Radiation Oncology, IOSI - Oncology Institute of Southern Switzerland, EOC, Switzerland
Bellinzona, Svizzera
Joined September 2018
- Tweets2.9K
- Following1K
- Followers2K
- Likes6.3K
Thomas Zilli retweeted
⚡️ Phase 2 trial in RCC with inferior vena cava tumor thrombus: neoadjuvant stereotactic ablative radiotherapy (SAbR) followed by surgery (n=23).
1-year recurrence-free survival: 71.4% — above the 55.7% historical benchmark. Thrombus downstaging in 22%.
A promising approach for one of the most challenging complications in kidney cancer.
#KidneyCancer #RCC @JAMAOnc
jamanetwork.com/journals/jam…
Thomas Zilli retweeted
Excited to share our JAMA Oncology phase 2 trial of neoadjuvant SAbR for RCC with IVC tumor thrombus!
1-year RFS: 71.4%, meeting the prespecified criterion. Feasible with encouraging safety findings. Larger trials are next!
doi.org/10.1001/jamaoncol.20…
#KidneyCancer #RadOnc
Thomas Zilli retweeted
Interesting data- penile bulb dose predicts ED in CHHiP, data from PACE-B will show association with crura D2% <12.7Gy, validating @Achard_Verane ‘s previous work (D2% <12Gy) . Prob all measuring the same thing.
Thomas Zilli retweeted
Nice work! Study shows more RT fx > more lymphocyte depletion > worse OS.
Palliative RT setting, but relevant to definitive/SBRT.
Post-RT lymphocyte = underutilized biomarker IMO (though cheap, routinely collected) but increasingly important w more RT/IO integration. @OncoAlert
So proud of rockstar med student / future #RadOnc @JoshuaKimMSx on this important work on #palliative RT and #lymphopenia, now officially in press! #RT fractionation matters! @IJROBP Clinical and Treatment Factors associated with Lymphopenia after Palli… sciencedirect.com/science/ar…
Thomas Zilli retweeted
Enjoyed this session & learned a lot!
Both TARE & SBRT can deliver ablative RT in HCC. Key q is which approach is best suited for a given pt/tumor.
Sharing some of my slides below re: decision-making b/w the 2 modalities.
TY to @GIcancerDoc & @EileenMOReilly for the invite.
Thomas Zilli retweeted
New in #practicalRO: Analysis of Major Joint Dosimetry Based on a Standardized Contouring Method Among Patients with Extremity Soft Tissue Sarcoma. This article was presented during #ASTRO2026 in Oral Scientific Session 24. bit.ly/46ODYbw
Thomas Zilli retweeted
☢️ #ASTRO26: LDRT in knee OA is fascinating.
292 patients | 4.5 Gy/10 fractions
At 3 years:
🦵 VAS pain: 21 vs 55
📈 Responders: 69% vs 25% (p<0.0001)
Long-term: disability 14% vs 25%; KL-2 knee replacement 14% vs 36% (HR 0.32, p=0.021).
Thomas Zilli retweeted
@RTOGFoundation STEEL presented by @EdwinPosadasMD and team.
Adding 24 mo enzalutamide to ADT + salvage RT improved an early PFS endpoint (HR 0.62; 80% CI 0.42–0.91), but Grade 3 AEs rose 19%→30%.
With AR signaling further suppressed, it’s unclear how much early PSA differences tell us. If 95%CI used would be non-significant even.
Need mature metastasis/clinical outcomes and ARPI doublet with SRT remains unproven. FORMULA-509 negative overall also.
#ASTRO26 @ASTRO_org @HimanshuNagarMD @rtdess @NRGonc @TylerSbrt @ndesai2005 @angela_jia_ @Soum_Roy_RadOnc
Thomas Zilli retweeted
Danny Song and team present on correlation of penile bulb dose and sexual function.
Planning pearl from #ASTRO26: does penile bulb dose matter?
PB mean dose ≤9.94 Gy was associated with less 48-mo sexual QOL decline (MCID):
🎈 Spacer: 0% vs 52.9%
Control: 33.3% vs 71.4%
A potentially actionable dose constraint hiding in plain sight? Post-hoc and not validated in RCT...correlation vs causation. #ProstateCancer
@Soum_Roy_RadOnc @TylerSbrt @ndesai2005 @rtdess @angela_jia_ @HimanshuNagarMD @AmarUKishan @DrAndrewLoblaw @alison_tree @urotoday @ASTRO_org
Thomas Zilli retweeted
With great imaging comes great responsibility to not overtreat
Time to find more ways for MRI and PSMA PET to reduce overtreatment of #ProstateCancer
@ASTRO_org #ASTRO26
In Collaboration with our partners at ASTRO we continue our coverage of #ASTRO26 🚨
LBA 03 - SWOG S1827/MAVERICK: A RANDOMIZED PHASE III TRIAL OF BRAIN MRI SURVEILLANCE WITH AND WITHOUT PROPHYLACTIC CRANIAL IRRADIATION (PCI) FOR SMALL-CELL LUNG CANCER (SCLC)
Presented by Dr. Paul Brown 🇺🇸
@DrewMoghanaki, @JhanelleGray, @PDBrownOnc, @lynnhenrymd, @LauraAlderMD
This phase III trial evaluated MRI surveillance 🆚 prophylactic cranial irradiation ☢️ (PCI) in 304 patients with #SCLC without brain 🧠 metastases.
