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The Accelerators co-hosts Drs. Matt Spraker and Simul Parikh hang out over lunch and discuss a potpourri of #RadOnc current events!

We cover ASTRO’s ROCR policy proposal, Dr. Sameer Keole's ASTRO presidential campaign and engagement on Student Doctor Network, and the recent dysphagia optimized IMRT trial.

Then, Simul hypothesizes about the future of radiation oncology under case rate payment models.

We close with some more thoughts about proton therapy inspired by Dr. Mark Storey's latest piece.

Here are a lot of links to things we discussed on the show:

• The Moto ROKR 
• Accreditation Programs by the ACR, ACRO, and ASTRO
• ASTRO ROCR Policy Page 
• Register for the ROCR Town Hall this Friday, July 21 4:00 PM - 5:00 PM ET
• What Big Medicine Can Learn from the Cheesecake Factory by Atul Gawande
• Out.Of.The.Basement with Beckta, MD: The Code Bundling Conundrum: A Medicare Misadventure (the saga of 77280-77290 and 77301)
• ASTRO Strategic Plan
• Nutting et al., Dysphagia Optimized IMRT
• Kamran et al., Esophagus-Sparing IMRT
• Oncora.ai
• Common Sense Oncology
• The Accelerators Podcast: Mobilize the Canadians! A Workflow Episode
• Protons 101 by Mark Storey, MD

Podcast art generously donated by Dr. Danielle Cunningham. Intro and Outro music by Emmy-award winning artist Lucas Cantor Santiago.

The Accelerators Podcast is a Photon Media production. 

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Dear Radiation Oncology,

Here are some thoughts about ASTRO's methods, and some reflections on ROCR and the updated Proton Model Policy.

It is my plea for a more open and inclusive society.

Love,

Matt 

Here are some things that were discussed in this episode:

• RTanswers.org sarcoma section
• Radiation for Sarcoma Ask Me Anything
• ASTRO Sarcoma PPT slides (and others)
• TAP episode: The One About Jobs
• TAP episode: The One About Jobs (Boost), Facility Volumes
• The Graypeace Article on the Rad Onc Workforce 
• The Virtual Visiting Professor Network lecture featuring Simul has apparently been removed, but a transcription of his famous speech can be found on SDN
• TAP episode: RO-APM
• ASTRO updated proton policy 
• Join Luh, Radiation Oncology Alternative Payment Model's Impact on Small and Rural Practices
• ASTROgram from 5/3 stating that NAPT and Maryland Proton Treatment Center developed the updated proton policy. 
  • ASTRO tried to delete this, see the internet archive instead
• ASTROgram from 5/10 correcting the 5/3 ASTROgram that "mischaracterized" the stakeholders' role.
  • See the internet archive instead
• ASTRO VP of Advocacy Dave Adler on Twitter

The Accelerators Podcast is a production of Photon Media, a division of Cold Light Legacy.

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It's an ACROPOLIS Live! welcome party with the Accelerators (Drs. Anna Brown, Matt Spraker, and Simul Parikh).

In this episode, newly matched #RadOnc residents-to-be Jazmyne Tabb, Tony Menghini, and Ashlynn Clark join the show to talk about the field. 

We discuss the radiation oncology learning curve, our excitement about the future of the field, the new doctors' future plans to spread the word about radiotherapy, and more. 

You will walk away inspired! 

Here are some things that were mentioned during the show:

• TAP Episode: I Can't Get No!... Patient Satisfaction
• TAP Episode: Low Dose Radiotherapy 
• Society of Women in Radiation Oncology (SWRO)
• Ma et al., Patient Experience Performance at a Primary Cancer Center Versus Affiliated Community Facilities
• RadOnc Tables and RadOnc Review Constraints
• eContour
• RadOncQuestions
• ROECSG
• RadOnc Wikibooks
• ACRO PAC
• ASTRO

Podcast art generously donated by Dr. Danielle Cunningham. Intro and Outro music by Emmy-award winning artist Lucas Cantor Santiago.

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In anticipation of our #RadOnc Welcome Party, Accelerators co-host Dr. Simul Parikh records solo!

In this episode, he shares how he thinks #RadOnc has changed since he trained many, many... many years ago. Most things are better, but a few things are worse.

Podcast art generously donated by Dr. Danielle Cunningham. Intro and Outro music by Emmy-award winning artist Lucas Cantor Santiago.

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The Accelerators (Drs. Anna Brown, Matt Spraker, and Simul Parikh) are joined by the hosts of the popular #RadOnc #MedEd podcast, At The Beam!

Drs. Trudy Wu and Hyunsoo Joshua No are PGY-4 radiation oncology residents at UCLA and Stanford and innovators in medical education. They started their podcast to help learners in all stages of their training master work up and treatment of all types of cancers.

In the show, we share the origin stories of At The Beam and The Accelerators Podcast, and discuss our thoughts about the changing landscape of medical education. We talk current unmet needs in medical education and how they might be filled: podcasts, The Accelerators Anthology, something else?

We cap the episode by heating things up with the return of Simul's Lightning Round. As expected, Trudy and Josh crush it.

Podcast art generously donated by Dr. Danielle Cunningham. Intro and Outro music by Emmy-award winning artist Lucas Cantor Santiago.

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Accelerators co-host Dr. Matt Spraker hosts Radiation Oncologists Drs. Krish Jethwa, Neil Newman, and Jeff Ryckman for part 2 of our discussion on radiotherapy for liver tumors.

We kick off with Neil reviewing his Twitter thread comparing TACE and SBRT for liver tumors. We discuss the data supporting SBRT as superior therapy, especially in patients who have recurrence after TACE. We further share some talking points for your tumor board.

