Absolutely agree. Which is why "all available" other therapy (outside of a trial) should be given to all patients in the trial, irrelevant if they are irradiated or not. Do you get Remdisevir only on trial in the US?
Thought i heard "compassionate use" also being done in US?
Know 0 about him, but that is over the top as it gets. Doubt even Ghandi or the Dalai Lama would ever describe themselves that way.
For anything abscopal related, Jim Welsh is Mulder and Silvia Formenti is Scully
The Genius Hack Every Radiation Oncologist Should Know:
What happened to him was a form of cyberbullying. I don't think he should have removed the post though. There is still a news release on the Emory site however. Had it been me I would have defended the hell out of the thought process on twitter; the rationale, goals, risks, etc. Not only for my own sake but for my specialty's sake. And Ralph W showed himself to be yet again, at the very least, not a very collegial fellow (called it "hocum"! for pete's sake). And not very intellectually honest. There is way more tangible data that RT affects pneumonia outcomes than RT interacts meaningfully with immunotherapy. And way more years of history for the former vs the latter. Ralph criticized RT for pneumonia along the lines of "how does it even work?" yet seldom hesitates to wax I'm-clever speculative about oligomets and immuno, etc.
Not greatest choice of words. Heck horrible word choices. We can’t pull up the tweet now. But he did not say “will” change outcomes and made no overt promises or claims. I think in fact he said “could” or “hopes” to be a game changer. Making claims like “will” would be a graver sin. But at one time or another we are all guilty of poor word choices. One thing to rib, another to pelt or crucify. However it’s a spicy stew when you mix covid anxiety, studies from a hundred years ago, social justice/ethics warrioring, radiation fears, the Emory ivory tower... and twitter.
Dangerous? Hmm. Maybe just on the basis of carting sick patients around a hospital. Exposure to staff etc. But the XRT is not dangerous. About 100,000 women a year get breast RT, millions more walking around who have. I have never called their "covid equivalent" lung XRT exposure "dangerous," nor have I ever seen rad oncs say so.
Zero chance of harm.* IMHO. Why?
I'll defer to your recollection... it's like he went through that whole first they ignore you/then ridicule you/then attack you thing, in reverse, in his own head.
it's hormesis pornOk, I'm afraid the click on your links while I'm still at work
I presume lots of the clinical research work in nuclear medicine is linked to certain doses being received by the personell injecting isotopes.
In theory, it's immunomodulatory. And if you look into the ex-vivo research, you will see that the dose ranges are variable. Which means that if you go substantially over 1 Gy (but still in "safe regions") you may have a counter-effect. So, 2-4 Gy seem to be immunosuppressive, but doses up to 1 Gy seem not to.
The point is, that perhaps 1 Gy of WLI may be good for pneumonia. That's at least what was studied back in the 30s and based on that, people are speculating it may work on COVID too. That's the theory. And to prove that, you need an experiment.
Valid arguments. It's a risk/benefit calculation.
I posted here a couple of weeks ago that one of our patients got COVID in the middle of his head&neck treatment. We kept on treating him, daily, with full PPE and all. The whole show. For ONE patient. Yes, one cancer patient and one important part of his treatment (adjuvant RT for pN+ SCC of H&N), but we decided to subject personell to all those risks to help this one patient. With a fractionated treatment and something like 20+ fractions to go... On a daily basis.
NOW I recall.
