Jared Peralta Rowley, MD retweeted
Thank you ASTRO Speed of Light for highlighting our research and this inspiring patient’s story. This was a lot of fun to make and important to spread the word about the work @SpeedofLightFdn and @ASTRO_org are doing to advance #radonc!
Research Gives Hope
Ted K. Yanagihara, MD, PhD, is leading a clinical trial on GRID therapy for sarcoma with support from Speed of Light – The ASTRO Foundation. Watch this video to learn how the grant is making an impact for the investigative team and clinical trial participant, Rhonda Sachs.
Read about the ASTRO Foundation's Impact: bit.ly/4jpzijB
Donate to support our mission: bit.ly/4AUemI7
@ASTRO_org @tedradonc @UNC_Health_Care
Congratulations!
Replying to @ASTRO_org
@ASTRO_org is in great, and I would argue better, hands with this passing of the gavel.
Good luck @NehaVapiwala ! You will do great and we are all in your corner.
Jared Peralta Rowley, MD retweeted
Two brilliant GU physicians working toward the same goal. A hug and a photo. I really do love the GU oncology community. ❤️
#radonc #ASTRO26 @ASTRO_org
Glad to have you at @MaimoHealth!
Lucky to train under Dr @JaredRowleyMD, @MaimoHealth at our poster on the BLAZE Meta-analysis #ASTRO26
Jared Peralta Rowley, MD retweeted
Thank you to #ROCR Act champion Rep. Paul Tonko (D-NY) for giving remarks on the Radiation Oncology Case Rate Act during today's House Energy and Commerce Committee hearing and advocating for ROCR to be considered as part of the Patients First Act.
We appreciate his continued leadership and commitment to advancing policies that improve access to high-quality cancer care for patients.
Learn more about the #ROCR Act: bit.ly/4dhLyyO
@RepPaulTonko @HouseCommerce
Wow Congrats @Jalal_Ahmed!
Congratulations to the winners of the 2026 Publication Excellence Awards!
Join Speed of Light – The ASTRO Foundation in recognizing these emerging leaders in radiation oncology during the Research Honors presentation at 9:00 a.m. on Mon., Sep. 28, before the keynote address at #ASTRO26 in Boston.
Learn more about the winners: bit.ly/4xVLDAI
@karamarieruicci @ZihangChenMD @Jalal_Ahmed
Jared Peralta Rowley, MD retweeted
Please see here for detailed analysis of 0-5 year patient QOL in PACE B pubmed.ncbi.nlm.nih.gov/4247… I am trying to stay out of this unbecoming exchange which demeans both urology and oncology imo, but please try to quote the best data you can find.
Jared Peralta Rowley, MD retweeted
Two ABR Trustees becoming @ASTRO_org officers.
theabr.org/beam/announcement…
Jared Peralta Rowley, MD retweeted
From our paper redjournal.org/article/S0360…, RE vertebral body compression fracture (VCF) after spine SBRT —
tl;dr: The risk of VCF requiring intervention (kypho or stabilization) at 2y post spine SBRT was 11% for 24x1, 3.1% for 10x3, and 2% for 9x3.
Jared Peralta Rowley, MD retweeted
New in #practicalRO: Peri-rectal Nodal Clinical Target Volume (CTV) Delineation in Patients with Prostate Cancer. #radonc tinyurl.com/probjdavis
Jared Peralta Rowley, MD retweeted
⚡️Just published: NEW STUDY ON MULTI-COURSE RT IN DIPG ⚡️
What happens when #DIPG progresses after re-irradiation?
💊 Systemic therapy?
🧪 Clinical trial?
🕊️ Hospice?
☢️ Or… can we irradiate the brainstem a third time, and could it actually help?
A few years ago, a family of a DIPG patient asked me exactly that. My immediate reaction was: "No, that would be too risky. Too dangerous. She’s already had radiation twice". But I kept thinking about it. 🤔 I spoke with several colleagues, reviewed the very limited literature, and eventually started asking a different question:
Do we actually know that a third course is too dangerous, or have we simply assumed it is?
We ultimately treated this patient with a carefully selected, low-dose third course of RT.
✨ She experienced significant improvement in symptoms.
⏳ She lived for nearly 9 months after that treatment.
That experience prompted us to look more systematically at this question.
