Tissana Prasartseree

@SirirajRadOnco
@MDAndersonNews Complex RadOnc Fellow

[Tissana Prasartseree @TissanaPra]

Humbly and Proudly present our “Early Results of HYPOCx-iRex Trial 44Gy/20F CCRT” https://t.co/YjtqmAlEC3
The work through my medical student and residency years @SirirajRadOnco
Kudos to exceptional mentorship of PiWin (Pittaya @kuppashiryu) and PiTonn (Wiwatchai).

Thank you @ClinOncology for publication
Thank you @gusviani and @roxboxfix, for recognizing our works.

Reported at 19-mo median FU
💡Potential superior LRC, especially nodal control and hopefully OS (Not powered to answer this question)
☢️HYPO 44Gy/20F +/- SIB boost to 53 and 55Gy in 20F for gross LN
☢️Standard EMBRACE-II MRI-guided brachy deliver 8Gyx4F: Median D90 HR-CTV = 90Gy
☢️Extended PAN field HYPO was successfully performed in 2 patients, recruited after the positive result of interim analysis.
💊Standard concurrent chemotherapy scheme: wkly Cis 40mg/m2 x 5 cycles
🕑OTT sig reduced to 39 days!
🕐Time to brachy sig reduced to 29 days without compromising PreBT response (Waterfall plot)

💊Adjuvant chemo is allowed without sig diff between arms.
All without ICI (also none at adjuvant/palliative at recurrence) or induction chemo.

👁‍🗨Higher Acute GI toxicity but resolved at 1 month after treatment. As seen in HRQoL.
👁‍🗨A trend of non-sig higher Late GI Tox.
👁‍🗨No difference in GU Tox.

A work in progress to improve the protocol for future Phase III multicenter trial in Thailand!

Updated cost-effectiveness analysis in 2-yr follow up will be presented in Poster #ASTRO2025
29Sep 10.45am No. 2824
https://t.co/KIcoS1mRFJ

Please also kindly have a glimpse at our Detailed Appendix, some presented here in comment section.

(1/5)

[Bouthaina Dabaja MD @BouthainaDabaja]

Dr. Dreyfus #ASTRO pioneering Pembro RT in HL to avoid. Transplant and not compromising outcome. Radiation is back front and center. @ASH_hematology @estro @ASCO @MDAndersonNews @ILROGTeam

[Tissana Prasartseree @TissanaPra]

@Supriya_Sastri @SirirajRadOnco @kuppashiryu Thank you so much Prof.Supriya ❤️ Hope to see you in person soon 😊

[Tissana Prasartseree @TissanaPra]

Humbly and Proudly present our “Early Results of HYPOCx-iRex Trial 44Gy/20F CCRT” https://t.co/YjtqmAlEC3
The work through my medical student and residency years @SirirajRadOnco
Kudos to exceptional mentorship of PiWin (Pittaya @kuppashiryu) and PiTonn (Wiwatchai).

Thank you @ClinOncology for publication
Thank you @gusviani and @roxboxfix, for recognizing our works.

Reported at 19-mo median FU
💡Potential superior LRC, especially nodal control and hopefully OS (Not powered to answer this question)
☢️HYPO 44Gy/20F +/- SIB boost to 53 and 55Gy in 20F for gross LN
☢️Standard EMBRACE-II MRI-guided brachy deliver 8Gyx4F: Median D90 HR-CTV = 90Gy
☢️Extended PAN field HYPO was successfully performed in 2 patients, recruited after the positive result of interim analysis.
💊Standard concurrent chemotherapy scheme: wkly Cis 40mg/m2 x 5 cycles
🕑OTT sig reduced to 39 days!
🕐Time to brachy sig reduced to 29 days without compromising PreBT response (Waterfall plot)

💊Adjuvant chemo is allowed without sig diff between arms.
All without ICI (also none at adjuvant/palliative at recurrence) or induction chemo.

👁‍🗨Higher Acute GI toxicity but resolved at 1 month after treatment. As seen in HRQoL.
👁‍🗨A trend of non-sig higher Late GI Tox.
👁‍🗨No difference in GU Tox.

