Daniel A Hamstra

@DGlaucomflecken It gets the red out. Isn’t that good?

For the 10th time in my life, this country will elect a president with no plan for eradicating Vis*ne

@SbrtSean Artera currently only prognostic in high risk. Not predictive of ADT benefit. There was an analysis presented (but not published) on STAD v LTAD using Artera. (2/3 predicted for LTAD).

Prostate SBRT Question of the Day: 72 yo with High Risk Prostate Cancer PSA 12 T1c Gleason 4 +4 = 8 2/13 Cores You recommend ADT plus SBRT If the Patient had a Negative Artera AI, Would You Treat with SBRT Alone?

@daniel_hamstra Have you see the CTCAE GI toxicity curves with SBRT vs CRT? They’re overlaid. Same with bowel QoL. Where are you getting those numbers from?

This is just incredible spin. The cumulative risk of grade 2+ toxicity is 42.5% (37.8-47.5) vs 29.8 (25.5-34.5) with HR 1.58(1.25-1.98)

@5_utr I’m Twitter illiterate my two part tweet got cut up.

@5_utr Appendix of Lancet Publication. All physician scored toxicity is crude and biased compared to PRO. IMHO

@5_utr The patient reported outcomes from the Lancet Oncology paper appendix likely do a very good job of settling the pt experience (Flomax or not). At 2-yrs a measurable decline in urinary incontinence greater with SBRT (23% v 32%, p=0.01) and obstruction (26% vs 33%, p=0.12 (NS))

NYT tweeted this to its 55 million followers and it has under 500 retweets - presumably suppressed due to the link out. “John Kelly, Donald Trump’s longest-serving chief of staff, said Trump met the definition of a fascist and would try to govern like a dictator if elected”

Has the U.S. economy, historically, been better under Republican presidents or Democratic presidents? A Republican financial analyst decided to find out. His name? Bart Starr, Jr. (Yes, the son of THAT Bart Starr.) The answer may surprise you.🧵

1/11 So the first 3 volumes of Smith's evidence against Trump are released. About 70% still sealed, but, pretty damning stuff, which is all either their own messages, or testimony from Republican staff under oath:

@rweichselbaum @DrAndrewLoblaw @cristian_udo @YasirAlayed Agree. Many of my pts getting SBRT for prostate cancer are choosing over surgery.

@DrAndrewLoblaw @cristian_udo @YasirAlayed Therapy I would think this would really cut down on radical proctectomy. The time is a bigger issue than I think. Most people give a credit for patient. Wanted a quick fix. This is pretty close.

There's already data! Our group compared 2 fx with #GULok immobilization (2mm margin) vs 2fx SBRT (5mm margin) Safe efficacy @ 9.4y mFU (@cristian_udo) but better sexual and bowel QOL (@YasirAlayed). Confirmatory RCT ongoing (#iSMART) doi.org/10.1016/j.rado…

@HenningWillers @lauremarignol @_MichaelBaumann @sophia_kamran @drjefstathiou @DeborahCitrin @BrianMarples These are only “clinical data” if your clinic treats mice. I would temper the enthusiasm appropriately.

👨‍🏫We do teach that high-LET #radiotherapy can overcome tumor hypoxia 📢Now finally some clinically relevant data in #ProstateCancer🔥 #radbio @lauremarignol @_MichaelBaumann @sophia_kamran @drjefstathiou @DeborahCitrin @BrianMarples FREE PDF‼️ redjournal.org/article/S0360-…

Standing ovation #ASTRO24 for @felixfengmd, recognised for his outstanding mentorship in our field, and also to formally announce the Felix Feng Clinician Scientist Development award

@yuanjamesrao @SprakerMDPhD I don’t put in pad in my pants every morning “just in case”.

One of the real eye openers to me from this study is that 50% (!!) of men after prostatectomy required one or more pads per day due to urinary leakage/incontinence at 2 years. I'm not sure most patients know about this prior to deciding on surgery. #radonc

I’m not tired.

@ProjectLincoln @gtconway3d #FatElvis

We need 5000 people to reply to this tweet with #FatElvis

@RCruzChamorro @DrLouisCappelli Felt the same way 20 years ago. Physics very scatter shot with questions about setup of clinical simulator all the way to both protons and neutrons. All in the test then didn’t seem like it was testing common or reasonable knowledge but mostly esoterica.

@DrLouisCappelli I agree!!

2024 Rad Bio & Physics impressions: Rad Bio - straightforward, knew it or you didn’t, didn’t try to trick you, recommended resources through ASTRO were helpful and could definitely get you to pass. Physics… I felt quite the opposite. Whether I passed or didn’t for either, recommended ASTRO resources were not very helpful for physics. Prior Raphex exams did not help. Maybe the devil was in the details, but didn’t seem as straightforward to me. Proton Heavy. I was caught off-guard for sure. Best of luck to all who took them 🤞🤞 #radonc

Dr. Anthony Fauci is an American hero. Retweet if you agree.

@rweichselbaum @CParkMD @OncLive Well deserved Ralph.

@CParkMD @OncLive And thank you!

⭐️As a selection committee member @OncLive Giants of Cancer Care for close to ten years, it is w/great pleasure we celebrate 2024 inductees. Join us as we hear stories of luminaries in oncology and their journey to prominent contributions in oncology. 👇 giantsofcancercare.com @YLeyfman @MedNewsWeek @GlopesMd @curijoey @DrYukselUrun @crisbergerot @CharuAggarwalMD @VivekSubbiah @DrChoueiri @CancerVisit_com @HamidMD10 @jacobadashek @DarcyBurbage @fumikochino @JaniceTNBCmets @devikadasMD @ADesaiMD @OncBrothers @TheFellowOnCall @TheDrWood @DrMMurphy @ramsedhom @AshleysumrallMD @KekoaMDPhD @drteplinsky @ShannonWestin

@5_utr Most of my pts choosing SBRT choose this as alternative to surgery. I think in that context the toxicity profile takes on a much different aspect.

@daniel_hamstra Fair - but we need to be careful to not go backwards with NI trials Pace-b and now c clearly more toxicity with less fractions / sbrt

NI hazards RTOG 0415: NI margin DFS 1.52x for 5-yr DFS; 28 fx vs 41 fx Late grade 2 & 3 GI adverse events were approximately 60% more likely in men who were assigned to treatment with 28 fx (RR, 1.55 to 1.59). Similarly, late grade 2 and 3 GU had higher RR 1.31 to 1.56 1/n