For patients with small, well-lateralized tonsil cancers, this meta-analysis suggests the absolute risk of contralateral neck failure is low. However, this rate is statistically higher than with bilateral neck RT. Find the article here (https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2801100).
It is great to learn that Scientific Reports in the past year or two expanded its scope to engineering and psychology as a means for manuscript submissions. Consider publishing your unique work to this journal.
https://www.nature.com/srep/highlights/announcements
This article highlights the life changes and perceptions of individuals who left their careers in Academia to another sector. What experiences have people here had when navigating change from the sectors of academia, government, private, or industry? How has it affected you? Find the article here (https://www.science.org/content/article/leaving-academia-was-losing-our-intellectual-home-here-s-how-we-adjusted).
This interesting article demonstrates that breast cancer patients treated with anthracyclines for breast cancer or lymphoma had twice the rate of later congestive heart failure than age-matched controls, while receipt of radiation appeared to have no effect. Find the article here (https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2800936).
It is extremely important when treating the brain with stereotactic radiosurgery that normal brain tissue is limited as much as possible to minimize risks of radiation necrosis particularly when combined with immune checkpoint blockade. Recent data demonstrates clear correlation with incidence of radionecrosis and volume of brain receiving ≥12 Gy (V12 Gy). Here the V12 Gy included the target volume and did not need to be contiguous. Risks of radionecrosis at one and two years when V12 Gy was <12 cc were 4% and 8%, when 12-20 cc were 10% and 14%, and when >20 cc were 13% and 15%. Find the article here (https://www.redjournal.org/article/S0360-3016(23)00057-3/fulltext).
In the treatment of rectal cancer there has been a good bit of data suggesting total neoadjuvant therapy (TNT) is the best sequencing of treatment for locally-advanced rectal cancer. Long-term data now demonstrates that TNT improves disease-free survival for high risk rectal cancer. TNT with standard-course radiation followed by chemo then surgery is likely the treatment strategy to afford the best local and distant control for high-risk locally-advanced rectal cancer. Find the interesting article here (https://journals.lww.com/annalsofsurgery/abstract/9900/locoregional_failure_during_and_after_short_course.366.aspx).
This article exposes the inner workings and dialogues of United Health, made public by a lawsuit brought by a college athlete denied life-altering meds for his crippling ulcerative colitis, and it’s about as sickening as you always imagined. Find the article here (https://www.propublica.org/article/unitedhealth-healthcare-insurance-denial-ulcerative-colitis).
Most glioblastoma multiforme (GBM) failures are in-field, leading many people to push for tighter clinical target volumes closer to 1 cm or even 0.5 cm as to limit extraneous dose to normal brain tissue as to limit radiation necrosis. This prospective study aimed to answer this by treating newly-diagnosed GBM with a 0.5 cm clinical margin with no additional planning margin using standard stereotactic brain techniques. The total dose was delivered over 5 fractions to a total dose escalated from 25 Gy to 40 Gy. At a median follow-up of 15 months, only one of 27 progressions occurred outside of a minimum EQD2 of 48 Gy10 but within 2 cm of the tumor volume. An interesting side note was that patients with radiation necrosis (n=7) were less likely to have in-field progression (14% v 80%) and lived longer (median overall survival 27 v 12 months) than those without it. Very interesting discovery. Find the article here (https://www.practicalradonc.org/article/S1879-8500(23)00035-8/fulltext).
When treating head and neck cancer with radiation the likelihood of recurrences are quite high unfortunately. Therefore dose constraints are extremely critical. Occasionally practicing clinicians revert to palliative regimens with lower doses as to not adversely impact tissues such as the spinal cord, mandible, oral cavity, and other tissues. This makes proton therapy a very attractive option due to it limiting the degree of exit dose. This retrospective study at Sloan Kettering highlights the impact of proton therapy compared to palliative radiation in those patients requiring reirradiation. Find the article here (https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2800711).
Treating small cell lung cancer (SCLC) with definitive chemoradiation is critical for medical management. Though there are many regimens that can be utilized. So the question asks what is the right dose? This clinical trial highlights that a regimen of 70 Gy in 35 fractions is comparable, but not superior to 45 Gy in 30 BID fractions when treating limited stage SCLC. Find the article here (https://pubmed.ncbi.nlm.nih.gov/36623230/).
Until it was recently dethroned by COVID-19, tuberculosis was the world’s reigning infectious killer. The World Health Organization estimates that 1.6 million people died of tuberculosis in 2021. Existing first-line treatments last 4–6 months and are complex multidrug regimens with considerable toxicity. GSK recently announced positive results of its open-label phase 2a trial of GSK30336656, a first-in-class drug for the treatment of tuberculosis. The molecule functions as an inhibitor of the Mycobacterium tuberculosis enzyme leucyl-tRNA synthetase, blocking protein synthesis. Patients with drug-susceptible pulmonary tuberculosis treated with the investigational drug for 14 days showed a significant, dose-dependent reduction in colony-forming units in their sputum, the trial’s primary endpoint. Find the article here (https://www.nature.com/articles/d41591-022-00114-z).
This article attempted to answer the comparative effectiveness of first-line immune checkpoint inhibitors (ICIs) vs chemotherapy in standard practice settings among patients with metastatic colorectal cancer (MCRC) with high microsatellite instability (MSI-H) determined by next-generation sequencing (NGS). Authors of this study found that MSI determined by NGS is a robust biomarker of ICI outcomes in patients with MCRC. Find the article here (https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2800704).
There is no consensus on appropriate organ at risk (OAR) constraints for short-course radiotherapy for patients with glioblastoma. This study demonstrated higher left hippocampal mean doses were predictive for neuro-cognitive decline post-radiotherapy. Routine contouring and use of dose constraints to limit hippocampal dose is recommended to minimize neuro-cognitive decline in patients with glioblastoma treated with chemoradiotherapy. Find the article here (https://www.thegreenjournal.com/article/S0167-8140(22)04510-8/fulltext).
If you are not aware glioblastoma multiforme is a very lethal tumor with 5-year survival rates of 30.9% for grade 3 gliomas and 6.6% for grade 4 gliomas. The add-on efficacy of interferon alfa is unclear for the treatment of HGG. In this phase 3 randomized clinical trial study of 199 patients with HGG, compared with temozolomide alone, temozolomide plus interferon alfa significantly improved the overall survival of patients with HGG, especially those with O6-methylguanine-DNA methyltransferase (MGMT) unmethylation, which met the primary overall survival end point. This is a very novel finding and could change the way we manage GBM going forward. Find the article here (https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2800859).
This is a contentious article that highlights possible misappropriation and practice patterns involved in educational rankings. What are the thoughts of folks on the merit and ethical dilemma by the likes of US News and World Reports on institutions of higher learning. Find the article here (https://www.science.org/doi/10.1126/science.adg8723).
Hub