@PBlanchardMD @c_abramowitz Congratulations @c_abramowitz and team, fantastic trial! Curious how frequently the 40Gy GTV SIB was done on the accelerated arm, and if it was predominantly mri or psma pet delineated?
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Sympascho Young MD
46 posts
Sympascho Young MD
@DrSymYoung
MD | Radiation Oncology Fellow @ UTSW | Residency @WesternU | Alumni @UBCMedicine @UofTBiochem | cancer care, musician, NBA enthusiast | Tweets = Own views
London, Ontario Katılım Ekim 2022
162 Takip Edilen105 Takipçiler
The HEAT trial is another randomized demonstration of the safety & efficacy of SBRT compared to hypofractionted RT in #prostatecancer at #ESTRO26
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Another tremendous #ESTRO2026! So wonderful to reconnect with old friends and make new ones. Grateful for the opportunity to present a proffered paper on HN ENI omission. And congratulations to @drdavidpalma & @ldawsonmd on well-deserved honorary ESTRO member awards! 👏🇨🇦
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Incredibly grateful for your mentorship and the opportunity to lead this analysis, @DavidSherMD! These long-term results make a compelling case for the INRT paradigm. Excited for the future of AI-guided precision radiation and HN de-escalation! 📈✨ #ESTRO26 @UTSW_RadOnc
David Sher@DavidSherMD
Absolutely terrific work by @DrSymYoung to report the long-term outcomes of our INRT experience from two prospective trials (INRT-AIR and DARTBOARD). Short version: with long-term follow-up (median 5.2 years for INRT-AIR, 3 years for DARTBOARD), we've seen zero solitary elective nodal recurrences. Longer version: ESTRO has highlighted novel approaches to managing the elective neck in HNSCC, and I believe the future will be very different than the present. Current ENI fields deliver the majority of the integral dose to patients and contribute substantially to critical structures (swallowing and xerostomia OARs). Minimizing ENI dose and volume may meaningfully improve the short- and especially long-term tolerance of radiotherapy. A few more thoughts on our INRT paradigm below:
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@DavidSherMD @DrSymYoung Congrats Sympascho and David!
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Absolutely terrific work by @DrSymYoung to report the long-term outcomes of our INRT experience from two prospective trials (INRT-AIR and DARTBOARD).
Short version: with long-term follow-up (median 5.2 years for INRT-AIR, 3 years for DARTBOARD), we've seen zero solitary elective nodal recurrences.
Longer version: ESTRO has highlighted novel approaches to managing the elective neck in HNSCC, and I believe the future will be very different than the present. Current ENI fields deliver the majority of the integral dose to patients and contribute substantially to critical structures (swallowing and xerostomia OARs). Minimizing ENI dose and volume may meaningfully improve the short- and especially long-term tolerance of radiotherapy.
A few more thoughts on our INRT paradigm below:
OncoAlert@OncoAlert
Day FOUR of #ESTRO26 Coverage by OncoAlert 🚨 Omission of elective nodal irradiation in HNSCC: long-term results and patient-level pooled analysis from 2 prospective trials (INRT-AIR & DARTBOARD) Presenter Sympascho Young 🇺🇸 A patient-level pooled analysis of 117 patients from two prospective trials (INRT-AIR and DARTBOARD) showed that omission of elective nodal irradiation for HNSCC was oncologically safe long-term, with a 0% rate of solitary elective nodal recurrence at 5 years. The trials used an involved nodal radiotherapy (INRT) approach assisted by an artificial intelligence model for detection of suspicious nodes. @DrSymYoung @DavidSherMD #RadOnc @ESTRO_RT @yasemin09896924 @LindaMrissa @christian_roenn @Valeriadionisi @gerryhanna @clchiang_hk @mtugceyilmaz @B_Tomasik @gmpetrianni @CiroFranzese1 @Atem84 @piet_ost @brachyexpert @BlanceS90 @The_PT_Explorer @BarbaraJereczek @Mat_Guc @ZilliThomas @AnnaKirby17 @PBlanchardMD @achoud72 Pinging OA faculty @MKnoll_MD @_ShankarSiva @Icro_Meattini @seanmmcbride @NiuSanford @nataliagandur @acampsmalea @to_be_elizabeth
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Sympascho Young MD retweetledi
Yesterday, I presented the @GETUG_Unicancer PEACE 2 trial at #ESTRO26 on the role of pelvic RT in very high risk #prostatecancer pts (staged with conventional imaging).
