James Chow

Clinical oncologist in #hongkong with special interest in head & neck and thoracic cancers #npc #hncsm #radonc

[James Chow @jameschowch]

Grateful to our colleagues around the world for bringing this work together and helping translate evolving evidence into practical guidance! 🌎

@imrtlee @sueyom @Qle_stanford @ADColevasMD @DrMLChua @PierluigiBonomo @RuehleAlex @amanda_psyrri @h_mehanna @YG_TAO

🧵5/5

[James Chow @jameschowch]

How far should we pursue curative-intent treatment in de novo metastatic #NPC?

Delighted to have contributed to this newly published international consensus guideline @TheLancetOncol.

🧵1/5

[James Chow @jameschowch]

📍Evidence gaps remain. Curative intent is not a promise of cure. Dedicated prospective trials are needed to refine patient selection and treatment choices.

Beyond “metastatic or not?”, we should ask: "could we offer this patient a realistic chance of long-term survival?"

🧵4/5

[James Chow @jameschowch]

What a wonderful #ESMO26! Grateful to co-chair the Second Primary Cancer symposium with Dr. Suzette Delaloge.

As we celebrate remarkable breakthroughs in cancer treatment, we must also bring together evidence-based strategies to support survivors’ long-term health.

[Herbert Loong, MBBS, FASCO @herbloong]

Excellent overview by my friend and colleague @jameschowch 🎉 from #QEH in #hongkong 🇭🇰 on the possibility of #behaviouralinterventions in survivorship and reducing risks of #secondarycancers.

As clinicians, we are in a position to not only treat the current cancer, but intercept any future ones.

#ESMO26 @myesmo #ESMOAmbassadors @CUHKMedicine

[James Chow @jameschowch]

These are modeled benefits, not clinical outcomes—but they highlight a compelling theme: small refinements in contouring today could make a difference to patients' lives for years to come.

And that's what makes our work as #HNC radiation oncologists so rewarding!

🧵(3/3)

[James Chow @jameschowch]

Recent international consensus efforts harmonized CTV delineation for #nasopharyngeal cancer.

One seemingly small refinement shifts the anterior border of level IVa to spare the space between #strap and #SCM.

But how much difference can one contour change make? ✏️

🧵(1/3)

[James Chow @jameschowch]

We evaluated the dosimetric impact on the #thyroid in 30 patients with varying lower-neck LN patterns.

On average, this small CTV change resulted in a 9% absolute reduction in NTCP-predicted #hypothyroidism risk (20% RRR), while maintaining comparable PTV coverage.

🧵(2/3)

[Anson Yeung @mlansonyeung]

Just published: our review on pulmonary LCNEC - a rare but aggressive & heterogeneous entity.
We review current evidence across all disease stages and emerging strategies including molecular profiling and DLL3-targeted therapy. @jameschowch
#LCNEC #LungCancer #Oncology

[James Chow @jameschowch]

@ProtonStorey Thank you for this very nice article. It’s a pity to see how the primary endpoint/ design of phase III had to compromise. Concurrent chemo gives 5-6% gain in 5yEFS and has become SOC for advanced HNC. A 9% 3yPFS margin is simply too wide and clearly clinically inferior.

[Yungan TAO @YG_TAO]

The 5-year follow-up results of phase 2 trial Xevinapant + CRT in LA-HNSCC in press: The risk of death halved in xevinapant vs placebo with HR 0.47. Phase 3 trial ongoing. @PBlanchardMD
@GustaveRoussy @FAndreMD https://t.co/paYqZSpf2K

[Sana Karam, MD, PhD @KaramLab]

IT'S OUT:Our paper on elective nodal irradiation mitigates local and systemic immunity generated by combination radiation + immunotherapy in head and neck tumors. Link: https://t.co/ssDN5N5fyc

[James Chow @jameschowch]

@StephenRameyMD @cd_fuller For every cc reduction in thyroid volume, the risk of post-RT hypothyroidism is estimated to increase by ~12%, such effect is independent of radiation dosimetry. These small glands tend to overlap significantly with nodal PTV in radical HNC plans esp with bil irradiation

[James Chow @jameschowch]

Happy to share our external validation work on radiation DV constraints of the thyroid gland for #HNC out in the #greenjournal ☢️

While keeping VS60 above 10cc should limit 5-year primary hypothyroidism risk to <15%, ALARA remains the golden rule.🏅

#radonc
#savethethyroid

[James Chow @jameschowch]

@StephenRameyMD @cd_fuller We have reviewed all published thyroid constraints in the literature and most studies have shown that thyroid volume per se is a predictor for post-RT hypothyroidism independent of radiation dosimetry. Patients with small glands are inherently high-risk👇🏻
https://t.co/RkTWWCswpo

[James Chow @jameschowch]

Love this! A complex and crucial region when it comes to #NPC contouring 🤩

[Lea Alhilali, MD @teachplaygrub]

1/Does PTERYGOPALATINE FOSSA anatomy feel as confusing as its spelling?Does it seem to have as many openings as letters in its name?

Let this #tweetorial on PPF #anatomy help you out

#meded #medtwitter #FOAMed #FOAMrad #medstudent #neurosurgery #neurology #neurorad #headandneck

[Herbert Loong, MBBS, FASCO @herbloong]

The Role of Systemic Therapies in Head & Neck Sarcomas https://t.co/qTsZVK7IKx via @YouTube