➡️ MRI surveillance significantly improved cognitive failure-free survival (HR 0.60) and reduced cognitive failure, with no apparent overall survival detriment (HR 0.90).
➡️Benefits were consistent across stage and immunotherapy subgroups, including patients eligible for hippocampal-avoidant PCI.
➡️Longitudinal analyses also demonstrated improved patient-reported cognitive concerns and quality of life with MRI surveillance alone.
Social Champtions
@DrewMoghanaki, @themednet, @nadinehousri, @IAbuGheidaMD, @lauren_henke, @TugceKutukMD, @ARRO_org, @sarthakshah097, @P_Shams_, @CJTsaiMDPhD, @TylerSbrt, @barrosonco, @AlexisNarvaezMD, @OncoAlert, @CancerNetwrk , @ASTRO_org @PRJeffWhite
OncoAlert RT Faculty
@MKnoll_MD @HenningWillers @fumikochino @_ShankarSiva
@PercyLeeMD @Icro_Meattini @ErinGillespieMD @seanmmcbride @NiuSanford @to_be_elizabeth
Thomas Zilli retweeted
🙏🏼 for the shout out Pres. @NehaVapiwala!
Can’t wait for this international consensus guideline to be published
#ASTRO26 @ASTRO_org
Thomas Zilli retweeted
LINACS is online!
What? Living Systematic Review on Safety of Stereotactic RT ⚡️+ Novel Anticancer Drug 💊
Published url.de.m.mimecastprotect.com…
Online Database: linacs.net
Housed in @ESTRO_RT @EORTC Oligocare consortium
Updated every 6 mo 🔄
🧵
Thomas Zilli retweeted
What is the optimal RT for brain mets in small cell lung cancer. NRG -CC009 compared SRS vs HA-WBRT. Although SRS doesn’t improve neurocognative function but it improves OS. SRS will be an option (preferred?) for brain mets in small cell lung cancer.
Thomas Zilli retweeted
Great trial!!
We need more data for MDT in synchronous Oligometastases. In I-STOP, 97% were metachronous.
Best evidence we have so far for comes from EXTEND, where ~30% had genuine synchronous Oligomets. Table S4👇 is priceless (variable denoting synchronous vs metachronous is Primary tumor presence).
EXTEND is a gem!
@ChadTangMD @AlexSherryMD @jryckman3 @TylerSbrt @5_utr
Thomas Zilli retweeted
👏👏Congrats to @ALLIANCE_org, @PDBrownOnc , Dr. Ayal Aizer & the team for Alliance A071801 Ph III postop single vs frac SRS for brain mets, & the eloquent discussion by @Rrkotecha!!
🌟fractionated-SRS ⬆️ surgical bed control, OS (exploratory), and ⬇️ WBRT.
@ASTRO_org #ASTRO26
Thomas Zilli retweeted
#ASTRO26: In PSMA-PET+ oligometastatic prostate cancer, adding SBRT to iADT showed:
📉 3-yr biochemical progression: 21% vs 60% (p=0.004)
⏱️ Time to progression: NR vs 27 mo
🔄 ADT re-initiation: 18% vs 41% (p=0.06)
📊 No significant QoL difference
Promising signal for MDT!
🤖 Made with AI
Thomas Zilli retweeted
Very nice results, confirming EXTEND from @ChadTangMD et al. MDT has added value over systemic Tx alone. #ASTRO26. @RKSayyid these results have to be added to Wolverine!
STOP: RCT of iADT +/- SBRT in PSMA PET+/ CI-oligometastatic HSPC/BCR (n=60)
🔹91% of eligible pts enrolled → feasibility endpoint met
🔹3-yr biochemical progression: 21% vs 60% favoring iADT+SBRT (p=0.004)
🔹Median time to biochemical progression: NR vs 27 mo
🔹3-yr ADT re-initiation: 18% vs 41% (p=0.06)
🔹No significant difference in QoL
🔹CD14high/CD14low monocyte ratio showed potential as predictive biomarker
🔑Adding SBRT to iADT substantially improved biochemical control & may delay ADT re-start in PSMA+ oligometastatic recurrence; larger trials/longer follow-up needed
@urotoday
#ASTRO26
Thomas Zilli retweeted
Dr Buyyounouski @StanfordRadOnc w 5y AE outcomes after hypofrac vs standard post-op RT for #ProstateCancer in @NRGonc GU003
Outcomes are encouraging. Do we need to wait for 13y outcomes in light of Wisconsin study?
@ASTRO_org #ASTRO26
Thomas Zilli retweeted
SO, the GU-003 data could continue to look worse with time as f/u matures, because of the DOSE ESCALATION. 📉 These data don’t kill hypofrac, they just strengthen the case for 52.5 Gy/20 fx, as used in RADICALS, to be preferred hypofrac postop regimen—shorter tx **without the dose escalation** used in GU003. #ASTRO26 #ProstateCancer
#ASTRO26 #Pcsm #RadOnc
