Radiation Oncologist resident | INCan ⚡️☢️
Joined September 2011
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Dulce María Urías retweeted
¿Cómo es la radioterapia adaptativa guiada por resonancia magnética en el cáncer de pulmón?
Mediante el uso de imágenes simultaneas, es posible monitorear el desplazamiento tumoral y ajustar cada sesión de tratamiento.
Un trabajo con la valiosa participación de la Dra. Dulce Urías @dulceua del @INCanMx.
#INCanInvestiga #INCanPublica
Dulce María Urías retweeted
Con la participación de la Dra. Dulce Urías del @incanMX, este trabajo analiza la radioterapia corporal estereotáctica guiada por resonancia magnética en el lecho prostático: un estudio prospectivo de seguridad, tolerabilidad y resultados de calidad de vida reportados por los pacientes.
#INCanInvestiga #PublicacionesINCan
Dulce María Urías retweeted
Among patients with localized intermediate-risk #ProstateCancer, stereotactic body #Radiotherapy was not superior to moderately hypofractionated intensity-modulated radiation therapy for disease-free survival.
ja.ma/3VJ3FaS
Dulce María Urías retweeted
Is whole-pelvic radiotherapy still justified for everyone with high-risk prostate cancer—or are we treating beyond the evidence?
Article 🗞️
sciencedirect.com/science/ar…
Whole-pelvic Versus Prostate-only Radiotherapy in Clinically Node-negative High-Risk Localised Prostate Cancer: A Systematic Review and Meta-analysis with Reconstructed Individual-patient Data
A meta-analysis of five phase III trials involving 5,172 patients found that whole-pelvic radiotherapy ☢️ (WPRT) does not 🚫 improve overall survival compared with prostate-only radiotherapy (PORT) in high-risk localized #ProstateCancer
Apparent progression and metastasis-free benefits were driven entirely by one PSMA-staged, single-centre trial and disappeared when excluded.
✅ Reconstructed individual-patient data confirmed these findings. Routine elective pelvic irradiation therefore remains unsupported, with potential for modest late toxicity.
@josedsh, @Julia_Aumatell, @jgomezrivas, @alongi_filippo, @CZamboglou, @NicosiaMd, @Antoniojconde, @fcounago, @lsanjosemanso, @oscar_buisan
@OncoAlert @LPCCC27
@Silke_Gillessen
@AOmlin
@ProfKHerrmann
@weoncologists
Dulce María Urías retweeted
🚀 Our meta-analysis comparing whole-pelvic vs prostate-only RT in cN0 high-risk prostate cancer is now published.
WPRT did not improve OS, and the progression benefit disappeared after excluding one PSMA-enriched single-centre trial.
🔗 authors.elsevier.com/c/1nlZ3…~
Dulce María Urías retweeted
🎗️ World Radiotherapy Awareness Day
Radiotherapy is not just machines, technology or dose.
It is biology, precision, innovation and teamwork — always with the patient at the center.
Proud to be a radiation oncologist and part of a field that never stops evolving.
#RadOnc
Dulce María Urías retweeted
🚀 New publication!
Our prospective study shows that MR-guided adaptive SBRT to the prostate bed after radical prostatectomy is safe and feasible, with no Grade ≥3 toxicity, no Grade ≥2 GI toxicity, preserved quality of life.
🔗ctro.science/article/S2405-6…
👏Thanks to all authors!
Dulce María Urías retweeted
📢 New publication in @Cancers_MDPI !
Our review explores the current role of MR-guided adaptive radiotherapy in lung cancer, with particular potential in central/ultra-central tumors, locally advanced NSCLC and re-irradiation
mdpi.com/2072-6694/18/17/281…
🙏Thanks to all co-authors!
Dulce María Urías retweeted
🔴Online now: Chemoradiotherapy versus short-course radiotherapy for response-adapted organ preservation in early-stage and intermediate-stage rectal cancer (STAR-TREC): 12-month results of a randomised, phase 2/3 trial
📉thelancet.com/journals/lanon…
&
✏️thelancet.com/journals/lanon…
Dulce María Urías retweeted
En FOCUS 2026, cada argumento encontró una respuesta y cada postura tuvo que sostenerse frente a una mirada distinta.