A work in progress to improve the protocol for future Phase III multicenter trial in Thailand!

Updated cost-effectiveness analysis in 2-yr follow up will be presented in Poster #ASTRO2025
29Sep 10.45am No. 2824
https://t.co/KIcoS1mRFJ

Please also kindly have a glimpse at our Detailed Appendix, some presented here in comment section.

(1/5)

[Tissana Prasartseree @TissanaPra]

@Sushilberiwal @AnnKloppMD Thank you so much for your suggestion :)

[Tissana Prasartseree @TissanaPra]

@AnnKloppMD @Sushilberiwal
An honour to share my thread.

[Tissana Prasartseree @TissanaPra]

(5/5) Except for the patient with initial rectal invasion, grade 3 GI tox occurred once without persistence.

[Gustavo @gusviani]

🔬 Can 20 Fractions Compete? Early Results from HYPOCx-iRex Trial

A phase II RCT exploring hypofractionation in LACC. Promising? Let’s dive in

🎯 Objective
Evaluate safety & efficacy of 44 Gy/20F hypofractionated chemoradiation vs 45 Gy/25F

🏥 Methods
• Open-label RCT (n=40)
• IMRT + IGABT + weekly cisplatin
• HYPO arm: 44 Gy/20F over 39 days
• CVRT arm: 45 Gy/25F over 47 days

📊 Key Results
• 🔻 OTT: HYPO = 39d vs CVRT = 47d (P<0.001)
• GI tox Gr≥3: HYPO 43% vs CVRT 32% (NS)
• 18-mo para-aortic control: HYPO 100% vs CVRT 71% (P=0.003)
• HRQoL ↓ during HYPO but recovered by 3 mo

💡 Conclusion: HYPO is feasible, shortens OTT, and shows strong regional control. Long-term data awaited‼️

[Tissana Prasartseree @TissanaPra]

@gusviani Thank you for recognizing our work🙏,
The official publication is out now: https://t.co/CGdthEhODU

[Tissana Prasartseree @TissanaPra]

Humbly and Proudly present our “Early Results of HYPOCx-iRex Trial 44Gy/20F CCRT” https://t.co/YjtqmAlEC3
The work through my medical student and residency years @SirirajRadOnco
Kudos to exceptional mentorship of PiWin (Pittaya @kuppashiryu) and PiTonn (Wiwatchai).

Thank you @ClinOncology for publication
Thank you @gusviani and @roxboxfix, for recognizing our works.

Reported at 19-mo median FU
💡Potential superior LRC, especially nodal control and hopefully OS (Not powered to answer this question)
☢️HYPO 44Gy/20F +/- SIB boost to 53 and 55Gy in 20F for gross LN
☢️Standard EMBRACE-II MRI-guided brachy deliver 8Gyx4F: Median D90 HR-CTV = 90Gy
☢️Extended PAN field HYPO was successfully performed in 2 patients, recruited after the positive result of interim analysis.
💊Standard concurrent chemotherapy scheme: wkly Cis 40mg/m2 x 5 cycles
🕑OTT sig reduced to 39 days!
🕐Time to brachy sig reduced to 29 days without compromising PreBT response (Waterfall plot)

💊Adjuvant chemo is allowed without sig diff between arms.
All without ICI (also none at adjuvant/palliative at recurrence) or induction chemo.

👁‍🗨Higher Acute GI toxicity but resolved at 1 month after treatment. As seen in HRQoL.
👁‍🗨A trend of non-sig higher Late GI Tox.
👁‍🗨No difference in GU Tox.

A work in progress to improve the protocol for future Phase III multicenter trial in Thailand!

Updated cost-effectiveness analysis in 2-yr follow up will be presented in Poster #ASTRO2025
29Sep 10.45am No. 2824
https://t.co/KIcoS1mRFJ

Please also kindly have a glimpse at our Detailed Appendix, some presented here in comment section.

