Jeff Ryckman @jryckman3 Twitter profile | Pikagi

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Jeff Ryckman

@jryckman3

4,131

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3,110

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1,363

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9,276

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Medical physicist➡️MD. Passionate about #RadOnc . Focus on QoL⚖️, LR-PFS 🎯, OS, constraints🙅‍♀️, standardization, & reproducibility. #RadOncCalc @RadOncReview

https://t.co/h3TvIPMR3R

Joined October 2009

Don't wanna be here? Send us removal request.

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@jryckman3

Jeff Ryckman

9 days

Amazing to connect with the incredible @TargetingCancer team & friends at #ASTRO24 ! 🌟 Despite ~2% of global onc research spend going to #RadOnc , RT is saving lives every day. Proud to be part of the global push to raise awareness for its vital role in cancer treatment! 💪🌍

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@jryckman3

Jeff Ryckman

2 years

Is there a role for Local Tx of the Primary Tumor for Patients with Metastatic Cancer? 🚫Many studies demonstrate no benefit. 📌We performed a MetaAnalysis to evaluate the average effect of Local Tx across various tumors. A thread🧵 #AMSM #PRIMETX 1/25

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Jeff Ryckman

1 year

Wow, this made the @nytimes ! 🤯 #radonc #fixpriorauth

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@jryckman3

Jeff Ryckman

2 years

Wow, I can't get over the accuracy of insurance rebuttals using Chat-GPT! What used to take me around a half hour to write now takes one minute. Such a huge time-saver, and with some guidance, even the Bibliographies can sometimes check out! #radonc #PCSM

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@jryckman3

Jeff Ryckman

1 year

This three-pager is a must-read by every oncologist. Chris Booth is one of my heroes #timetoxicity “Thus, intensive treatments associated with more time toxicity are not incorrect choices themselves, and decisions for patients should be individualized. The most important first

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@Aiims1742

Anirban Maitra

1 year

@statnews @matthewherper @Charlotte_Huff Here’s the #OpenAccess commentary on the time toxicity of cancer treatment by @guptaarjun90 and colleagues.

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@jryckman3

Jeff Ryckman

2 years

Constraint data is confusing.😵‍💫 Here is the final product of nearly a decade of work, 2,500+ metrics (+citations!) and counting, just in time for #ASTRO22 @ASTRO_org 🦾🎯 HT @culbert_md for creating this fantastic GUI 💫 We hope you find this helpful in your practice! #RadOnc

@radoncreview

radoncreview_org

2 years

🗣️We are SO excited to announce #RadOncCalc is now available on the web! Includes: 📌Per-OAR contouring instructions with links to @eContourRadOnc cases. 📌Data for Brachytherapy, Re-RT, & all Fx schemes. 📌FREE access! 📌2,500 metrics & counting #RadOnc

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@jryckman3

Jeff Ryckman

11 months

Radiotherapy sentiment in @NYTimes is eye-opening. Since 2009, over half of articles show negative bias towards RT, while only 1/4 are positive. Despite major advancements in tech like MR-Linac, adaptive RT, & heavy ions, media celebration is scarce. 1/7

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@jryckman3

Jeff Ryckman

2 years

Wow, I can't get over the accuracy of insurance rebuttals using Chat-GPT! What used to take me around a half hour to write now takes one minute. Such a huge time-saver, and with some guidance, even the Bibliographies can sometimes check out! #radonc #PCSM

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@jryckman3

Jeff Ryckman

2 years

1 year LC 99% with 🫁 SABR for metastatic #sarcoma patients "unsuitable for surgery" #radonc 📌 30/1, 60/3, and 48/4 for peripheral ≤ 1 cm, 1.1-2.0 cm, and > 2.0 cm, respectively. 📌 60/8 for central. So, what RCT made surgery SoC? 🧐 Fantastic work!🥇

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@jryckman3

Jeff Ryckman

2 years

I put together a few high-yield slides for #RadOnc oral boards RT-friendly regimens for HL and NHL. 📌 For HL, there is a focus on GHSG staging for a simplified decision tree. 📌 Goal: Not comprehensive. Comments and feedback are welcomed! Enjoy 😃

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@jryckman3

Jeff Ryckman

3 years

Slowly getting around to building in #reirradiation constraints. 📌 Conventional re-RT for the cord is up! 📌 Re-RT filter (for all OARs) coming soon! 🚧🏗️ Please let us know if you have any feedback. Your critique is vital to the success of this project! #RadOncCalc #radonc

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Jeff Ryckman

3 years

After over a year of work, my non-canonical paper concerning the TIMING of neoadj RT for pancreatic ca is out! Includes A021501 commentary and thoughtful review of current paradigm. HT @whallradonc @mbaineunmcedu1 et al for their support! #radonc #PancSM

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Jeff Ryckman

1 year

"Radiotherapy is the most #costeffective of the three main cancer treatments." "Radiotherapy is the closest thing to a silver bullet." It would be amazing to see similar articles like this in the 🇺🇸! However, it's all about the clickbait on this side of the pond... #radonc

