Neo-DRATEC: 50.4 vs 41.4 Gy before surgery for ESCC increased major pathologic response (73.9% vs 52.7%) but not 2-year PFS (56.7% vs 49.3%; phase 2, n=147), with more esophagitis. Is pathologic response worth 5 extra fractions? pubmed.ncbi.nlm.nih.gov/4171…

Neoadjuvant SABR before IVC thrombectomy for RCC: 1-year RFS was 71.4% vs a 55.7% historical benchmark; no grade 4/5 RT-attributed toxicity (phase 2, n=23). Single-center, nonrandomized data, so promising, not practice-changing. pubmed.ncbi.nlm.nih.gov/4287…

CAN-2409 + valacyclovir added to RT improved DFS in intermediate/high-risk prostate cancer (HR 0.70; phase 3, n=745). Grade ≥3 AEs were 8% vs 7%. Long-term follow-up is ongoing; the therapy remains investigational. pubmed.ncbi.nlm.nih.gov/4222…

Five to 20 brain mets: SRS improved symptom/function scores vs HA-WBRT (−0.32 vs +0.74; phase 3, n=196), with similar OS. New mets were higher at 1 year (45.4% vs 24.2%). Is MRI surveillance capacity now part of treatment selection? pubmed.ncbi.nlm.nih.gov/4171…

Inspirational talk by trailblazer, @ASTRO_org president, @UCSDHealth CMO @catherynyashar about the “Hero’s Journey” in the field of radiation oncology at @COH_RadOnc annual symposium.

BART: Post-cystectomy pelvic IMRT raised 2-year locoregional recurrence-free survival from 76.0% to 87.1% in high-risk MIBC (phase 3, n=153). No patient received immunotherapy. Would you add RT for pT3/4 or node-positive disease today? pubmed.ncbi.nlm.nih.gov/4216…

STAR-TREC: In early/intermediate rectal cancer, 12-month TME-free survival was 78.5% with long-course chemoradiation vs 60.6% with short-course RT. This is an interim phase 2/3 result; the 30-month primary endpoint is pending. pubmed.ncbi.nlm.nih.gov/4263…

ConCERT: Weekly cisplatin 40 mg/m² was noninferior to 100 mg/m² q3wk with definitive RT for LA-HNSCC (phase 3, n=272). 2-year LRC was 61.3% vs 51.1%; grade ≥3 AEs, 44.7% vs 60.7%. The cohort was largely HPV-independent. pubmed.ncbi.nlm.nih.gov/4263…

S1914: Atezolizumab added to SBRT for high-risk, inoperable early NSCLC did not improve 2-year OS (82% both arms; HR 1.04; n=400). Grade ≥3 AEs rose from 3% to 12%; accrual stopped for futility. Is biomarker selection still worth testing? pubmed.ncbi.nlm.nih.gov/4270…

ROADS: Cs-131 tiles placed at brain metastasis resection improved surgical-bed RFS vs postoperative SRT (HR 0.48; phase 3, modified ITT n=204). Median follow-up was only 12.9 months. Would this change your postop approach? pubmed.ncbi.nlm.nih.gov/4280…

Metastasis-directed ablation did not improve PFS in oligometastatic breast cancer. NRG-BR002 (n=125): median PFS was 19.5 vs 23.0 months with systemic therapy alone (HR 0.92); OS was also similar. 93% of ablation patients received SBRT. pubmed.ncbi.nlm.nih.gov/4284…

LUNAR: Median PFS was 17.6 vs 7.4 months with ¹⁷⁷Lu-PNT2002 before SBRT vs SBRT alone (phase 2, n=92). PFS counted new PSMA PET lesions or hormonal salvage. Is that enough to add radioligand therapy for oligorecurrent prostate cancer? pubmed.ncbi.nlm.nih.gov/4286…

Six 6-Gy fractions with TMZ fared worse than standard six-week chemoradiation for glioblastoma (KPS ≥70). In a phase 3 trial (n=135), median OS was 13 vs 21 months; necrosis/pseudoprogression was 48% vs 16%. Accrual stopped early. pubmed.ncbi.nlm.nih.gov/4257…

ROAM (phase 3, n=157): After complete resection of grade 2 meningioma, 5-year DFS was 79.9% with RT vs 64.3% with observation (HR 0.51). Grade 2/3 radiation-related serious AEs occurred in 8% treated. Who would you still observe? pubmed.ncbi.nlm.nih.gov/4279…

7.4% vs 22.7%: acute grade ≥2 oral mucositis with protons vs IMRT in a randomized phase 2 trial of unilateral postoperative head and neck RT (n=98). Dysgeusia was also lower; dysphagia and 3-year local control were similar. pubmed.ncbi.nlm.nih.gov/4269…

RT CHARM, published Oct 12: 16 vs 25 fractions of PMRT had 2-year reconstruction complications of 12.3% vs 10.2% (n=825), meeting noninferiority. The prespecified margin was 10 percentage points; 3-year locoregional recurrence was 1.5% vs 2.2%. pubmed.ncbi.nlm.nih.gov/4286…

NeoORB: breast pCR was 52% with preop RT vs 27% with postop RT. But pCR was assessed before control patients received RT. Interim n=60; breast-conserving surgery was 26% in both arms. Which endpoint would justify moving RT before surgery? amportal.astro.org/sessions/…

For ≤2 cm HCC eligible for either approach, SBRT met noninferiority to RFA for 2-year local PFS: 91.5% vs 87.0% (n=93). This is a single-center interim result, not proof SBRT is superior. Would a perivascular location tip your choice? amportal.astro.org/sessions/…

SOAR-HN: 2-year grade ≥3 treatment-related toxicity was 6.7% with SBRT reirradiation vs 23.9% with conventional RT (P=.073). Among 59 evaluable patients, 59% assigned to conventional RT crossed over to SBRT. That makes survival comparisons difficult. amportal.astro.org/sessions/…