Radiation oncologist with a thing for science
Joined February 2019
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Robbe Van den Begin retweeted
🚨📣 big news at #ESMO26: 🧵1/MASTERPLAN RCT shows adding SABR to perioperative chemotherapy for high-risk localized #pancreatic cancer ⬆️⬆️ median overall survival to 22.0 months vs 14.0 months (HR 0.45). #PancreaticCancer #RadOnc @TROGfightcancer in press @TheLancetOncol - thelancet.com/journals/lanon…
Robbe Van den Begin retweeted
Across 3 prospective studies, the signal for post-prostatectomy SBRT in 5 fx is increasingly consistent: feasible, low toxicity & excellent in-field control. StereoBed randomized data show no PRO/toxicity penalty; POPART/esSBRT show few local failures.
#ASTRO26 @rtdess @HimanshuNagarMD @RadOncDocJ @NRGonc @ASTRO_org @urotoday @ChadTangMD @TylerSbrt @SbrtSean @jryckman3 @seanmmcbride
Robbe Van den Begin retweeted
Long-term PACE-A data at #ASTRO26 (van As LBA32, Yasar LBA10): the first randomized comparison of prostatectomy vs SBRT, 36.25 Gy in 5 fractions.
These are contemporary surgical data: all prostatectomies were laparoscopic, 84% robotic.
Using ≥1 pad/day, RP vs SBRT:
• 2 years: 50% vs 7%
• 5 years: 48% vs 8%
Sexual function at 5 years:
• EPIC sexual domain: 62→17 after RP vs 79→58 after SBRT
• Median IIEF-5: 5 vs 19
Important caveats: as-treated analysis, approximately 60% PRO completion at 5 years, baseline sexual function imbalance, and enrollment of 123 of a planned 234 patients.
Biochemical control looks similar through 8 years, but 13 events cannot establish equivalence.
For shared decision-making, these are numbers I’d want patients to see. Every patient considering prostatectomy should have the opportunity to meet with a radiation oncologist before choosing treatment.
#RadOnc #PCSM
Interesting view of @lauren_henke !
FYI: StereoBed phase II results will be presented today at ASTRO!
@JulesBordet
SO, the GU-003 data could continue to look worse with time as f/u matures, because of the DOSE ESCALATION. 📉 These data don’t kill hypofrac, they just strengthen the case for 52.5 Gy/20 fx, as used in RADICALS, to be preferred hypofrac postop regimen—shorter tx **without the dose escalation** used in GU003. #ASTRO26 #ProstateCancer
#ASTRO26 #Pcsm #RadOnc
Robbe Van den Begin retweeted
#ESTRO26 - 📣 FASTRACKII final results, median F/U of 5 years. Thank you patients, funders, investigators - #kidneycancer #kcsm
1) 100% Local Control: No local recurrences were observed at 36, 60, or 84 months.
2) 100% Cancer-Specific Survival
3) Grade 3 AEs remain at 10%
Robbe Van den Begin retweeted
❗️ OLIGOMA
Metastatic breast cancer -> systemic tx +/- SBRT
PFS 0.48 (0.25-0.91)
Wow
#estro2026
Pleased to share our latest work in the Green Journal!
There is few evidence that informs the use of a CTV for SBRT of non-spine bone mets. We analyzed 261 treatments in 193 patients.
Thanks to Dr Elisa Bodson and the whole team!
@JulesBordet
authors.elsevier.com/c/1m~ld…
Robbe Van den Begin retweeted
Israeli strike kills infant girl in south Lebanon during father's funeral reut.rs/4t6xqOZ reut.rs/4t6xqOZ
Robbe Van den Begin retweeted
Adaptive radiotherapy involves modifying treatment plans to account for changes in anatomical geometry that are not adequately mitigated with changes in alignment. Online adaptive radiotherapy capitalizes on advances in image guidance, real-time tumor tracking, and the enhanced speed of multiple steps in radiotherapy planning and delivery workflows (seen in image).
Learn more in the Review Article “Effects of Radiotherapy in Normal Tissue” by @DeborahCitrin, MD, and Robert D. Timmerman, MD (@BobTimmermanMD), from the National Cancer Institute and @UTSWMedCenter: nejm.org/doi/full/10.1056/NE…
ALT Figure 5. Online and Offline Approaches to Adaptive Radiotherapy. In both online and offline approaches, the patient undergoes a simulation and treatment planning. On the day of treatment delivery, a pretreatment image is obtained and compared with a reference (planning) image. If the alignment is within an acceptable range, the treatment is delivered. If the alignment is outside the acceptable range or if marked anatomical changes are noted, the treatment must be replanned. With online adaptive approaches, replanning and quality assurance (QA) occur while the patient remains on the treatment table, and the new treatment is delivered without delay. Online adaptive approaches are resource-intensive and require real-time availability of radiation oncologists, physicists, and dosimetrists. Offline approaches allow for the care team to prepare a new plan without real-time availability, but a delay or break in the treatment may occur.
