ASTRO has selected 29 members to receive the ASTRO Fellow (FASTRO) designation. Congratulations to the 2023 Fellows! The 2023 class of Fellows will be inducted during the Awards Ceremony at
#ASTRO23
in San Diego. View the full list here:
It is with great sadness to let you know that Jay Loeffler, MD, former Chief of
#radonc
@MGHCancerCenter
passed away ๐ข
He was a clinical innovator and leader, having pioneered the use of linacs for intracranial SRS
I am forever indebted to him for hiring me & starting up my
@AshleyGWinter
5, eh?๐
Standard fractionation = I give you a small piece of chocolate every day for like 2 months
Hypofractionation = Larger piece of chocolate for 4 weeks
Ultrafractionation = HUGE piece 5 days in a row๐
IMRT = I am gonna throw the chocolate at you from more than 4
AUDARA update with longer F/U but OS data still withheld
Interesting๐ Brain mets incidence starts to rise AFTER 3 years osi is up in stage II/IIIA while in control group it plateaus at ~10%. So does osi really only delay recurrence?๐ง
Do we need MRIs???
More than 100 years ago Dr Dessauer demanded
#radiotherapy
dose homogeneity in the field; a concept that has rightfully enduredโข๏ธโ ๏ธ
But with modern IMRT why not give more to the tumor centerโ๏ธ๐ง๐คจ
[unless critical normal tissue mixed in with tumor]
#radbio
#doubletrouble
#lcsm
Nice job by
@MayoRadOnc
team exploiting biology of
#protontherapy
#radbio
๐จPaper includes FIRST in vivo data suggesting that homologous recombination defects (BRCAmut) indeed cause proton sensitivity, validating in vitro studies by us & others๐จ
๐๐๐
There are 4 teachings I picked up from Noah Choi, MD who was a thoracic
#radonc
attending here for almost 40 years:
1โฃ Never lose hope (even a very large
#lungcancer
can sometimes be cured with
#radiotherapy
)
2โฃAlways take the extra step for your patients
3โฃLeverage
๐Congratulations to Anthony Zietman MD FASTRO who has won the
@MassGenBrigham
2020 Medical Education Award for Outstanding Program Director
#HROP
#radonc
๐
Always engaged, kind, listening, full of positive energy, and eager to improve things!๐ But, still not on Twitter๐
That time of year againโข๏ธ๐ง
Official
@harvardmed
course teaching a tidy 20 hrs of radiation biology to
#radonc
residents,
#medphysics
students, fellows, the occasional attending๐ & more
Dr. Kathy Held
@MGHCancerCenter
has taught this course for 25+ years ๐๐๐
#radbio
#meded
Farewell Natasha, lead
#radiation
therapist (RTT) for our
#lungcancer
patients, after 12+ years. She's the best, always kind, caring, compassionate. We love her. North Shore you're lucky!
RTTs - often underappreciated yet critical for patient care + precise radiation delivery๐๐
Anthony Zietman again showing leadership uniting
#radonc
faculty, nursing, physicists, lab, staff, therapists and other for THE DANCE at annual MGH Departmental holiday/winter party ๐พ๐๐บ๐ฅ
1/
๐จ
#radonc
-pick up the new
#RedJournal
issue
(Dec1 -ahead of its time)
Lovely, lovely tribute to outgoing Editor-in-Chief Anthony Zietmanโฅ๏ธ
I can't possibly do justice in 1
#MondayMorning
tweet ๐งต but if y'all chime in, maybe we can make
#LoveALZ
trendโ๐
@sueyom
#ASTRO21
#LCSM
Important phase II trial
Closed at 50/120 patients
With caveat of small sample addition of SBRT to nivo
#immunotherapy
in metastatic
#lungcancer
did not show (dramatic) efficacy signal
@_ShankarSiva
- thoughts on way forward in this space?
