ChandraKota,Ph.D.

Amazing to connect with the incredible @TargetingCancer team & friends at #ASTRO24! 🌟 Despite ~2% of global onc research spend going to #RadOnc, RT is saving lives every day. Proud to be part of the global push to raise awareness for its vital role in cancer treatment! 💪🌍

@johndavid_JDMD @JordanJ65544091 @SprakerMDPhD @cameronatharp @adapthyun @JoshuaSchiffMD @samsonpp @AndrewFarach @KamravaMD @AmericanBrachy @AnthonyNguyenMD @ArjitB_medphys @DrMarinaSala I agree. LDR or 1-2 Fx HDR for prostate is like a surgical procedure, get one shot to do it right, can’t really salvage. My Docs do most of work for LDR PSI, I assist as physicist; I like this model better than physicists doing more (planning).

@RadOnc_AI @JordanJ65544091 @SprakerMDPhD @cameronatharp @adapthyun @JoshuaSchiffMD @samsonpp Wait I'm confused, if we are calling SBRT equivalent to surgery, then what would you say brachytherapy is comparable to? Just saying... brachytherapist do alot each fraction... @AndrewFarach @KamravaMD @AmericanBrachy @AnthonyNguyenMD @ArjitB_medphys @DrMarinaSala

A cool paper that was shared with me by a listener about... The On Table Adaptive Contouring APRT Credentialed through in-house training, no degree. And a payoff of significant time savings for physicians and the department. (Research led by... an APRT, ay @cameronatharp)

@SprakerMDPhD @JordanJ65544091 @cameronatharp @adapthyun @JoshuaSchiffMD @samsonpp Agree ! having done adaptive on MRIdian, I feel that as we move towards 1-2 Fx Pulsar type Tx paradigm, everyone needs to get better at CT/MR based contouring of OARS, Would be nice to have a certification course in segmentation to validate our skills.

@RadOnc_AI @JordanJ65544091 @cameronatharp @adapthyun @JoshuaSchiffMD @samsonpp This is a good analogy. I know many surgeons that operate with a mid-level or extender, I would guess delegating "less important" parts of the surgery. In the paper, they state that APRT contours are reviewed and verified by the physician prior to treatment. Pretty similar.

@JordanJ65544091 @SprakerMDPhD @cameronatharp @adapthyun @JoshuaSchiffMD @samsonpp My concern would be delegating down a very important part of the adaptive process for SBRT, which I feel is equivalent to surgery. As far as I know, surgeons and IR docs only delegate tasks of lesser importance.

@SprakerMDPhD @cameronatharp @adapthyun @JoshuaSchiffMD @samsonpp As long as you are willing to give up something then it works. RO, is exactly like Anesthesiology and Radiology when you look at these angles. Every site is very different, and the inward consolidation will continue. Value is by tasks association unfortunately.

We argued: 1. Public and private payers aiming to improve radiotherapy access while controlling costs should incentivize SBRT, yet most create disincentives.   2. No one owns a patent on radiotherapy. The lack of resources directed toward studying its optimal delivery through clinical research is a market failure. Governments must step in to address the disparity between radiotherapy’s critical role in cancer care and the lack of research funding.   3. The latest Lancet Oncology Commission is another tremendous resource for anyone interested in radiotherapy at a systems level. @TheLancetOncol @ASTRO_org @ESTRO_RT @Elekta @ARPA_H

This is why @RO_Institute exists #radonc

@EliasKress It’s a policy and reimbursement issue. When reimbursement is tied to outcomes, it will spur innovation in surgical and radiation oncology, and newer non pharmacological interventions.

radiation therapy is used in over 50% of all cancer cases due to its efficacy as a curative treatment and improved quality of life over surgery, yet the field sees a meager 3% of global oncology research budget. it’s time to change this

Together, Mike Milken & @felixfengmd of @UCSF have made a massive impact on the #prostatecancer community. Dr. Feng led foundational research on advanced prostate cancer as part of the West Coast Dream Team Help us fund more life-saving research: tinyurl.com/ycyuhhyv

@PCFnews Some level of medical literacy is so important these days.. so that folks can learn when they are healthy and be able to make informed decisions as patients when needed.

