30-Second Takeaway
- Y-90 TARE as first-line bridge for HCC transplant candidates lowered waitlist dropout versus TACE in a large US cohort.
- Among men presenting with late GU events after prostate RT, 5-year hospitalization and surgery needs remained substantial.
- CPAP during breast VMAT was mostly tolerable and produced notable cardiac and pulmonary dose reductions versus free breathing.
Week ending January 31, 2026
Radiation Oncology Grand Rounds: Concise Clinical Updates Across Liver, Brain, Prostate, Breast, and Pelvic RT
Y-90 radioembolization reduces transplant waitlist dropout versus TACE in HCC
This UNOS-based cohort included 5,677 liver transplant candidates with HCC treated first-line with either TACE or TARE in equal proportions. TARE patients more often had solitary tumors and required only a single locoregional treatment, with higher complete necrosis rates on explant (35.3% vs 20.2%). Inverse probability–weighted competing-risk analysis showed TARE reduced waitlist dropout hazard by 22% versus TACE (HR 0.78, 95% CI 0.69–0.89). Cumulative dropout incidence was consistently lower with TARE at 1, 2, and 3 years despite broadly similar tumor burden.
Late GU toxicity after prostate RT drives prolonged hospital and surgical burden
The IRRADIaTE registry prospectively enrolled 321 men with localized prostate cancer presenting with late (≥6 months) GU complications after curative or salvage RT. Half had prior primary RT and half postprostatectomy RT, with 43% presenting with grade 3–5 GU toxicity at admission. Hospitalization-free survival declined from 86% to 42% over 5 years after RT, indicating sustained healthcare utilization. The proportion not requiring major GU surgery fell from 81% at 12 months to 66% at 60 months after RT completion.
CPAP during breast VMAT meaningfully lowers heart and lung dose
This single-institution phase I/II trial evaluated CPAP-assisted versus free-breathing VMAT planning after breast cancer surgery. Of 20 enrolled patients, four discontinued at simulation due to CPAP discomfort, but no CPAP-related adverse events above grade 2 occurred. CPAP reduced mean heart dose by 33.8% and significantly decreased left ventricular and LAD V5–V30 versus free breathing. Ipsilateral lung mean dose and V5–V40, including a 4.4% reduction in V20, were also significantly lower with CPAP.
Proton therapy in lower-grade glioma: durable control, modest long-term toxicity
This prospective phase II trial treated 60 patients with WHO grade 1–2 or IDH-mutant grade 3 gliomas using proton therapy to 54–59.4 Gy(RBE). With 7 years’ median follow-up, 5-year progression-free and overall survival were 79.1% and 85.6%, respectively, best in IDH-mutant, 1p/19q co-deleted tumors. New neurocognitive deficits occurred in 26% at 5 years, while radiation-attributed neuroendocrine dysfunction was infrequent (5.3% overall, one case from RT). FACT-Brain quality of life declined transiently at 6 months, with only 15% having clinically meaningful decline at 5 years.
References
Numbered in order of appearance. Click any reference to view details.
Additional Reads
Optional additional studies from this edition.