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Sharin T, Leinen LJ, Schreiber D, Swenson VA, Emsley SA, Trammell EJ, Videau P, Crump D, Gaylor MO. Description of Solvent-Extractable Chemicals in Thermal Receipts and Toxicological Assessment of Bisphenol S and Diphenyl Sulfone. Bull Environ Contam Toxicol 2024; 112:63. [PMID: 38615298 DOI: 10.1007/s00128-024-03871-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Accepted: 02/16/2024] [Indexed: 04/15/2024]
Abstract
Research on thermal receipts has previously focused on the toxic effects of dermal exposure from the most publicized developers (e.g., bisphenol A (BPA) and bisphenol S (BPS)), while no studies have reported on the other solvent-extractable compounds therein. Diphenyl sulfone (DPS) is a sensitizer added to thermal receipts, but little is known about DPS concentrations in receipts or potential toxicity. Here, we quantified BPA, BPS, and DPS concentrations and tentatively identified the solvent-extractable compounds of thermal receipts collected from three South Dakota (USA) cities during 2016-2017. An immortalized chicken hepatic cell line, cultured as 3D spheroids, was used to screen effects of DPS, BPS, and 17ß estradiol (E2; 0.1-1000 µM) on cell viability and gene expression changes. These chemicals elicited limited cytotoxicity with LC50 values ranging from 113 to 143 µM, and induced dysregulation in genes associated with lipid and bile acid homeostasis. Taken together, this study generated novel information on solvent-extractable chemicals from thermal receipts and toxicity data for DPS.
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Affiliation(s)
- Tasnia Sharin
- National Wildlife Research Centre, Environment and Climate Change Canada, Ottawa, ON, K1A 0H3, Canada
| | - Lucas J Leinen
- Department of Chemistry, Dakota State University, Madison, SD, USA
| | - David Schreiber
- Department of Chemistry, Dakota State University, Madison, SD, USA
| | - Vaille A Swenson
- Department of Chemistry, Dakota State University, Madison, SD, USA
- Graduate School of Biomedical Sciences, Mayo Clinic, Rochester, MN, USA
| | - Sarah A Emsley
- Department of Biology, Southern Oregon University, Ashland, OR, USA
| | - E Jamie Trammell
- Environmental Science and Policy Program, Southern Oregon University, Ashland, OR, USA
| | - Patrick Videau
- Department of Biology, Southern Oregon University, Ashland, OR, USA.
| | - Doug Crump
- National Wildlife Research Centre, Environment and Climate Change Canada, Ottawa, ON, K1A 0H3, Canada.
| | - Michael O Gaylor
- Department of Chemistry, Dakota State University, Madison, SD, USA.
- Bayer Crop Science, Chesterfield, MO, USA.
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Mattessich S, Silver B, Youssef I, Stern C, Schreiber D. National Trends in Definitive Radiation for Large Unresected cT3N0 Non-Small Cell Lung Cancer Tumors. Int J Radiat Oncol Biol Phys 2022. [DOI: 10.1016/j.ijrobp.2022.07.1528] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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Schreiber D, Opitz A. A Novel Background Modeling Algorithm for Hyperspectral Ground-Based Surveillance and Through-Foliage Detection. Sensors (Basel) 2022; 22:7720. [PMID: 36298071 PMCID: PMC9610167 DOI: 10.3390/s22207720] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Revised: 09/22/2022] [Accepted: 09/24/2022] [Indexed: 06/16/2023]
Abstract
Foliage penetration is an unsolved important part of border surveillance of remote areas between regular border crossing points. Detecting penetrating objects (e.g., persons and cars) through dense foliage in various climate conditions using visual sensors is prone to high fault rates. Through-foliage scenarios contain an unprecedented amount of occlusion-in fact, they often contain fragmented occlusion (for example, looking through the branches of a tree). Current state-of-the-art detectors based on deep learning perform inadequately under moderate-to-heavy fragmented occlusion. The FOLDOUT project builds a system that combines various sensors and technologies to tackle this problem. Consequently, a hyperspectral sensor was investigated due to its extended spectral bandwidth, beyond the range of typical RGB sensors, where vegetation exhibits pronounced reflectance. Due to the poor performance of deep learning approaches in through-foliage scenarios, a novel background modeling-based detection approach was developed, dedicated to the characteristics of the hyperspectral sensor, namely strong correlations between adjacent spectral bands and high redundancy. The algorithm is based on local dimensional reduction, where the principal subspace of each pixel is maintained and adapted individually over time. The successful application of the proposed algorithm is demonstrated in a through-foliage scenario comprised of heavy fragmented occlusion and a highly dynamical background, where state-of-the-art deep learning detectors perform poorly.
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Silver B, Mattessich S, Yacoub I, Rhee B, Schreiber D. Patterns of Care and Utilization of Radiation for Women With Good-Risk Ductal Carcinoma In Situ: A National Cancer Database Analysis. Cureus 2022; 14:e28223. [PMID: 36158412 PMCID: PMC9486958 DOI: 10.7759/cureus.28223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/20/2022] [Indexed: 11/05/2022] Open
Abstract
Purpose/objective(s) Lumpectomy followed by whole-breast radiation therapy (WBRT) provides a 50% recurrence rate reduction in ductal carcinoma in situ (DCIS) patients when compared to lumpectomy alone. Certain factors increase the risk of recurrence, including higher nuclear grade, large size, age less than 50, and close margins. RTOG 9804 demonstrated a reduction in local failure after WBRT with the use of adjuvant radiation in women with "good-risk disease" (mammographically detected, measuring less than or equal to 2.5 cm, with a predominant nuclear grade of 1 or 2, and a margin of greater than or equal to 1 cm, or a negative re-excision). The purpose of this study is to retrospectively identify the patterns of care in women with low-risk DCIS utilizing the National Cancer Database (NCDB). We hypothesize that with the utilization of hypofractionation, there may be an increase in the delivery of RT for these "good-risk" patients. Materials/methods The National Cancer Database was queried to identify women treated with lumpectomy for <2.5 cm, nuclear grade 1 or 2 DCIS of the breast from 2004 to 2016. Data were collected regarding age, tumor size, endocrine therapy use, ER receptor status, race, insurance type, and distance from the treatment center. The distance was stratified into quartiles consisting of 0-3.9, 4-8, 8.1-15.8, and > 15.8 miles, respectively. Radiation fractionation was collected and categorized as hypofractionation, standard fractionation, or other if fractionation could not be ascertained. Clinical and patient-related factors were compared between patients who received radiation and those who received no radiation. The frequency distributions between categorical variables were compared using the Chi-square test. Multivariable logistic regression was used to identify covariables that impacted the receipt of radiation. Results The eligibility criteria were met by a total of 12,846 patients. Of those, 6,600 (51.4%) received adjuvant WBRT. On multivariable regression, patients whose tumors were ER (OR 1.24, P<0.001) and those who had not received endocrine therapy (OR 2.24, P<0.001) were more likely to receive WBRT. Factors less likely to receive WBRT included increasing age over 50 (age 50-65 OR 0.83, P<0.001; age>65 OR 0.58, P<0.001), and distance of >15.8 miles (OR 0.78, P<0.001). The fractionation technique was categorized as standard or hypofractionated in 52.2% of patients. Of those, the use of hypofractionation increased from 0.4% in 2004 to 8.9% in 2010 and to 53.8% in 2016. Conclusion This NCDB analysis demonstrated that patients who meet the RTOG 9804 criteria for "good-risk" DCIS are less likely to receive RT as time progresses despite an increase in the utilization of hypofractionation techniques. Overall, slightly more than half of these patients receive adjuvant RT.
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Schreiber D, Picus C, Fischinger D, Boyer M. The defalsif-AI project: protecting critical infrastructures against disinformation and fake news. Elektrotech Inftech 2021; 138:480-484. [PMID: 35693024 PMCID: PMC8447119 DOI: 10.1007/s00502-021-00929-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Accepted: 09/06/2021] [Indexed: 11/24/2022]
Abstract
In this paper, we describe the concept and ongoing work of the project defalsif-AI, which addresses the protection of critical infrastructures against disinformation and fake news. Defalsif-AI deals particularly with the protection of the main democratic processes and the public trust in democracy and its institutions against engineered social media attacks, which, for example, attempt to manipulate the electoral process. Federal ministries and media institutions require new methods and tools to evaluate the ever increasing amount of digital media in terms of identification, verification, and correction of sources. Based on these requirements, the project focuses on research on audio-visual media forensics, text analysis, and multimodal fusion with the support of artificial intelligence (AI) and machine learning methods. One main focus of this research is to make the results more comprehensible and interpretable for non-experts in the forensic/technical field. The primary project outcome is a proof of concept of a multimodal detection platform, which can operate with a variety of sources, including the surface web and social media. Additional research carried out within the project focuses on providing and generating multimodal data necessary to train and test machine learning models. Finally, an analysis and assessment concerning the law and social science are carried out as well.
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Affiliation(s)
- David Schreiber
- Austrian Institute of Technology (AIT) GmbH, Giefinggasse 4, 1210 Vienna, Austria
| | - Cristina Picus
- Austrian Institute of Technology (AIT) GmbH, Vienna, Austria
| | | | - Martin Boyer
- Austrian Institute of Technology (AIT) GmbH, Vienna, Austria
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Malakhov N, Kim JK, Adedoyin P, Albert A, Schreiber D, Lee A. Patterns of Care and Outcomes of Low-Lying Adenocarcinoma and Squamous Cell Carcinoma of the Rectum. J Gastrointest Cancer 2020; 53:105-112. [PMID: 33211265 DOI: 10.1007/s12029-020-00552-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/08/2020] [Indexed: 12/11/2022]
Abstract
PURPOSE Squamous cell carcinoma (SCC) of the rectum is a unique entity that lacks definitive guidelines regarding prognosis and treatment. This study aimed to analyze patterns of care and survival for SCC and adenocarcinoma (AC) of the rectum. METHODS This was a retrospective analysis of patients with stage I-III SCC or AC of the rectum treated from 2004 to 2016 from the National Cancer Database. The treatment groups analyzed were surgery alone (S), chemoradiation followed by surgery (CRT + S), surgery followed by chemoradiation (S + CRT), and definitive chemoradiation (CRT). Patient- and clinical-related factors were compared. Overall survival was assessed with the Kaplan-Meier method and Cox proportional regression models. RESULTS Of the patients studied, 21,587 (97.1%) were AC and 640 (2.9%) were SCC. Among patients with AC, most (n = 8549, 59.4%) received chemoradiation followed by surgery; those with SCC (n = 305, 66.4%) received definitive chemoradiation. Among patients who received surgery, the majority (69.2%) with AC histology had a low anterior resection while the majority (52.1%) of SCC had an abdominoperineal resection. Five-year overall survival of AC versus SCC in the entire cohort was 61.6% versus 56.1%, respectively (p < 0.001). On multivariable analysis for AC, CRT + S (HR 0.61, p < 0.001), or S + CRT (HR 0.67, p < 0.001) had improved survival compared to S alone while those who had definitive CRT (HR 1.55, p < 0.001) had worse survival. CONCLUSIONS SCC of the rectum tends to be treated like anal cancers with definitive chemoradiation, with similar survival to historical reports of anal cancer. AC of the rectum is most commonly treated under the rectal cancer paradigm.
