Radiation Nation jim grimm Brian Kavanagh Søren M Bentzen Ronald Chen Jona Hattangadi-Gluth, MD Percy Lee MD Michael Milano Matthew Katz, MD 🇺🇸🟦 It originated long before us! Radiation has a dose response. Has anyone seen an earlier dose response model than Edith Quimby’s erythema dose model in 1928 (RSNA 1928 Dec 3-7, Chicago, IL)? #HyTEC #RadOnc #JC

Radiation Nation jim grimm Brian Kavanagh Søren M Bentzen Laura Dawson Ronald Chen Jona Hattangadi-Gluth, MD Percy Lee MD Michael Milano "Please introduce yourself:" Hi, I am a clinical physicist. My first question when entering this field was, "how do we know what is a safe dose?" Someone handed me a table. I searched it and found it was The Emami Paper. Then QUANTEC - the rest is history! #HyTEC #radonc #jc

JimmGrimm M. Bolton Michael Milano Hina Saeed, MD Ian Pereira Radiation Nation jim grimm Brian Kavanagh Søren M Bentzen Ronald Chen Jona Hattangadi-Gluth, MD Percy Lee MD @cd_fuller John Kang The first #HyTEC article we’re discussing touches on some of the optimal pieces we need for better data collection redjournal.org/article/S0360-… #radonc #jc

Here is another classic dose response model on graph paper, from 1942, compliments of Drs. Halperin, Constine, and Yorke: Hinkel CL. Effect of Roentgen Rays Upon the Growing Bones. AmJ Roentg 1942. Potential genesis of understanding late effects in children. #PENTEC #radonc #jc

JimmGrimm Radiation Nation Timothy Kerwin, MD C. Jillian Tsai, MD, PhD Elaine M. Zeman, PhD James Bates Sue Yom Dr. Luis A. Pérez-Romasanta Stephen Chin For those whom might not know who Rubin is … astro.org/About-ASTRO/Hi… urmc.rochester.edu/news/story/urm…

Maybe this is where it DOES get interesting Matthew Katz, MD 🇺🇸🟦 #radonc #jc Hats off to HyTEC, it IS a major effort, but it is also a stunning testament to the lack of high-quality data, suited for synthesis across papers, that really are out there... Agree?

Sue Yom M. Bolton Søren M Bentzen Ian Pereira Matthew Katz, MD 🇺🇸🟦 Petra Jankowska Kuan-Wen Chen Ane Appelt Radiation Nation Michael Milano Hina Saeed, MD jim grimm Brian Kavanagh Ronald Chen Jona Hattangadi-Gluth, MD Percy Lee MD @cd_fuller John Kang Jean Moran PhD Richard Simcock Mark Gooding Joe Butts Cynthia McCollough Tyler Blackwell When the risk of complications is low, a lot of data is required. Spinal cord is the “Poster Child” to show the need for data pooling. Hopefully no single institution ever gets enough myelopathy cases to create their own model. We need to work together on this #HyTEC #radonc #jc

Michael Milano Radiation Nation Jona Hattangadi-Gluth, MD Simon Lo Amit Chowdhry, MD, PhD Trevor J. Royce MD MPH FASCO We will need a #RadOncRosettaStone for several leading Endpoint definitions. Authors need to report their data using multiple grading scales per patient so we can convert them. #HyTEC #radonc #jc

Michael Milano Radiation Nation Jona Hattangadi-Gluth, MD Simon Lo Amit Chowdhry, MD, PhD Trevor J. Royce MD MPH FASCO Here is an example #RadOncRosettaStone source data paper, the table in the previous tweet corresponds to the data and models in this graph, comparing Grade 1-3 Edema-Necrosis to Grade 3 pathologically confirmed Necrosis. #HyTEC #radonc #jc

Michael Milano Radiation Nation Jona Hattangadi-Gluth, MD Simon Lo Amit Chowdhry, MD, PhD Trevor J. Royce MD MPH FASCO #WashRinseRepeat. The institutional datasets pooled together become the HyTEC datasets. We need to keep doing it for all relevant Endpoint scales and specific grades of interest including various clinical scenarios and factors affecting outcomes. #HyTEC #radonc #jc