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@DrewMoghanaki

Drew Moghanaki 🐕

1 year

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@jryckman3

Jeff Ryckman

4 years

Put together a list of Summary Articles for incoming #RadOnc residents. Focused on brevity, current practice, and <10 references per site. Thoughts/Comments? #MedEd @NicholasZaorsky @ErinGillespieMD @d_golden @roecsg @ShaunaRadOnc @ARRO_org @ACRORadOnc

Rad Onc Summary Articles

For best navigation, click on the table of contents to navigate and click on and header or subheader to return to the table of contents. Otherwise, use the Document Outline feature (to the left on...

docs.google.com

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@jryckman3

Jeff Ryckman

3 years

Fun fact: There are 33 @NCCN panel members on the guidelines for kidney cancer. Only one is a Radiation Oncologist. No wonder why there isn't a section on "Principles of Radiotherapy" despite strong data from the IROCK group. That is all. #radonc #medonc

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@jryckman3

Jeff Ryckman

10 months

👋Hi friends! Check out the Sheets version of the Airtable with 53 ready-to-use site-specific templates derived from the ASTRO consensus paper (PMID 30576843). The program generates output that is compatible with all treatment planning systems. #radonc

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@subatomicdoc

Matthew Katz, MD 🟦

10 months

@jlundbergwright @sueyom @Musjawan @AAPM @ChuckMayoPhD @JeanMoranPhD @ToddRMcNutt @jmmrad @MaryFengMD @jryckman3 @EstesRadonc @elizapowerpuff @RaedZuhour @astro @UCSF @MDAndersonNews @umichmedicine The structure sets are hosted on @Airtable for download, editing and use within your treatment plannings systems. To start, we’ve made it available in English, Spanish, or French. Hopefully more languages to come! You can get them here at 7/

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@jryckman3

Jeff Ryckman

7 months

Dose Constraints for Reirradiation: What Do We Know? 📌The seminar is now accessible! 📌Availability may range from 1 month to as long as 6 months. 📌Please sign up if you are to access these videos here: #radonc #reirradiation #ReRT #ReCARE #ReTECH

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@jryckman3

Jeff Ryckman

8 months

@SimonLo21054188 @ARRO_org @roecsg @ACROresident @ACRORadOnc @ASTRO_org @ESTRO_RT Open to everyone! Seminars will be available for around 1 month here: Please sign up if you are to access these videos here:

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Jeff Ryckman

1 year

@NiuSanford @csoncol This paragraph 😍

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Jeff Ryckman

9 months

TACE vs. SBRT for HCC TACE 🚫 📈 G3+ Toxicity. 🚫 Less cost-effective than RT, even if compared to carbon ions! 🚫 Invasive. 🚫Total ablation = the exception. 🚫LC ~40-50%. SBRT ✅📉 G3+ Toxicity. ✅More cost-effective. ✅Non-invasive. ✅Total ablation = the rule. ✅ LC ~85%.

@jryckman3

Jeff Ryckman

9 months

🚨 #EMERALD1 represents just a tiny portion of ongoing trials examining TACE in combo with immunotherapy. Additional studies underway: #CHECKMATE74W , #LEAP012 , #TACE3 , #RENOTACE , & #ABCHCC . ⚠️Achieving a 40-50% rate of LC in #HCC in 2024 is unacceptable. #LiverTwitter #radonc

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Jeff Ryckman

10 months

Critical observation: Bevacizumab can obscure disease progression, making the choice of PFS as a primary endpoint rather questionable. Given the lack of improvement in overall survival (OS), this costly treatment might not be a justifiable option for patients. #radonc

@JAMAOnc

JAMA Oncology

10 months

Induction bevacizumab, cisplatin, and etoposide (BEEP) preceding whole-brain radiotherapy (WBRT) improved brain-specific progression-free survival as compared to WBRT alone in metastatic breast cancer patients wi/ brain metastasis irrespective of subtypes.

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Jeff Ryckman

10 months

Fantastic read about low-dose radiation treatment for osteoarthritis, highlighting @CShahMD Thanks for the heads-up @SprakerMDPhD @AcceleratorsRO ! #radonc

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Low-Dose Radiation Therapy Reemerging for Osteoarthritis

Use of low-dose radiation a non-invasive treatment for certain types of osteoarthritis

consultqd.clevelandclinic.org

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Jeff Ryckman

1 year

Equity in specialty representation on @NCCN is vital across all disease sites. 4 #RadOnc 11 #SurgOnc 21 #MedOnc It's unjust to expect underrepresented specialists to do more heavy lifting to make up for imbalances. The solution? Balanced representation across specialties.

