SBRT memes for hypofractionated teens
@sbrtmemes
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When a Urologist breaks ranks and recommends radiation...
#treatmentsorkitchenappliances
#blenderprocedureisnext
#radonc
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Therapist: It's ok medonc, SBRT man isn't real, he can't hurt you
SBRT man:
(source: )
#sbrt
#radonc
#polymetsmorelikeallmets
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🛏️ >>> 🧠
@SprakerMDPhD
@ProtonStorey
And then throw in reirradiation based on BED and EQD2 metrics with heterogeneous fractionation schemes...
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Hmm....With protons, 5-year ORN rate is 14.4% in oropharynx, 9.9% in oral cavity, and 11.5% combined.
Authors point to higher RBE of protons as one possibility. Credit to them for sharing and publishing this, would love a podcast discussion
#radonc
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Can we omit 5 years of pills that give side effects? No, let's omit 5 days of radiation instead.
The DEBRA Study, NRG-BR007, will be checking to see if treatment with hormonal therapy alone is the same as the usual treatment of radiation and hormonal therapy in women with low-risk, hormone-sensitive
#breastcancer
who have had a lumpectomy. Learn more:
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I've been waiting for a piece like this for a long time.
Surgeons often sacrifice tissues/organs to remove the tumor
Medoncs accept 50% grade 3-5 AE for immunotherapy (), and yet
1/2
#radonc
Out now in
@IJROBP
, my piece with
@BobTimmermanMD
describing a new way to approach radiation toxicity that we term as CUT: calculated useful trauma.
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Time to rebrand radiotherapy as radiatumumab and re publish all our OS, PFS, and safety profile data
@US_FDA
@POTUS
#radonc
Aggregate safety data for pembrolizumab monotherapy across trials in European Journal of Cancer with Dr.
@JulieBrahmer
et al (n=8937). G3+ AEs in 51% of pts, discontinuation from AE in 13%, fatal AEs 6%. Median time to immune-mediated AE was 85d.
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@drmattmc
Yup. The priorities for men are to preserve function whereas the priorities for women are set by leaders with their own “priorities” (ego, career, fame, money), rather than to try to help the patients suffering from breast cancer.
If we did a survey asking what these women
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Some radoncs have not learned sometimes the worst toxicity is the tumor. There should be nuance in how constraints are applied case to case, when to violate/sacrificewhen to respect.
We need a new paradigm in precision RT. You can't make a Jedi with stormtrooper energy
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I just love learning in this particular city so much pleeaaaase let me learrrn
#beachvibes
#spf50
#radonc
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He's a 10 but only prescribes 2 Gy per fraction
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Every year we play this game at Astro...
#ASTRO2023
#radonc
Great to see the awaited results of
@NRGonc
RTOG0920 evaluating the addition of cetuximab to adj RT in int risk HNSCC. Improved 3yr DFS 78.3% vs 71.5% HR 0.75, but not OS. Anticipated ⬆️ acute toxicity but similar long term.
@ShlomoKoyfmanMD
@ajacobmiller
@JLGeigerMD
@YilmazMDPhD
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Me on my 5th contour of the day
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When you show surgeons any data showing inferior outcomes with surgery in literally any setting
"Not in my hands..."
#myrobotcanpeelgrapestho
#radonc
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Radoncs putting out positive sabr trials when other specialties explicitly told them to stop 🛑
#ASTRO2023
#radonc
#donth8abl8
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Community submission by Flomax:
Prostate elective pelvic nodal radiation debate
#communitymemes
#radonc
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You gotta love those 300% + plans, lots of potential to grow
#radonc
#sbrteverything
#brachyablateeverything
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When you explain the only 3 radiation physics facts you remember to junior residents
#ABRandforget
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Me watching an alternate reality where radoncs get their act together and innovate cancer care fast rather than do the same dumb studies of dose/fx comparisons and making dumb arguments no other specialty cares about.
#victimmentality
#lookinthemirror
#radonc
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If you believe hard enough...
