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Semeniuk O, Yu E, Rivard MJ. Current and Emerging Radiotherapy Options for Uveal Melanoma. Cancers (Basel) 2024; 16:1074. [PMID: 38473430 DOI: 10.3390/cancers16051074] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2024] [Revised: 03/01/2024] [Accepted: 03/04/2024] [Indexed: 03/14/2024] Open
Abstract
What treatment options are there for patients having uveal melanoma? A randomized, prospective, multi-institutional clinical trial (COMS) showed no difference in survival between brachytherapy and enucleation for medium-sized lesions. With the obvious benefit of retaining the eye, brachytherapy has flourished and many different approaches have been developed such as low-dose-rate sources using alternate low-energy photon-emitting radionuclides, different plaque designs and seed-loading techniques, high-dose-rate brachytherapy sources and applicators, and low- and high-dose-rate beta-emitting sources and applicators. There also have been developments of other radiation modalities like external-beam radiotherapy using linear accelerators with high-energy photons, particle accelerators for protons, and gamma stereotactic radiosurgery. This article examines the dosimetric properties, targeting capabilities, and outcomes of these approaches. The several modalities examined herein have differing attributes and it may be that no single approach would be considered optimal for all patients and all lesion characteristics.
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Affiliation(s)
- Oleksii Semeniuk
- Department of Radiation Oncology, Warren Alpert Medical School, Brown University and Rhode Island Hospital, Providence, RI 02903, USA
| | - Esther Yu
- Department of Radiation Oncology, Warren Alpert Medical School, Brown University and Rhode Island Hospital, Providence, RI 02903, USA
| | - Mark J Rivard
- Department of Radiation Oncology, Warren Alpert Medical School, Brown University and Rhode Island Hospital, Providence, RI 02903, USA
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Shukla U, Langner UW, Linshaw D, Tan S, Huber KE, Miller CJ, Yu E, Leonard KL, Sueyoshi M, Diamond B, Edmonson D, Wazer DE, Gass J, Hepel JT. Comparison of Tumor Bed Delineation Using a Novel Radiopaque Filament Marker Versus Surgical Clips for Targeting Breast Cancer Radiotherapy. Am J Clin Oncol 2023; 46:427-432. [PMID: 37440682 DOI: 10.1097/coc.0000000000001028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/15/2023]
Abstract
BACKGROUND Accuracy of tumor bed (TB) delineation is essential for targeting boost doses or partial breast irradiation. Multiple studies have shown high interobserver variability with standardly used surgical clip markers (CMs). We hypothesize that a radiopaque filament marker (FM) woven along the TB will improve TB delineation consistency. METHODS An FDA-approved FM was intraoperatively used to outline the TB of patients undergoing lumpectomy. Between January 2020 and January 2022, consecutive patients with FM placed after either (1) lumpectomy or (2) lumpectomy with oncoplastic reconstruction were identified and compared with those with CM. Six "experts" (radiation oncologists specializing in breast cancer) across 2 institutions independently defined all TBs. Three metrics (volume variance, dice coefficient, and center of mass [COM] deviation). Two-tailed paired samples t tests were performed to compare FM and CM cohorts. RESULTS Twenty-eight total patients were evaluated (14 FM and 14 CM). In aggregate, differences in volume between expert contours were 29.7% (SD ± 58.8%) with FM and 55.4% (SD ± 105.9%) with CM ( P < 0.001). The average dice coefficient in patients with FM was 0.54 (SD ± 0.15), and with CM was 0.44 (SD ± 0.22) ( P < 0.001). The average COM deviation was 0.63 cm (SD ± 0.53 cm) for FM and 1.05 cm (SD ± 0.93 cm) for CM; ( P < 0.001). In the subset of patients who underwent lumpectomy with oncoplastic reconstruction, the difference in average volume was 21.8% (SD ± 20.4%) with FM and 52.2% (SD ± 64.5%) with CM ( P <0.001). The average dice coefficient was 0.53 (SD ± 0.12) for FM versus 0.39 (SD ± 0.24) for CM ( P < 0.001). The average COM difference was 0.53 cm (SD ± 0.29 cm) with FM versus 1.25 cm (SD ± 1.08 cm) with CM ( P < 0.001). CONCLUSION FM consistently outperformed CM in the setting of both standard lumpectomy and complex oncoplastic reconstruction. These data suggest the superiority of FM in TB delineation.
