I don't post that much, but wanted to respond to give some encouragement as I sound much like yourself. I am a 4th year currently applying for rad onc. I have a step 1 score almost identical to yours and am also in the top of my class at a lesser known medical school. BUT...I only started a research project in rad onc a few months ago as I found out about the field late in my third year. Luckily, I did have 2 papers already, but not in rad onc (just like you again). One was a retrospective chart review type thing (not first author) and the other was a case report (first author). My step 2 score was very high, but not sure how much this matters. Anyhow, I currently have 18 interviews and I think 8 or so rejections out of 52 applications. The "top" programs are typically the ones I am getting rejections from, but I am starting to feel confident that I can match (although of course I will be nervous until I find out I actually matched). And even if you want to go into academics as I do without a significant background in research, I think you can make your own way wherever you go. It may just not be as easy as places like MDACC and MSKCC. So my point is: definitely apply! But also try to at least get involved in a rad onc project as soon as you can even if not published by the time you interview. Good luck- I think you will be just fine.