📄 Our phenomenal resident Dr. Lauren Jacobs @laurenjacobs_md led this newly published study in #practicalRO, combining
🌎 2 patients treated at our institution + 10 previously published cases we identified in the literature = 12 patients total.
To our knowledge, this represents the entire published global experience with ≥3 courses of RT for DIPG.
📊 What did we find?
➡️ Median survival from diagnosis: 27 months
➡️ Symptomatic improvement after reRT was frequently reported
➡️ Despite substantial cumulative radiation doses, the limited available experience did not identify a clear signal of prohibitive toxicity
⚠️ Of course, this is only 12 highly selected patients. These retrospective observations cannot establish a survival benefit - or definitively tell us how safe a third course of RT is.
But they do suggest that perhaps the answer shouldn't automatically be “No.”
For carefully selected patients with progressive DIPG and few remaining options, low-dose multi-course reRT may provide meaningful palliation and deserves prospective study.
🔬 What’s next? We’re hoping to develop a prospective study at @MountSinaiRO to better define patient selection, dose, timing, benefit, and toxicity.
Sometimes patients and families ask questions we simply don't have good answers to.
💡 Those questions are often worth studying
@BecherOren @sindhu_kunal @QuadShotNews @TischCancer @MountSinaiRO @sgilheeney @ASTRO_org
Glad to have this reference
Updated SFRO dose constraints for organs at risk in adult patients.
#Radonc
New recommendations from the French Society of Radiation Oncology cover #normofractionation , #hypofractionation , #SBRT and #reirradiation.
They offer a unified, practical framework adapted to modern techniques (IMRT/SBRT), while noting that many limits still derive from 3D-CRT data — clinical judgment remains essential in complex cases.
A useful tool to help minimize normal-tissue toxicity in daily practice.
sciencedirect.com/science/ar…
Jared Peralta Rowley, MD retweeted
Is age prognostic for lower grade IDH mutant glioma?
NO, according to this pooled analysis
In molecular era age alone should not influence decision-making adjuvant treatment
Age is surrogate for IDH status ascopubs.org/doi/10.1200/JCO…
Jared Peralta Rowley, MD retweeted
What is the Risk Hemorrhage Brain Mets?
· Overall Risk 12%
· NOT assoc w/RT,SRS,chemo, anti-VEGF, anti-thrombotic therapy
· ↑↑risk hemorrhage antiplatelet therapy, seminoma, melanoma
Congratulations!
Humbled by the opportunity provided by @the_RSS. Thankful for the members who voted and believe I can add to the society! Looking forward to for the next 12 months! @MaimoHealth @sunydownstate #radiosurgery #radonc
Jared Peralta Rowley, MD retweeted
Dr Gasparyan, it's wonderful to see your feed filled with posts about the challenges AI brings to scientific publishing.
I imagine being Editor-in-Chief of Rheumatology International is a lot different today than a few years ago.
Last week, I contacted you, your Associate Editors, and Springer Nature about a 2025 manuscript published in your journal that is one of the most obvious examples of AI-hallucinated insanity I've ever seen.
It's especially brazen as the lead author has a website (clever-academy.com/about.htm…) where he sells an AI tool that produces these exact meta-analyses.
Unfortunately, this hallucinated fiction of a paper is being cited by the American insurance company EviCore as a reason to deny covering a commonly used treatment, which they have covered for many years - until now.
I'm attempting to get you/your journal's attention through multiple channels specifically because of the real-world, negative patient impact this AI paper has.
A copy of my August 4th letter is attached.
I am happy/willing/able to expand in great detail on literally any of this - just let me know!
AI In Academic Publishing for Non‐Native English Speakers: The Good, the Bot, and the Ugly - Gönülal - 2026 - Learned Publishing
@BurhanFatihKoy1 @DDoskaliuk @ahmetusen @OlenaZimba @anarsiknotrofil @nesecabuk @NeslihanGken7
onlinelibrary.wiley.com/doi/…
Jared Peralta Rowley, MD retweeted
1/n This is some brilliant investigatory work by @drbeckta. Nothing to add to his substantive critique of the underlying evidence itself or the incorporation of flawed data into guidelines by benefit managers like EviCore. But how best to remedy? Brief 🧵#radonc #medtwitter
Let's keep adding context, but from a different angle:
EviCore was formally created in 2014/2015 through a merger of MedSolutions and CareCore National.