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@DrewMoghanaki

Drew Moghanaki 🐕

1 year

How is it possible that the only 3 prospective comparison studies of Surgery v SBRT for operable stage I NSCLC show similar to superior outcomes after SBRT, yet the @NCCN guidelines don’t even mention SBRT as an option for this population? #radonc

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Jeff Ryckman

3 years

DIBH should be Routinely Considered for Right-sided Breast Cancer receiving Regional Nodal Irradiation 📌 Significant improvement in all Lung and Liver parameters! #radonc #bcsm 👏👏👏 @XRT_GabrielleWP

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Jeff Ryckman

1 year

@COlazagasti Hang in there. I hope you never grow numb to these feelings. Sometimes, our job is to sit in the rubble with our patients, and nothing is the right thing to say. 💜

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@jryckman3

Jeff Ryckman

4 years

I'm the luckiest guy alive! Due to all the curveballs of 2020, we started our lives together, making lemonade. After a family-only social distance ceremony, we look forward to the real celebration to come in 2021! 😊🥂 #RyckMANandWife #TheDrsRyckman

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Jeff Ryckman

10 months

A review of SBRT clinical trial pubs reveals significant variability in technical and dosimetric data, often missing key information needed for replicating procedures. Pre-trial QA in 45%. No study fully met criteria for technical reproducibility. #radonc

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Jeff Ryckman

3 years

1/2 "How 3 Academic Centers Prescribe SBRT for Primary Lung" 📌 A fantastic read! 📌 All recommend PTV D95% ≥ 100%. 📌 All agree OAR metrics should be prioritized over target coverage, if necessary. @UFRadOnc @MDAndersonNews @MSK_RadOnc @QuadShotNews

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Jeff Ryckman

1 year

Speaking of mock orals... #RadOnc #Heme in a nutshell! 🌲Evergreen Google Doc here: HT @JamesBatesMD for some of the content, and @NicholasZaorsky and @CunninghamOnc for the illustrations! (Some illustrations are only posted within Google Slides) 1/2

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@dmkoffler

Daniel Koffler, MD

1 year

@jryckman3 @NiuSanford @radoncreview This is just in time for my mock orals and it’s awesome!

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Jeff Ryckman

2 years

Here's a nice cheat sheet for internal medicine residents (or med students). I would hand this out whenever giving a lecture to internal medicine residents about what we do in #radonc Comments are open to all - please let us know if this can be improved!

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Rad Onc IM Sheet

General concepts to tell your patients: What is it: Use of a focal, painless external beam of radiation therapy (EBRT) to treat a region. Patients are not radioactive. Toxicities: Other than mild-m...

docs.google.com

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@jryckman3

Jeff Ryckman

10 days

49 - Risk of Radiation Myelitis after Hypofractionated Spine SBRT Amazing work, @Chris_JacksonMD ! Any insight on 0.35-1.2cc? This data looks ideal to explore whether 18 Gy to 0.35 cc or 12.3-13 Gy to 1.2 cc (TG-101) are meaningful! @JAMRadOnc @NicholasZaorsky #ASTRO24 #radonc

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Jeff Ryckman

29 days

🚨 New Insights into Patterns of Locoregional Recurrence in #PancreaticCancer after TNT & Their Impact on Neoadjuvant RT Volumes 🚨 #PancSM #Radonc 🙌 @SaraBelPonMD n=1/8

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Jeff Ryckman

8 months

Super excited for today's events! Looking forward to seeing you there! #radonc #reirradiation 9:00 AM - 10:30 AM EST @ARRO_org @ROECSG @ACROresident @ACRORadOnc @ASTRO_org

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@ESTRO_RT

ESTRO

8 months

📌 Save the date! The 5th webinar of our #Reirradiation Series is approaching. 🔍 Theme: Dose Constraints for Reirradiation: What Do We Know? 🗓️ Monday 5 February 2024 ⏰ 15:00 to 16:30 CET Chaired by Ane Appelt. ✅ Register here: #radonc #medphys

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Jeff Ryckman

1 year

@ACCP I hope we can agree that this kind of behavior is unacceptable and toxic. And no, for the record, I don't support many of VP’s viewpoints. The Canceling of the American Mind: Cancel Culture Undermines Trust & Threatens Us All―But There Is a Solution

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@jryckman3

Jeff Ryckman

4 years

Shout out to my training program, UNMC, for being approved for six residency spots for many years, accounting for residents' opinions NOT to expand from 4 to 6, and electing not to SOAP this year. Bravo! #radonc 👏👏👏

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Jeff Ryckman

10 months

@5_utr @maximeronot @BCLC_group I concur! Here are seven reasons why it's time to move beyond TACE: 1️⃣ TACE became a common treatment in the early 2000s, initially favored over bland embolization - but it was a low benchmark to surpass. 2️⃣ The success rates for TACE hover around 40-50%. It's not a curative

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Jeff Ryckman

10 months

Radiotherapy remains “the most effective single agent in the treatment of lymphomas” -James Armitage, former ASCO president & highly regarded lymphoma leader Thrilled to have trained at UNMC, a leader in RT-accommodating HL/NHL approaches, guided by Dr. Armitage! #ASH23 #radonc

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@subatomicdoc

Matthew Katz, MD 🟦

10 months

@ChelseaPinnix @aallam_mo @MDAndersonNews @JillGunther @BouthainaDabaja @suwusan Radiation therapy remains one of the most effective "drugs" in treating lymphoma #ASH23 #lymsm #radonc

