Protons for oropharyngeal cancer? Following the presentation of TORPedO results at #ASTRO25, it seems like it might come down to whether you believe in UK or US data - or, in the words of Dr Takiar, the session discussant, 'whether you believe in a round or a flat earth' #radonc


Personally, I note that:
🔹The US trial saw significant insurance approval issues and large proportion of cross over
🔹Enrolment started over a decade ago, when IMRT optimisation & OARs were very different from today
🔹The fnding of OS benefit was very unexpected

I cleared my schedule in anticipation of 2nd jab side-effects, and I’m aching all over with muscle pains, so it’s just the right time to channel my inner grumpy old man (I’m moving like one anyway).
In other words:
🔹Time to critique #ESTRO2021 abstracts! 🔹
#radonc #medphys Standard disclaimer:
I’m just one abstract reviewer. My opinions and dislikes may not be representative.
I’m not targeting any specific authors - so even if you feel this hits too close to home, it’s probably not you that I’m thinking of (five other people did the same!)

Is there a radiation dose-response relationship for rectal cancer managed non-surgically?

Short answer: Yes - at least based on published patient series

Longer answer: See our #ESTRO2020 Poster Highlight - or thread below


#rectalcancer
#radonc
postersessiononline.eu/173580348_eu/c… Non-operative management of rectal cancer is becoming increasingly important - more and more patients are offered observation instead of surgery if they have a complete response after (chemo-)radiotherapy #radonc #ESTRO2020

For the first question: No trials showing higher pCR w/ higher dose. Trials are actually remarkably consistent (no difference):
INTERACT pubmed.ncbi.nlm.nih.gov/31005204/
RECTAL-BOOST pubmed.ncbi.nlm.nih.gov/32565319/
Dose-Effect pubmed.ncbi.nlm.nih.gov/22592048/
#jc questions #radonc

https://twitter.com/CarmeloT2681/status/1330177386592301057

❗️*However* ❗️
pCR doesn't matter to the patient! Only OS or QoL does! And pCR / tumour regression is not a surrogate for radiotherapy effects on OS, so why should we care about it? #radonc #jc
pubmed.ncbi.nlm.nih.gov/25611452/
pubmed.ncbi.nlm.nih.gov/26723110/

After reviewing 'predictive modelling & radiomics' abstracts for #ESTRO202, I had quite a few thoughts. I've finally found time to organise them in a semi-coherent manner

To follow: Some common pitfalls in modelling & radiomics abstracts for clinical conferences #radonc #medphys First of all, the basic stuff:
Get somebody who’s never seen your study before to read through the abstract - to ensure fundamental information isn't missing.
(And no, you won't notice yourself, because you’re too concerned with whether you can squeeze in another AUC value ...)

Part II of today’s tweetorial for International clinical trials day: #CTD2019 #ICTD2019

Why do you want to give physicists a central role in your radiotherapy trials?

https://twitter.com/cancerphysicist/status/1130374463730671618

#medphys #radonc
@ipemnews @EFOMP_org @aapmHQ @EORTC @CTRad_CChan First, what characterises medical physicists?
- We're quantitative, systematic & analytical
- We're trained in modelling, data visualisation, & interpretation of evidence

(And sometimes we - by which I mean me - go exploring in caves, which is almost like running a trial 😅)

Today is International Clinical Trials Day! #CTD2019

In the spirit of #CTD2019, I thought I’d take a bit of time to talk about medical physicists and radiotherapy trials #medphys #radonc
@ipemnews @EFOMP_org @aapmHQ Why should radiotherapy trialists care about medical physicists? And why should physicists involve themselves in trials?