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Affiliation(s)
- Utkarsh Shukla
- Department of Radiation Oncology, Tufts University School of Medicine, Boston
- Department of Radiation Oncology, Lifespan Cancer Institute
- Warren Alpert Medical School of Brown University
| | - Ulrich W Langner
- Department of Radiation Oncology, Lifespan Cancer Institute
- Warren Alpert Medical School of Brown University
| | - David Linshaw
- Department of Surgical Oncology, University of Massachusetts School of Medicine, Worcester, MA
- Program in Women's Oncology, Women and Infants' Hospital, Providence, RI
| | - Sydney Tan
- Warren Alpert Medical School of Brown University
| | - Kathryn E Huber
- Department of Radiation Oncology, Tufts University School of Medicine, Boston
- Department of Radiation Oncology, Lifespan Cancer Institute
- Warren Alpert Medical School of Brown University
| | - Chelsea J Miller
- Department of Radiation Oncology, Tufts University School of Medicine, Boston
- Department of Radiation Oncology, Lifespan Cancer Institute
- Warren Alpert Medical School of Brown University
| | - Esther Yu
- Department of Radiation Oncology, Tufts University School of Medicine, Boston
- Department of Radiation Oncology, Lifespan Cancer Institute
- Warren Alpert Medical School of Brown University
| | - Kara L Leonard
- Department of Radiation Oncology, Tufts University School of Medicine, Boston
- Department of Radiation Oncology, Lifespan Cancer Institute
- Warren Alpert Medical School of Brown University
| | - Mark Sueyoshi
- Department of Radiation Oncology, Tufts University School of Medicine, Boston
- Department of Radiation Oncology, Lifespan Cancer Institute
- Warren Alpert Medical School of Brown University
| | - Brett Diamond
- Department of Radiation Oncology, Tufts University School of Medicine, Boston
- Department of Radiation Oncology, Lifespan Cancer Institute
- Warren Alpert Medical School of Brown University
| | - David Edmonson
- Warren Alpert Medical School of Brown University
- Program in Women's Oncology, Women and Infants' Hospital, Providence, RI
| | - David E Wazer
- Department of Radiation Oncology, Tufts University School of Medicine, Boston
- Department of Radiation Oncology, Lifespan Cancer Institute
- Warren Alpert Medical School of Brown University
| | - Jennifer Gass
- Warren Alpert Medical School of Brown University
- Program in Women's Oncology, Women and Infants' Hospital, Providence, RI
| | - Jaroslaw T Hepel
- Department of Radiation Oncology, Tufts University School of Medicine, Boston
- Department of Radiation Oncology, Lifespan Cancer Institute
- Warren Alpert Medical School of Brown University
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Mondia MWL, Kritselis MA, Donahue JE, Elinzano H, Sarangi S, Bryant D, Capelletti M, Korn WM, Yu E, Yan S, Toms SA, Wong ET. Dimorphic glioblastoma with glial and epithelioid phenotypes: Clonal evolution and immune selection. Front Neurol 2023; 13:1017087. [PMID: 36703629 PMCID: PMC9871816 DOI: 10.3389/fneur.2022.1017087] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Accepted: 12/13/2022] [Indexed: 01/11/2023] Open
Abstract
Purpose Epithelioid glioblastoma is an unusual histologic variant of malignant glioma. The present study investigates both the genomic and transcriptomic determinants that may promote the development of this tumor. Methods Whole-exome sequencing (WES) and whole-transcriptome sequencing (WTS) were performed on an epithelioid glioblastoma, along with a specific bioinformatic pipeline to generate electronic karyotyping and investigate the tumor immune microenvironment. Microdissected sections containing typical glioblastoma features and epithelioid morphology were analyzed separately using the same methodologies. Results An epithelioid glioblastoma, with immunopositivity for GFAP, Olig-2, and ATRX but negative for IDH-1 and p53, was identified. The tumor cell content from microdissection was estimated to be 85-90% for both histologic tumor components. WES revealed that both glioma and epithelioid sections contained identical point mutations in PTEN, RB1, TERT promoter, and TP53. Electronic karyotype analysis also revealed similar chromosomal copy number alterations, but the epithelioid component showed additional abnormalities that were not found in the glioblastoma component. The tumor immune microenvironments were strikingly different and WTS revealed high levels of transcripts from myeloid cells as well as M1 and M2 macrophages in the glioma section, while transcripts from CD4+ lymphocytes and NK cells predominated in the epithelioid section. Conclusion Epithelioid glioblastoma may be genomically more unstable and oncogenically more advanced, harboring an increased number of mutations and karyotype abnormalities, compared to typical glioblastomas. The tumor immune microenvironment is also different.