Robbe Van den Begin retweeted
🚀 MDT in oligometastatic #ProstateCancer 🚀
👉WOLVERINE IPD meta-analysis in @TheLancetOncol
🧪 7 randomized trials, 574 pts
📉 MDT → ↓ progression, ↓ radiographic progression, ↓ time to CRPC
🔁 Consistent benefit across SOC (obs, ADT, ARPI)
🛡️ Low toxicity, short treatment courses
⚖️ OS not definitive; but this is the strongest evidence yet to integrate MDT
👏 @ChadTangMD @piet_ost
🔗 to study shorturl.at/566C9
🔗 to editorial shorturl.at/cq7IK
@PCFnews @urotoday @UrologyTimes
Robbe Van den Begin retweeted
Congrats to study authors.
Sadly it appears RP didn’t result in delayed progression in low volume M1, but earlier calling of failure appeared to lead to earlier initiation of life prolonging systemic therapy which improves CSM. Unfortunate RP couldn’t be shown to delay progression.
Even the overall stampede cohort including high volume showed FFS benefit of RT to primary.
Good to have the data out, especially the common high grade toxicity, much higher than expected with RP in localized dz.
Look forward to SWOG trial and curious what percent will be low volume receiving RP. It may be better powered to assess FFS benefit.
The RAMPP trial has landed ‼️
Congratulations to the authors for this great work!!
It compared best systemic therapy + RP (with extended LND) to BST alone for patients with de-novo synchronous oligometastatic PCa, defined as =< 5 bone mets. BST consisted of lifelong ADT. It closed early due to STAMPEDE results. Cancer-Specific mortality was the primary enpoint. Clinical progression and OS were secondary endpoints.
An X-torial
1/n
@euplatinum @urotoday @dr_coops @chapinmd @pcaparker @soum_roy_radonc @drspratticus @drandrewloblaw @tylersbrt @seanmmcbride @sbrtsean @alison_tree @vedangmurthy @piet_ost @paulsargos @jryckman3 @5_utr @protonstorey @docpriyamvada @_shankarsiva @alexsherrymd @albertobossial @xristodouleas @amarukishan @zklaassen_md @themednet
#OncoTwitter #ProstateCancer #RadOnc #UroOnc @oncoalert
sciencedirect.com/science/ar…
Robbe Van den Begin retweeted
That first pillar should probably be "new treatments".
But, you know.
The 5 pillars of modern Oncology, @myESMO President in the Opening Ceremony of #ESMO25 Congress
#ESMOAmbassadors
Robbe Van den Begin retweeted
After 47 years, Jerry has made the difficult decision to step down from the company we built together. I’m sharing his words as he resigns from Ben & Jerry’s. His legacy deserves to be true to our values, not silenced by @MagnumGlobal #FreeBenAndJerrys
Robbe Van den Begin retweeted
NEW:
🇮🇱 Israeli snipers admit to intentionally shooting starving children in large numbers as they try to get food - Israeli Haaretz
A sniper in the Nahal Brigade said, “Every day we have the same mission: to secure the humanitarian aid in the north of the Strip.” Those waiting for aid try to move forward to get a good spot in line, but there is a boundary in front of them that they can’t see. “A line that if they cross, I can shoot them,” Beni explains. “It’s like a game of cat and mouse. They try to come each time from a different route, and I’m there with the sniper rifle, and the officers yell at me, ‘Take them down, take them down.’ I fire 50–60 bullets every day. I stopped counting Xs. I have no idea how many I’ve killed, a lot. Children.”
Robbe Van den Begin retweeted
Time for perhaps the most damning stat of all:
One in 25 American five-year-olds today will not make it to their 40th birthday.
No parent should ever have to bury their child, but on average across the US one set of parents from every kindergarten class most likely will.
Robbe Van den Begin retweeted
[The body of 5-year-old Jamal al-Najjar is placed on the ground atop bricks before a funeral prayer after he died at Nasser Hospital in Khan Younis, Tuesday, Aug. 12. The head of Nasser’s pediatrics unit said Jamal, who was born with rickets, died from severe malnutrition.]
Robbe Van den Begin retweeted
📢 New in European Urology:
SABR is not just for brain mets. A systematic review shows excellent results in RCC—alone or with IO.
🧠 Local control in primary RCC
🛡️ Delay of systemic therapy in oligomets
⚡ IO + SABR: promising combos
🔗 buff.ly/5XN3Ejr
#RCC #SABR #Immunotherapy #UroOncology
Robbe Van den Begin retweeted
Dozens killed and injured near a Gaza aid distribution point, health officials say, in the third day of shooting near the site
cnn.it/45C39yj