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Jeff Ryckman

9 months

The entire specialty of radiation oncology costs Medicare Part B about $1.6 billion a year. “Aw. Good job guys.” - Literally every pharmaceutical company (HT @toddscarbrough )

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@BalazsHalmosMD

Balazs Halmos

@BalazsHalmosMD

9 months

Looks like Keytruda revenues have become so fat, Merck might need to start taking Ozempic😉

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Jeff Ryckman

5 months

Excited for the #ESTRO24 interdisciplinary premeeting course in reirradiation - a one day bootcamp! ☢️ #radonc

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Jeff Ryckman

3 months

@JackWestMD A medical oncologist asking a radiation oncologist, "How many prospective phase III trials are there about the role of radiation in [insert setting]?" is like an elephant sitting on one’s chest and asking why you can't get up. Instead, we should ask why only 4% of global oncology

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@jryckman3

Jeff Ryckman

2 years

#radonc programs where attendings cannot function without resident coverage should be avoided. So glad we are openly discussing this taboo topic! #medtwitter New rule (which will never happen): all attendings need to go uncovered for 3+ months out of the year *grabs popcorn*

@AlmahariqMuayad

Muayad Almahariq, MD-PhD

@AlmahariqMuayad

2 years

@ParikhSimul @DrSpratticus Awesome. Wish all programs would stop the practice of making sure certain attendings "are always covered" because they can't function independently. Often, their rotations are the least educational. If you NEED a resident to run your clinic , then time to retire

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Jeff Ryckman

3 years

Exemplary work! By far THE densest collection of constraints I have ever come across. That Table 4 and 5 tho🤩 (Appendix E2 was a doozy!) 📌Everything is now in the AirTable! 📌 For #1ONC : Search "PRO Oligo '21"! 📌 High yield for boards! #radonc 📇🎯👏

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Jeff Ryckman

5 months

Giulio Francolini: Re-SBRT after previous definitive or salvage radiotherapy (RE-START): A report on the retrospective cohort. At 302 patients, this is the largest study of which I am aware concerning prostate (70%) or prostate bed (30%) reirradiation! #AIRO #PCSM #radonc

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Jeff Ryckman

7 months

Hanging out with the crew at #ACRO24 ! @ACRORadOnc @ACROresident #radonc

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Jeff Ryckman

1 year

I hope the @nytimes is listening to the president-elect of @ESTRO_RT The New York Times is spreading misinformation about radiotherapy and should release a correction to this article if they value the truth. It is unclear if truthful reporting is their standard. #StandUpForRT

@Mat_Guc

Matthias Guckenberger

1 year

(1/n) PROSPECT – important study of high quality & relevance for rectal cancer pts HOWEVER, misleading & dangerous interpretation of @nytimes „brutal effects of RT“

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Jeff Ryckman

2 years

Last night of #ACRO2023 with my favorite radiation oncologists! #radonc See you in Orlando next year!

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Jeff Ryckman

9 months

👋 Hi friends! 📌3 RCTs have shown negative results for TARE, specifically 2 comparing TARE and Sorafenib (SARAH, SIRveNIB), and 1 studying Sorafenib ± TARE (SORAMIC). 📌Concerns about these studies include potentially 📉 doses and historic techniques. 1/10 #LiverTwitter #HCC

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@guildsman

Michael Shusterman, MD

10 months

I am interested what about TARE particularly with newer techniques IR utilizes now versus RT methods? Which one should be considered?

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Jeff Ryckman

8 months

A fantastic read on the role of SBRT in #HCC ! "We can advocate for SBRT by discussing cases at TB conferences, educating multiD colleagues about the comparative advantages of SBRT as a LRT, and encouraging referrals of all pts considered for LRT to both IR & RO" #LiverTwitter

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@safaviaa

Amir Safavi

8 months

🤔How can we advocate for #SBRT (and pts) in multi-D #HCC mgmt? #radonc ⚾️ Yesterday’s home runs don’t win today’s games! 🏆Now in @ctRO_Journal : Future of liver ☢️ is 🌟 and 🙏 to liver team 🇨🇦 @ldawsonmd Aruz Mesci ( @RadMedPM @UofTDRO ) for collab!

