@DrAndrewLoblaw Very much agree. Cure rates are probably as good as they'll be, so how can we make the experience of treatment, and the weeks/months/years after as good as possible

@DrAndrewLoblaw @gerard_morton 100%. 1 vs 2 HDR has been asked and answered. What hasn't been fully flushed out is the exact mechanism and whether there is something unique about prostate RadBio that explains the apparent benefit of at least some fractionation

@_ShankarSiva @TheLancetOncol @DrAndrewLoblaw @WallisCJD @DrAlexLouie @MichaelStaehler @spsutkaMD @DrewMoghanaki @drphil_urology @wandering_gu @MRoupret @uretericbud Nice work! SBRT is a phenomenal option for these patients! Hope to have our data out soon for the larger tumors also 💪💪. Way to go Shankar

@VedangMurthy @akshay_dinesan @RadOncTMC @docpriyamvada @drmaneesh_singh @PrachiSMehta Great example of curiosity --> discovery!! And now we all benefit! Strong work 👍👍

RT @APCCC_Lugano: Two-fraction Versus Five-fraction Stereotactic Body Radiotherapy for Intermediate-risk Prostate Cancer: The TOFFEE Meta-a…

Way to go guys! I haven't kept track but what is this, like a paper a month?! 💪💪

RT @DrAndrewLoblaw: Kudos @cristian_udo for leading this analysis of long-term oncologic outcomes of 2 vs 5 fractions of SBRT. Stay tuned…

@merino_tomas @VedangMurthy @DrAndrewLoblaw @DrSpratticus @aleberlin2 Agree mostly with Vedang 😊. He is young, healthy, I'm going to assume with very good baseline function and PS. Nowadays w/ option of highly effective and safe 5-fx pelvic RT, can most likely cure and prevent need for ADT in future. While aggressive, I would offer

@singhv2003 Very true. But a challenge, as many pts are older w/ multiple comorbidities, surgery not w/o risks, and even biopsy has high chance of bleed. Radiographic diagnosis is pretty good, but a worthwhile endeavor to keep working on

@dr_alimuhammad @DrAndrewLoblaw @AmarUKishan @alison_tree @_ShankarSiva I would, certainly 6mo, and if tolerating, cont. to 18mo. He technically has HR disease and LT-ADT shown to ⬆️ clinically meaningful endpoints. Depending on specs of the bx (# cores per ROI), the math could even work out to 50%➕. I'd lay off the LNs w/ RT, prob min/no benefit 👍

Next major game changer in Rad Onc - PULSAR, hands down. In my experience so far, decent/mixed results in metastatic RCC and 2 phenomenal outcomes in widely metastatic and progressing cutaneous melanoma. So much to yet learn and so much potential @BobTimmermanMD @DavidSherMD

Couldn't agree more! I'd say 80% of our men at the Davidoff Center, whether intermediate, high, or oligomet, are getting SBRT. It almost pains me to have to offer someone more than 5 (or 6) fxs! Let's keep heading toward efficient and effective care 👍👍 @RabinMedical_

RT @drdavidpalma: We are looking to feature research focused on: 1) Growing the evidence base for SBRT 2) Clinical implementation of SBRT…

RT @oncodaily: Prophylactic Pelvic RT with SBRT for High-Risk node negative Prostate Cancer - @gusviani @VedangM…

That's exactly the goal. Fortunately we've gotten to the point where "cure" is achievable for almost all, so our focus needs to be on quality , safety, efficiency. Not worried about losing my job if "we cure cancer" b/c our job is part of the solution 👍👍.

Important question is in the context of CSPC, do the benefits of NOT having to have ADT outweigh the ⬆️ risk of biochemical progression, at which time ADT can always be given. MDT w/ SBRT, followed by ADT if necessary may be preferred by many pts.

RT @VedangMurthy: With the new year, comes new insight. Is 25Gy/5# enough for prophylactic nodal RT in high-risk #ProstateCancer? Borrowed…

Very worthwhile expert opinion report on urethral sparing! My personal practice - planning MRI, contour urethra on T2 (usually requires 5-6mm brush), limit to 102% of rx, add 2mm PRV, limit that to 104%. Goal of maintaining coverage but keeping relatively cool 😎

@nickva1 @TylerSbrt @DrAndrewLoblaw @jaydetsky @VedangMurthy @alison_tree @cpeedell @VickersBiostats Great background and overall I feel and practice very similarly

@SbrtSean I would do one at the beginning to confirm bladder and rectum, but then tracking (fiducial or MR) is ideal!