Los residentes llevaron la discusión más allá de una respuesta correcta o incorrecta: defendieron criterios, confrontaron perspectivas y pusieron a prueba su capacidad para analizar, responder y decidir bajo presión académica.
Cada enfrentamiento abrió nuevas preguntas. Cada réplica obligó a reconsiderar certezas. Y cada diferencia de opinión se convirtió en una oportunidad para profundizar en el razonamiento clínico.
Porque debatir también es una forma de aprender: escuchar otras perspectivas, cuestionar las propias decisiones y construir argumentos cada vez más sólidos.
En Mérida, la intensidad no estuvo únicamente en el ambiente. También estuvo en cada discusión, en cada respuesta y en cada decisión defendida hasta el final.
#FOCUS2026 #SMeO #Oncología #EducaciónMédica #DebateClínico
Dulce María Urías retweeted
La Dra. Dulce Urias 🇲🇽 (INCAN) finaliza su fellowship en GenesisCare Madrid 🇪🇸
🔬 Radioterapia adaptativa con MR-Linac e Investigación
👏 Rotante ejemplar
¡Gracias por todo, Dulce! Mucho éxito ✨
#Radioterapia #MRLinac #Oncología
Dulce María Urías retweeted
🎯 MR-guided Adaptive Radiotherapy in action
Complex paracardiac lung lesion treated with MR-Linac SBRT
🫁 50 Gy / 5 fractions
📡 Automatic respiratory gating
📍 Beam on only when the tumor stays within the boundary
⚡ Ambulatory treatment
🙂 Patient asymptomatic
Dulce María Urías retweeted
From @JAMA_current: #Obesity is associated with higher risk for 12 #cancer types and accounts for approximately 10% of annual new cancer cases in the US.
📄 This Review summarizes the biological pathways connecting obesity and cancer development. ja.ma/4sq8C3q
Dulce María Urías retweeted
Radiation oncology is changing fast.
But radiation can still injure normal tissue.
An excellent review in @NEJM explains how modern RadOnc is reducing that risk:
-Precision planning
-Adaptive radiotherapy
-Biologic personalization
-AI-assisted treatment design
the goal is simple: maximize tumor control while protecting normal tissue
nejm.org/doi/full/10.1056/NE… @OncoAlert
Dulce María Urías retweeted
#ASCOGU26 🚨 CYTOSHRINK Trial - SBRT + Ipi/Nivo in de novo mRCC
Can we replace cytoreductive nephrectomy with SBRT in the IO era? 🎯
Phase II randomized trial testing primary kidney SBRT + Ipilimumab/Nivolumab vs Ipi/Nivo alone in untreated IMDC intermediate/poor-risk clear cell mRCC.
🧪 Design
• 2:1 randomization
• SBRT 30-40 Gy in 5 fractions between cycles 1-2
• Primary endpoint: 12-month PFS
• n = 67 (target 78)
• Median follow-up: 23.5 months
👥 Baseline
SBRT arm had worse disease biology
• More T3/T4 tumors 70% vs 46%
• Larger primary tumors
• More liver metastases 23% vs 8%
📊 Efficacy (ITT)
• 12-mo PFS: 35% vs 48%
HR 1.29
• ORR: 33% vs 42%
• 18-mo OS: 59% vs 70%
No PFS improvement with addition of SBRT.
📊 Per-protocol (received 4 cycles)
• 12-mo PFS: 46% vs 56%
• ORR: 50% vs 44%
• 18-mo OS: 74% vs 79%
🛡 Safety
Grade 3-4 AEs: 23% vs 29%
No new safety signals from SBRT.
🧠 Takeaway
Early cytoreductive SBRT to the primary did not improve 12-month PFS when added to Ipi/Nivo. However, baseline imbalances favoring the control arm and small sample size limit conclusions.
