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PMRT ASTRO-ASCO-SSO guideline: PMRT recommended for pN1 (Strong/High) and post-NST cT4/cN2-3 or ypN+, conditional for ypN0 after cT1-3N1/cT3N0, moderate hypofx preferred.
Breast carried the day: two joint guidelines set PMRT indications by pN and post-NST ypN status and keep RT open to BRCA1/2 carriers, with intact-breast RT contraindicated only for germline TP53. HyTEC models anchor vestibular schwannoma SRS (12 Gy x1 โ 3-5y TCP 91.2% or 95.6%) and adrenal SBRT (1-yr LC >95% at BED10 116.4 Gy).
read the full digest โStudies ยท 246
- SRS for Vestibular Schwannomas: TCP Analyses (HyTEC)Pooled model of 35 series and 5162 pts: 12 Gy single-fraction predicts 3-5y TCP of 91.2% (LQ) or 95.6% (LQ-L). No outcome data below 11 Gy.
- LINAC SRS Technique Comparison: DCA vs VMATPaddick CI 0.78 VMAT vs 0.75 DCA+SSO+VDR vs 0.6 plain DCA across 11 replanned cases. VMAT needed 41 ยฑ 17% more MU than DCA+SSO+VDR.
- Hereditary Breast Cancer ASCO-ASTRO-SSO GuidelineRT not withheld for mutation status (strong rec), except germline TP53, where intact-breast RT is contraindicated; BCT stays open to BRCA1/2 carriers.
- PMRT ASTRO-ASCO-SSO GuidelinePMRT recommended for pN1 (Strong/High) and post-NST cT4/cN2-3 or ypN+; conditional for ypN0 after cT1-3N1/cT3N0; moderate hypofractionation preferred.
- Adrenal SBRT Tumor Control Probability Modeling (HyTEC)Poisson TCP fit to pooled adrenal SBRT series: 1-yr LC >95% at BED10 116.4 Gy (EQD2 โ97 Gy), fit P<.0001.
- DCAT vs CoVMAT vs NcVMAT for single brain metastasis (planning study)Non-coplanar VMAT gave the lowest normal-brain V12Gy (9.4 vs 11.6 DCAT vs 15.1 cm3 coplanar VMAT) for 2-3 cm single BM SRS plans.
- Elements MME vs RapidArc single-isocenter SRS plan qualityRapidArc VMAT gave lower V12Gy (19.2 vs 23.7 cm3) and better conformity; Elements MME gave lower V5Gy and mean brain dose (2.57 vs 2.76 Gy).
- Single-isocenter SRS for multiple brain mets with automated planning (Minniti)1-yr LC 89%, 1-yr OS 68%, no G3-4 toxicity after single-isocenter DCA SRS for 4-10 BM; a 1-mm GTV-to-PTV margin kept dose coverage on every lesion.
- Dose-adapted single-isocenter multitarget SRS for 4-10 brain metsmOS 8.1 mo, 1-yr OS 35.7%; 22 of 40 pts outlived DS-GPA prediction (bar was 17), 1-yr local failure 5%, no G3-5 AEs.
- HyperArc vs manual VMAT SRS: automated planning and deliveryPaddick GI 5.42 vs 7.09 (P<.001) favoring automated HyperArc over expert manual VMAT SRS; conformity equal; 1-yr LC 90.1% in HyperArc brain mets.
- UK practice survey of NMSC radiotherapyOf 63 UK respondents, most chose one of four daily schedules (18-20 Gy/1#, 35 Gy/5#, 45 Gy/10#, 55 Gy/20#). Non-standard schedules varied widely, with 24 different regimens proposed.
- Radiotherapy for epithelial skin cancer (Locke)Local control 89% overall (93% untreated vs 80% recurrent) across 531 BCC/SCC lesions; dose/fx <2 Gy predicted local failure (p=0.01).