Mike Milken has dedicated himself to raising prostate cancer awareness nationwide. His passion stems from his own battle with the disease and a desire to help others walking a similar path. Join our team for the 29th season of the #HomeRunChallenge bit.ly/3QzgjE8

@toddscarbrough @olusolaodavies @SprakerMDPhD @jryckman3 True, I have found that the desire to too tightly conform dose to the ptv, with rings, etc, or make it uniform, can both play a huge role,as expected in affecting dmin dose around ptv edges.

@olusolaodavies @RadOnc_AI @SprakerMDPhD @jryckman3 How do you get to Broadway? Practice, practice, practice How do you increase Dmin of a PTV voxel edge? Make the center more 🔥,🔥,🔥

Poll and opinion request, inspired by my awesome dosimetrists. Should a #RadOnc be using a target volume Dmin goal in their directives? Bonus points for informative comments! @jryckman3

@toddscarbrough IMRT/vmat to sutures with igrt??😀

New #radonc thing: Radiation helps organs hold sutures better (!) (The less we question this the better, take the win, etc)

@olusolaodavies @toddscarbrough @SprakerMDPhD @jryckman3 Does that mean the in the context of SBRT, with high central dose, min dose is not as important for tumor control? Or is the lower min only to ptv and gtv gets close to Rx dose?

@toddscarbrough @SprakerMDPhD @jryckman3 @toddscarbrough in the CK optimizer, you can set dose minimums to anything but it may not meet. For instance, your V54 for a 3fx lung might be 95% but your Dmin could be 37 Gy. I've seen it!

@JordanJ65544091 @toddscarbrough LOL meant to write not to do…

@JordanJ65544091 @toddscarbrough There is no reason for MDs or physicists to do planning very efficiently, with semi automated TPS. Autocontouring, knowledge based planning, etc. Happens in the rest of the world.

When the pressure cooker increases. Apparently, a medical dosimetry salary survey was published, and the max end is $240k. We have been told that there were chat forums encouraging them to inflate wages on the survey. Now, they are asking for $40-$50k raises. Not all of them obviously, but they do understand how this works and what it creates. Economics 101. This will have a very negative impact if it becomes a wave. will lead to faster push for software automation and finding cheaper dosimetrist. I added them at 180k so you can see the impact. @SprakerMDPhD @SameerKeoleMD @srob61 @StrasserMD @toddscarbrough @5_utr @subatomicdoc @wdavidlindsay @seanmmcbride

@DrSpratticus Great points, Dan. Reframing may also help. Radiotherapy = spatiotemporal drug delivery of subatomic particles. Linacs= both factory and delivery system. One of at least two reasons to consider rebranding as Radiation Medicine #radmed From 2020 slideshare.net/subatomicdoc/r…

As long as the community, which often is medoncs discussing radiopharm, as ‘dose’ we are doomed to not make progress. Pains me this basic rad physics 101 terminology is not even known. Now nuc med, who 100% knows the difference, is saying ‘dose’ to over simplify, when they know it is ‘activity’. End of the day this is ionizing radiotherapy and dose to tumor matters for cell kill. Giving same activity for someone with 2 bone Mets vs 100 bone Mets is giving very different doses to normal and tumor. These are not simple drugs like ARPI or chemo. @US_FDA needs to have greater flexibility for more personalized activity and dosimetry. I encourage @DrMHofman @thomashopemd Herrmann, Emmett, and others to force the clinical community to adapt to appropriate terminology so we can make progress. If the ordering providers of RLT can’t understand this difference they shouldn’t be giving it.

Can Men Get Breast Cancer? We know that #men get #breastcancer but is the general public aware? #bcsm @OncoAlert oncologynurseadvisor.com/home/cancer-ty…

Despite value in #cancertreatment relative to drugs, #radonc has faced continuous #MPFS cuts @daveadler10 discusses #ROCR at #ACR2024 Economics Forum moderated by @GregoryNNicola

What I learned in 🇨🇱 today … $5mill = one #radiotherapy machine☢️, can treat 10k patients. $5mill = 135 patients worth of trastuzumab. 🧐 @TheLancetOncol - tinyurl.com/6bry9a2a “an essential pillar in multi-D oncology…an inexpensive modality” - 👏🏽 well said @TargetingCancer