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Affiliation(s)
- Nikita Malakhov
- Department of Medicine, New York Presbyterian-Weill Cornell Medical Center, New York, NY, USA.
| | - Joseph K Kim
- Department of Radiation Oncology, New York University, New York, NY, USA
| | - Paul Adedoyin
- Department of Veterans Affairs, New York Harbor Healthcare System, Brooklyn, NY, USA.,Department of Radiation Oncology, SUNY Downstate Medical Center, Brooklyn, NY, USA
| | | | | | - Anna Lee
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
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Youssef I, Lee A, Kukunoor S, Taiwo E, Luhrs CA, Schreiber D. Patterns of Care and Survival of Metastatic Metaplastic Breast Cancer Patients. Cureus 2020; 12:e10339. [PMID: 33150115 PMCID: PMC7605212 DOI: 10.7759/cureus.10339] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Background: Metaplastic breast cancer (MBC) is a rare, aggressive variant of breast cancer, usually triple negative disease and chemotherapy refractory. Despite this, the standard of care remains the same as invasive ductal breast cancer. We sought to analyze patterns of care and outcomes among patients with metastatic MBC. Methods: Patients over 18 years diagnosed with metastatic MBC from 2004-2015 were identified in the National Cancer Database (NCDB). Clinical and demographic details were compared between two groups (chemotherapy vs no chemotherapy). Logistic regression was performed to assess for predictors of receiving chemotherapy. The Kaplan-Meier method was used to assess overall survival (OS) and Cox regression analysis was used to assess the impact of covariates on OS. Results: There were 7,580 patients with MBC of which 417 (5.5%) presented with metastatic disease. Median age was 65 years (interquartile range (IQR) 54-76) and median follow up for living patients was 48 months (IQR 31-77). One hundred and fifty-six (37.4%) patients received chemotherapy. On multivariable logistic regression analyses, treatment at an academic facility was associated with an increased likelihood of receiving chemotherapy (OR 3.14, 95% CI 1.95-5.03, p<0.001) while age ≥65 years (OR 0.54, 95% CI 0.34-0.86, p=0.009) and receipt of hormonal therapy (OR 0.35, 95% CI 0.15-0.85, p=0.021) were associated with a decreased likelihood of receiving chemotherapy. On multivariable Cox regression analysis, higher Charlson-Deyo score (hazard ratio (HR) 1.35-1.78, p<0.05) was associated with worse survival while receipt of chemotherapy (HR 0.76, 95% CI 0.59-0.99, p=0.041) and having insurance (HR 0.34-0.47, p<0.05) were associated with improved survival. Patients who received chemotherapy had improved median (twelve versus eight months), one-year (51% versus 38%), and two-year (35% versus 21%) OS, as compared to those who did not receive chemotherapy (p=0.006). Conclusions: In this study of MBC patients, there was a survival benefit with palliative chemotherapy in the setting of metastatic disease. As expected, treatment was most often given to younger patients.
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Affiliation(s)
- Irini Youssef
- Medical Oncology, State University of New York (SUNY) Downstate Medical Center, Brooklyn, USA
| | - Anna Lee
- Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, USA
| | - Sparsha Kukunoor
- Medical Oncology, State University of New York (SUNY) Downstate Medical Center, Brooklyn, USA
| | - Evelyn Taiwo
- Hematology and Oncology, New York-Presbyterian Brooklyn Methodist Hospital, Brooklyn, USA
| | - Carol A Luhrs
- Medical Oncology, State University of New York (SUNY) Downstate Medical Center/New York Harbor Healthcare System, Brooklyn, USA
| | - David Schreiber
- Radiation Oncology, Summit Medical Group, Berkeley Heights, USA
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Rotsides JM, Oliver JR, Moses LE, Tam M, Li Z, Schreiber D, Jacobson AS, Hu KS, Givi B. Socioeconomic and Racial Disparities and Survival of Human Papillomavirus-Associated Oropharyngeal Squamous Cell Carcinoma. Otolaryngol Head Neck Surg 2020; 164:131-138. [PMID: 32660368 DOI: 10.1177/0194599820935853] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
OBJECTIVE To investigate differences in epidemiology of oropharyngeal squamous cell carcinoma (OPSCC) with regards to human papillomavirus (HPV), race, and socioeconomic status (SES) using the National Cancer Database (NCDB). STUDY DESIGN Population-based cohort study. SETTING Racial and socioeconomic disparities in survival of OPSCC have been previously acknowledged. However, the distribution of HPV-related cancers and its influence on survival in conjunction with race and SES remain unclear. SUBJECTS AND METHODS All patients with OPSCC in the NCDB with known HPV status from 2010 to 2016 were included. Differences in presentation, HPV status, treatment, and outcomes were compared along racial and socioeconomic lines. Univariable and multivariable Cox regression survival analyses were performed. RESULTS In total, 45,940 patients met criteria. Most were male (38,038, 82.8%), older than 60 years (23,456, 51.5%), and white (40,156, 87.4%), and lived in higher median income areas (>$48,000, 28,587, 62.2%). Two-thirds were HPV positive (31,007, 67.5%). HPV-negative disease was significantly more common in lower SES (<$38,000, 2937, 41.5%, P < .001) and among blacks (1784, 55.3%, P < .001). Median follow-up was 33 months. Five-year overall survival was 81.3% (95% CI, 80.5%-82.1%) and 59.6% (95% CI, 58.2%-61.0%) in HPV-positive and HPV-negative groups, respectively. In univariable and multivariable analyses controlling for HPV status, age, stage, and treatment, black race (hazard ratio [HR], 1.22; 95% CI, 1.11-1.34; P < .001) and low SES (HR, 1.58; 95% CI, 1.45-1.72; P < .001) were associated with worse survival. CONCLUSION Significant differences in HPV status exist between socioeconomic and racial groups, with HPV-negative disease more common among blacks and lower SES. When controlling for HPV status, race and SES still influence outcomes in oropharyngeal cancers.
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Affiliation(s)
- Janine M Rotsides
- Department of Otolaryngology-Head and Neck Surgery, NYU Langone Health, New York, New York, USA
| | - Jamie R Oliver
- Department of Otolaryngology-Head and Neck Surgery, NYU Langone Health, New York, New York, USA
| | - Lindsey E Moses
- Department of Otolaryngology-Head and Neck Surgery, NYU Langone Health, New York, New York, USA
| | - Moses Tam
- Department of Radiation Oncology, NYU Langone Health, New York, New York, USA
| | - Zujun Li
- Department of Medical Oncology, NYU Langone Health, New York, New York, USA
| | - David Schreiber
- Department of Radiation Oncology, SUNY Downstate, Brooklyn, New York, USA
| | - Adam S Jacobson
- Department of Otolaryngology-Head and Neck Surgery, NYU Langone Health, New York, New York, USA
| | - Kenneth S Hu
- Department of Radiation Oncology, NYU Langone Health, New York, New York, USA
| | - Babak Givi
- Department of Otolaryngology-Head and Neck Surgery, NYU Langone Health, New York, New York, USA
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Sheth N, Osborn V, Lee A, Schreiber D. Stereotactic Ablative Radiotherapy Fractionation for Hepatocellular Carcinoma in the United States. Cureus 2020; 12:e8675. [PMID: 32699675 PMCID: PMC7370686 DOI: 10.7759/cureus.8675] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Accepted: 06/16/2020] [Indexed: 12/23/2022] Open
Abstract
Introduction This study aims to analyze the patterns of care, including fractionation and utilization, of hypofractionated stereotactic ablative radiotherapy (SABR) in the treatment of hepatocellular carcinoma (HCC). Methods The National Cancer Database was queried for patients diagnosed with HCC from 2004 to 2014 and treated with SABR in three, four, or five fractions in 15-20Gy, 10-13Gy, or 6-12Gy per fraction, respectively. Patients with stage IV and Charlson-Deyo Comorbidity Index > 0 were excluded in order to avoid bias resulting from the selection of poorer prognosis patients. The patients were then stratified based on several characteristics including biologically equivalent doses (BEDs) of =/> 100 Gy and <100 Gy to determine whether there was an association with overall survival (OS) and a multivariable analysis (MVA) was performed to assess for potential confounding factors. Results There were 462 patients identified in whom the most common SABR fractionation regimen was 10Gy x five fractions (25.3%), followed by 8Gy x five fractions (17.7%), and 15-16Gy x three fractions (26.4%). A total of 152 patients were treated to a BED < 100Gy, which was associated with a median OS of 20.8 months (95% CI 14.55-27.11). Three hundred and ten patients were treated to a BED =/> 100Gy, which was associated with a median OS of 30.8 months (95% CI 5.25-32.08). On MVA, BED =/> 100Gy was not significantly associated with improved OS (HR 0.85, 95% CI 0.64-1.14, p = 0.28). Factors that were associated with significantly worse survival were tumor size in the largest quartile (HR 2.197 CI 1.440-3.354, p < 0.0001) and T3a disease (HR 2.474 CI 1.472-4.158, p = 0.001 compared to T1). Conclusion SABR fractionation schemes vary widely, but are most commonly 10Gy x five fractions followed by 8Gy x five fractions and 15Gy x three fractions. BED of at least 100Gy is not associated with improved OS. Further studies are needed to best identify the optimal SABR dose and fractionation.
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Affiliation(s)
- Niki Sheth
- Radiation Oncology, State University of New York - Downstate Medical Center, New York, USA
| | - Virginia Osborn
- Radiation Oncology, NYC Health + Hospitals/Elmhurst, New York, USA
| | - Anna Lee
- Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, USA
| | - David Schreiber
- Radiation Oncology, Summit Medical Group, Berkeley Heights, USA
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Malakhov N, Lee A, Albert A, Lederman A, Byun J, Safdieh J, Schreiber D. Patterns of Care and Outcomes of Adjuvant Chemoradiation for Node-Positive Pancreatic Adenocarcinoma. J Gastrointest Cancer 2020; 51:506-514. [PMID: 31236851 DOI: 10.1007/s12029-019-00265-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
PURPOSE The literature has been conflicting on the superiority of adjuvant chemoradiation over chemotherapy for node-positive adenocarcinoma of the pancreas following definitive surgery. We aimed to evaluate the patterns of care and outcomes of these two treatment options using the National Cancer Database (NCDB). METHODS Patients diagnosed with non-metastatic, node-positive adenocarcinoma of the pancreas from 2006 to 2014 who received oncologic resection with negative margins were identified in the NCDB. Patient- and clinical-related factors were compared between those who received adjuvant chemotherapy alone (aC) versus adjuvant chemoradiation (aCRT). Univariable and multivariable logistic regression was performed to assess for predictors of adjuvant chemoradiation use. The Kaplan-Meier method was used to assess overall survival (OS) and Cox regression analysis was used to assess impact of covariables on OS. RESULTS There were 3609 patients who met the study criteria, of which 2988 (82.8%) received chemotherapy alone and 621 (17.2%) who received chemoradiation. Median follow up for living patients was 33.8 months (IQR 22-51). On multivariable logistic regression, those who received treatment in more recent years of diagnoses (OR 0.21-0.37, p < 0.001) were less likely to receive aCRT over aC. Two-year OS for those who received chemo alone was 44.9% and for chemoradiation was 42.6% (p = 0.169). This finding was sustained on multivariable survival analysis (HR 0.99, p = 0.867). CONCLUSIONS Adjuvant chemotherapy alone for adenocarcinoma of the pancreas is the predominant treatment of choice among US hospitals. There was no overall survival benefit noted in those who were treated with adjuvant chemoradiation.
