Radiation Oncologist. Worships Bruce & Arnold. Opinions are my own. #radonc
Melbourne, Victoria
Joined December 2011
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Key message: These findings highlight the importance of discussing reconstruction options when radiotherapy is anticipated.
doi.org/10.1007/s10549-026-0…
#BreastCancer #RadiationOncology
Mike Chao retweeted
We have never run a sham-controlled RCT for total knee replacement.
Not once. The most commonly performed orthopedic procedure in the United States, 700,000+ per year, has never been tested against placebo.
And yet when low-dose radiotherapy (LDRT) for knee OA is presented, the first objection is always: "Where's the sham-controlled data?"
That double standard is worth naming out loud.
Here is what LDRT actually has:
→ 2 positive sham controlled trials (Korean and Iranian)
→ A 292-patient prospective RCT (Russian) with 11 year follow-up
→ 4.5x difference in pain scores at 36 months across every domain (pain, stiffness, function, quality of life)
→ Plain-film radiography and MRI at 10 years showing a statistically significant reduction in marked progression
→ A 50-year European safety record with no meaningful toxicity
Here is what the treatments currently in OA guidelines have:
→ NSAIDs: known cardiovascular, renal, and GI harm at chronic doses
→ Glucosamine/chondroitin: failed large RCTs. Still in some guidelines.
→ Corticosteroid injections: emerging evidence of accelerated cartilage loss with repeat use
→ TKA: no sham trial. Ever.
If LDRT was a pill, it would be in every guideline.
The evidence bar being applied to LDRT is not being applied to anything else in this space.
The critics aren't wrong that we need a multicenter sham-controlled trial. We do. That's the ask.
But the argument that the current evidence is insufficient to justify treatment while we continue recommending interventions with weaker or more harmful evidence bases is not scientific rigor.
It is asymmetric scrutiny.
The field has been waiting decades for a non-surgical, disease-modifying treatment for OA. The data suggests we may have had it all along.
That conversation is overdue.
Mike Chao retweeted
Reason why they don't want it to be filmed
Mike Chao retweeted
Dr. Anne Hong tells us how she partners with Radiation Oncologists and what they think of the Barrigel spacer in her patients.
Visit spklr.io/6015BJfFD to learn how Barrigel spacer may fit within your practice.
Mike Chao retweeted
Has anyone used SpaceOAR where SBRT is being considered for a solitary kidney RCC with <1 mm (but clear) fat plane to large bowel? Radical nephrectomy would mean dialysis, and let's say patient is highly motivated to avoid that route. Hypothetical, but curious. @_ShankarSiva
Mike Chao retweeted
Eminence Advisory economist Dimitri Burshtein said changing the superannuation tax rules after people had invested was manifestly wrong.
“It is utterly egregious to tax unrealised gains and it is unindexed.” @Johnkehoe23 @FinancialReview
Mike Chao retweeted
Barrigel rectal spacer will be in Nashville for #ABS25. Be sure to attend our symposium to learn more about the rectal spacer proven superior in the reduction of acute grade 2+ GI toxicity compared to control. (1) Join our symposium at Belle Meade at 7:15 am Saturday, June 21.
The use of stabilized hyaluronic acid (sHA) spacers in SBRT is safe and feasible for retroperitoneal cancers. It enhances PTV coverage while ensuring safe doses to surrounding OARs.
doi.org/10.1016/jctro.2025.1…
Mike Chao retweeted
Should prostate RT be an option for all men with de novo mCSPC (high and low volume), despite systemic intensification? Check out our @DrAndrewLoblaw @TheLancet editorial on PEACE-1 RT.
↗️ rPFS and castrate resistance-free survival in low volume
↘️ serious GU AEs regardless of volume
thelancet.com/journals/lance…
Mike Chao retweeted
Join us at our booth (#1223) Sunday and Monday at 11am or 3pm to hear from Dr. Michael Greenberg. Learn about the latest techniques in rectal spacing and pearls for navigating difficult cases.
#ASTRO2024 #radonc #Barrigel
Mike Chao retweeted
The biggest fear about nuclear power just vanished. Scientists in China worked out a way to prevent the widespread damage caused by meltdowns, it was revealed this week.
The key idea is simple. In a standard nuclear power plant design, excess heat around the fuel rods is handled by automated cooling mechanisms. If the problem gets too big, humans intervene by employing emergency systems using water or liquid carbon dioxide.
But in earlier real-life scenarios, such as the accident at Japan's Fukushima plant in 2011, the power to those systems failed and a massive radiation leak followed.
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PLANT SHUTS ITSELF DOWN
Chinese scientists redesigned nuclear reactors, using globally developed research findings, so that the likelihood of problems was lower, and in any case, the plant could cool itself without external power.
"A relatively new kind of reactor design, called a pebble-bed reactor, has the advantage of being passively safe, which means that if power for cooling systems is lost, then the reactor can safely shut down by itself," wrote Alex Wilkins in the latest issue of New Scientist, a top UK-based science journal.
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NO RODS, NO COOLING SYSTEM
China's pebble-bed reactors have no fuel rods. Instead, they have a large number of low-energy-density “pebbles” made up of a small amount of uranium surrounded by graphite. Excess heat is spread over all the pebbles, said Zhe Dong at Tsinghua University, now rated one of the world's top educational institutes.
The plant in Shandong is officially known as the High-Temperature Gas-Cooled Reactor Pebble-Bed Module, or HTR-PM. “Up to now, every commercial reactor except HTR-PM has had an emergency core cooling system,” Dong told the journal. “However, due to the inherent safety, there is no emergency core cooling system in the HTR-PM plant.”
While the system cannot be retroactively implanted into existing nuclear power plants, it appears set to cause a revolution in the future design of large-scale energy production operations.
