Radiation Oncology

Author specialty biases conclusions in nonrandomized RP versus RT comparisons

In 105 nonrandomized studies comparing radical prostatectomy (RP) versus radiation therapy (RT), 44% reported no conclusive difference, 42% favored RP, and 14% favored RT. Multivariable analysis showed use of national databases and urology author specialty predicted conclusions aligned with the author's specialty (p = 0.01). Association persisted after excluding studies relying only on biochemical recurrence, with urologists more likely to favor RP (p = 0.006). These findings suggest clinicians should interpret nonrandomized RP versus RT comparisons cautiously and seek multidisciplinary input. 1

High rates of radiation pneumonitis with concurrent third‑generation EGFR‑TKI and thoracic RT

In 209 treatment‑naive EGFR‑mutant NSCLC patients, concurrent first‑line third‑generation EGFR‑TKI plus thoracic radiotherapy produced Grade ≥2 RP in 43.54% (22.01% grade 2, 21.53% grade 3). No grade 4 or 5 RP occurred in this cohort, and median PFS was 26.7 months with no TKI PFS differences reported. Osimertinib was associated with higher Grade ≥2 and Grade 3 RP rates than aumolertinib or furmonertinib in this series. Ipsilateral lung V5 ≥ 35.93%, ipsilateral V30 ≥ 24.61%, and larger GTV were independent predictors of Grade ≥2 or grade 3 RP. 2

Families value treatment recommendations in pediatric precision medicine despite poor prognosis

In the PRISM trial, 87% of families expected benefit and 68% expected a treatment recommendation at enrollment. Seventy percent of parents received a recommendation, but roughly half recalled it; parents reported high involvement (median 93/100) and satisfaction (95/100). Receiving a recommendation was not associated with increased regret about trial participation (p > 0.05). Families described recommendations as providing hope and reassurance that all options had been explored. 3