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Affiliation(s)
- Nikita Malakhov
- Department of Radiation Oncology, SUNY Downstate Medical Center, 450 Clarkson Avenue, Mail Stop #1211, Brooklyn, NY, 11203, USA
- Department of Medicine, New York Presbyterian-Weill Cornell Medical Center, New York, NY, USA
| | - Anna Lee
- Department of Radiation Oncology, SUNY Downstate Medical Center, 450 Clarkson Avenue, Mail Stop #1211, Brooklyn, NY, 11203, USA.
- Department of Veterans Affairs, New York Harbor Healthcare System, Brooklyn, NY, USA.
| | - Ashley Albert
- Department of Radiation Oncology, University of Mississippi Medical Center, Jackson, MS, USA
| | - Ariel Lederman
- Department of Radiation Oncology, SUNY Downstate Medical Center, 450 Clarkson Avenue, Mail Stop #1211, Brooklyn, NY, 11203, USA
- Department of Veterans Affairs, New York Harbor Healthcare System, Brooklyn, NY, USA
- Kings County Hospital Center, Brooklyn, NY, USA
| | - John Byun
- Department of Radiation Oncology, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, USA
| | - Joseph Safdieh
- Department of Radiation Oncology, SUNY Downstate Medical Center, 450 Clarkson Avenue, Mail Stop #1211, Brooklyn, NY, 11203, USA
- Kings County Hospital Center, Brooklyn, NY, USA
| | - David Schreiber
- Department of Radiation Oncology, SUNY Downstate Medical Center, 450 Clarkson Avenue, Mail Stop #1211, Brooklyn, NY, 11203, USA
- Summit Medical Group, Berkeley Heights, NJ, USA
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Abstract
Background:In contrast to delta-9-tetrahydrocannabinol, the phytocannabinoid cannabidiol does not exert psychotomimetic effects. Cannabidiol was suggested a re-uptake inhibitor of anandamide and potential antipsychotic properties have been hypothesized for it. We therefore performed a clinical trial to investigate thesis hypothesis and to clarify the underlying link to the neurobiology of schizophrenia.Methods:We performed an explorative, 4-week, double-blind, controlled clinical trial on the effects of purified cannabidiol in acute schizophrenia compared to the antipsychotic amisulpride. The antipsychotic properties of both drugs were the primary target of the study. Furthermore, side-effects and anxiolytic capabilities of both treatments were investigated.Results:42 patients fulfilling DSM-IV criteria of acute paranoid schizophrenia participated in the study. Both treatments were associated with a significant decrease of psychotic symptoms after 2 and 4 weeks as assessed by BPRS and PANSS. However, there was no statistical difference between both treatment groups. In contrast, cannabidiol induced significantly less side effects (EPS, increase in prolactin, weight gain) when compared to amisulpride.Conclusions:Cannabidiol revealed substantial antipsychotic properties in acute schizophrenia. This is in line with our suggestion of an adaptive role of the endocannabinoid system in paranoid schizophrenia, and raises further evidence that this adaptive mechanism may represent a valuable target for antipsychotic treatment strategies.The Stanley Medical Research Institute (00-093 to FML) and the Koeln Fortune Program (107/2000 + 101/2001 to FML) funded this study.
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Malladi SK, Schreiber D, Pramanick I, Sridevi MA, Goldenzweig A, Dutta S, Fleishman SJ, Varadarajan R. One-step sequence and structure-guided optimization of HIV-1 envelope gp140. Curr Res Struct Biol 2020; 2:45-55. [PMID: 33688632 PMCID: PMC7939140 DOI: 10.1016/j.crstbi.2020.04.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
Stabilization of the metastable envelope glycoprotein (Env) of HIV-1 is hypothesized to improve induction of broadly neutralizing antibodies. We improved the expression yield and stability of the HIV-1 envelope glycoprotein BG505SOSIP.664 gp140 by means of a previously described automated sequence and structure-guided computational thermostabilization approach, PROSS. This combines sequence conservation information with computational assessment of mutant stabilization, thus taking advantage of the extensive natural sequence variation present in HIV-1 Env. PROSS is used to design three gp140 variants with 17–45 mutations relative to the parental construct. One of the designs is experimentally observed to have a fourfold improvement in yield and a 4 °C increment in thermostability. In addition, the designed immunogens have similar antigenicity profiles to the native flexible linker version of wild type, BG505SOSIP.664 gp140 (NFL Wt) to major epitopes targeted by broadly neutralizing antibodies. PROSS eliminates the laborious process of screening many variants for stability and functionality, providing a proof of principle of the method for stabilization and improvement of yield without compromising antigenicity for next generation complex, highly glycosylated vaccine candidates. One-step stabilization of HIV-1 Env gp140. One-step yield improvement of HIV-1 Env gp140. Native-like oligomeric conformation of designed vaccine candidates. Unaltered antigenicity of designed vaccine candidates.
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Affiliation(s)
| | - David Schreiber
- Department of BioMolecular Sciences, Weizmann Institute of Science, Rehovot, Israel
| | - Ishika Pramanick
- Molecular Biophysics Unit (MBU), Indian Institute of Science, Bengaluru, India
| | | | - Adi Goldenzweig
- Department of BioMolecular Sciences, Weizmann Institute of Science, Rehovot, Israel
| | - Somnath Dutta
- Molecular Biophysics Unit (MBU), Indian Institute of Science, Bengaluru, India
| | | | - Raghavan Varadarajan
- Molecular Biophysics Unit (MBU), Indian Institute of Science, Bengaluru, India.,Jawaharlal Nehru Centre for Advanced Scientific Research, Jakkur, Bengaluru, India
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13
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Abstract
OBJECTIVE To analyze the patterns of care and survival of cutaneous angiosarcomas of the head and neck. STUDY DESIGN Retrospective cohort study. SETTING National Cancer Database. METHODS The National Cancer Database was queried to select patients with cutaneous angiosarcoma of the head and neck between 2004 and 2015. For survival analysis, patients were included only if they received definitive treatment and complete data. Prognostic factors were analyzed by univariate and multivariable Cox regression. RESULTS We identified 693 patients diagnosed with head and neck angiosarcomas during the study period. The majority were male (n = 489, 70.6%) and elderly (median, 77 years). A total of 421 patients (60.8%) met the criteria for survival analyses. These patients were treated with surgery and radiation (n = 178, 42.3%), surgery alone (n = 138, 32.8%), triple-modality therapy (n = 48, 11.4%), surgery and chemotherapy (n = 29, 6.9%), and chemoradiation (n = 28, 6.7%). With a median follow-up of 29 months, the 3-year survival was 50.1%. Patients undergoing surgery had better median survival than those who did not (38.1 vs 21.0 months, P = .04). Age, comorbidity, tumor size, and surgical margins were significant factors in univariate analyses. On multivariable analysis, age ≥75 years (hazard ratio, 2.65; 95% CI, 1.80-3.88; P < .001) and positive margins (hazard ratio, 1.91; 95% CI, 1.44-2.51; P < .001) predicted worse overall survival. CONCLUSION Angiosarcoma of head and neck is a rare malignancy that affects the elderly. Surgical treatment with negative margins is associated with improved survival. Even with curative-intent multimodality treatment, the survival of patients aged ≥75 years is limited.
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Affiliation(s)
- Clifford Chang
- New York University Langone Health, New York, New York, USA
| | - S Peter Wu
- New York University Langone Health, New York, New York, USA
| | - Kenneth Hu
- New York University Langone Health, New York, New York, USA
| | - Zujun Li
- New York University Langone Health, New York, New York, USA
| | | | - Jamie Oliver
- New York University Langone Health, New York, New York, USA
| | - Babak Givi
- New York University Langone Health, New York, New York, USA
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14
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Tang C, Hoffman KE, Allen PK, Gabel M, Schreiber D, Choi S, Chapin BF, Nguyen QN, Davis JW, Corn P, Logothetis C, Ward J, Frank SJ, Navai N, McGuire SE, Anscher M, Pisters L, Pettaway CA, Kumar R, Linson P, Tripuraneni P, Tomaszewski JJ, Patel AB, Augspurger M, Kuban DA. Contemporary prostate cancer treatment choices in multidisciplinary clinics referenced to national trends. Cancer 2019; 126:506-514. [PMID: 31742674 DOI: 10.1002/cncr.32570] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2019] [Revised: 07/01/2019] [Accepted: 07/02/2019] [Indexed: 11/09/2022]
Abstract
BACKGROUND The purpose of this study was to assess treatment choices among men with prostate cancer who presented at The University of Texas MD Anderson Cancer Center multidisciplinary (MultiD) clinic compared with nationwide trends. METHODS In total, 4451 men with prostate cancer who presented at the MultiD clinic from 2004 to 2016 were analyzed. To assess nationwide trends, the authors analyzed 392,710 men with prostate cancer who were diagnosed between 2004 and 2015 from the Surveillance, Epidemiology, and End Results (SEER) database. The primary endpoint was treatment choice as a function of pretreatment demographics. RESULTS Univariate analyses revealed similar treatment trends in the MultiD and SEER cohorts. The use of procedural forms of definitive therapy decreased with age, including brachytherapy and prostatectomy (all P < .05). Later year of diagnosis/clinic visit was associated with decreased use of definitive treatments, whereas higher risk grouping was associated with increased use (all P < .001). Patients with low-risk disease treated at the MultiD clinic were more likely to receive nondefinitive therapy than patients in SEER, whereas the opposite trend was observed for patients with high-risk disease, with a substantial portion of high-risk patients in SEER not receiving definitive therapy. In the MultiD clinic, African American men with intermediate-risk and high-risk disease were more likely to receive definitive therapy than white men, but for SEER the opposite was true. CONCLUSIONS Presentation at a MultiD clinic facilitates the appropriate disposition of patients with low-risk disease to nondefinitive strategies of patients with high-risk disease to definitive treatment, and it may obviate the influence of race.
