In honor of Brain Tumor Awareness Month in May, RadOnc on the Run host Brandon Mancini, MD, MBA, FACRO, discussed the extensive roles that radiation oncology can play in the management of brain tumors and central nervous system (CNS) malignancies. He touched upon how modalities like stereotactic radiosurgery, proton therapy, adaptive planning, artificial intelligence (AI), theranostics, and emergent radioligand therapies can elevate the care of patients with glioblastoma, medulloblastoma, ependymoma, CNS lymphoma, and other conditions.

Mancini emphasized how the field has increasingly adopted precise technologies like Gamma Knife, CyberKnife, and linear accelerator-based radiosurgery, which have allowed clinicians to target specific tumor locations while sparing normal brain tissue. Looking towards the future, he noted how advances in molecular imaging and circulating tumor DNA may help further develop personalized treatment strategies for patients.

The discussion also covered unique considerations for treating patients with meningiomas, which may require multiple lines of therapy due to their more malignant or aggressive nature at baseline. Mancini described how DOTATATE PET-based imaging may assist with visualizing disease and planning radiotherapy strategies for those with meningiomas.

“The field of CNS radiation oncology has evolved tremendously from large-field radiation decades ago to stereotactic radiosurgery, proton therapy, adaptive planning, AI integration, and molecular targeted radiopharmaceutical therapy. The pace of innovation is truly accelerating rapidly, and it is very exciting for patients as far as what the future holds…The center of all this technology is still the patient,” Mancini stated. “Every advancement ultimately aims to improve survival, preserve neurocognitive neurologic function, maintain dignity, and improve quality of life. For patients and families [with] brain tumors, hope increasingly comes not only from one breakthrough, but from the convergence of many advances happening simultaneously across imaging, radiation oncology, surgery, systemic therapy, and precision medicine.”

Mancini is the medical director at Bold Advanced Medical Future Health, a clinical associate professor in the Department of Radiology at Michigan State University College of Human Medicine, and the editor at large for RadOnc Review, a supplement of the journal ONCOLOGY®.

In observance of Head and Neck Cancer Awareness Month in April, RadOnc on the Run host Brandon Mancini, MD, MBA, FACRO, spoke with Henry S. Park, MD, MPH about the past, present, and future of radiotherapy as a tool for managing different head and neck malignancies. The experts discussed considerations for delivering timely diagnoses to patients and forming personalized treatment plans that balance efficacy with quality of life.

Regarding the overall head and neck cancer landscape, Park noted that it is now possible to cure many patients of their disease thanks to advances in radiotherapy, chemotherapy, immunotherapy, and surgery. In certain cases, he said, patients may be eligible to de-escalate portions of their therapy to help minimize the risk of toxicity.

Other key areas in the field included the management of adverse effects such as fatigue, sore throat, difficulty swallowing, and weight loss, which often involves collaboration with team members in supportive care to maintain one’s function and quality of life. As part of balancing hope with realism among patients, Park expressed that clinicians should be transparent about the potential toxicity that may occur with modalities like radiation and chemotherapy.

In the end, Park emphasized that patients should be open about any potential disease symptoms they have to avoid late diagnoses.

“[Patients should] not be shy about [their] symptoms…If we catch it early enough, it is certainly possible to cure many of these cancers,” Park stated. “I highly encourage [patients] to be upfront about any concerns [they] have because they may not always be apparent immediately during the initial patient encounter.”

Mancini is the medical director at Bold Advanced Medical Future Health, a clinical associate professor in the Department of Radiology at Michigan State University College of Human Medicine, and the editor at large for RadOnc Review, a supplement of the journal ONCOLOGY®. Park is a professor of Therapeutic Radiology and vice chair for Clinical Research, Health Services Research, and Faculty Development for Therapeutic Radiology at Yale School of Medicine and Yale New Haven Hospital.

During National Colorectal Cancer Awareness Month in March, Brandon Mancini, MD, MBA, FACRO, spoke with Krishan R. Jethwa, MD, MPH, about key themes that have emerged with the use of radiotherapy in the field. Among several topics discussed in this episode of RadOnc on the Run, the experts highlighted how the treatment paradigm has evolved to encompass more individualized treatment decision-making, particularly for patients with rectal cancer.

More than a decade ago, the standard of care for patients with locally advanced rectal cancer entailed a “cookie cutter” treatment pathway consisting of long-course chemoradiotherapy, surgery, and adjuvant systemic therapy, according to Jethwa. Over time, the field began to adopt more personalized treatment algorithms depending on patient goals, wishes, and values to optimize cancer control while protecting long-term quality of life and function.

Jethwa also touched upon strategies for mitigating acute and long-term toxicities, which range from fatigue and diarrhea in the short term to incontinence and bowel-related issues later down the line. Other topics of conversation included the evolution of imaging, genomics, and genetics in the field, as well as the potential next steps for researching risk stratification.

“Rectal cancer is a highly heterogeneous disease [with] a broad spectrum of local risk and a broad spectrum of risk for distant metastasis. Having the optimal treatment approach does require multidisciplinary care,” Jethwa said. “In 2026 and beyond, the care of patients is no longer one-size-fits-all. It's very much tailored to the individual. Contemporary practice utilizes all sorts of tools from a genomics imaging perspective, as well as multidisciplinary treatment approaches. It’s important for us to work together as colleagues and teammates to best care for our patients.”

Mancini is the medical director at Bold Advanced Medical Future Health, a clinical associate professor in the Department of Radiology at Michigan State University College of Human Medicine, and the editor at large for RadOnc Review, a supplement of the journal ONCOLOGY®. Jethwa is an assistant professor of Radiation Oncology at Mayo Clinic Rochester.