1/
#ASTRO23
Gold Medal ๐ to
@simonpowell213
โ ๏ธEver the commensurate
#physicianscientist
โ ๏ธRole model for
#radonc
#radbio
researchers๐
โ ๏ธInspirations to IMGsโ๏ธ
โ ๏ธProof of the impact of Random Events in Medicine (recruited to MGH following a talk given after Herman
Clinical Radiation Biology Triviaโข๏ธ No. 4โฃ
A Multifocal
#lungcancer
, ground glass lesion treated with
#SBRT
B 3.5 years later (with permission)
This resulted fromโ
a. massive TGFb release
b. tumor hypoxia
c. alpha/beta >20Gy
d. local immunosupression
๐
#radonc
#radbio
#MedEd
#ASTRO21
#LCSM
Clinical trial of SBRT for mediastinal nodes in
#lungcancer
with
#Immunotherapy
Dose 50 Gy/5 fx
Lack of serious early toxicity is encouraging though longer follow up is needed to assess long term AEs
Off protocol, probably should not go >30-35 Gy/ 5fx QOD IMHO
LungART trial finally out at
#ESMO20
. Postop
#radiotherapy
with no significant benefit. Mediastinal recurrence of 46% without PORT was what would be expected & PORT decreased it but (I must say surprisingly) did not translate into DFS or OS benefit
@PercyLeeMD
@KHigginsMD
#lcsm
#ESMO20
LUNG ART showed no improvement in DFS or OS with post-operative radiotherapy for completely resected N2 NSCLC. In fact, PORT had a non-significant increase in DFS and increased cardiopulmonary toxicity. Routine PORT no longer SOC.
#LCSM
@OncoAlert
Touching tribute at
#HROP
#radonc
residency graduation to 3 amazing
#womenwhocurie
we lost this past year:
Claire Beard
Melenda Jeter
Larissa Lee
Julia Wong &
@MiyamotoDavid
with a beautiful musical eulogy ๐
๐ฅ๐ฅ๐ฅ
Such a treat to hear
@DKirschMDPhD
speak on his now a couple of decades spanning research in the famous
@MassGeneralNews
Ether Dome๐
Good to know p53 is alive + well๐
Absolute photo op pleasure with Helen Shih & then residency program director Anthony Zietman
#ClassOf2005
๐
๐กIt has recently come to my attention that
@sophia_kamran
never got a๐while she rotated through the ๐ซThoracic service as a resident (even though that included her birthday & she [obviously] was a๐resident)๐ณ
Ok, that was back in 2014 ๐ but it's never too late to make
๐จThis is ... quite fascinating!! ๐จ
๐งฌDNA damage is a homeostatic driver for sleep, and PARP1 can sense this cellular pressure and facilitate sleep & repair activity๐
๐งBetter to give PARP inhibitor only in the morningโ๏ธ
@ProfAJChalmers
โก๏ธ
Live tweeting is exhausting ...
Awesome job everybody at
@ASTRO_org
Presidential Symposium arguing for and against
#SABR
use to try to cure oligometastatic
#cancer
It might be a tie๐
Wait for poll.
#ASTRO19
#OncoAlert
When a patient with early
#lungcancer
asks his/her surgeon or radiation oncologist about the chances of a local tumor recurrence, the answer depends on what type of definition of recurrence is used.
It's a bit like comparing ๐with ๐
#radonc
#SBRT
#lcsm
Memorial on the grounds of the Hermann-Holthusen-Institute in Hamburg Germany, honoring physicians, physicists, nurses etc lost to the complications of underappreciated radiation exposure in the early 1900s
#125YrsRadonc
#Radonc
@SorenBentzen
@Rad_Nation
#ASTRO21
#selfies
time
Awesome to congratulate in person the amazing
@DrWinkfield
for joining
@POTUS
National Cancer Advisory Board๐ช๐
Let's change our image as Machine Doctors who are defined by the machines we run (and market๐).
We are MORE.