Then discuss one of our faves, a randomized trial of sorafenib with or without SBRT (NRG/RTOG 1112). This leads to more discussion about how to approach large/unresectable liver tumors in your tumor board and possible future studies for these patients. 

Here are some things we discussed in the episode:

• Barcelona Liver Staging
• Sapir et al., Stereotactic Body Radiation Therapy as an Alternative to Transarterial Chemoembolization for Hepatocellular Carcinoma
• Comito et al., SBRT versus TACE/TAE for recurrence after TACE
• Akarapatima et al., TACE versus BSC for HCC
• Xiang et al., TACE versus BSC for HCC
• Llovet et al., TACE/TAE versus BSC for HCC 
• TRENDY trial., TACE versus SBRT for HCC
• Bush et al., proton radiotherapy versus TACE for HCC
• Verbus et al., SBRT versus TACE as bridging therapy in HCC 
• Hong et al., phase II trial of proton radiotherapy for unresectable cholangiocarcinoma
• RTOG 1112 survival curves

Podcast art generously donated by Dr. Danielle Cunningham. Intro and Outro music by Emmy-award winning artist Lucas Cantor Santiago.

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Accelerators co-host Dr. Matt Spraker hosts Radiation Oncologists Drs. Krish Jethwa, Neil Newman, and Jeff Ryckman for romp through the exciting world of radiotherapy for liver tumors! 

In the first of this two part episode, we Krish, Neil, and Jeff explore how liver tumors are treated in practice. We learn that Jeff can tell your Child-Pugh score by looking at your finger nails and other tips that can help with patient selection. Then we have a fantastic data-driven discussion on treatment planning. We also cover motion management and delivery. 

Toward the end, we approach the topic that inspired this episode, comparing SBRT with catheter-based therapies. 

Like Krish, we all want to know: will Neil "let it fly" on why SBRT should be the therapy of choice? 

Tune in next week to find out.

Here are some things that were discussed doing the show:

• Dr. Newman's epic Twitter thread on TACE versus SBRT for HCC
• The liver has a body - a Cook's tour by Adrien Ruben
• Dr. Zaorsky's Liver Anatomy Explained Using Your Right Fist
• Bujold et al., phase I and II studies of SBRT for HCC
• Ritter et al., Application of Critical Volume-Dose Constraints for SBRT in NRG Trials
• Dawson et al., Individualized image guided iso-NTCP based liver cancer SBRT
• Dawson et al., Partial Irradiation of the Liver

Podcast art generously donated by Dr. Danielle Cunningham. Intro and Outro music by Emmy-award winning artist Lucas Cantor Santiago.

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The Accelerators (Drs. Anna Brown, Matt Spraker, and Simul Parikh) host Clinical Geneticist Dr. Elizabeth Chao, Director of Medical Genetics at UC Irvine and Vice President and Clinical Diagnostics Laboratory Director at Ambry Genetics for a discussion about medical genetics in the oncology clinic and beyond! 
 
We start by discussing practice models for clinical geneticists and then spend some time discussing the role of genetic testing in pancreatic cancer care. 

We then discuss genetic testing more generally and what the future holds for the field. 

Our discussion concludes with Liz sharing her training path, which started in #RadOnc, to a very successful career. 
 
Here are some things that were discussed during the show: 

• Publication of the PALB2 pancreatic cancer susceptibility gene
• NCCN Guidelines for genetic/familial high-risk assessment: breast, ovarian, and pancreatic
• UK NHS 100,000 Genomes Project
• Ambry Genetics - The Care Program

Podcast art generously donated by Dr. Danielle Cunningham. Intro and Outro music generously donated by Emmy-award winning artist Lucas Cantor Santiago.

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In this episode, The Accelerators (Drs. Matt Spraker and Simul Parikh) discuss Matt's proposed composite quality of life measure for happiness of radiation oncologists. 

A lot is written on how to job search and evaluate the quality of a radiation oncology practice, but how to be happy practicing independently is less frequently discussed. 

Matt's lays out his theory for Rad Onc happiness, a composite quality measure made up of three components: technical occupational components (such as base salary and case load), fulfillment from career goals, and the "life" of work-life balance. In this discussion, Simul adds his thoughts. 

Creating a theory of happiness is a tall order to be sure, but at least it makes for great discussion!

Here are some things mentioned during the show:

• Evaluating a Practice in Radiation Oncology by Drs. Zaorsky and Trifelleti
• Office Space (a must see)
• Dark Side of the 90s on Hulu
• Jerry Springer (RIP)

Podcast art generously donated by Dr. Danielle Cunningham. Intro and Outro music generously donated by Emmy-award winning artist Lucas Cantor Santiago.

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The Accelerators (Drs. Matt Spraker and Simul Parikh) host radiation oncology resident physician and writer, Dr. Matt Farrell, to discuss narrative medicine.

We review his recent JCO publication "First Cousin Once Removed". In this piece, Matt describes his experience with a family meeting at the end of life for his cousin John, an actor and patient living with HIV and AIDS prior to the release of HAART. 

Matt's work sparks a discussion of family dynamics surrounding the death of a loved one, the language we use in medicine, and Matt's plans to keep writing a significant part of his life as a physician. 

Plus, book recommendations! 

Here are some things we discussed during the show:

• VVPN Reflections on Pandemics
• Cutting for Stone by Abraham Verghese 
• Thrillville, USA by Taylor Koekkoek
• Liberation Day: Stories by George Saunders
• The Combative Language of Cancer: A Plea for an Armistice by Dr. Matt Farrell

Podcast art generously donated by Dr. Danielle Cunningham. Intro and Outro music generously donated by Emmy-award winning artist Lucas Cantor Santiago.

The Accelerators Podcast is a Photon Media production.