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Affiliation(s)
- Chad Tang
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Karen E Hoffman
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Pamela K Allen
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Molly Gabel
- Department of Radiation Oncology, Summit Medical Group, Summit, New Jersey
| | - David Schreiber
- Department of Radiation Oncology, Summit Medical Group, Summit, New Jersey
| | - Seungtaek Choi
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Brian F Chapin
- Department of Urology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Quynh-Nhu Nguyen
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - John W Davis
- Department of Urology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Paul Corn
- Department of genitourinary medical oncology, The University of Texas MD Anderson cancer center, Houston, Texas
| | - Christopher Logothetis
- Department of genitourinary medical oncology, The University of Texas MD Anderson cancer center, Houston, Texas
| | - John Ward
- Department of Urology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Steven J Frank
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Neema Navai
- Department of Urology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Sean E McGuire
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Mitchell Anscher
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Louis Pisters
- Department of Urology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Curtis A Pettaway
- Department of Urology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | | | - Patrick Linson
- Scripps MD Anderson Cancer Center, San Diego, California
| | | | | | | | | | - Deborah A Kuban
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas
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15
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Lee A, Malakhov N, Albert A, Lederman A, Safdieh J, Schreiber D. Patterns of Care and Outcomes of Adjuvant Chemoradiation for Node-Positive Pancreatic Adenocarcinoma. Int J Radiat Oncol Biol Phys 2019. [DOI: 10.1016/j.ijrobp.2019.06.2015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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16
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Kavi A, Lee A, Lederman A, Sheth N, Safdieh J, Schreiber D. Patterns of Care and Comparison of Outcomes between Patients with Inflammatory Breast Cancer Who Were Treated with Standard versus Dose-Escalated Adjuvant Radiation Therapy. Int J Radiat Oncol Biol Phys 2019. [DOI: 10.1016/j.ijrobp.2019.06.624] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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17
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Youssef I, Osborn V, Lee A, Katsoulakis E, Kavi A, Choi K, Safdieh J, Schreiber D. Survival benefits and predictors of use of chemoradiation compared with radiation alone for early stage (T1-T2N0) anal squamous cell carcinoma. J Gastrointest Oncol 2019; 10:616-622. [PMID: 31392041 DOI: 10.21037/jgo.2019.02.06] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Background Standard of care treatment for anal squamous cell carcinoma (SCC) is concurrent chemoradiation (CRT). However, the necessity of CRT over radiation alone for T1-2N0 disease is less certain. Methods The National Cancer Database (NCDB) was queried to identify patients who received CRT, defined as initiation of chemo and RT within 14 days of each other, or RT alone (without any chemo during initial treatment phase) for cT1-2N0M0 SCC of the anus. The cohort was limited to patients less than 70 years old with Charlson-Deyo Comorbidity Index of 0, receiving a radiation dose range of 4,500-5,940 cGy. Univariable and multivariable logistic regression were performed to assess for predictors of CRT usage. Five-year overall survival (OS) was analyzed using the Kaplan-Meier method with the log rank test both for the full cohort and then on the subsets of T1 and T2 patients. Results We identified 4,564 patients, of whom 4,371 (95.8%) received CRT and 193 (4.2%) received RT alone. Median follow up was 49.8 months. About 33.5% of patients had cT1N0 disease, while 66.5% of patients had cT2N0 disease. On multivariable logistic regression, patients were more likely to receive CRT if they had T2 disease [OR 2.318 (1.732-3.102), P<0.0001]. Five-year OS was 86.6% for CRT and 79.1% for RT (P=0.001). For T1 patients, 5-year OS was 90.3% with CRT and 84.7% with RT (P=0.114). For T2 patients, 5-year OS was 84.7% with CRT and 72.8% with RT (P<0.0001). Multivariable Cox regression analysis confirmed association between OS and CRT use [HR 0.588 (95% CI: 0.430-0.804), P=0.001]. Conclusions The vast majority of patients under age 70 without significant comorbidities are treated with CRT over radiation alone for early stage anal SCC, with better survival associated with CRT.
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Affiliation(s)
- Irini Youssef
- SUNY Downstate Medical Center, Brooklyn, NY, USA.,Department of Veterans Affairs, New York Harbor Healthcare System, Brooklyn, NY, USA
| | - Virginia Osborn
- Mount Sinai Elmhurst Faculty Practice Group, Queens, NY, USA
| | - Anna Lee
- SUNY Downstate Medical Center, Brooklyn, NY, USA.,Department of Veterans Affairs, New York Harbor Healthcare System, Brooklyn, NY, USA
| | - Evangelia Katsoulakis
- Department of Veterans Affairs, James A. Haley Veterans' Hospital, Tampa, Florida, USA
| | - Ami Kavi
- SUNY Downstate Medical Center, Brooklyn, NY, USA.,Department of Veterans Affairs, New York Harbor Healthcare System, Brooklyn, NY, USA
| | - Kwang Choi
- SUNY Downstate Medical Center, Brooklyn, NY, USA
| | | | - David Schreiber
- Summit Medical Group MD Anderson Cancer Center, Florham Park, NJ, USA
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18
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Lee A, Albert A, Sheth N, Adedoyin P, Rowley J, Schreiber D. Patterns of care and outcomes of intensity modulated radiation therapy versus three-dimensional conformal radiation therapy for anal cancer. J Gastrointest Oncol 2019; 10:623-631. [PMID: 31392042 DOI: 10.21037/jgo.2019.02.12] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Background Definitive chemoradiation is the standard of care for anal squamous cell carcinoma. Compared to three-dimensional conformal radiation therapy (3DCRT), intensity modulated radiation therapy (IMRT) is increasingly becoming the preferred technique in order to reduce treatment related toxicity. The objective of this study is to evaluate practice patterns and total radiation treatment times of two radiation modalities. Methods A total of 6,966 patients with non-metastatic squamous cell carcinoma of the anus who received definitive chemoradiation were queried from the National Cancer Database (NCDB) from 2004-2013. Logistic regression was performed to assess for predictors of IMRT receipt. The Kaplan-Meier method and multivariable Cox regression analysis was used to assess overall survival (OS). Results In total, 3,868 (55.5%) received 3DCRT and 3,098 (44.5%) received IMRT. Total radiation treatment time was <7 weeks for 54.3% of patients treated with 3DCRT versus 63.8% of patients treated with IMRT. On multivariable logistic regression, positive clinical nodes (OR =1.20, P=0.001) and treatment at an academic facility (OR =1.23, P<0.001) were associated with increased likelihood of receiving IMRT. The 5-year OS was 73.0% for 3DCRT and 73.9% for IMRT (P=0.315). On multivariable analysis, total radiation treatment time ≥7 weeks (HR =1.33, P<0.001) was associated with worse survival while radiation modality (3DCRT vs. IMRT) did not impact survival (HR =0.98, P=0.763). Conclusions IMRT has dramatically increased in utilization from 2% to 65% during the study time period. IMRT was less likely than 3DCRT to have prolonged radiation treatment times, which was associated with worse survival.
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Affiliation(s)
- Anna Lee
- Department of Radiation Oncology, SUNY Downstate Medical Center, Brooklyn, NY, USA.,Department of Veterans Affairs, New York Harbor Healthcare System, Brooklyn, NY, USA
| | - Ashley Albert
- Department of Radiation Oncology, University of Mississippi Medical Center, Jackson, MS, USA
| | - Niki Sheth
- Department of Radiation Oncology, SUNY Downstate Medical Center, Brooklyn, NY, USA.,Department of Veterans Affairs, New York Harbor Healthcare System, Brooklyn, NY, USA
| | - Paul Adedoyin
- Department of Radiation Oncology, SUNY Downstate Medical Center, Brooklyn, NY, USA.,Department of Veterans Affairs, New York Harbor Healthcare System, Brooklyn, NY, USA
| | - Jared Rowley
- Department of Radiation Oncology, SUNY Downstate Medical Center, Brooklyn, NY, USA.,Department of Veterans Affairs, New York Harbor Healthcare System, Brooklyn, NY, USA
| | - David Schreiber
- Department of Radiation Oncology, SUNY Downstate Medical Center, Brooklyn, NY, USA.,Summit Medical Group MD Anderson Cancer Center, Berkeley Heights, NJ, USA
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19
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Abstract
PURPOSE Anal mucosal melanoma is an uncommon malignancy of the anal canal, with few large studies available to establish clear trends in the treatment modalities presently available. The primary goal of this study was to identify the patterns of care in the treatment of anal melanoma and secondarily to determine outcomes. METHODS This was a retrospective study performed utilizing the National Cancer Database (NCDB). A total of 787 patients diagnosed with anal melanoma between 2004 and 2014 were selected, of which 398 had staging information. The four treatment groups analyzed were surgical excision alone, surgical excision and radiation therapy, surgical excision and immunotherapy/chemotherapy, and radiation therapy plus minus immunotherapy/chemotherapy. Treatment was grouped by extent of disease; the Kaplan-Meier method was used to analyze overall survival and multivariate Cox proportional model was used to identify factors associated with overall survival. RESULTS The majority of patients presented with either node-positive (39.4%) or metastatic disease (37.4%). Patients with surgical excision and radiation therapy had the highest median survival at 32.3 months. This is in contrast with those receiving surgical excision alone (22.9 months), surgery and immunotherapy/chemotherapy (18.4 months), and radiation without surgery (5.1 months) (p < 0.0001). CONCLUSIONS Treatment with surgical excision was the most common initial treatment with no single modality superior over another in this rare entity.
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Affiliation(s)
- Jaffer Naqvi
- Department of Radiation Oncology, SUNY Downstate Medical Center, 450 Clarkson Avenue, Mail Stop #1211, Brooklyn, NY, 11203, USA
| | - Anna Lee
- Department of Radiation Oncology, SUNY Downstate Medical Center, 450 Clarkson Avenue, Mail Stop #1211, Brooklyn, NY, 11203, USA.
- Department of Veterans Affairs, New York Harbor Healthcare System, Brooklyn, NY, USA.
| | - Ariel Lederman
- Department of Radiation Oncology, SUNY Downstate Medical Center, 450 Clarkson Avenue, Mail Stop #1211, Brooklyn, NY, 11203, USA
- Department of Veterans Affairs, New York Harbor Healthcare System, Brooklyn, NY, USA
| | - Ami Kavi
- Department of Radiation Oncology, SUNY Downstate Medical Center, 450 Clarkson Avenue, Mail Stop #1211, Brooklyn, NY, 11203, USA
- Department of Veterans Affairs, New York Harbor Healthcare System, Brooklyn, NY, USA
| | - Virginia W Osborn
- Department of Radiation Oncology, Elmhurst Hospital Center, Queens, NY, USA
| | - David Schreiber
- Department of Radiation Oncology, SUNY Downstate Medical Center, 450 Clarkson Avenue, Mail Stop #1211, Brooklyn, NY, 11203, USA
- Summit Medical Group, Berkeley Heights, NJ, USA
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20
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Oliver JR, Wu SP, Chang CM, Roden DF, Wang B, Hu KS, Schreiber D, Givi B. Survival of oral tongue squamous cell carcinoma in young adults. Head Neck 2019; 41:2960-2968. [DOI: 10.1002/hed.25772] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2018] [Revised: 03/02/2019] [Accepted: 04/02/2019] [Indexed: 01/09/2023] Open
Affiliation(s)
- Jamie R. Oliver
- Department of Otolaryngology, NYU School of Medicine New York New York
| | - S. Peter Wu
- Department of Radiation OncologyNYU Langone Health New York New York
| | - Clifford M. Chang
- Department of Otolaryngology, NYU School of Medicine New York New York
| | - Dylan F. Roden
- Department of OtolaryngologyThomas Jefferson University Philadelphia Pennsylvania
| | - Binhuan Wang
- Department of Population HealthNYU Langone Health New York New York
| | - Kenneth S. Hu
- Department of Radiation OncologyNYU Langone Health New York New York
| | - David Schreiber
- Department of Radiation OncologySUNY Downstate Medical Center Brooklyn New York
| | - Babak Givi
- Department of OtolaryngologyNYU Langone Health New York New York
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21
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Liati A, Schreiber D, Alpert PA, Liao Y, Brem BT, Corral Arroyo P, Hu J, Jonsdottir HR, Ammann M, Dimopoulos Eggenschwiler P. Aircraft soot from conventional fuels and biofuels during ground idle and climb-out conditions: Electron microscopy and X-ray micro-spectroscopy. Environ Pollut 2019; 247:658-667. [PMID: 30711821 DOI: 10.1016/j.envpol.2019.01.078] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/14/2018] [Revised: 01/17/2019] [Accepted: 01/21/2019] [Indexed: 05/20/2023]
Abstract
Aircraft soot has a significant impact on global and local air pollution and is of particular concern for the population working at airports and living nearby. The morphology and chemistry of soot are related to its reactivity and depend mainly on engine operating conditions and fuel-type. We investigated the morphology (by transmission electron microscopy) and chemistry (by X-ray micro-spectroscopy) of soot from the exhaust of a CFM 56-7B26 turbofan engine, currently the most common engine in aviation fleet, operated in the test cell of SR Technics, Zurich airport. Standard kerosene (Jet A-1) and a biofuel blend (Jet A-1 with 32% HEFA) were used at ground idle and climb-out engine thrust, as these conditions highly influence air quality at airport areas. The results indicate that soot reactivity decreases from ground idle to climb-out conditions for both fuel types. Nearly one third of the primary soot particles generated by the blended fuel at climb-out engine thrust bear an outer amorphous shell implying higher reactivity. This characteristic referring to soot reactivity needs to be taken into account when evaluating the advantage of HEFA blending at high engine thrust. The soot type that is most prone to react with its surrounding is generated by Jet A-1 fuel at ground idle. Biofuel blending slightly lowers soot reactivity at ground idle but does the opposite at climb-out conditions. As far as soot reactivity is concerned, biofuels can prove beneficial for airports where ground idle is a common situation; the benefit of biofuels for climb-out conditions is uncertain.