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Affiliation(s)
- Mark Willy L. Mondia
- Department of Neurosciences, College of Medicine and Philippine General Hospital, University of the Philippines Manila, Manila, Philippines
| | - Michael A. Kritselis
- Department of Pathology and Laboratory Medicine, The Warren Alpert Medical School of Brown University, Rhode Island Hospital, Providence, RI, United States
| | - John E. Donahue
- Department of Pathology and Laboratory Medicine, The Warren Alpert Medical School of Brown University, Rhode Island Hospital, Providence, RI, United States
| | - Heinrich Elinzano
- Department of Neurology, The Warren Alpert Medical School of Brown University, Rhode Island Hospital, Providence, RI, United States
| | - Sasmit Sarangi
- Department of Neurology, The Warren Alpert Medical School of Brown University, Rhode Island Hospital, Providence, RI, United States
| | | | | | | | - Esther Yu
- Department of Radiation Oncology, The Warren Alpert Medical School of Brown University, Rhode Island Hospital, Providence, RI, United States
| | - Sherry Yan
- Department of Radiation Oncology, The Warren Alpert Medical School of Brown University, Rhode Island Hospital, Providence, RI, United States
| | - Steven A. Toms
- Department of Neurosurgery, The Warren Alpert Medical School of Brown University, Rhode Island Hospital, Providence, RI, United States
| | - Eric T. Wong
- Department of Neurology, The Warren Alpert Medical School of Brown University, Rhode Island Hospital, Providence, RI, United States,Department of Radiation Oncology, The Warren Alpert Medical School of Brown University, Rhode Island Hospital, Providence, RI, United States,Department of Neurosurgery, The Warren Alpert Medical School of Brown University, Rhode Island Hospital, Providence, RI, United States,Division of Hematology/Oncology, Department of Medicine, The Warren Alpert Medical School of Brown University, Rhode Island Hospital, Providence, RI, United States,*Correspondence: Eric T. Wong ✉
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Gulstene S, Lang P, Qu M, Laba J, Yaremko B, Rodrigues G, Yu E, Warner A, Palma D. Assessing Treatment Response after Lung SABR: An Evaluation of the Predictive Value of RECIST Criteria. Int J Radiat Oncol Biol Phys 2022. [DOI: 10.1016/j.ijrobp.2022.07.1510] [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: 11/27/2022]
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Chau O, Islam A, Lock M, Yu E, Dinniwell R, Yaremko B, Brackstone M, Pavlosky W, Butler J, Biernaski H, Graf C, Wisenberg G, Prato F, Gaede S. Assessing Acute Cardiac Inflammation after Left-Sided Breast Cancer Radiotherapy with Hybrid PET/MRI (RICT-BREAST). Int J Radiat Oncol Biol Phys 2022. [DOI: 10.1016/j.ijrobp.2022.07.761] [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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Van Citters A, Aliaj E, Cary J, King J, Alvarez J, Brown C, Cravens R, Frederick C, Georgiopoulos A, Goss C, Kazmerski T, Lawrence M, Lovell C, Tillman L, Yu E. 322 Highly-effective modulator therapies: Impact on the well-being of people living with cystic fibrosis and implications for the cystic fibrosis care model. J Cyst Fibros 2022. [DOI: 10.1016/s1569-1993(22)01012-8] [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: 11/06/2022]
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Chau O, Islam A, Yu E, Qu M, Butler J, Biernaski H, Sun A, Bissonnette JP, MacDonald A, Graf C, So A, Wisenberg G, Lee T, Prato FS, Gaede S. Multi-Modality Imaging Assessment of the Heart Before and After Stage III Non-Small Cell Lung Cancer Radiotherapy. Adv Radiat Oncol 2022; 7:100927. [PMID: 35434423 PMCID: PMC9006649 DOI: 10.1016/j.adro.2022.100927] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Accepted: 02/07/2022] [Indexed: 11/26/2022] Open
