Thread by @biniamkidaneMD

1/important to understand the realities that have driven our pivot to this protocol
-surgery is SOC
-these healthy & operable patients want surgery for many reasons (including known longterm cure rates)
-surgery is being delayed/cancelled due to #covid19 as is invasive staging

https://twitter.com/drewmoghanaki/status/1250370638726017026

2/
-#sbrt can offer safer therapy while preserving PPE & ⬇️ risk during #covid19
-patients can elect to undergo #sbrt as bridge to surgery
-they can elect not to undergo surgery later
-surgery will allow for appropriate nodal staging & resection as per SOC...& answer🔑questions

3/
-randomization may be something that can be considered in future but these are not patients that are considering #sbrt vs surgery:these patients want surgery but it is either not possible,delayed or highly risky during #covid19
-MISSILE has shown us safety of this approach

4/there may be patients that are ok with just #SBRT &might consider Sx later for salvage➡️these aren’t the people we’re talking about.
Fundamentally,we’re trying to offer best possible care during difficult times.Despite differences in opinion, we all share that common goal #LCSM

@threadreaderapp please compile