30-Second Takeaway
- SBRT outperforms HDR brachytherapy for intermediate‑risk prostate cancer biochemical control with less acute GU toxicity and similar late QoL.
- Induction ipilimumab–nivolumab followed by chemoradiotherapy enables high bladder‑intact event‑free survival in stage II/III MIBC.
- Expert ESMO–ESTRO consensus favors holding or adapting EGFR, ALK, and BRAF/MEK inhibitors for many concurrent RT scenarios.
- Protocol‑guided SBRT for central and ultra‑central early NSCLC yields excellent 4‑year local control with minimal clinically significant toxicity.
- Early consolidative thoracic RT during EGFR‑TKI therapy, proton therapy for pediatric ependymoma, and selective breast IORT refine long‑term outcomes.
Week ending February 28, 2026
Targeted, high‑precision radiotherapy strategies across disease sites: modality choice, timing, and combination therapy
SBRT vs HDR brachytherapy for intermediate‑risk prostate cancer: better biochemical control and less acute GU toxicity with SBRT
In this pooled analysis of five prospective trials, 247 intermediate‑risk prostate cancer patients received SBRT (n=180) or HDR brachytherapy (n=67) monotherapy without ADT. At 10 years, biochemical failure was substantially lower with SBRT than HDR (10.4% vs 38.0%, P < .001). HDR brachytherapy caused more acute grade ≥2 GU adverse events than SBRT (74.6% vs 51.7%, P = .007). Late clinician‑reported toxicity and late patient‑reported quality of life did not differ significantly between modalities.
Ipilimumab–nivolumab induction plus chemoradiotherapy achieves high bladder‑intact EFS in stage II/III MIBC
The single‑arm phase 2 INDIBLADE trial enrolled 50 patients with stage II/III MIBC for induction ipilimumab plus nivolumab followed by chemoradiotherapy. Estimated 2‑year bladder‑intact event‑free survival was 78% and 2‑year overall survival 96%. Grade 3‑4 immune‑related adverse events occurred in 24% of patients, while grade 3‑4 chemoradiotherapy‑related events occurred in 7%. Undetectable ctDNA after induction immunotherapy correlated with improved bladder‑intact event‑free survival (hazard ratio 8.3, P = 0.02).
ESMO–ESTRO consensus on combining RT with EGFR, ALK, and BRAF/MEK inhibitors
ESMO and ESTRO convened 19 experts to develop safety recommendations for combining radiotherapy with EGFR, ALK, and BRAF/MEK inhibitors across 57 clinical scenarios. Systematic reviews screened 2745 records, ultimately including 110 reports to inform toxicity risk estimates. Consensus was reached on all scenario‑specific statements, despite limited high‑quality prospective data. For most scenarios, concurrent RT with these targeted agents may increase toxicity, prompting recommendations for treatment interruption, dose reduction, or major RT adaptation.
References
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Additional Reads
Optional additional studies from this edition.