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Park J, Park I, Hwang J, Bae W, Lee G, Kim L, Choi Y, Jung H, Kim M, Hong S, Lee H, Yu E, Lee A, Park Y, Chae Y. P21.02 Real-World Concordance Between Tumor Mutational Burden From Blood and Tissue in Lung Cancer and Other Cancers. J Thorac Oncol 2021. [DOI: 10.1016/j.jtho.2021.08.354] [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: 10/20/2022]
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Shore N, Kramer G, Joshua A, Li X, Poehlein C, Schloss C, de Bono J, Yu E. 639TiP KEYNOTE-365 cohort I: Phase Ib/II study of platinum containing chemotherapy in combination with pembrolizumab and chemotherapy alone for treatment-emergent neuroendocrine prostate carcinoma (t-NE). Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.1152] [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: 11/16/2022] Open
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Yu E, Piulats J, Gravis G, Fong P, Todenhöfer T, Laguerre B, Arranz J, Oudard S, Massard C, Stoeckle M, Nordquist L, Carles J, Huang M, Li Y, Qiu P, Poehlein C, Schloss C, de Bono J. 73P Association between homologous recombination repair mutations and response to pembrolizumab (pembro) plus olaparib (ola) in metastatic castration-resistant prostate cancer (mCRPC): KEYNOTE-365 Cohort A biomarker analysis. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.353] [Citation(s) in RCA: 1] [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] [Indexed: 10/20/2022] Open
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Reck M, Okines A, Pohlmann P, Yu E, Bekaii-Saab T, Nakamura Y, Monk B, O'Malley D, Kang V, Walker L, Stinchcombe T. 557TiP SGNTUC-019: Phase II basket study of tucatinib and trastuzumab in previously treated solid tumors with HER2 alterations. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.1079] [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: 10/20/2022] Open
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Kramer G, Shore N, Joshua A, Li X, Poehlein C, Schloss C, de Bono J, Yu E. 640TiP Phase Ib/II trial of pembrolizumab (pembro) + lenvatinib combination therapy in patients (pts) with adenocarcinoma metastatic castration-resistant prostate cancer (mCRPC) or treatment-emergent neuroendocrine mCRPC (t-NE): KEYNOTE-365 cohorts E and F. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.1153] [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] Open
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Barrios-Anderson A, Radhakrishnan R, Yu E, Shimanovsky A. Paraspinal radiation recall myositis after gemcitabine for pancreatic adenocarcinoma. BMJ Case Rep 2021; 14:e240896. [PMID: 33947675 PMCID: PMC8098950 DOI: 10.1136/bcr-2020-240896] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [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] [Accepted: 04/17/2021] [Indexed: 01/02/2023] Open
Abstract
Radiation recall (RR) is a chemotherapy-induced reaction that leads to inflammation and necrosis in previously irradiated tissue. Gemcitabine is a cytidine analogue that is often used in conjunction with nab-paclitaxel in the treatment of pancreatic cancer. Herein, we present a case of a 56-year-old woman with stage III pancreatic adenocarcinoma diagnosed with gemcitabine-induced RR when she presented with lower back pain and new rim-enhancing collections within the right and left paraspinal musculature 5 months after radiation therapy to the pancreas. A PubMed search was performed for 'Radiation Recall Myositis' and a complete literature review performed. This case and review of the literature of published cases of RR myositis highlight the clinical course and presentation of RR myositis. This review highlights the importance of considering RR in the differential diagnosis when patients who are undergoing chemotherapy and radiation present with inflammatory changes in previously irradiated areas.
