30-Second Takeaway
- Stereotactic radiation for 5–20 brain metastases improved symptom burden versus hippocampal-avoidance WBRT with similar serious toxicity.
- Regional nodal irradiation after neoadjuvant chemotherapy and breast-conserving surgery did not improve overall survival in clinically node-positive disease.
- Low-dose fractionated radiotherapy added to induction chemotherapy enhanced response and tumor regression in high-risk nasopharyngeal carcinoma without excess acute toxicity.
- SPECT-based functional lung dosimetry identified ventilation and perfusion dose thresholds associated with symptomatic radiation pneumonitis risk.
- Selective internal radiation therapy for liver metastases from neuroendocrine neoplasia showed a clear tumor dose–response with low rates of severe toxicity.
Week ending February 21, 2026
Radiation oncology updates: intracranial, breast, nasopharyngeal, thoracic, liver-directed, and global access considerations
Stereotactic radiation improves symptoms versus hippocampal-avoidance WBRT for 5–20 brain metastases
In this phase 3 trial, 196 patients with 5–20 brain metastases and no prior brain RT were randomized to stereotactic radiation or hippocampal-avoidance WBRT. Stereotactic radiation improved the MDASI-Brain Tumor symptom and interference score over 6 months, while scores worsened with hippocampal-avoidance WBRT (mean difference −1.06; P<.001). Rates of grade 3–5 treatment-related adverse events were similar, but fatigue was less frequent with stereotactic treatment. These results support stereotactic radiation as the preferred approach in this population to reduce symptom burden and functional interference.
Regional nodal irradiation after NAC and BCT shows no overall survival benefit in cN+ breast cancer
This NCDB study evaluated 7,137 cN+ stage II–III breast cancer patients treated with neoadjuvant chemotherapy and breast-conserving treatment. Regional nodal irradiation was used in 57.7% of patients and was associated with worse overall survival versus no RNI (79.9% vs 84.4% at 68 months). Among ypN0 patients, RNI did not improve overall survival, while ypN+ patients receiving RNI had worse survival than those without RNI. These observational data support individualized omission of RNI in ypN0 patients after NAC and BCT, acknowledging potential selection bias and unmeasured confounders.
Low-dose fractionated RT during induction chemotherapy enhances response in high-risk nasopharyngeal carcinoma
This randomized phase 2 trial enrolled 82 high-risk LANPC patients with advanced nodal disease to induction chemotherapy with or without low-dose fractionated RT to involved nodes. The LDFRT group received 50 cGy twice daily for 2 days each induction cycle, followed by standard concurrent chemoradiotherapy in both arms. Overall objective response after induction was higher with LDFRT (100% vs 85.4%), with significantly greater lymph node and total tumor volume regression. Two-year progression-free and distant metastasis–free survival numerically favored LDFRT, though differences were not statistically significant at current follow-up. Acute toxicities were comparable, suggesting LDFRT can safely potentiate induction response in selected high-risk LANPC patients.
References
Numbered in order of appearance. Click any reference to view details.
Additional Reads
Optional additional studies from this edition.