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Affiliation(s)
- A Liati
- Empa, Swiss Federal Laboratories for Materials Science and Technology, Automotive Powertrain Technologies Laboratory, CH-8600, Dübendorf, Switzerland.
| | - D Schreiber
- Empa, Swiss Federal Laboratories for Materials Science and Technology, Automotive Powertrain Technologies Laboratory, CH-8600, Dübendorf, Switzerland
| | - P A Alpert
- PSI, Paul Scherrer Institute, Laboratory of Environmental Chemistry, CH-5232, Villigen, Switzerland
| | - Y Liao
- Empa, Swiss Federal Laboratories for Materials Science and Technology, Automotive Powertrain Technologies Laboratory, CH-8600, Dübendorf, Switzerland
| | - B T Brem
- Empa, Swiss Federal Laboratories for Materials Science and Technology, Laboratory for Advanced Analytical Technologies, CH-8600, Dübendorf, Switzerland
| | - P Corral Arroyo
- PSI, Paul Scherrer Institute, Laboratory of Environmental Chemistry, CH-5232, Villigen, Switzerland
| | - J Hu
- Empa, Swiss Federal Laboratories for Materials Science and Technology, Automotive Powertrain Technologies Laboratory, CH-8600, Dübendorf, Switzerland
| | - H R Jonsdottir
- University of Bern, Institute of Anatomy, CH-3012, Bern, Switzerland
| | - M Ammann
- PSI, Paul Scherrer Institute, Laboratory of Environmental Chemistry, CH-5232, Villigen, Switzerland
| | - P Dimopoulos Eggenschwiler
- Empa, Swiss Federal Laboratories for Materials Science and Technology, Automotive Powertrain Technologies Laboratory, CH-8600, Dübendorf, Switzerland
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22
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Oliver J, Wu P, Chang C, Roden D, Wang B, Liu C, Hu K, Schreiber D, Givi B. Patterns of Care and Outcome of Clear Cell Carcinoma of the Head and Neck. Otolaryngol Head Neck Surg 2019; 161:98-104. [PMID: 30857486 DOI: 10.1177/0194599819835779] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
OBJECTIVE Clear cell carcinoma (CCC) is a rare salivary gland malignancy, believed to be generally low grade. We investigated CCC epidemiology and clinical behavior, using the National Cancer Database (NCDB). STUDY DESIGN Retrospective cohort study. SETTING NCDB. SUBJECTS AND METHODS All CCCs of the salivary glands were selected between 2004 and 2015. Patient demographics, tumor characteristics, treatments, and survival were analyzed. Cox regression analyses were performed in treated patients. RESULTS We identified 268 patients with CCC. Median age was 61 (21-90) years. Most were female (145, 54%). The most common site was oral cavity (119, 44%), followed by major salivary glands (68, 25%) and oropharynx (41, 15%). Most tumors were low grade (81, 68%) and stages I to II (117, 60.6%). Nodal (36, 17.5%) and distant metastases (6, 2.4%) were rare. Most were treated by surgery alone (134, 50.0%), followed by surgery and radiotherapy (69, 25.7%). Five-year overall survival (OS) was 77.6% (95% CI, 71.4%-84.2%). In univariate analysis, older age, major salivary gland and sinonasal site, stages III to IV, high grade, and positive margins were associated with worse OS. In multivariate analysis, only high tumor grade (hazard ratio [HR], 5.76; 95% CI, 1.39-23.85; P = .02), positive margins (HR, 4.01; 95% CI, 1.20-13.43; P = .02), and age ≥60 years (HR, 3.45; 95% CI, 1.39-8.55; P = .01) were significantly associated with OS. CONCLUSION We report the largest series of clear cell carcinomas of the head and neck. Outcomes are generally favorable following surgical-based treatments. In this series, pathologic tumor grade is associated with worse survival. Routine evaluation and reporting of tumor grade might better guide physicians in recommending appropriate treatments in this rare malignancy.
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Affiliation(s)
- Jamie Oliver
- 1 New York University School of Medicine, New York, New York, USA
| | - Peter Wu
- 2 Department of Radiation Oncology, NYU Langone Health, New York, New York, USA
| | - Clifford Chang
- 1 New York University School of Medicine, New York, New York, USA
| | - Dylan Roden
- 3 Department of Otolaryngology, NYU Langone Health, New York, New York, USA
| | - Binhuan Wang
- 4 Department of Population Health, NYU Langone Health, New York, New York, USA
| | - Cheng Liu
- 5 Department of Pathology, NYU Langone Health, New York, New York, USA
| | - Kenneth Hu
- 2 Department of Radiation Oncology, NYU Langone Health, New York, New York, USA
| | - David Schreiber
- 6 Department of Radiation Oncology, SUNY Downstate Medical Center, Brooklyn, New York, USA
| | - Babak Givi
- 3 Department of Otolaryngology, NYU Langone Health, New York, New York, USA
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Adedoyin P, Lee A, Malakhov N, Kavi A, Sheth N, Garay E, Schreiber D. Patterns of care and outcomes of low-lying adenocarcinoma and squamous cell carcinoma of the rectum. J Clin Oncol 2019. [DOI: 10.1200/jco.2019.37.4_suppl.715] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
715 Background: To analyze the patterns of care and survival for stage I-III squamous cell (SCC) and adenocarcinoma (AC) of the rectum from 2004-2015 based on receipt of surgery alone (S), neoadjuvant chemoradiation followed by surgery (CRT+S), surgery followed by adjuvant chemoradiation (S+CRT) and definitive chemoradiation (CRT). Methods: The NCDB was explored to identify patients diagnosed with low-lying stage I-III AC and SCC of the rectum from 2004-2015 who received S, CRT+S, S+CRT or CRT. Frequency distributions between the categorical variables were compared using the Chi-square test. Overall survival data and Kaplan-Meier curves were compared via the log-rank test stratifying the groups (AC vs. SCC) by stage and treatment. Cox proportional hazards regression models were performed to assess for covariates that had an impact on survival. Results: There were 22,227 patients included in this study, from which 21,587 (97.1%) were AC and 640 (2.9%) were SCC. Median follow-up for the entire cohort was 54 months. The median RT dose for AC was 5040 cGy and for SCC 5400 cGy. 5-year OS of AC vs. SCC in the entire cohort was 61.6% vs. 56.1%, respectively (p<0.001). The OS for AC was 51.5% for S alone, 71.1% for CRT+S, 65.6% for S+CRT, and 36.2% for CRT (p<0.001). The OS for SCC was 49.2% for surgery alone, 54.2% for CRT+S, 67.1% for S+CRT, and 65.7% for CRT (p=0.227). On multivariable Cox regression for AC, patients who received CRT+S (HR 0.61, p<0.001) or S+CRT (HR 0.67, p<0.001) had improved survival compared to S alone while those who had definitive CRT (HR 1.55, p<0.001) had worse survival. Conclusions: This is the largest case series of rectal SCC in the literature to date. Analysis suggests that SCCs of the rectum are more often treated with definitive CRT but are associated with slightly worse survival than adenocarcinoma, suggesting that perhaps surgery may need an increased utilization in this disease. [Table: see text]
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Affiliation(s)
| | - Anna Lee
- Department of Radiation Oncology, SUNY Downstate Medical Center, Brooklyn, NY
| | - Nikita Malakhov
- Department of Radiation Oncology, SUNY Downstate Medical Center, Brooklyn, NY
| | - Ami Kavi
- SUNY Downstate Medical Center, Brooklyn, NY
| | - Niki Sheth
- SUNY Downstate Medical Center, Brooklyn, NY
| | - Elizabeth Garay
- Department of Radiation Oncology, SUNY Downstate Medical Center, Brooklyn, NY
| | - David Schreiber
- Department of Radiation Oncology, SUNY Downstate Medical Center, Brooklyn, NY
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24
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Garay E, Kavi A, Givi B, Lee A, Schreiber D. Patterns of Care and Outcomes in Patients with Squamous Cell Carcinoma of the Buccal Mucosa. Int J Radiat Oncol Biol Phys 2018. [DOI: 10.1016/j.ijrobp.2018.07.762] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Lee A, Tam M, Wu P, Gerber N, Lederman A, Garay E, Sheth N, Safdieh J, Choi K, Schreiber D. Patterns of Care of Adjuvant Radiation Therapy after Lumpectomy and Survival in T1N0M0 Estrogen Receptor Positive Breast Cancer. Int J Radiat Oncol Biol Phys 2018. [DOI: 10.1016/j.ijrobp.2018.07.1622] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Wu S, Yan S, Tam M, Lee A, Gerber N, Schreiber D, Schiff P, Lymberis S. Patterns of Care and Outcomes of Adjuvant Treatment in Stage II Endometrioid Carcinoma. Int J Radiat Oncol Biol Phys 2018. [DOI: 10.1016/j.ijrobp.2018.07.1776] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Kavi A, Lee A, Sheth N, Adedoyin P, Lederman A, Schreiber D. Patterns of Care and Comparison of Outcomes Between Primary Anal Squamous Cell Carcinoma and Anal Adenocarcinoma. Int J Radiat Oncol Biol Phys 2018. [DOI: 10.1016/j.ijrobp.2018.07.210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Osborn V, Garay E, Adedoyin P, Han P, Safdieh J, Schreiber D. Small Cell Carcinoma of the Anus: Patterns of Care Study Utilizing a Large Hospital-Based Database. Int J Radiat Oncol Biol Phys 2018. [DOI: 10.1016/j.ijrobp.2018.07.225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Youssef I, Osborn V, Katsoulakis E, Kavi A, Choi K, Safdieh J, Schreiber D. Patterns of Care and Outcomes for Early Stage (cT1-T2N0M0) Squamous Cell Carcinoma of the Anus. Int J Radiat Oncol Biol Phys 2018. [DOI: 10.1016/j.ijrobp.2018.07.223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Youssef I, Lee A, Garay EL, Becker DJ, Schreiber D. Patterns of care and outcomes of postoperative radiation for low-grade gliomas in United States hospitals. J Clin Neurosci 2018; 58:124-129. [PMID: 30287250 DOI: 10.1016/j.jocn.2018.09.010] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2017] [Revised: 09/03/2018] [Accepted: 09/24/2018] [Indexed: 01/30/2023]
Abstract
It is unclear whether there is a survival benefit with postoperative radiation for low-grade gliomas deemed to be high-risk. We sought to analyze patterns of care and outcomes of radiation use. We accessed the National Cancer Database to identify patients with WHO grade II oligodendroglioma or astrocytoma between 2010 and 2012. Multivariable logistic regression was used to identify predictors of radiation use and multivariable Cox regression was used to identify covariables associated with differences in survival. There were 1952 patients included in this study, of which 518 (26.5%) received postoperative radiation. The majority had oligodendroglioma histology (n = 1121, 57.4%) compared to astrocytoma (n = 831, 42.6%). There were 1626 patients who were either ≥40 years old or underwent a subtotal resection ("high-risk"), and from these 495 (30.4%) received postoperative radiation. On multivariable logistic regression treatment at an academic facility (OR 0.72) was associated with a lower likelihood of receiving postoperative radiation. Astrocytoma histology (OR 2.08), age ≥40 years (OR 2.23), tumor size ≥6 cm (OR 1.64), subtotal resection (OR 1.55), and chemotherapy use (OR 3.93) were associated with an increased likelihood of postoperative radiation. On multivariable analysis, astrocytoma histology (HR 3.49, p < 0.001) and receipt of radiation (HR 2.06, p < 0.001) were associated with worse overall survival. GTR (HR 0.51, p = 0.001) was associated with improved overall survival. Patients treated in United States hospitals are not routinely referred for postoperative radiation for high-risk, low-grade gliomas. Patients who received radiation did not do better than those who did not receive radiation.