Twittorial below
Key conclusion: pelvic RT did not improve clinical outcomes (cPFS, MFS, PCSS, OS)...
1/n
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@robt_heartdoc @OncoAlert Absolutely. A RCT is already underway at @UTSW_RadOnc, the protocol is in press and available here link.springer.com/article/10.118…
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@OncoAlert Agree . 0% recurrence is striking, but I would not adopt INRT outside trials on pooled phase II data alone. RCTs first.
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Day FOUR of #ESTRO26 Coverage by OncoAlert 🚨
Omission of elective nodal irradiation in HNSCC: long-term results and patient-level pooled analysis from 2 prospective trials (INRT-AIR & DARTBOARD)
Presenter Sympascho Young 🇺🇸
A patient-level pooled analysis of 117 patients from two prospective trials (INRT-AIR and DARTBOARD) showed that omission of elective nodal irradiation for HNSCC was oncologically safe long-term, with a 0% rate of solitary elective nodal recurrence at 5 years. The trials used an involved nodal radiotherapy (INRT) approach assisted by an artificial intelligence model for detection of suspicious nodes.
@DrSymYoung @DavidSherMD
#RadOnc
@ESTRO_RT
@yasemin09896924
@LindaMrissa
@christian_roenn
@Valeriadionisi
@gerryhanna
@clchiang_hk
@mtugceyilmaz
@B_Tomasik
@gmpetrianni
@CiroFranzese1
@Atem84
@piet_ost
@brachyexpert
@BlanceS90
@The_PT_Explorer
@BarbaraJereczek
@Mat_Guc
@ZilliThomas
@AnnaKirby17
@PBlanchardMD
@achoud72
Pinging OA faculty
@MKnoll_MD
@_ShankarSiva
@Icro_Meattini
@seanmmcbride
@NiuSanford
@nataliagandur
@acampsmalea
@to_be_elizabeth
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Sympascho Young MD retweetledi
Day TWO of #ESTRO26 Coverage by OncoAlert 🚨
De-intensification of postoperative radiotherapy in HNSCC by omitting contralateral elective neck irradiation– long term outcomes of the DIREKHT trial Presented by Charlotte Frei 🇩🇪
#RadOnc ☢️
The DIREKHT trial is a prospective multicentre phase II trial investigating de-intensified risk-adapted radiation in patients with newly diagnosed, non-metastatic HNSCC after surgery. A total of 140 patients were included in the analysis. After five years, overall locoregional recurrence rate was 6.0% (95% CI [1.9; 9.9]). Cumulative incidence of locoregional recurrence was 3.0% (95%-CI [0.1; 5.8]). Details on recurrence patterns and dysphagia rates are presented at ESTRO 2026.
@ESTRO_RT
@yasemin09896924
@LindaMrissa
@christian_roenn
@Valeriadionisi
@gerryhanna
@clchiang_hk
@mtugceyilmaz
@B_Tomasik
@gmpetrianni
@CiroFranzese1
@Atem84
@piet_ost
@brachyexpert
@BlanceS90
@The_PT_Explorer
@BarbaraJereczek
@Mat_Guc
@ZilliThomas
@AnnaKirby17
@PBlanchardMD
@achoud72
Pinging OA faculty
@MKnoll_MD
@_ShankarSiva
@Icro_Meattini
@seanmmcbride
@NiuSanford
@nataliagandur
@acampsmalea
@to_be_elizabeth
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Sympascho Young MD retweetledi
Day TWO of #ESTRO26 Coverage by OncoAlert 🚨
Paradigm shift from bilateral elective nodal irradiation to SPECT/CT-based SNP to guide unilateral irradiation in HNSCC: multicenter prospective study Presented by Abrahim Al-Mamgani🇳🇱
SPECT/CT- and SN-guided selection tool for unilateral nodal irradiation (UNI) in patients with HNSCC is feasible, safe and very effective, as only 2 patients developed CRF (2.4%) with significant reduction of acute and late toxicity, compared to patients treated to both sides of the neck. Adding SNP to SEPCT/CT increased number of patients treated with UNI from 78% using only SPECT/CT to 91% by using combination of SPECT/CT- and SNP
#RadOnc
@ESTRO_RT
@yasemin09896924
@LindaMrissa
@christian_roenn
@Valeriadionisi
@gerryhanna
@clchiang_hk
@mtugceyilmaz
@B_Tomasik
@gmpetrianni
@CiroFranzese1
@Atem84
@piet_ost
@brachyexpert
@BlanceS90
@The_PT_Explorer
@BarbaraJereczek
@Mat_Guc
@ZilliThomas
@AnnaKirby17
@PBlanchardMD
@achoud72
Pinging OA faculty
@MKnoll_MD
@_ShankarSiva
@Icro_Meattini
@seanmmcbride
@NiuSanford
@nataliagandur
@acampsmalea
@to_be_elizabeth
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Sympascho Young MD retweetledi
Two of our faculty, Drs. @MonaArbabMD and Aurelie Garant, along with one of our fellows, Dr. @DrSymYoung, having a great time this weekend at #ESTRO26!