The oldest EviCore radiotherapy guidelines I personally have archived is from 2019. I believe this was close to, if not THE first...but they make this difficult to find (for obvious and shady reasons).
But we can say with certainty that EviCore themselves deemed LDRT for osteoarthritis "medically necessary" at least as far back as 2019.
So what changed?
Well, though LDRT started its journey of rediscovery in America in 2020/2021, it was still relatively unknown to the public and uncommonly performed in American clinics.
Because LDRT, you know, actually works - more and more of us started to offer it, and patients have the ability to like...talk to each other.
In my own practice, for example, I have never once advertised. All of my LDRT patients are word of mouth self-referrals, or referrals from local doctors after they saw me treat their other patients.
Naturally, as this happened across the country, the public took notice.
In 2025, the radiotherapy professional society ASTRO made benign disease/LDRT the theme of their yearly conference.
As you can see from the Google Trends data, Americans searching for "low dose radiation therapy" really took off in early 2025 - and kept going.
Recently, this culminated in an article appearing on NBC's "Today" website, authored by @LaVarsovienne.
It was a classic, feel-good story of LDRT literally making a person, well...feel good.
This article was published on June 16th, 2026, at 1:08PM.
As seen in the Google Trends data, June 2026 is currently the absolute pinnacle of public interest in LDRT.
Which makes sense. "Today" is a massive, international platform. A lot of people saw it.
Almost certainly the people at EviCore saw it.
Which is why the PDF metadata of EviCore's latest guidelines - the one where they abruptly reverse course on LDRT - is extremely interesting.
What are the chances that this PDF was created on June 17th, 2026, at 11:13AM?
As in: 22 hours after one of the biggest platforms in the world runs a story on the benefits of LDRT, the largest benefits manager in the country creates the PDF of their newest guidelines, reversing course on covering this exact treatment, after explicitly covering it for nearly a decade?
Based on a fraudulent AI slop meta-analysis paper?
Really?
I mean sure, it COULD be a coincidence.
Or it could be that EviCore had already drafted most (all?) of this new version, saw this "Today" article drop on a Tuesday, internally said "nope, shut it down", and within 24 hours created this nonsensical non-coverage.
That's quite a coincidence for a company known to utilize their own AI platforms to make immediate, slash-and-burn decisions.
Within that context, it could be considered a consistent pattern of behavior.
Has anyone re-read that @statnews investigation into EviCore lately? The one from last year?
It's certainly compelling!
Jared Peralta Rowley, MD retweeted
I find this @JCO_ASCO article rather puzzling.
I treat glioblastoma routinely, and the premise that we are routinely giving prophylactic dexamethasone simply does not reflect contemporary neuro-oncology practice - at least not any practice I’m familiar with.
We use steroids when patients are symptomatic from tumor- or treatment-related edema, usually for the shortest period necessary, because they can produce rapid and sometimes dramatic symptomatic improvement. Of course we recognize the toxicities and taper aggressively when clinically feasible.
The emphasis on infection-related morbidity also feels overstated relative to my clinical experience. Significant infectious complications from short-term dexamethasone are uncommon, and many of us increasingly use steroid-sparing approaches, including Boswellia, when appropriate.
Most puzzling is presenting bevacizumab as a preferable steroid-sparing strategy. Bevacizumab is hardly benign: it carries meaningful toxicity, requires IV infusions and monitoring, and imposes its own burden on patients and quality of life.
Steroids should absolutely be used judiciously. But arguing against a version of clinical practice that many of us don't actually practice, and then proposing bevacizumab as the safer alternative - makes for a very odd article.
Corticosteroids in Glioblastoma Management: A Reconsideration of a 65-Year Practice.
Read the full article. bit.ly/4wvCiyy
Wow!
New ASTRO President’s Corner – featuring Mark Cuban
In Part 1, ASTRO President @NehaVapiwala, MD, FASTRO, sits down with Mark Cuban of “Shark Tank,” founder of the Mark Cuban Cost Plus Drug Company.
Together, they tackle the current state of the healthcare sector, projecting future physician shortages and discussing the heavy burden insurance authorizations place on daily clinical practice.
Watch/listen to parts 1 & 2 on
YouTube: bit.ly/459Mjpe
Spotify: bit.ly/4gdXQdp
ASTRO's website: bit.ly/455r7Rp
@costplusdrugs @mcuban



