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Affiliation(s)
- Irini Youssef
- Department of Radiation Oncology, SUNY Downstate Medical Center, Brooklyn, NY, USA
| | - Anna Lee
- Department of Radiation Oncology, SUNY Downstate Medical Center, Brooklyn, NY, USA; Department of Veterans Affairs, New York Harbor Healthcare System, Brooklyn, NY, USA.
| | - Elizabeth L Garay
- Department of Radiation Oncology, SUNY Downstate Medical Center, Brooklyn, NY, USA; Department of Veterans Affairs, New York Harbor Healthcare System, Brooklyn, NY, USA
| | - Daniel J Becker
- Department of Medicine, New York University School of Medicine, New York, NY, USA
| | - David Schreiber
- Department of Radiation Oncology, SUNY Downstate Medical Center, Brooklyn, NY, USA; Department of Veterans Affairs, New York Harbor Healthcare System, Brooklyn, NY, USA; Summit Medical Group at MD Anderson Cancer Center, Berkeley Heights, NJ, USA
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Tam M, Lee A, Wu SP, Gerber NK, Li Z, Givi B, Hu K, Schreiber D. Neoadjuvant chemotherapy in local-regionally advanced nasopharyngeal carcinoma: A National Cancer Database analysis. Laryngoscope 2018; 128:2770-2777. [DOI: 10.1002/lary.27254] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2018] [Revised: 03/19/2018] [Accepted: 04/02/2018] [Indexed: 11/10/2022]
Affiliation(s)
- Moses Tam
- Department of Radiation Oncology; New York University Langone Health; New York New York
| | - Anna Lee
- Department of Radiation Oncology; SUNY Downstate Medical Center; New York New York
| | - S. Peter Wu
- Department of Radiation Oncology; New York University Langone Health; New York New York
| | - Naamit K. Gerber
- Department of Radiation Oncology; New York University Langone Health; New York New York
| | - Zujun Li
- Department of Medical Oncology; New York University School of Medicine; New York New York
| | - Babak Givi
- Department of Otolaryngology-Head and Neck Surgery; New York University School of Medicine; New York New York
| | - Kenneth Hu
- Department of Radiation Oncology; New York University Langone Health; New York New York
| | - David Schreiber
- Summit Medical Group MD Anderson Cancer Center; Florham Park New Jersey U.S.A
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Wu SP, Tam M, Shaikh F, Lee A, Chun J, Schnabel F, Guth A, Adams S, Schreiber D, Oh C, Gerber NK. Post-mastectomy Radiation Therapy in Breast Cancer Patients with Nodal Micrometastases. Ann Surg Oncol 2018; 25:2620-2631. [DOI: 10.1245/s10434-018-6632-1] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2018] [Indexed: 11/18/2022]
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Albert A, Lee A, Vijayakumar S, Kanakamedala M, Allbright R, Schreiber D. Adjuvant treatment of meningioma with stereotactic radiation surgery and hypofractionated stereotactic radiation surgery: Patterns of care and survival in a large, hospital database. Adv Radiat Oncol 2018; 3:280-287. [PMID: 30202797 PMCID: PMC6128035 DOI: 10.1016/j.adro.2018.04.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2018] [Revised: 04/13/2018] [Accepted: 04/16/2018] [Indexed: 01/30/2023] Open
Abstract
OBJECTIVES Stereotactic radiation surgery (SRS) and hypofractionated stereotactic radiation surgery (HF-SRS) have become an alternative to external beam radiation therapy (EBRT) in the adjuvant treatment of meningiomas. The purpose of this study was to identify national treatment patterns and survival outcomes for meningiomas on the basis of radiation treatment modality in the adjuvant setting. METHODS AND MATERIALS The National Cancer Database was queried for patients with meningioma diagnosed between 2010 and 2012. World Health Organization grade I disease with subtotal resection and all cases of grade II disease regardless of the extent of the resection were included. Logistic regression was used to determine factors that were associated with receipt of SRS/HF-SRS compared with EBRT. Cox regression was used to determine covariables associated with differences in overall survival (OS). RESULTS A total of 802 patients met the inclusion criteria of which 173 patients received SRS/HF-SRS (22%) and 629 patients (78%) received EBRT. The 3-year OS rate was 97.3% for the SRS/HF-SRS group and 93.4% for the EBRT group (P = .018). On subgroup analysis by grade, for grade I the 3-year OS rate was 98.3% for the SRS/HF-SRS group versus 96.7% for the EBRT group (P = .117). For grade II disease, the 3-year OS rate was 94.4% in the SRS/HF-SRS group versus 92.4% in the EBRT group (P = .199). On multivariable analysis, World Health Organization grade II histology (odds ratio [OR]: 0.34; 95% confidence interval [CI], 0.21-0.56; P < .001) and gross total resection (OR: 0.29; 95% CI, 0.15-0.57; P < .001) were associated with a decreased likelihood of receiving SRS/HF-SRS but private insurance (OR: 8.89; 95% CI, 1.15-68.47; P = .036) and Medicare (OR: 10.03; 95% CI, 1.28-78.69; P = .028) were associated with an increased likelihood of receiving SRS/HF-SRS. Year of diagnosis was not associated with receipt of SRS/HF-SRS. The multivariable Cox regression demonstrated a trend toward improved OS for treatment with SRS/HF-SRS (hazard ratio: 0.24; 95% CI, 0.06-1.03; P = .055). CONCLUSIONS SRS and HF-SRS are associated with similar survival as EBRT; however, SRS/HF-SRS is used infrequently and usage has not increased over time.
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Affiliation(s)
- Ashley Albert
- Department of Radiation Oncology, University of Mississippi Medical Center, Jackson, Mississippi
| | - Anna Lee
- Department of Radiation Oncology, SUNY Downstate Medical Center, Brooklyn, New York
- Department of Veterans Affairs, New York Harbor Healthcare System, Brooklyn, New York
| | - Srinivasan Vijayakumar
- Department of Radiation Oncology, University of Mississippi Medical Center, Jackson, Mississippi
| | - Madhava Kanakamedala
- Department of Radiation Oncology, University of Mississippi Medical Center, Jackson, Mississippi
| | - Robert Allbright
- Department of Radiation Oncology, University of Mississippi Medical Center, Jackson, Mississippi
| | - David Schreiber
- Department of Radiation Oncology, SUNY Downstate Medical Center, Brooklyn, New York
- Summit Medical Group at MD Anderson Cancer Center, Berkeley Heights, New Jersey
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Sheth N, Youssef I, Osborn V, Lee A, Safdieh J, Schreiber D. Association of Nadir Prostate-specific Antigen >0.5 ng/mL after Dose-escalated External Beam Radiation with Prostate Cancer-specific Endpoints. Cureus 2018; 10:e2790. [PMID: 30112266 PMCID: PMC6089484 DOI: 10.7759/cureus.2790] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Objective Prior studies have suggested that prostate-specific antigen (PSA) nadir of 0.5 ng/mL is an important surrogate endpoint for prostate cancer-specific and all-cause mortality. This study analyzed our well-followed patient cohort to assess whether this endpoint was associated with differences in prostate cancer-specific endpoints in patients receiving dose-escalated radiation. Methods Patients with intermediate- or high-risk prostate cancer (≥T2b, or prostate-specific antigen >10 ng/mL, or Gleason score ≥7) who were treated with external beam radiation to a minimum dose of 7560 cGy +/- androgen deprivation between 2003 and 2011 were identified. Biochemical control, distant metastasis-free survival (DMFS), prostate cancer-specific survival (PCSS), and overall survival (OS) were compared between those who achieved a nadir PSA ≤0.5 ng/mL with those who did not via Kaplan-Meier analysis. Univariable and multivariable Cox regression was performed on all endpoints to assess their impact on OS. Results There were 367 patients identified with a median follow-up of 99.5 months. Two hundred five patients (55.9%) received androgen deprivation for a median of 24 months (range 1-81 months). Most patients (n = 308, 83.9%) achieved a nadir PSA ≤0.5 ng/mL, which was associated with improvement across all endpoints at 10 years. This included biochemical control (68.0% versus 24.0%, p < 0.001), DMFS (89.6% versus 80.8%, p = 0.019), PCSS (91.1% versus 85.7%, p = 0.01), and OS (55.7% versus 45.8%, p = 0.048). On multivariable analysis, nadir PSA >0.5 ng/mL remained strongly associated with worse outcomes across all endpoints. Conclusions Achievement of nadir PSA ≤0.5 ng/mL after completion of dose-escalated radiation therapy was associated with improvement of all prostate cancer endpoints.