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Jeff Ryckman

1 year

Dear #radonc : Why do we still use EQD2 conversions? #NSCLC #CentralLung

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Jeff Ryckman

2 years

Kicking off #ACRO23 #ACRO2023 with two of my favorite radiation oncologists! @LeilaTchelebi @NicholasZaorsky

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Jeff Ryckman

5 months

To all oncologists, It's vital to recognize: “Patients with resectable disease have better outcomes, and you can’t account for that without randomizing.” #hncsm This truth is universal across ALL disease sites! #blcsm #esocsm #hpbcsm #kcsm #lcsm #radonc #surgonc #ESTRO24

@drdavidpalma

Dr. David Palma

5 months

12 years after we launched ORATOR, what did we learn? Three summary slides 👇👇👇

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Jeff Ryckman

24 days

We should not be excited about #LEAP012 . TACE has the worst local control among all LC modalities of any disease site, with a ~50-60% LF rate. In 2024, TACE should be reserved for special cases (e.g., caudate lobe tumors where radiotherapy risks complicate liver transplant),

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@VPrasadMDMPH

Vinay Prasad MD MPH

24 days

What do you think? Should oncologists be excited? #ESMO24

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Jeff Ryckman

9 days

Hanging with the crew at #ASTRO24 ! #radonc

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@jryckman3

Jeff Ryckman

8 months

Incredible piece – truly commendable! Essential for all #radonc and #medonc professionals. Our field delivers tremendous value and merits a larger share of global oncology research investment, well beyond the current < 5% Deep gratitude to the team for this editorial! 🙏

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@oncology_bg

Bishal Gyawali

8 months

Congratulations and thanks to @NiuSanford and @fabiomoraesmd for leading this important @csoncol radiation oncology edition with this great team of CSO radiation oncologists.

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Jeff Ryckman

2 years

🚨 New #RadOncCalc update available (for free) in the Android Market & App Store!🚨 📌 Now displays BT & Re-RT data. 📌 Now displays volume ranges in % & cc's. 📌 Many other updates! Can we do better? Please let us know via DM or by hitting the➕sign in the app. Enjoy! 1/3

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@jryckman3

Jeff Ryckman

3 years

Slowly getting around to building in #reirradiation constraints. 📌 Conventional re-RT for the cord is up! 📌 Re-RT filter (for all OARs) coming soon! 🚧🏗️ Please let us know if you have any feedback. Your critique is vital to the success of this project! #RadOncCalc #radonc

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Jeff Ryckman

1 year

Cost-effective? Without an OS benefit? Can someone please explain this to me. I'm confused. 🫠 Appropriate inclusion of RT for select candidates often provides a 5-10% PFS benefit. Likely at ONE QUARTER the cost of ONE CYCLE of this new drug. @toddscarbrough

@vinibizzarro

Bizzarro

1 year

@AaronGoodman33 Pola-R-CHP for DLBCL: cost-effective at first glance

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Jeff Ryckman

2 years

An interim analysis of 200 patients on STABLE-MATES has shown acceptable toxicities in both arms, and current data support the continuation of the trial as initially designed. 72 patients to go. Looking forward to the results of this trial! #radonc #LCSM

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Jeff Ryckman

2 years

#CALGB50801 : Omitting RT in bulky (>10 cm or 1/3 the maximum intrathoracic diameter) early-stage cHL 🚫 Omits RT at expense of 2 addnl cycles of ABVD. 🚫 Does not discuss the degree of CT-based residual. 🚫 Utilized outdated RT methods (IFRT) in SER. 1/3

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Positron Emission Tomography-Adapted Therapy in Bulky Stage I/II Classic Hodgkin Lymphoma: CALGB...

Our study of PET-adapted therapy in bulky stage I/II cHL met its primary goal and was associated with an excellent 3-year PFS rate of 92.3% in all patients, with the majority being spared radiother...

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Jeff Ryckman

3 years

"A lot of these positions that get labeled misinformation or anti-vax or whatever are mainstream positions taken by Europe." #HopeForUnity #ThereIsAMiddleGround #AltMiddle #NotABadFaithActor @Plenary_Session 4.41: The Mask Debacle @VPrasadMDMPH

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4.41 The Mask Debacle with Jacob Hale Russell

Jacob Hale Russell is back from Rutgers law to talk about his new piece in Tablet Magazine.

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Jeff Ryckman

3 years

So excited! After months of waiting, I finally got 25 printouts for each disease site represented by the #CEBRE and #CoGBE guides for patients!! 📌 @roecsg @RO_Institute @d_golden 👏👏👏 #radonc #patientexperience #pcsm #bcsm #lcsm #gyncsm

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Jeff Ryckman

7 months

Many disease sites (lung, liver, pancreas, kidneys) have stronger prospective evidence for non-invasive SBRT over IR-based approaches. It's time to rethink the "IR-first" dogma, esp for lesions >2-3 cm that aren’t in ideal locations for invasive ablation. #SBRT #radonc #IRad

@_ShankarSiva

Shankar Siva

7 months

@d_shapiro1 @TheLancetOncol @TROGfightcancer @CancerAustralia @ANZUPtrials @VarianMedSys Thanks! So where is the robust prospective trial of thermal ablation to back up that statement? Everything looks good for small renal masses when looked at retrospectively; including surveillance. We already have 5 year data for SABR and 13 clinical trials… sounds pretty

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Jeff Ryckman

10 months

Interesting tidbits on #HCC and #SBRT : A small study revealed that a quarter of patients with Child-Pugh B7-8 (CPB) may improve to Child-Pugh A status following Stereotactic Body Radiotherapy (SBRT) treatment. Psst, Check this out, @BCLC_group ! #LiverTwitter #radonc 🌶️🎯

@jryckman3

Jeff Ryckman

10 months

Questioning the evidence strength? Check the five RCTs mentioned in the previous 1-7 post. Additional insight from a prospective study: Fascinating fact: 25% of patients initially graded as CPB7-8 progress to a CPA classification after SBRT treatment.