#radonc
#oncology
#DEI
1/n
#ASTRO20
#OncoAlert
#LCSM
Phase I trial of contralateral esophagus sparing for locally advanced NSCLC & SCLC, presented by rising ๐
@sophia_kamran
G3 esophagitis =terrible AE (G2 can be bad too!) & may limit treatment intensification with โฌ๏ธdose (see RTOG 0617) andโdrugs
Our poster at
#NACLC19
โก๏ธ KRAS/TP53 (KP) mutation mediates radioresistance (we have now 4 papers on this)
โก๏ธ Radiation tumor response curves are sigmoid, more dose is better!
โก๏ธRadioresistance can be overcome by dose escalation or KP selective inhibitors
#radonc
#lcsm
#OncoAlert
1/
Presidential Symposium on normal tissue toxicityโ ๏ธ
Great intro by Sarah Kerns๐
There is some evidence for genetic predisposition to unusual normal tissue toxicity but outside perhaps ATM how to predict?
It's complex...
#ASTRO22
#radbio
@OncoAlert
Report on brachial plexopathy after SRS for apical lung tumors
๐for sharing these data
Worth discussing
๐คShould the rate of nerve injury after SBRT be a firm 0?
๐คWhat is appropriate follow up (median only 21 mo)?
@SBRT_CR
@JoeChangMD
@SorenBentzen
1st hair cut in 4 months feels pretty good๐ People don't seem to know that the hair salon at
@MassGeneralNews
is open again, though for employees only.
I was the only customer today!๐
@Caroline_Bartma
Pro Tip: If you have to pick one or more cell lines, pick one(s) that grow well and reasonably fast, are myco free, and authenticated๐๐
๐Parking can cost families hundreds. It should be FREE.
โThe parking is outrageous. We already have to pay for medical bills & are trying to take care of our sick child โฆ & then we have to pay for parking on top of all of that.โ
#ASTRO20
Why do we seem so fond of mean OAR doses?
Mean heart dose not mean much in the setting of relevant substructures. Mean heart dose can be low & still the LAD might get fried
IMHO same for mean esophagus dose. You can burn a whole segment and still have low mean
Wrong?
1/
Great to see CALGB 30610/RTOG 0538 finally out!
๐จ70 Gy/7 wk equivalent to 45 Gy BID/3 wk๐จ
Some thoughts
1โฃInteresting that increased G3+ lymphopenia in 70Gy does not result in worse outcomes?!
@StevenLin_MDPhD
@CGrassberger
@OncoAlert
#LCSM
Used to drag around these large poster printouts, a pain on the plane.
But then found this supereasy cloth solution at
For only ~$20!
Should be fun to hang it up at
#nasclc19
#lcsm
tomorrow morning ๐
This phase I trial tested a contralateral esophagus sparing technique (CEST) in 25 pts w/
#LungCancer
& treated w 70 Gy IMRT & concurrent chemo. There was no G3+ & ~25% G2 esophagitis; results support
@NCCN
guidelines & favor integration into practice
#LCSM
Wow busy day๐
I just want you to know I probably can't keep this up๐คฃ but either way its an honor to be
#ASTRO21
#SocialChampion
๐๐๐
Awesome meeting so far and scientific content was simply phenomenal!!!
Who is excited that the annual Harvard
#RadBio
Course directed by Kathy Held is starting up againโ๐
20 solid hours of โข๏ธ๐ฌ funโผ๏ธ๐
Like every year we'll mix it up a bit again to keep it interesting. Maybe throw in a few Twitter polls about clinical relevance of BED calcs๐
BID
#radiotherapy
(hyperfractionation) superior to standard QD in recurrent nasopharyngeal cancer
Reirradiation remains one of the few scenarios where BID radiation is still clinically used for benefit!
(also shows that radiation doesn't cause radioresistance)
@OncoAlert
This exciting paper was just published showing proof-of-principle of a core belief in radiobiology weโve had for a long time: that hyperfractionation can reduce long-term side effects of radiation, in this case translating to OS improvement!
#radbio