The nephrectomy vs radiation cytoreduction question in the IO era remains open.
@OncoAlert @myesmo @esmo_open @asco @larvol
#GU26 #OncoTwitter #KidneyCancer
🚨 ASCO GU 2026 Practice-Changing RCC Update 🚨
Renal cell carcinoma just entered a new era at #ASCOGU26. From adjuvant intensification to HIF-2α expansion, here are the 10 trials redefining care:
🟢 Adjuvant
1️⃣ LITESPARK-022
🆚 Pembro vs Pembro + Belzutifan
✅ DFS improved in high-risk post-nephrectomy ccRCC
2️⃣ RAMPART
🆚 Durvalumab ± Tremelimumab vs observation
✅ DFS benefit in highest-risk resected pts
🟢 1L Metastatic
3️⃣ CheckMate 9ER - 5 yr update
🆚 Nivo + Cabo
📈 Median OS 46.5 mo - long-term benchmark
4️⃣ COSMIC-313
🆚 Cabo + Nivo + Ipi
📈 PFS gain - toxicity vs OS debate continues
5️⃣ CYTOSHRINK
🆚 SBRT primary + IO/IO
🎯 “Virtual nephrectomy” strategy emerging
🟢 nccRCC
6️⃣ KEYNOTE-B61
🆚 Pembro + Lenva
🌍 Durable responses across major histologies
🟢 2L and Beyond
7️⃣ LITESPARK-011
🆚 Belzutifan + Lenva vs Cabo
🏆 New 2L leader post-IO
8️⃣ PEAK-1
🆚 Casdatifan + Cabo
📈 High ORR, improved tolerability signal
9️⃣ OPTIC RCC
🧬 RNA-guided therapy selection
🎯 IO-heavy vs TKI-heavy precision approach
🔟 LITESPARK-024
🆚 Belzutifan + Palbociclib
🔬 IO-free strategy in heavily pretreated pts
📌 Takeaway: RCC management is shifting from uniform sequencing to biology-driven intensification.
#ASCOGU26 #GU26 #OncoTwitter #MedTwitter #KidneyCancer #RCC
@OncoAlert @myesmo @esmo_open @asco @larvol
Dulce María Urías retweeted
2026 Genitourinary Oncology Spring Refresher - Dry Run
Updates in the management of cancers of the prostate, bladder, kidney, testes, from @NCCN @ASTRO_org @ESTRO_RT @Uroweb
#Radonc residents @ARRO_org, I hope it helps you ace the board exams!
youtu.be/IOQB79eXWH8
Dulce María Urías retweeted
Can we skip pelvic RT in selected LARC? CONVERT says maybe. 🎯🧠
CONVERT trial | JCO 2026
In locally advanced rectal cancer with uninvolved mesorectal fascia (MRF-negative), neoadjuvant CAPOX alone achieved very low local recurrence, similar DFS and OS, and less long-term toxicity compared with standard chemoradiation.
🧪 Study population
LARC within 12 cm from anal verge
MRI-confirmed uninvolved MRF
Median follow-up 48 months
⚔️ Treatment strategy
🟦 CAPOX x4 cycles → surgery
🟥 Pelvic RT + capecitabine → surgery
📊 Key 3-year outcomes
LRRFS 97.4% (CRT) vs 96.3% (CAPOX) | HR 1.40
DFS 89.2% vs 87.9% | HR 0.88
OS 95.0% vs 94.1% | HR 0.86
🛡️ Long-term toxicity matters
Grade 2-4 late AEs 26.3% (CRT) vs 16.0% (CAPOX)
Chronic proctitis 41.7% vs 33.6%
🧠 Clinical interpretation
Non-inferiority was not formally met due to extremely low event rates.
But efficacy is comparable and toxicity clearly favors CAPOX-only.
This supports RT de-escalation discussions in carefully selected MRF-negative LARC.