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Jeff Ryckman

1 year

"I have to start with #ADAURA because the Cheerleaders are out there in full force." Bring the truth, VP! Oncology has too many Cheerleaders. Put down the pom-poms and think about trial design, folks. Let's put patients front and center, where they belong. @csoncol

@VPrasadMDMPH

Vinay Prasad MD MPH

1 year

My analysis of ADAURA now on youtube in high resolution #ASCO23 ADAURA OS - Control arm participants who progressed got poor medical car... via @YouTube

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Jeff Ryckman

1 year

Freedom from systemic therapy ~40% at five years! #radonc Complete metastatic ablation is key

@DrewMoghanaki

Drew Moghanaki 🐕

2 years

A new report from @_ShankarSiva shows why TOTAL METASTATIC ABLATION is preferred whenever feasible. #radonc 1/

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Jeff Ryckman

2 years

Happy anniversary @radoncreview ! Thanks to everyone who has contributed to make this one of the most comprehensive (free) oncology resources out there 🙏 New PC website interface for constraints coming 🔜, just in time for #ASTRO22 ! (for mobile, use #RadOncCalc ) HT @culbert_md

@radoncreview

radoncreview_org

2 years

Do you remember when you joined Twitter? I do! #MyTwitterAnniversary #SameDayAsWebsiteLaunch #ASTRO19 #radonc #medonc #surgonc #hemeonc #AcademicTwitter

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Jeff Ryckman

1 year

#RadOnc physics concept of the day: 📌If one liberalizes low dose in the VMAT era, it allows for intermediate and high dose ALARA. 📌Intermediate and high doses drive the lion's share of treatment-related toxicity. Thank you for attending my lecture today.

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Jeff Ryckman

1 year

I’m happy to see things added so quickly, but if this were radiation, there’s no way it would be incorporated into @NCCN guidelines this early. Why is there a lack of equity in specialty representation on NCCN? This applies to all disease sites. Will this ever be fixed?

@DrShubhamPant

Dr. Shubham Pant

1 year

🔥🔥🔥Less than a month from ➡️ @ASCO Plenary presentation ➡️ @JCO_ASCO publication #Adagrasib is part of the @NCCN guidelines for patients with #PancreaticCancer and 🎯 #KRAS G12C mutation

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Jeff Ryckman

1 year

@VPrasadMDMPH Disagree with the argument that "only all-cause mortality (ACM) matters" when it comes to screening The total toxicity burden of treatment is lower with stage I (e.g., CTCAE, time, and financial toxicity). To say "only all-cause mortality matters" ignores the fact TTB 📈 as

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Jeff Ryckman

4 years

👏🏼👏🏼👏🏼 Look what came in the mail today! Every #radonc should have this on their bookshelf. I can’t believe it’s been six years since the second edition. Time flies! #meded #medtwitter

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Jeff Ryckman

1 year

@NiuSanford Thank you so much for the plug! Yes, @RadOncReview is a misnomer - it also has lots of systemic tx and surg onc data! Notably, around 90-95% of commentary is from experts in our field - the way it should be, from site-specific experts! Here are the latest user metrics 😍

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Jeff Ryckman

3 years

Hanging with the legendary @EricLehrer , @NicholasZaorsky , and @radioisomer ! #radonc #ASTRO21

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Jeff Ryckman

1 year

A must-read for every oncologist. Many of these issues do not plague #radonc or #surgonc trials, but rather, systemic therapy trials. #pharmacoindustrialcomplex

@VPrasadMDMPH

Vinay Prasad MD MPH

1 year

These days we talk a lot about post protocol therapy crossover good control arms adequate power PFS as a surrogate Surrogacy analysis All of these themes got started in Malignant book Still worth your time

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Jeff Ryckman

8 months

The incidence of SMN at 10 mo following CAR-T closely mirrors PFS advantages (~5-10%) observed when RT is properly used for (N)HL in many 1L scenarios. It appears that we're essentially swapping the “benefit” of avoiding RT for the risk of developing SMNs or experiencing G5 tox.

@JAMAOnc

JAMA Oncology

8 months

6.5% of adults developed myeloid neoplasms (MN) post-CART therapy at a median interval of 10 months. Routine baseline data stratified low-, intermediate- & high-risk categories w/ cumulative incidence rate of MN of 0, 4, and 27 cases/100 patient-years.

