Six years ago, Applied Radiation Oncology dedicated its March issue to the topic of radioimmunotherapy (RIT), exploring the safety and efficacy of combination immunotherapy and radiation therapy, and its potential to invoke the abscopal response. At that time, RIT was generating excitement for its effectiveness in treating hematological malignancies.

Today, RIT has moved from being a niche treatment for specific hematologic cancers to an emerging therapeutic option for solid tumors, metastatic cancers, and even non-cancer diseases. The field is on the brink of a new era with advanced precision medicine, personalized treatment strategies, and combination therapies that harness the power of RIT in novel ways. We revisit the topic of RIT with two review articles.

The first, Clinical Evidence of Combining Radiopharmaceutical Therapy (RPT) with Immune Checkpoint Inhibitors (ICIs), highlights clinical trials in which this therapeutic combination is improving outcomes in cancer treatment with reduced toxicities and enhanced immune response. The second article, Combination of External Beam Radiation Therapy (ERBT) and Immune Checkpoint Inhibitors in Cancer Treatment: Mechanisms, Limitations, and Clinical Applications , explores how RPT with ICIs enhances treatment effectiveness by overcoming treatment resistance and promoting immunogenic cell death.

This month’s research article, RefleXion X1 Treatment Planning Feasibility Study for Cranio-Spinal Irradiation (CSI) , highlights the success of a clinical biology-guided radiation therapy (BgRT) system in treating pediatric medulloblastoma patients. The study compares treatment planning using the BgRT system with multi-isocenter linac-based VMAT.

In clinical case studies, we examine a patient with a cervical spine schwannoma who experiences transient swelling following stereotactic body radiotherapy (SBRT) in Volumetric Changes in Cervical Schwannoma in Response to Adjuvant Stereotactic Body Radiation Therapy . In Robotic-assisted Seminal Vesicle Excision vs Brachytherapy for Isolated Seminal Vesicle and Recurrence and Radiation Therapy for the Management of Refractory Giant Condyloma Acuminata , the authors demonstrate the effectiveness of common therapeutic approaches in managing these cases.

Finally, the Resident Voice column, A rtificial Intelligence in Radiation Oncology Training: Integrating Clinical Skills and Automation , weighs the opportunities that AI presents in clinical training programs against its potential to contribute to a loss of fundamental skills.

Looking ahead, our issue for June will explore the impact of heavy particle treatment on the field, particularly in the application of intractable cancers. Until then, please remember to pause and admire the renewal and wonder that spring brings every year. Thank you, as always, for supporting this journal!