#surgeonshatehim
#localradoncturnsintosurgeonwithoneweirdoldtip
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Featuring meme submitted by "Flomax"
#radonc
#memecommunitygrowing
#bladderhalffullorhalfempty
(Yes I take submissions)
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When you get randomized to the control arm of a trial offering sub-standard therapy
#pharmaonc
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Me going to ASCO then returning to my center having to put 50+ Gy into necks again
Absolutely terrific thread here on ENI dosing for oropharyngeal cancer, touching not just on recent data but on how new standards are established.
Just a few thoughts on top of well-articulated arguments for different approaches. (1/n)
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Probably the most important study presented so far, and hopefully changes how we practice
Phase 3 please
@ErinGillespieMD
#ASTRO2022
Wow. I feel like this trial is a really big deal
@ErinGillespieMD
tremendous work!
@MSK_RadOnc
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"look at those trouble makers giving radiation without level randomized evidence powered for OS"
- radonc who let's patient with single site of recurrence get chemo for a year
#stateoftheunion
#radonc
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Hot off the press in
@IJROBP
: the ARREST phase I trial of SABR in poly-metastatic disease, led by
@lhscradonc
&
@TimkWin
Average number of lesions = 16
Dose safely escalated to 30 Gy in 5 fractions.
The phase II/III RCT ARREST2 is underway!
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Welcome to the sbrtmemes radonc residency program.
I will take your questions now
#radonc
#sbrt
#homogeneousinthestreetsheterogeneousinthesheets
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AP/PA is an awful way to treat in 2022 for almost anything, change my mind in$urance companies
#sbrteverything
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Reposting meme in honor of this:
Therapist: It's ok medonc, SBRT man isn't real, he can't hurt you
SBRT man:
Yesterday, we activated two new RCTs of SABR in the oligo/poly-metastatic space.
This one below is SABR-SYNC, enrolling patients with up to 10 metastases and a synchronous primary tumor. It's a phase III, primary endpoint is OS.
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When you return from a conference full of hope and ideas and go back to work in your dept
#radonc
#hellodarknessmyoldfriend
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Local medonc publishes single arm study of chemo/IO cocktail that contains neoadjuvant, concurrent, and maintenance therapy, writes "acceptable tolerance" with 30% completion rate and 50% grade ≥3 tox.
#2monthOSbenefit
#only200grandayear
#imagineifradoncdidthis
@NEJM
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*Everyone agreeing in tumor board about a plan*
That one person:
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Why have crisp and tight imaging focused contours when you can give rads to everything with
B o n y l a n d m a r k s
#tryittoday
#foralowlowcostoflotsofsideeffects
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Hi everyone,
I am deeply sorry for all my memes and if they have hurt anyone's feelings.
I have realized the error of my ways and this will now be strictly a proton appreciation account from now on.
Best,
sbrtmemes
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MD =/= good leader
Often we promote renowned researchers to leadership posts and assume they can lead well
Leadership is one of the hardest skills and needs a team that can criticise leaders without retaliation
#radonc
#benchtobedsidetoanothercenter
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🛑🛑🛑Here is our STOP RCT looking at SABR in patients with oligoprogressive cancers, just published in
@ijrobp
We learned a few important lessons for clinical practice and for the design of future trials...(thread 👇)
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So now that no one can see you liking my memes, what's stopping you??
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When a resident asks you to explain why this dose fractionation works over others.
#2gyadaykeepsthedoctoraway
#radonc
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Some day we will escape our past, but change is hard.
"I hang onto my prejudices, they are the testicles of my mind." Eric Hoffer
#radonc
How did 2Gy/fraction become standard in RT?
Answer: ram testicles.
Lab work done by the French showed less skin/sterility issues with 2Gy to ram testicles vs bigger fractions.
Much of the dogma in our field is based upon strong opinions, urban legend...& livestock lab data.
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Another meme contribution from Flomax. I wonder who they could be?? 👀
#sprinklesomerads
#ifyoubelievehardenough
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