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Sympascho Young MD retweetledi
If you're interested in SABR, check out this interview with 3 of the OG SABR pioneers in the @ijrobp special issue: Drs. Hiroshi Onishi, Suresh Senan, and Robert Timmerman.
sciencedirect.com/science/articl…
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Sympascho Young MD retweetledi
We have become very aggressive in bacterial decolonization to help mitigate oral mucositis in head and neck radiotherapy. It is impossible to say whether both interventions at once are better than either one on their own, but anecdotally I have been pleased. They are essentially harmless interventions to minimize a very difficult and frustrating side effect of treatment.
For those interested, here is a handout we give patients prior to starting treatment:
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Sympascho Young MD retweetledi
#ClinicalTrial EA3211, led by @DavidSherMD of @utswcancer, aims to improve results for patients with #HeadAndNeckCancer that has spread to a limited number of places. Learn more: bit.ly/ea3211-study
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Sympascho Young MD retweetledi
Our adaptive radiation therapy program, led by @BadiyanMD and @MHLinPhD, delivers real-time, personalized cancer treatment. Adaptive radiation therapy adjusts for daily anatomical changes—like tumor shrinkage or organ movement—enhancing precision and reducing side effects.
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Sympascho Young MD retweetledi
We are excited that our most recent amendment was approved, streamlining imaging criteria for enrollment.
EA3211 is a phase III randomized trial comparing consolidative radiotherapy plus pembro with pembro alone in patients with oligometastatic head and neck cancer who have not progressed on chemoimmunotherapy. It is powered for overall survival.
Eligibility includes both synchronous and metachronous oligometastatic disease.
Data suggests that radiotherapy may have an important role in prolonging survival in metastatic head and neck cancer, with an established and tolerable safety profile.
Let's prove whether it actually improves survival!
We are always looking for new sites to participate! Please message me with any questions.
ECOG-ACRIN Cancer Research Group@eaonc
#ClinicalTrial EA3211, led by @DavidSherMD of @utswcancer, aims to improve results for patients with #HeadAndNeckCancer that has spread to a limited number of places. Learn more: bit.ly/ea3211-study
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Sympascho Young MD retweetledi
I recently saw a patient 9 years following early-stage glottic larynx SAbR (on our original CyberKnife trial).
The images below represent the typical endoscopic appearance.
Our G-FORCE phase II RCT (LT-SAbR versus whole larynx) is now ~ 33% accrued!
clinicaltrials.gov/study/NCT06080…
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Sympascho Young MD retweetledi
Thrilled to activate PREVENT! This phase II/III RCT builds on the success of @DrAlexLouie's PROACTIVE trial by randomizing patients requiring palliative thoracic RT 2:1 to high-dose esophageal-sparing vs. traditional palliation to a max dose of 30 Gy in 10 equivalent
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Sympascho Young MD retweetledi
Rohann Correa’s talk today at the Yonsei RO Grand Round Seminar was incredible.👍
High-level talks like this are truly rare in Korea, where geographical and language barriers remain.
It was a big hit—especially inspiring for residents and students.
Thanks again, @DrCorreaRO .🙏
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