Sue Yom Brian Kavanagh JimmGrimm M. Bolton Søren M Bentzen Ian Pereira Matthew Katz, MD 🇺🇸🟦 Petra Jankowska Kuan-Wen Chen Ane Appelt Radiation Nation Michael Milano Hina Saeed, MD jim grimm Ronald Chen Jona Hattangadi-Gluth, MD Percy Lee MD @cd_fuller John Kang Jean Moran PhD Richard Simcock Mark Gooding Joe Butts Cynthia McCollough Tyler Blackwell All of this said in the context of Spring Kong being my hero in this area 🙏🏻🤓🎯

JimmGrimm Sue Yom Brian Kavanagh M. Bolton Søren M Bentzen Ian Pereira Matthew Katz, MD 🇺🇸🟦 Petra Jankowska Kuan-Wen Chen Ane Appelt Radiation Nation Michael Milano Hina Saeed, MD jim grimm Ronald Chen Jona Hattangadi-Gluth, MD Percy Lee MD @cd_fuller John Kang Jean Moran PhD Richard Simcock Mark Gooding Joe Butts Cynthia McCollough Tyler Blackwell Thank you!! 🙏🏻🙏🏻🙏🏻 Huge fan of #HyTEC. It has been my dream to get in the trenches with dosimetric data and plan optimization ever since medical physics attracted me to this field over a decade ago. #MCO For the record, might be my favorite #radonc #jc topic of all time!

Radiation Nation jim grimm Laura Dawson Sean Collins Prostate SBRT @ USF Health As we approach the last question, now that we all understand each other better, I would like to answer a question about 2yr prostate data that arose last week. 2yr details were requested by reviewers, it was not a p-value fishing expedition. #HyTEC #RadOnc #JC

Radiation Nation jim grimm Laura Dawson Sean Collins Prostate SBRT @ USF Health When HyTEC began, 5yr prostate TCP for SBRT was only a blank space predicted on a curve - that is why 2yr data exists in the HyTEC paper, reviewers asked for details about it. The 5yr model was the real goal and it matches Dr. Katz's prediction quite well. #HyTEC #RadOnc #JC

Radiation Nation Jona Hattangadi-Gluth, MD Castalia Fernández, MD. Timothy Kerwin, MD arjun sahgal Trevor J. Royce MD MPH FASCO Matthew Katz, MD 🇺🇸🟦 Hina Saeed, MD Amit Chowdhry, MD, PhD Avinash Chaurasia Mona Arbab, MD MEd Amishi Bajaj, MD Ian Pereira #HappyFathersDay to all! I was tweeting today from our Jeep, while my son was driving to get this motorcycle. The seller's grandson is patting it one last time goodbye- they had too many other motorcycles so sold us this one. #HyTEC #radonc #jc

#HyTEC #radonc #jc Need more data! Too much is never enough!

Petra Jankowska Ian Pereira If we could transition from the “Data Loss Paradigm” described in QUANTEC to the FAIR Reporting Standards proposed by Ian Pereira then we could finally answer most of the questions that keep flying back and forth during this exciting twitterfest. #HyTEC #radonc #jc

Petra Jankowska Ian Pereira Especially the trial data should have FAIR Reporting Standards- after all, We The People pay for it, and we need to know NTCP&TCP more accurately. Each cooperative trial has very specific purpose and that is good, but all the data should be pooled for NTCP&TCP #HyTEC #radonc #jc

Radiation Nation Trevor J. Royce MD MPH FASCO Shalini Moningi Matthew Katz, MD 🇺🇸🟦 Hina Saeed, MD Ian Pereira Amishi Bajaj, MD Amit Chowdhry, MD, PhD C. Jillian Tsai, MD, PhD Percy Lee MD jim grimm Brian Kavanagh I would answer this question with another #WashRinseRepeat, just continue refining and validating the models with independent datasets. If reviewers say it was already published, write a dataset manuscript. #HyTEC #radonc #jc

Radiation Nation Sue Yom jim grimm Brian Kavanagh Laura Dawson Søren M Bentzen Jona Hattangadi-Gluth, MD Percy Lee MD Michael Milano C. Jillian Tsai, MD, PhD Minh Huynh-Le, MD, MAS Elaine M. Zeman, PhD Thanks to everyone who joined #HyTEC #radonc #jc this weekend! I hope it was exciting, thought-provoking and productive. Let’s continue friendly discussions as we optimize patient outcomes together! We’ve come a long way since the first dose response models, many more soon!