What are your top takeaways from ASTRO 2022?

1. NRG RTOG 1005: A Phase III Trial of Hypofractionated Whole Breast Irradiation with Concurrent Boost vs. Conventional Whole Breast Irradiation Plus Sequential Boost Following Lumpectomy for High Risk Early-Stage Breast Cancer

The results showed that with hypofractionation and SIB technique, 7 years IBTR and cosmetic outcomes are similar to the sequential approach with conventional fractionation. These results are consistent with one of the experimental arms of IMPORT HIGH and establishes this ...

1. RTOG 1005 - In a large phase 3 trial, demonstrated the safety and efficacy of simultaneous integrated boost in the management of early stage practice. The question that emerges is who to offer this approach to.

2. Long-Term Outcomes of SABR to Primary Renal Cell Carcinoma: A Multicenter Analysis from IROCK (International Radiosurgery Oncology Consortium for Kidney) - Demonstrated the role of SABR in management of RCC, with single fraction appearing to have improved LC. We will need further st...

1. NRG/RTOG 1112: It is a phase III study of sorafenib vs. SBRT followed by sorafenib in locally advanced HCC. This study showed the addition of SBRT improved overall survival (OS), progression-free survival (PFS), Time to progression (TTP) without increased toxicity in this patient population. This study establishes SBRT as a new standard of care for this patient population on sorafenib.

2. Prophylactic RT for bone metastases: This is a multicenter randomized phase II trial of prophylactic RT ...

1. NRG/RTOG-1112: Randomized Phase III Study of Sorafenib vs. Stereotactic Body Radiation Therapy Followed by Sorafenib in Hepatocellular Carcinoma. The results of this long-awaited trial led by Dr. @Dr. First Last showed the benefit of adding SBRT to sorafenib in patients with locally advanced hepatocellular carcinoma. This study included patients with a high burden of liver disease - 74% of patients included in the study had macrovascular invasion with 63% having involvement of main vessels (I...

There were many interesting things presented at ASTRO this year. I have chosen the most important abstract for our near-term practice in treating breast cancer patients and two others that are quite novel but which will need much more study before considering whether to adopt them.

1. Abstract 1: Vicini F, et al. NRG RTOG 1005: A Phase III Trial of Hypo Fractionated Whole Breast Irradiation with Concurrent Boost vs. Conventional Whole Breast Irradiation Plus Sequential Boost Following Lumpectomy...

The issue of using IMPT vs. IMRT in HNC is contentious, with retrospective data suggesting likely similar tumor control but conflicting data regarding the potential clinical superiority of IMPT in reducing acute and late sequellae. While some publications suggest DVH-based superiority of IMPT regarding certain OARs, it is not clear whether or not a clinical benefit is gained. This issue is the subject of a randomized study in OPC led by MDA, whose estimated completion date is late 2025 (NCT01893...

Good presentations