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Malakhov N, Lee A, Garay E, Becker DJ, Schreiber D. Patterns of care and outcomes for glioblastoma in patients with poor performance status. J Clin Neurosci 2018; 52:66-70. [DOI: 10.1016/j.jocn.2018.03.006] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2018] [Accepted: 03/11/2018] [Indexed: 11/15/2022]
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Tam M, Lee A, Wu SP, Gerber NK, Givi B, Hu K, Schreiber D. (P32) Neoadjuvant Chemotherapy in Locally Advanced Nasopharyngeal Carcinoma: A National Cancer Database Analysis. Int J Radiat Oncol Biol Phys 2018. [DOI: 10.1016/j.ijrobp.2018.02.120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Malakhov N, Lee A, Garay E, Becker DJ, Schreiber D. Patterns of care and outcomes for glioblastoma in patients with poor performance status. J Clin Oncol 2018. [DOI: 10.1200/jco.2018.36.15_suppl.e14093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- Nikita Malakhov
- Department of Radiation Oncology, SUNY Downstate Medical Center, Brooklyn, NY
| | - Anna Lee
- Department of Radiation Oncology, SUNY Downstate Medical Center, Brooklyn, NY
| | - Elizabeth Garay
- Department of Radiation Oncology, SUNY Downstate Medical Center, Brooklyn, NY
| | | | - David Schreiber
- Department of Radiation Oncology, SUNY Downstate Medical Center, Brooklyn, NY
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Kukunoor S, Lee A, Taiwo EO, Schreiber D, Luhrs CA. Survival of metastatic metaplastic breast cancer patients receiving chemotherapy. J Clin Oncol 2018. [DOI: 10.1200/jco.2018.36.15_suppl.e13126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
| | - Anna Lee
- Department of Radiation Oncology, SUNY Downstate Medical Center, Brooklyn, NY
| | | | - David Schreiber
- Department of Radiation Oncology, SUNY Downstate Medical Center, Brooklyn, NY
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Ravyts S, Dzierzewski J, Schreiber D, Grah S, Perez E, Raldiris T. 0908 Avoidant Coping As A Mediator Of The Sleep-Pain Relationship In Mid- To Late-life. Sleep 2018. [DOI: 10.1093/sleep/zsy061.907] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- S Ravyts
- Virginia Commonwealth University, Richmond, VA
| | | | - D Schreiber
- Virginia Commonwealth University, Richmond, VA
| | - S Grah
- Virginia Commonwealth University, Richmond, VA
| | - E Perez
- Virginia Commonwealth University, Richmond, VA
| | - T Raldiris
- Virginia Commonwealth University, Richmond, VA
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40
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Imel JL, MacPherson A, Schreiber D, Lisech A, Dautovich N. 0283 Perceived Control Over One’s Health: Linking Dispositional Mindfulness and Sleep Outcomes. Sleep 2018. [DOI: 10.1093/sleep/zsy061.282] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- J L Imel
- Virginia Commonwealth University, Richmond, VA
| | | | - D Schreiber
- Virginia Commonwealth University, Richmond, VA
| | - A Lisech
- Virginia Commonwealth University, Richmond, VA
| | - N Dautovich
- Virginia Commonwealth University, Richmond, VA
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41
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MacPherson AR, Schreiber D, Imel JL, Dautovich ND. 0728 Sleep Timing, Not Sleep Duration, Predicts Breakfast Intake. Sleep 2018. [DOI: 10.1093/sleep/zsy061.727] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
| | - D Schreiber
- Virginia Commonwealth University, Richmond, VA
| | - J L Imel
- Virginia Commonwealth University, Richmond, VA
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Abstract
BACKGROUND Although outcomes for patients with squamous cell carcinoma of the anus (SCCA) have improved, the gains in benefit may not be shared uniformly among patients of disparate socioeconomic status. In the current study, the authors investigated whether area-based median household income (MHI) is predictive of survival among patients with SCCA. METHODS Patients diagnosed with SCCA from 2004 through 2013 in the Surveillance, Epidemiology, and End Results registry were included. Socioeconomic status was defined by census-tract MHI level and divided into quintiles. Multivariable Cox proportional hazards models and logistic regression were used to study predictors of survival and radiotherapy receipt. RESULTS A total of 9550 cases of SCCA were included. The median age of the patients was 58 years, 63% were female, 85% were white, and 38% were married. In multivariable analyses, patients living in areas with lower MHI were found to have worse overall survival and cancer-specific survival (CSS) compared with those in the highest income areas. Mortality hazard ratios for lowest to highest income were 1.32 (95% confidence interval [95% CI], 1.18-1.49), 1.31 (95% CI, 1.16-1.48), 1.19 (95% CI, 1.06-1.34), and 1.16 (95% CI, 1.03-1.30). The hazard ratios for CSS similarly ranged from 1.34 to 1.22 for lowest to highest income. Older age, black race, male sex, unmarried marital status, an earlier year of diagnosis, higher tumor grade, and later American Joint Committee on Cancer stage of disease also were associated with worse CSS. Income was not found to be associated with the odds of initiating radiotherapy in multivariable analysis (odds ratio of 0.87 for lowest to highest income level; 95% CI, 0.63-1.20). CONCLUSIONS MHI appears to independently predict CSS and overall survival in patients with SCCA. Black race was found to remain a predictor of SCCA survival despite controlling for income. Further study is needed to understand the mechanisms by which socioeconomic inequalities affect cancer care and outcomes. Cancer 2018;124:1791-7. © 2018 American Cancer Society.
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Affiliation(s)
- Daniel Lin
- Perlmutter Cancer Center, NYU Langone Medical Center, New York, New York
| | - Heather T Gold
- Perlmutter Cancer Center, NYU Langone Medical Center, New York, New York.,Department of Population Health, New York University School of Medicine, New York, New York
| | - David Schreiber
- Department of Radiation Oncology, State University of New York Downstate Medical Center, Brooklyn, New York
| | - Lawrence P Leichman
- Moores Cancer Center, University of California at San Diego, San Diego, California
| | - Scott E Sherman
- Department of Medicine, Veterans Affairs New York Harbor Healthcare System, New York, New York
| | - Daniel J Becker
- Perlmutter Cancer Center, NYU Langone Medical Center, New York, New York.,Department of Medicine, Veterans Affairs New York Harbor Healthcare System, New York, New York
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Tam M, Wu SP, Gerber NK, Lee A, Schreiber D, Givi B, Hu K. The impact of adjuvant chemoradiotherapy timing on survival of head and neck cancers. Laryngoscope 2018; 128:2326-2332. [PMID: 29481712 DOI: 10.1002/lary.27152] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2018] [Accepted: 01/31/2018] [Indexed: 11/11/2022]
Abstract
BACKGROUND Delays in postoperative head and neck (HN) radiotherapy have been associated with decreased overall survival; however, the impact of delays in postoperative HN chemoradiotherapy remains undefined. METHODS All patients with nonmetastatic HN cancer (oral cavity, oropharynx, larynx, hypopharynx) who underwent curative intent surgery and received adjuvant chemoradiotherapy were identified from the National Cancer Database (2005-2012). Overall treatment time (OTT) was defined as the time from surgery to the end of radiation therapy. Statistical methods included Cox proportional hazards modeling, which adjusted for clinicopathologic, demographic, and socioeconomic factors. Recursive partitioning analysis (RPA) identified the optimal threshold of OTT via conditional inference trees to estimate the greatest differences in overall survival (OS) on the basis of randomly selected training and validation sets. RESULTS A total of 16,733 patients were included, with a median follow-up of 37 months. Median OS for OTT in a predefined threshold of ≤ 13 weeks was 10.1 years (95% confidence interval [CI], 9.8 years; not reached) compared with 8.7 years (95% CI, 8.2-9.2 years) in > 13 weeks. On multivariate analysis, OTT of > 13 weeks versus ≤ 13 weeks independently increased mortality risk (hazard ratio, 1.10; 95% CI, 1.04-1.17; P = < 0.001). RPA identified an optimal OTT threshold of 97 days (interquartile range: 96-98 days). The OTT threshold of 97 days was confirmed in a full Cox regression model estimating the risk of death according to overall treatment time as a continuous variable. CONCLUSION In this large hospital-based national data, an OTT of greater than approximately 14 weeks most consistently increased the risk of death. LEVEL OF EVIDENCE 4. Laryngoscope, 128:2326-2332, 2018.
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Affiliation(s)
- Moses Tam
- Department of Radiation Oncology, New York University Langone Health, New York, U.S.A
| | - S Peter Wu
- Department of Radiation Oncology, New York University Langone Health, New York, U.S.A
| | - Naamit K Gerber
- Department of Radiation Oncology, New York University Langone Health, New York, U.S.A
| | - Anna Lee
- Department of Radiation Oncology, SUNY Downstate Medical Center, New York, U.S.A
| | - David Schreiber
- Veterans Affairs NY Harbor Healthcare System, Brooklyn, New York, U.S.A
| | - Babak Givi
- Department of Otolaryngology-Head and Neck Surgery, New York University School of Medicine, New York, U.S.A
| | - Kenneth Hu
- Department of Radiation Oncology, New York University Langone Health, New York, U.S.A
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Lee A, Youssef I, Osborn VW, Safdieh J, Becker DJ, Schreiber D. The utilization of MGMT promoter methylation testing in United States hospitals for glioblastoma and its impact on prognosis. J Clin Neurosci 2018; 51:85-90. [PMID: 29483008 DOI: 10.1016/j.jocn.2018.02.009] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2017] [Revised: 12/26/2017] [Accepted: 02/04/2018] [Indexed: 10/18/2022]
Abstract
Multiple studies have identified O6-methylguanine-DNA methyltransferase (MGMT) promoter methylation status to be an important prognostic factor in glioblastoma (GBM). We used the National Cancer Data Base (NCDB) to analyze completeness of coding for MGMT as well as to compare outcomes of GBM patients treated with adjuvant chemoradiation based on MGMT promoter methylation status (positive, negative, unknown). Patients diagnosed with GBM from 2010 to 2012 who received adjuvant chemoradiation were identified. MGMT promoter methylation status was obtained. The Kaplan-Meier method was used to assess overall survival (OS) by coding status of MGMT promoter methylation (positive, negative, unknown) and Cox regression analysis was used to assess impact of covariables on OS. There were 12,725 patients who met the study criteria, of which 626 (4.9%) were MGMT+, 1,037 (8.1%) were MGMT- and 11.062 (86.9%) were coded as unknown/not coded. Treatment at academic centers was strongly associated with MGMT promoter status testing (OR 2.23, p < 0.001), as well as hospital facility within the Northeast (OR 1.55, p < 0.001). The median and 2-year OS was 20 months and 40.2% for MGMT+ compared to 15 months and 24.1% for MGMT-, respectively (p < 0.001). For those coded as MGMT unknown, median and 2-year OS was 14.6 months and 27.5%, which was significantly worse compared to MGMT+ (p < 0.001) but not compared to MGMT- (p = 0.78). On multivariable analysis, MGMT+ was strongly associated with improved OS (HR 0.74, p < 0.001). Despite convincing evidence that MGMT promoter methylation status has a strong influence on prognosis; it appears to be a highly underutilized test in United States hospitals.
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Affiliation(s)
- Anna Lee
- Department of Radiation Oncology, SUNY Downstate Medical Center, Brooklyn, NY, USA; Department of Veterans Affairs, New York Harbor Healthcare System, Brooklyn, NY, USA.
| | - Irini Youssef
- Department of Radiation Oncology, SUNY Downstate Medical Center, Brooklyn, NY, USA
| | - Virginia W Osborn
- Department of Radiation Oncology, SUNY Downstate Medical Center, Brooklyn, NY, USA; Department of Veterans Affairs, New York Harbor Healthcare System, Brooklyn, NY, USA
| | - Joseph Safdieh
- Department of Radiation Oncology, SUNY Downstate Medical Center, Brooklyn, NY, USA; Department of Veterans Affairs, New York Harbor Healthcare System, Brooklyn, NY, USA
| | - Daniel J Becker
- Department of Veterans Affairs, New York Harbor Healthcare System, Brooklyn, NY, USA; Department of Medicine, New York University School of Medicine, New York, NY, USA
| | - David Schreiber
- Department of Radiation Oncology, SUNY Downstate Medical Center, Brooklyn, NY, USA; Department of Veterans Affairs, New York Harbor Healthcare System, Brooklyn, NY, USA
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Osborn VW, Givi B, Rineer J, Roden D, Sheth N, Lederman A, Katsoulakis E, Hu K, Schreiber D. Patterns of care and outcomes of adjuvant therapy for high-risk head and neck cancer after surgery. Head Neck 2018; 40:1254-1262. [PMID: 29451961 DOI: 10.1002/hed.25103] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2017] [Revised: 10/20/2017] [Accepted: 01/18/2018] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Postoperative chemoradiotherapy (CRT) is considered standard of care in patients with locally advanced head and neck cancer with positive margins and/or extracapsular extension (ECE). METHODS The National Cancer Data Base (NCDB) was queried to identify patients with squamous cell carcinoma of the head and neck with stages III to IVB disease or with positive margins and/or ECE diagnosed between 2004 and 2012 receiving postoperative radiotherapy (RT). Using univariable and multivariable logistic and Cox regression, we assessed for predictors of CRT use and covariables impacting overall survival (OS), including in a propensity-matched subset. RESULTS Of 12 224 patients, 67.1% with positive margins and/or ECE received CRT as well as 54.0% without positive margins and/or ECE. The 5-year OS was 61.6% for RT alone versus 67.4% for CRT. In the propensity-matched cohort, OS benefit persisted with CRT, including in a subset with positive margins and/or ECE but not without. CONCLUSION Postoperative CRT seems underutilized with positive margins and/or ECE and overutilized without positive margins and/or ECE. The CRT was associated with improved OS but the benefit persisted only in the subset with positive margins and/or ECE.