🔖 Save for MDT discussions
📖 Full paper in comment ⬇️
#OncoTwitter #MedTwitter #RectalCancer #ColorectalCancer
@OncoAlert @myesmo @esmo_open @asco @JCO_ASCO
Dulce María Urías retweeted
Pancreatic Adenocarcinoma: ITE/Board Pearls.
(Follow ASCO/NCCN for latest updates)
67,530 cases, 52,740 deaths (2026) | 3rd cancer killer → #2 by 2030 | 13% 5-yr survival
🧬 1. Genetics & Risk Factors (High-Yield)
->Germline Testing: Mandatory for ALL patients
Key Genes: BRCA1/2, PALB2, ATM (Platinum/PARP sensitive), CDKN2A (p16), STK11 (Peutz-Jeghers), Lynch Syndrome (MMR).
Somatic Drivers: KRAS (95%—early), CDKN2A, TP53, SMAD4 (DPC4—late).
Risk Triggers: Smoking (doubles risk), New-onset Diabetes >50 Yrs of age (1% risk within 3 years).
🔍 2. Diagnosis & Staging
Imaging: Thin-cut, dual-phase Pancreas Protocol CT is the gold standard.
Biopsy:
->Localized: EUS-FNA preferred (avoids track seeding, high yield for head tumors).
->Metastatic: Biopsy the metastatic site (Liver/Omentum) rather than the primary.
Markers: CA 19-9 is for monitoring/prognosis, not screening.
** ~10% of patients are Lewis Antigen negative and will not produce CA 19-9**
🏗️ 3. Management Buckets
1. Resectable->No vessel contact (SMA, Celiac, SMV)-->Surgery (Whipple/Distal) + 6mo Adjuvant Chemo (mFOLFIRINOX)
2. BorderlineAbutment (<180°) of vessels-->Neoadjuvant Systemic Chemo ± Radiation
3. Locally Adv : Encasement (>180°) of SMA/Celiac-->Systemic Induction Chemo (Radiation is optional consolidation)
4. Metastatic: Distant spread (Liver, Peritoneum)Palliative Systemic Therapy
Metastatic :
1. ECOG 0-1: FOLFIRINOX 🔥
2. KPS>70: Gem+nab-paclitaxel
3. Poor PS: Gem alone
Adjuvant (fit): mFOLFIRINOX > Gem+capcitabine > Gem+nab
💊 4. Systemic Therapy (The "Money" Trials)
Adjuvant (Post-Op)
->mFOLFIRINOX: Preferred for fit (ECOG 0-1) patients (PRODIGE-24 trial).
->Gemcitabine + Capecitabine: Preferred if less fit (ESPAC-4 trial).
***Performance Status is the strongest predictor of OS (3x difference between KPS 70 vs 100)***
Targeted / Precision
->BRCA1/2 + Platinum Response: Maintenance Olaparib (PARP inhibitor) after 16 weeks of stable disease (POLO trial).
->MSI-High: Pembrolizumab.
->NTRK Fusion: Larotrectinib or Entrectinib.
🧠 5. Board "One-Liners" & Rules
->Painless Jaundice: Head of pancreas tumor.
->Back Pain: Body/Tail tumor (often advanced).
->T4 Disease: Always Unresectable (Celiac/SMA involvement).
->LAP07 Trial: In locally advanced disease, adding Radiation after induction chemo improves PFS but NOT Overall Survival.
->Supportive: Celiac plexus neurolysis for refractory pain; LMWH for VTE (reduces clots, not mortality).
#OncTwitter #HemOnc #MedOnc #OncBoards #ITE #ABIM #MedEd #FOAMed
#Pancsm #PancChat #PancreaticCancer #PDAC
#PancreasCancer #GIonctwitter @ASCO @NCCNorg @JCO_ASCO @OncLive @TargetedOnc @Pancanorg @Letswinpc @ProjectPinkBlue @HemOncFellows @IMG_Oncologists @UToledo @realbowtiedoc
Follow X: @MamthaB/ Insta: @Hemonc_dr
