Author: QuadShot News

While aggressive work-up of ipsilateral axillary adenopathy is not typically recommended after COVID-19 mRNA vaccination, even in the setting of a history of cancer, this case presentation would like to remind you that this might not be the case in the setting of a new diagnosis of any breast malignancy, including DCIS. Citation(s) Lam, JAMA 2021

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SABR-5 offered further support of the safety of ablative radiation for oligomets across sites, though liver and adrenal proved the trickiest. Here is a dosimetric evaluation of the potential benefit of using the SMART approach (stereotactic MR-guided adaptive radiation therapy) versus the more standard CT-guided VMAT approach for 20 patients receiving five-fraction ablative radiation (to a median of 50 Gy) for adrenal mets—with each case planned using both techniques. Interestingly, the baseline CT-guided VMAT plan employing breath hold for motion management resulted in superior target coverage and conformality as well as better bowel and kidney dosimetry compared to the base…

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Top Line: Little in oncology is more convoluted than the ideal adjuvant treatment for intermediate-risk endometrial cancer. The Study: The trick isn’t achieving superior oncologic outcomes alone–it’s doing so in a way that minimizes toxicity for those who will do well regardless. This retrospective study of 198 patients receiving post-hysterectomy vaginal brachytherapy for low- (n=90) and high- (n=108) intermediate risk endometrial cancer asks if mismatch repair (MMR) status informs risk of recurrence above and beyond standardly-referenced clinicopathologic features. As expected, patients with MMR-deficient tumors (n=69) were more likely to be high-intermediate risk (65% v 49%), more likely to be high-grade…

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The long-awaited Phase 3 CONVERT trial published this week in Lancet failed to show that once-daily radiation was superior to twice-daily radiation for limited-stage SCLC. Median overall survival did not significantly differ for the 547 patients randomized to 45 Gy / 20 delivered BID (30 months) vs 66 Gy / 33 delivered daily (25 months). Everyone received cisplatin/etoposide x 4-6 cycles, and the only difference in toxicity was an 11% increase in G4 neutropenia in the BID arm. This should squelch criticisms of the 1999 Turrisi trial which first established a survival benefit with the BID regimen, including the one…

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