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Jeff Ryckman

8 months

IT DOESNT MATTER HOW HOT YOU GET A SMALL FRACTION OF THE TARGET IF THE ENTIRE TARGET ISN’T COVERED #IRad #HCC #LiverTwitter #Why90

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Jeff Ryckman

3 years

For 20-fx prostate plans, consider adding a posterior expansion to the rectal contralateral avoidance structure. Optimizing this structure will avoid "islands" of sparing and create a 20 Gy posterior avoidance sector. #radonc #treatmentplanning #contralateralavoidance

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Jeff Ryckman

3 years

Tx Planning Tip-O-Da-Day: Contralateral avoidance structures 101! 1) Set View to a representative slice. 2) Duplicate. Transform. Shift 2-3mm towards the target. Make it as wide as possible. 3) Crop! Pro tip: Don't compromise PTV coverage when attempting contra sparing! #radonc

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Jeff Ryckman

1 year

Temporary tattoos for radiotherapy? What a fantastic concept! Patients may prefer not to have a daily reminder of their treatment. Great space to enter, @ephemeraltattoo 👏 #radonc

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Radiation Therapy meets Made-to-Fade Ink

Ephemeral for Radiotherapy offers new alternative to permanent tattoos

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Jeff Ryckman

10 months

Great study! It's noteworthy that local management using SBRT in HCC cases, including larger tumors (for instance, sizes ranging from 10-20 cm, and with VP3/4 involvement), typically maintains a minimum local control of at least 70%. #radonc @BCLC_group

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@ArndtVogel

Arndt Vogel

10 months

TACE for HCC Has Different Treatment Effects Depending on Central or Peripheral Tumor Location @LiverCancer 👉Peripheral tumors had longer LRFS/ PFS compared to central tumors 🧐Food for thoughts: Combinations for central tumors? @EASLnews @ILCAnews

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Jeff Ryckman

3 months

🚀 Unleashing the Power of SABR! 🚀 Curious about Stereotactic Ablative Radiotherapy (SABR)? 🌟 🔍 What exactly is SABR? 🔍 Who can benefit the most from SABR? 🔍 Can SABR be a cure for certain cancers? 🔍 What is the biggest myth or misconception about radiotherapy? 1/2

@RANZCRcollege

RANZCR

3 months

SABR Power. @TargetingCancer shines a light on stereotactic ablative body radiotherapy in the latest edition of Inside News. Read the story here: #RANZCR #TargetingCancer

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Jeff Ryckman

5 months

Hanging with the crew at #ESTRO24 ! #radonc @RadOncConnor

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Jeff Ryckman

2 years

Provocative question of the day: Should HA-WBRT be the SoC for all patients being considered for WBRT (e.g., > 10 BM), even with < 4 mo of life expectancy? Hair loss may be avoided with this technique and likely 📈QoL, even with a short life expectancy. #radonc @joshuapalmermd

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Jeff Ryckman

7 months

#ACRO24 after hours! 🍀 @ACRORadOnc @ACROresident

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Jeff Ryckman

1 year

How many patients make it to CAR-T without ever seeing radiotherapy? Bet it’s the majority. Why aren’t we making noise about the 5-10% PFS benefits with appropriate use of #costeffective RT? #radonc Is avoidance of toxic salvage therapy not a priority? @ILROGTeam

@dgermain21

David Russler-Germain, MD/PhD

1 year

CART cells are revolutionizing B-NHL treatment. But… Let’s not sweep under the rug: (1) ~$400k product, ~$1M “total package” (2) ~1/4 patients required ICU care (3) Non-relapse mortality ~10% We need to acknowledge the downsides to make CART cells cheaper, faster, and safer.

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Jeff Ryckman

2 years

Fantastic crew, meeting Julius and Matt for the first time in real life at #ASTRO22 ! #RadOnc

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Jeff Ryckman

4 years

🔥🔥🔥 @WashURadOnc strikes again: SC-RT f/b consolidative chemo demonstrates promise for NOM of rectal cancer! 📌 90 pts. Nearly all T3+ or N+. 7 cm from verge. 📌 50% cCR (DRE, MRI, endoscopy performed *after* SC-RT➡️ 6-12c of Ox-based chemo). #ASTRO20 #ROEdu #Radonc #crcsm

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Jeff Ryckman

4 years

1/3 This project is a dream come true! I want to highlight that ~95% of the content is from leading resources and commentary from the leaders in our field, and maybe 5% my personal interpretation. Treat it as a digital Rolodex of information! #radonc #meded #medtwitter

@radoncreview

radoncreview_org

4 years

1/3 One year ago today, RadOncReview was launched after years of compiling literature and commentary from the leaders in our field. Since then, we've had countless contributions & over 5,000 unique visitors from 79 counties. Thank you all so much for your support! #radonc

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Jeff Ryckman

2 years

📌Why does RT-free survival continue to be a thing with modern RT techniques? 📌 Protons most useful if below L main coronary A or mediastinum+axilla in young female TL;DR Addn'l Adriamycin is not benign! Modern RT techniques have come a long way. #StandUpForRadOncInHeme #RadOnc

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Jeff Ryckman

1 year

@n8pennell @LemmonOnc With all due respect, how can one run a cost-effectiveness analysis when the control arm was not the standard of care in the United States? Only 38% of patients on the control arm received salvage osimertinib at progression, which was the prevailing SoC at the time of trial

