@ASCO @NCCNorg @ESMO_Open @JCO_ASCO @OncLive @TargetedOnc @HemOncFellows @IMG_Oncologists @realbowtiedoc
#OncBoards
Follow: @MamthaB (X) | @Hemonc_dr (Insta)
(see the generated image above)
Gerardo CM retweeted
CONVERT V/S PROSPECT in Rectal cancer
Radiation for all LARC? Not anymore.
CONVERT + PROSPECT challenge routine CRT.
✔ Comparable DFS & OS
✔ Local control >96%
✔ Major reduction in long-term toxicity
MRF uninvolved?
Low-risk T2N+/T3N0–1?
Selective RT is here.
#RectalCancer #Oncology #ASCO #MedTwitter @NiuSanford @OscarTahuahua @OncoAlert @hoperugo @ASCOPost @JCO_ASCO @NEJM @dr_yakupergun @myESMO
