Recent content by Palex80

Well, the far larger POP-RT trial, with moderate hypofractionation, did not show these high rates of rectal bleeding. Actually, I am not aware of any other trial with or without ENI in the prostate field with hypofractionation that managed to demonstrate 13.5% grade III gasttointestinal...

Well we do know the V40 and V60 of rectum in CHIiP in 20 fractions seemingly play no role. So, why should I care about 25 fractions? I understand the argument that delivering low doses to all of the rectum with ENI may change the profile of acute AEs and this would perhaps explain higher rates...

CHIIP had over 3000 patients. No increase in late GI toxicity was noted. I‘m gonna place my bets on that trial and not the 180 phase II study.

Well, if that's the explanation, then why don't the majority of the other phase III trials on hypofractionation show a diference in late toxicity? What's so different about this trial? Help me understand why 68 Gy in 25 fractions to the rectum are worse than 78 Gy in 39 fractions, when at the...

I don't really understand the findings of PHART2. CTV-PTV margins in the normofractionated were considerably larger, yet there was higher toxicity? How do we explain that? This goes against everything we know so far concerning margins and their impact on toxicity. I don't really understand...

So, what type of increased GI toxicity was that? Rectal GI toxicity?

So we now weight a randomized phase 2 trial with 180 (!) patients higher than then landmark phase 3 trial with >3000 patients?

Does moderate hypofractionation really lead to more late GI toxicity? In my understanding, only RTOG 0415 and HYPRO showed more late GI toxicity with hypofractionation. In CHHiPP, rates were the same. In PROFIT they were even lower with moderate hypofractionation (although not significant).

Patients will all kinds of primary treatment were eligible a) prostatectomy without adjuvant/salvage prostate bed RT b) prostatectomy with adjuvant/salvage prostate bed RT c) primary RT of the prostate Patients with prior WPRT (either in the setting of primary or postop RT) were excluded...

Potentially practice changing

So, 25 x 2.5 Gy = 62.5 Gy is well tolerable. However, isn't there a "hidden" dose escalation when going for hypofractionation with this regime? Isn't 25 x 2.5 Gy = 62.5 Gy "more dose" than 33 x 2 Gy = 66 Gy? With ab a/b of 3 Gy, 24 x 2.5 Gy would be equivalent to 33 x 2 Gy (BED 110 Gy).

Protons for keloids?

Especially in a multicenter setting and if RT-QA is not great or surgeons not very experienced, delivering a higher dose to lungs & heart in the preoperative setting may indeed impair outcomes.

Your pathologist: Why are you treating a patient with esophageal cancer with a definitive dose if he has "nodes down near into the pelvis"???