Radiation Oncology

ARS guideline: margin-negative resection drives outcomes in locoregionally recurrent rectal cancer

This multidisciplinary guideline synthesizes 116 trials to frame management of locoregionally recurrent rectal cancer. The ability to achieve a margin-negative surgical resection is identified as the ultimate determinant of survival and local control. Preoperative systemic therapy, radiation, or both can downsize tumors and improve likelihood of margin-negative resection. An individualized, multidisciplinary combined-modality approach is recommended; the guideline does not mandate major practice changes. 1

CARE Initiative: feasibility limits for oncology RCT emulation using EHR-based RWD

The CARE Initiative evaluated six EHR-based RWD sources against 23 candidate oncology RCTs and 54 RCT-RWD combinations. Only nine combinations advanced to detailed feasibility and three reached protocol-development readiness. Fitness failures were driven by complex eligibility, biomarker capture, performance status, and outcome ascertainment. Authors recommend systematic, stagewise feasibility assessments and data linkage or custom abstraction to improve fitness. 2

Multimodal ML predicts acute dermatitis after IMRT hypofractionation in early-stage breast cancer

In a single-center cohort of 160 patients, a DS-LightGBM model combined clinical, radiomic, dosiomic, and deep features to predict acute dermatitis. The model achieved strong internal performance: multiclass test accuracy 0.87 and ROC-AUC 0.95, binary accuracy 0.89 and ROC-AUC ~0.88–0.90. SHAP analysis implicated high-dose dosiomic subvolumes and deep imaging features as leading predictors. External validation and prospective testing are required before clinical deployment. 3