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Jeff Ryckman

3 years

Some SBRT prostate rectal optimization structures! #radonc #treatmentplanning 🦾🤓🎯

@jryckman3

Jeff Ryckman

3 years

@lemmiwenks 1/2 Nice! Here are 33% & 50% avoidance structures (usually, I only bust these out for 5 fx SBRT to meet HyTEC V39 <33% circumference and V24 < 50% circumference), but cropping (PTV_High+1 cm) from the 50% avoidance structure might help automate this structure (see gif next post)

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Jeff Ryckman

5 months

Catching up with friends, old and new! #ESTRO24

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Jeff Ryckman

1 year

The average wholesale price of Osimertinib: $440,000. Shouldn't we ensure this OS benefit is real by running a trial with an appropriate control arm before bankrupting patients? #NotCommonSense Prediction: The climate for ADAURA results is sky-high; nay-sayers will go ignored.

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Jeff Ryckman

3 months

@VPrasadMDMPH What's it like leading radiation trials with just 3% of the global oncology research budget? We're maximizing our small slice. Every bit counts. Starting from somewhere, with Phase III to follow.

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Jeff Ryckman

5 months

Fabio Arcidiacono: Five year survival and safety outcomes from the START-NEW-ERA non-randomized phase II trial #ESTRO24 #LCSM #radonc

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Jeff Ryckman

2 years

🚫Each cycle of ABVD is equivalent to 5 Gy mean ❤️ dose (MHD) - EORTC-LYSA: 🚫 #CALGB50801 "delivers" 10 Gy MHD by omitting RT and replacing it with adria x2c: 🚫CCSS St. Jude CV Risk calculator

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Cardiovascular Risk Calculator

This risk assessment tool predicts risk of heart failure, ischemic heart disease, and stroke by age 50 among survivors of childhood cancer.

ccss.stjude.org

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Jeff Ryckman

1 year

Despite the substantially less financial burden of #radonc healthcare services, the #priorauth burden falls disproportionately on our #costeffective specialty. Many patients I treat will have a built-in two-week delay before simulation due to #priorauth #fixpriorauth In my

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@toddscarbrough

Todd Scarbrough

@toddscarbrough

2 years

@jryckman3 working on a #radonc presentation wanted to add one more true fact Medicare offers rad onc care to about 350,000 beneficiaries/yr at a cost of about $5000 per person Mcr offers Keytruda to about 50,000 beneficiaries/yr at a cost of about $50K per person CMS should♥️rad onc

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Jeff Ryckman

3 years

A fascinating discussion on constraints in @NCCN Hodgkins! ✅View all NCCN constraints: Pro tip: Great review for boards (Note: there is a disproportionate representation of #peds ). Scroll to right for notes. #1ONC compatibility coming soon! #radonc

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Jeff Ryckman

1 year

Dear #hemeonc , please consult your friendly neighborhood #radonc before osimertinib alone for brain metastases. It’s best not to observe if lesions are located in critical areas where progression may be detrimental. Sometimes, dose reduction happens!

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Osimertinib early dose reduction as a risk to brain metastasis control in EGFR-mutant non-small...

Early dose reduction of osimertinib was a risk factor for the worsening of BMs. A higher risk was associated with younger patients and those presenting BMs before treatment.

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Jeff Ryckman

1 year

“… hopes to challenge the current radiotherapy paradigm for patients with polymetastatic disease.” 😍 Complete ablation with targeted, modern RT and short bursts of systemic therapy is the future! Congratulations to the investigators. So excited for these data and SABR-SYNC!

@TimkWin

Tim Nguyen

1 year

ARREST-2 opened for accrual yesterday! This is a new randomized phase 2/3 trial for patients with >10 mets that hopes to challenge the current radiotherapy paradigm for patients with polymetastatic disease. Thanks to the whole team esp @drdavidpalma and @lhscradonc @LHSCCanada

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Jeff Ryckman

7 months

Guess who I bumped into in Charlotte as we were returning from an amazing #ACRO24 - perfect timing for a classic Ron selfie! Looking forward to next year in Vegas for #ACRO25 ! #RadOnc @ACRORadOnc

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Jeff Ryckman

2 years

@AmarUKishan strikes again! Consider a larger (~8-9 mm) posterior and superior PTV when using intra-prostatic fiducial-based registrations for patients with node-positive prostate cancer when treating with SIB. #radonc #PCSM Great job, @Trudywu2 !🥇🤓🎯

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Jeff Ryckman

9 months

🚨 #EMERALD1 represents just a tiny portion of ongoing trials examining TACE in combo with immunotherapy. Additional studies underway: #CHECKMATE74W , #LEAP012 , #TACE3 , #RENOTACE , & #ABCHCC . ⚠️Achieving a 40-50% rate of LC in #HCC in 2024 is unacceptable. #LiverTwitter #radonc

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Jeff Ryckman

3 years

Just got back from Montana, and it was amazing! So, what was all of this oral boards studying about? 😅

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