Alex Coffman, MD
@CoffeeMan_3Radiation Oncologist with Green Bay Oncology. Alumni of Loma Linda University, University of Vermont COM, and University of Utah. Views my own.
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This is what we thought would be but didn’t have evidence like this to support . Excellent work @Icro_Meattini and team @CShahMD @ErinGillespieMD
Low Dose Radiotherapy, it is wonderful to get these messages in the patient portal:
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)
Pacific version of SCLC. New SOC
📢🚨#ASCO24 plenary @DavidRSpigel - pivotal ADRIATIC ph III trial; adjuvant durvalumab arm after chemoradiotherapy (cCRT) ± PCI in small cell #lungcancer; ⬆️ OS (HR 0.73), median OS 55.9 vs 33.4 for placebo. Grade 3/4 AEs in 24.3% vs 24.2%. 💥Practice changing!!! #radonc #lcsm
More data showing that cancers that can be resected have better outcomes, even if surgery isn't part of treatment: in patients getting RT for T1T2 p16-neg OPSCC, a 39% OS difference! This is why non-randomized comparisons of surgery vs. RT don't work.
Treat with RX bone Mets not only in case of symptoms. -RT delivered prophylactically to asymptomatic,high-risk bone metastases reduced SRE and hospitalizations. ⬆️ in OS with prophylactic RT was also found. Another important message to change practice ascopubs.org/doi/abs/10.120…
H&N contouring tip. There are no lymph nodes inside the submandibular gland (in contrast to the parotid). So when contouring level IB, do not include the gland in your volume. It will unnecessarily increase your oral cavity dose (for non-oral cavity primaries).
Fantastic read about low-dose radiation treatment for osteoarthritis, highlighting @CShahMD Thanks for the heads-up @SprakerMDPhD @AcceleratorsRO! #radonc consultqd.clevelandclinic.org/low-dose-radia…
Results of B51 show patient selection for RNI based on response to systemic therapy is safe at first report! #SABCS23 Subtypes represented. Over half got SLN. Longer follow up planned; EBCTCG question: study notes RNI benefit is a long term investment. #radonc
So proud of Dr. Janice Lyons @RadOncUH chairing the updated APBI breast cancer guidelines! Way to go. Not easy to get agreement. @cwspeers @amandaaminmd @TedTeknosMD @DanSimonMD @NicholasZaorsky practicalradonc.org/article/S1879-…
In 8 newer trials of RNI, in the new EBCTCG meta-analysis of individual pt data finds, “estimated abs reductions in 15-yr breast cancer mortality were 1·6% for women w/ 0 + LN, 2·7% with 1-3 +LN, and 4·5% for those with 4+ LN. The Lancet #radonc #bcsm thelancet.com/journals/lance…
Bone Met week 4/5 Any benefit RT for asymptomatic high-risk bone mets? Randomized Trial Prophylactic RT less skeletal events/hospitalizations (& improved OS) compared to standard of care (SOC) ascopubs.org/doi/10.1200/JC…
Breast cancer patients undergoing neoadjuvant chemo benefit significantly from 3-month dietary counseling & home exercises w/ pCR rate of 53% vs 28% in those without intervention in a newly published RCT. Impact strongest in HR+, HER-2 negative & triple negative cancers.
New FIGO staging taking histology and substantial LVSI into account @KamravaMD @AnnKloppMD @bindhu2102 @AndrewKellerMD #gynsm
There has been a lot of 🔥discussion lately of short course radiation (SCRT) for locally advanced rectal cancer (LARC). I❤️SCRT bc it is convenient for working patients or those who travel for 🏥care. However, the RAPIDO update gives me pause. Let’s look at the history of SCRT:
Randomized trial of intermittent hormone therapy +/- radiation to oligometastatic sites of #prostatecancer shows significantly improved PFS & assoc time off hormone therapy & w/normal testosterone from combination. ja.ma/3nPhfZu #RadOnc #PCSM #GUCSM
Phase III Randomized Trial for Use of Docetaxel in Patients With Head and Neck Cancer, Unsuitable for Cisplatin-Based Chemoradiation. @VanitaNoronha @Amolpatel_dr @Nandinimenon18 @DrEzraCohen @JCO_ASCO @HHKhar @TataMemorial @DrHaddadRobert ascopubs.org/doi/abs/10.120…
Brilliant prospective study proving that boom boom 2Gy x2 is the way to go for orbital MALT by my brilliant colleague @ChelseaPinnix at plenary session @ASTRO_org @myESMO @ILROGTeam @ARRO_org @ASH_hematology @MDAndersonNews @SocietyofHemOnc
Excellent start for lymphoma radiation oncology in #ASTRO22 with an important presentation from @ChelseaPinnix on 4Gy/2# for orbital LG b-NHL. High response rate, low toxicity & very few needed re-treatment with mFU ~3ys. @ILROGTeam
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