(1/5)

[Tissana Prasartseree @TissanaPra]

@roxboxfix Thank you for recognizing our work🙏,
The official publication is out now: https://t.co/CGdthEhODU

[Tissana Prasartseree @TissanaPra]

Humbly and Proudly present our “Early Results of HYPOCx-iRex Trial 44Gy/20F CCRT” https://t.co/YjtqmAlEC3
The work through my medical student and residency years @SirirajRadOnco
Kudos to exceptional mentorship of PiWin (Pittaya @kuppashiryu) and PiTonn (Wiwatchai).

Thank you @ClinOncology for publication
Thank you @gusviani and @roxboxfix, for recognizing our works.

Reported at 19-mo median FU
💡Potential superior LRC, especially nodal control and hopefully OS (Not powered to answer this question)
☢️HYPO 44Gy/20F +/- SIB boost to 53 and 55Gy in 20F for gross LN
☢️Standard EMBRACE-II MRI-guided brachy deliver 8Gyx4F: Median D90 HR-CTV = 90Gy
☢️Extended PAN field HYPO was successfully performed in 2 patients, recruited after the positive result of interim analysis.
💊Standard concurrent chemotherapy scheme: wkly Cis 40mg/m2 x 5 cycles
🕑OTT sig reduced to 39 days!
🕐Time to brachy sig reduced to 29 days without compromising PreBT response (Waterfall plot)

💊Adjuvant chemo is allowed without sig diff between arms.
All without ICI (also none at adjuvant/palliative at recurrence) or induction chemo.

👁‍🗨Higher Acute GI toxicity but resolved at 1 month after treatment. As seen in HRQoL.
👁‍🗨A trend of non-sig higher Late GI Tox.
👁‍🗨No difference in GU Tox.

A work in progress to improve the protocol for future Phase III multicenter trial in Thailand!

Updated cost-effectiveness analysis in 2-yr follow up will be presented in Poster #ASTRO2025
29Sep 10.45am No. 2824
https://t.co/KIcoS1mRFJ

Please also kindly have a glimpse at our Detailed Appendix, some presented here in comment section.

(1/5)

[Tissana Prasartseree @TissanaPra]

Our pleasure to share the results of #3DprintedBrachyApp for GYN patients -- improved version are in preparation, cannot wait to share soon!
@SirirajRadOnco
Thank you @JContBrachyther for the publication :)

[Tejaswi Kanala MD @TSKanala]

Radiation Oncology 101 this #NEETPG season for the uninitiated med student. Most MBBS grads in India come across #RadOnc for the very first time when preparing for NEETPG &amp; a 4 hour lecture doesn't cut what we do in our sacred basements. Here is a primer to help you choose. 1/n

[Tissana Prasartseree @TissanaPra]

@TSKanala Love this thread!

[Dr. Nina Niu Sanford @NiuSanford]

RACE-GB is out! Congrats to authors for FIRST RCT of RT in gallbladder cancer.

N=135 w unresectable GBC, after 4c chemo, addition of RT (vs. obs) improved OS from 4 to 10 months.

Several limitations (single center, chemo gem/cis &amp; 4 mo) but OS benefit shouldn’t be ignored.

[Matt Spraker @SprakerMDPhD]

Deep diving the low dose radiotherapy literature, it is loaded with cool concepts.

Low dose radiotherapy as a potentiator of gemcytabine in pancreatic cancer, 60 cGy x4 BID for 4 cycles.

How about more of this and less boring omission trials?

#RadOnc #RadBio @NiuSanford

[John Christodouleas @Xristodouleas]

Definitely one of the highlights of the @mr_linac meeting so far.

[Tissana Prasartseree @TissanaPra]

Officially Published "SiRO Experience of IGABT"
CT-based VS MRI-based showed no significant difference in outcomes.
To achieve this " #IGABTtraining " is crucial!
Great work led by My Mentor: Pittaya Wiwatchai

Click to Read
https://t.co/GWOJAI9muw

@SirirajRadOnco

[Tissana Prasartseree @TissanaPra]

My greatest honour to share Radiotherapy insights for CholangioCA among world-renowned experts from Japan.

Looking forward to the collaboration and advancements of MDT in the Capital of CholangCA, Thailand!

@SirirajRadOnco @IASGO_Thailand