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Affiliation(s)
- Virginia Wedell Osborn
- Department of Veterans Affairs New York Harbor Healthcare System, New York, New York.,SUNY Downstate Medical Center, Brooklyn, New York
| | - Babak Givi
- Department of Veterans Affairs New York Harbor Healthcare System, New York, New York.,NYU Langone Medical Center, New York, New York
| | - Justin Rineer
- UF Health Cancer Center Orlando Health, Orlando, Florida
| | - Dylan Roden
- Department of Veterans Affairs New York Harbor Healthcare System, New York, New York.,NYU Langone Medical Center, New York, New York
| | - Niki Sheth
- Department of Veterans Affairs New York Harbor Healthcare System, New York, New York.,SUNY Downstate Medical Center, Brooklyn, New York
| | - Ariel Lederman
- Department of Veterans Affairs New York Harbor Healthcare System, New York, New York.,SUNY Downstate Medical Center, Brooklyn, New York
| | | | - Kenneth Hu
- NYU Langone Medical Center, New York, New York
| | - David Schreiber
- Department of Veterans Affairs New York Harbor Healthcare System, New York, New York.,SUNY Downstate Medical Center, Brooklyn, New York
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Sidiqi B, Sheth N, Lee A, Safdieh J, Schreiber D. Patterns of stereotactic radiotherapy utilization and fractionation for acoustic neuroma in the United States. J Radiosurg SBRT 2018; 5:201-207. [PMID: 29988251 PMCID: PMC6018040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 01/19/2018] [Accepted: 04/23/2018] [Indexed: 06/08/2023]
Abstract
OBJECTIVE Stereotactic radiosurgery is a commonly offered modality utilized for the treatment of acoustic neuromas. In this study we sought to analyze the national practice patterns and utilization of GK compared to LINAC based radiosurgery. METHODS Patients diagnosed with an acoustic neuroma between 2004-2013 and treated with LINAC or GK radiosurgery in 1-5 fractions were identified in the National Cancer Database. RESULTS There were 2,705 patients analyzed, of which 2,222 (82.1%) received GK and 483 (17.9%) received LINAC based radiosurgery. Single fraction treatment was observed in 98.8% of GK patients, versus 19.5% of LINAC patients. LINAC based radiosurgery use increased from 3.5-3.7% in 2004-2005 to 15-26% from 2007-2013. On multivariable logistic regression the use of 3-5 fractions was strongly associated with LINAC based radiosurgery (p<0.001). CONCLUSION GK remains the predominant modality for delivering radiosurgery to acoustic neuroma. LINAC based radiosurgery is being cautiously adopted and often utilizes a hypofractionated approach.
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Affiliation(s)
- Baho Sidiqi
- Department of Radiation Oncology, SUNY Downstate Medical Center, Brooklyn, NY, USA
| | - Niki Sheth
- Department of Radiation Oncology, SUNY Downstate Medical Center, Brooklyn, NY, USA
| | - Anna Lee
- Department of Radiation Oncology, SUNY Downstate Medical Center, Brooklyn, NY, USA
| | - Joseph Safdieh
- Department of Radiation Oncology, SUNY Downstate Medical Center, Brooklyn, NY, USA
- Department of Radiation Oncology Kings County Hospital Center, Brooklyn, NY, USA
| | - David Schreiber
- Department of Veterans Affairs, New York Harbor Healthcare System, Brooklyn, NY, USA
- Summit Medical Group of MD Anderson Cancer Center, Berkeley Heights, NJ, USA
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Lee A, Givi B, Roden DF, Tam MM, Wu SP, Gerber NK, Hu KS, Schreiber D. Utilization and Survival of Postoperative Radiation or Chemoradiation for pT1-2N1M0 Head and Neck Cancer. Otolaryngol Head Neck Surg 2017; 158:677-684. [DOI: 10.1177/0194599817746391] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Objective To analyze the patterns of care and survival for pT1-2N1M0 head and neck cancer based on receipt of surgery alone, surgery + postoperative radiotherapy (S + RT), or surgery + postoperative chemoradiotherapy (S + CRT). Study Design Retrospective analysis. Setting National Cancer Database. Subjects and Methods We queried the database for patients with stage pT1-2N1M0 squamous cell carcinoma of the oral cavity, oropharynx, hypopharynx, or larynx between 2004 and 2012 who were treated with surgery with negative margins and no extracapsular extension. Logistic regression was used to assess predictors of receipt of postoperative treatment. Overall survival was assessed by the Kaplan-Meier method, and Cox regression analysis identified covariates that affected it. Results There were 1598 patients included in this study: 566 (35.4%) received surgery alone; 726 (45.4%), S + RT; and 306 (19.1%), S + CRT. The 5-year overall survival was 68.8%, 74.0%, and 87.8%, respectively ( P = .009 comparing S + RT and surgery alone, P < .001 for all other comparisons). On multivariable logistic regression, academic centers were associated with a decreased likelihood of S + RT (odds ratio = 0.71) and S + CRT (odds ratio = 0.66). Multivariable Cox regression demonstrated no difference in survival for S + RT over surgery alone (hazard ratio = 0.88, 95% CI = 0.70-1.09, P = .24); however, there was a survival benefit associated with S + CRT (hazard ratio = 0.57, 95% CI = 0.39-0.81, P = .002). Conclusion Nearly 65% of patients with pT1-2N1 head and neck cancer with negative margins and no extracapsular extension received S + RT or S + CRT. Improvement in survival was noted only for patients who received S + CRT.
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Affiliation(s)
- Anna Lee
- Department of Radiation Oncology, SUNY Downstate Medical Center, Brooklyn, New York, USA
- Department of Veterans Affairs, New York Harbor Healthcare System, Brooklyn, New York, USA
| | - Babak Givi
- Department of Otolaryngology, New York School of Medicine, New York, New York, USA
| | - Dylan F. Roden
- Department of Otolaryngology, New York School of Medicine, New York, New York, USA
| | - Moses M. Tam
- Department of Radiation Oncology, New York School of Medicine, New York, New York, USA
| | - S. Peter Wu
- Department of Radiation Oncology, New York School of Medicine, New York, New York, USA
| | - Naamit K. Gerber
- Department of Radiation Oncology, New York School of Medicine, New York, New York, USA
| | - Kenneth S. Hu
- Department of Radiation Oncology, New York School of Medicine, New York, New York, USA
| | - David Schreiber
- Department of Radiation Oncology, SUNY Downstate Medical Center, Brooklyn, New York, USA
- Department of Veterans Affairs, New York Harbor Healthcare System, Brooklyn, New York, USA
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Lee A, Givi B, Wu SP, Tam MM, Gerber NK, Hu KS, Han P, Schreiber D. Patterns of care and impact of brachytherapy boost utilization for squamous cell carcinoma of the base of tongue in a large, national cohort. Brachytherapy 2017; 16:1205-1212. [DOI: 10.1016/j.brachy.2017.08.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2017] [Revised: 08/17/2017] [Accepted: 08/23/2017] [Indexed: 11/24/2022]
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Osborn VW, Lee A, Garay E, Safdieh J, Schreiber D. Impact of Timing of Adjuvant Chemoradiation for Glioblastoma in a Large Hospital Database. Neurosurgery 2017; 83:915-921. [DOI: 10.1093/neuros/nyx497] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2017] [Accepted: 09/11/2017] [Indexed: 11/14/2022] Open
Abstract
Abstract
BACKGROUND
Although the standard of care for glioblastoma remains maximal safe resection followed by chemoradiation, conflicting reports have emerged regarding the importance of the time interval between these 2 treatments.
OBJECTIVE
To assess whether differences in the duration between surgery and initiation of chemoradiation for glioblastoma had an impact on overall survival (OS) in a large hospital-based database.
METHODS
The National Cancer Database was queried to identify patients diagnosed with glioblastoma between 2010 and 2012 treated with surgery followed by chemoradiation. Patients who received biopsy only were excluded. The time from surgery to initiation of radiation therapy was divided into 4 equal quartiles of ≤24, 25 to 30, 31 to 37, and >37 d. Patient characteristics were compared between groups using Pearson Chi Square and Fisher's Exact test. OS was analyzed via the Kaplan–Meier method and compared via the log-rank test. Univariable and multivariable Cox regression were performed to assess for impact of covariables on OS.
RESULTS
A total of 11 652 patients were included in the analysis. Median duration from surgery to radiation was 30 d. On multivariable regression, black race, larger tumor, gross-total resection, methyguanine-methyl transferase (MGMT+), and treatment at an academic facility were associated with a duration >30 d. On multivariable analysis, there were no significant differences when comparing start within 24 d to 25 to 30 d (hazard ratio [HR] 0.96, 95% confidence interval [CI] 0.90-1.01, P = .13) or > 37 d (HR 0.97, 95% CI 0.91-1.03, P = .26), although a small OS improvement was seen if initiated within 31 to 37 d (HR 0.93, 95% CI 0.88-0.99, P = .02).
CONCLUSION
There was no clear association between duration from surgery to initiation of chemoradiation on OS.
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Affiliation(s)
- Virginia W Osborn
- Department of Veterans Affairs, New York Harbor Healthcare System, New York, New York and SUNY Downstate Medical Center, Brooklyn, New York
| | - Anna Lee
- Department of Veterans Affairs, New York Harbor Healthcare System, New York, New York and SUNY Downstate Medical Center, Brooklyn, New York
| | - Elizabeth Garay
- Department of Veterans Affairs, New York Harbor Healthcare System, New York, New York and SUNY Downstate Medical Center, Brooklyn, New York
| | - Joseph Safdieh
- Department of Veterans Affairs, New York Harbor Healthcare System, New York, New York and SUNY Downstate Medical Center, Brooklyn, New York
| | - David Schreiber
- Department of Veterans Affairs, New York Harbor Healthcare System, New York, New York and SUNY Downstate Medical Center, Brooklyn, New York
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Sheth N, Osborn V, Lee A, Schwartz D, Schreiber D. Association of Nadir PSA >0.5ng/Ml after Dose Escalated External Beam Radiation With Prostate Cancer-Specific Endpoints. Int J Radiat Oncol Biol Phys 2017. [DOI: 10.1016/j.ijrobp.2017.06.1235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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