ASTRO 2026 Special | 28 September–4 October 2026
1. MRI surveillance improves cognitive outcomes without PCI in SCLC
MAVERICK showed better cognitive failure-free survival with MRI surveillance alone than with surveillance plus PCI. Preliminary overall survival showed no apparent difference; the final OS analysis remains pending. Reliable access to scheduled MRI and timely salvage treatment remains essential.
2. SRS shows a survival signal in SCLC brain metastases
NRG-CC009 did not demonstrate a significant improvement in its primary neurocognitive endpoint versus HA-WBRT plus memantine. Median survival favored SRS, but OS was a secondary endpoint and follow-up remains limited.
3. Five-fraction prostate SBRT shows durable control at eight years
PACE-A reported excellent long-term cancer control with both SBRT and prostatectomy, with better urinary continence after SBRT. The small trial was not designed to establish oncological noninferiority or equivalence.
4. Protons do not demonstrate a survival advantage in HCC
NRG-GI003 did not show an overall survival advantage for protons over photons. Severe treatment-related toxicity was numerically lower with protons, without a statistically significant difference. These results do not establish equivalence or exclude benefit in selected patients.
5. Fractionated SRS improves postoperative cavity control
Alliance A071801 improved one-year surgical-bed control with fractionated versus single-fraction SRS: 87% versus 81%. Reported toxicity did not differ significantly, strengthening the randomized evidence for fractionation after resection of larger brain metastases.
These are conference-reported findings. Full publications and further analyses will help clarify their implications.
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That's the week. See you next Sunday.
Alexey Cherchik, MD
Founder and editor, RadOncToday