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Affiliation(s)
| | | | - Esther Yu
- The Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA
| | - Alexei Shimanovsky
- The Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA
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Wayman H, Yu E, Lamptey O, Wilkinson S, Mujtaba G, Maitra A, Shawcross A. P160 Detection and management of nontuberculous mycobacteria in cystic fibrosis patients in a tertiary paediatric centre. J Cyst Fibros 2021. [DOI: 10.1016/s1569-1993(21)01186-3] [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: 10/21/2022]
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Kamali S, Yu E, Bates B, McBride JR, Johnson CE, Taufour V, Stroeve P. Magnetic properties of γ-Fe 2O 3 nanoparticles in a porous SiO 2 shell for drug delivery. J Phys Condens Matter 2020; 33:065301. [PMID: 33231198 DOI: 10.1088/1361-648x/abc403] [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] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
A method is presented for synthesizing core-shell nanoparticles with a magnetic core and a porous shell suitable for drug delivery and other medical applications. The core contains multiple γ-Fe2O3 nanoparticles (∼15 nm) enclosed in a SiO2 (∼100-200 nm) matrix using either methyl (denoted TMOS-γ-Fe2O3) or ethyl (TEOS-γ-Fe2O3) template groups. Low-temperature Mössbauer spectroscopy showed that the magnetic nanoparticles have the maghemite structure, γ-Fe2O3, with all the vacancies in the octahedral sites. Saturation magnetization measurements revealed that the density of γ-Fe2O3 was greater in the TMOS-γ-Fe2O3 nanoparticles than TEOS-γ-Fe2O3 nanoparticles, presumably because of the smaller methyl group. Magnetization measurements showed that the blocking temperature is around room temperature for the TMOS-γ-Fe2O3 and around 250 K for the TEOS-γ-Fe2O3. Three dimensional topography analysis shows clearly that the magnetic nanoparticles are not only at the surface but have penetrated deep in the silica to form the core-shell structure.
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Affiliation(s)
- S Kamali
- Department of Mechanical, Aerospace and Biomedical Engineering, University of Tennessee Space Institute, Tullahoma, TN 37388, United States of America. Department of Physics and Astronomy, Middle Tennessee State University, Murfreesboro, TN 37132, United States of America
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Pilar A, Yu E, Su J, Bartlett E, O’Sullivan B, Waldron J, Spreafico A, de Almeida J, Bayley A, Bratman S, Cho J, Giuliani M, Hope A, Hosni A, Kim J, Ringash J, Perez-Ordonez B, Tong L, Xu W, Huang S. Validating and Refining the 8th Edition TNM N-Classification for HPV Negative Oropharyngeal Cancer. Int J Radiat Oncol Biol Phys 2020. [DOI: 10.1016/j.ijrobp.2020.07.369] [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: 10/23/2022]
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Vallone N, Schwer M, Cardarelli G, Yu E, Koffer P, Yang Y. Dosimetric Evaluation of an Automatic Treatment Planning Option for Multiple Brain Metastases Stereotactic Radiosurgery (SRS). Int J Radiat Oncol Biol Phys 2020. [DOI: 10.1016/j.ijrobp.2020.07.643] [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: 10/23/2022]
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Koffer P, Hepel J, Milman S, Yu E, DiPetrillo T. The Effect of Radiotherapy Dose on Overall Survival and Mediastinal Pathologic Response in Locally Advanced Non-Small Cell Lung Cancer Treated with Neoadjuvant Chemoradiation Followed by Surgical Resection. Int J Radiat Oncol Biol Phys 2020. [DOI: 10.1016/j.ijrobp.2020.07.1209] [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: 10/23/2022]
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Leonard K, Breakstone R, Wazer D, Nack E, Yu E, Almhanna K, Safran H, Vrees M, DiPetrillo T. Predictors of Severe Lymphopenia During Chemoradiation Therapy for Anal Cancer. Int J Radiat Oncol Biol Phys 2020. [DOI: 10.1016/j.ijrobp.2020.07.1765] [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: 10/23/2022]
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Soria F, Giordano A, Black P, Fairey A, Cookson M, Yu E, Kassouf W, Dall’Era M, Sridhar S, McGrath J, Wright J, Thorpe A, Morgan T, Daneshmand S, Holzbeierlein J, Bivalacqua T, North S, Barocas D, Lotan Y, Grivas P, Stephenson A, Shah J, van Rhijn B, Spiess P, Shariat S, Gontero P. Neoadjuvant chemotherapy plus radical cystectomy versus radical cystectomy alone in clinical T2 bladder cancer patients without hydronephrosis: results from a large multicenter cohort study. EUR UROL SUPPL 2020. [DOI: 10.1016/s2666-1683(20)35401-x] [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] Open
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Saini P, Rudakou U, Yu E, Ruskey J, Asayesh F, Laurent S, Spiegelman D, Fahn S, Waters C, Monchi O, Dauvilliers Y, Dupré N, Greenbaum L, Hassin-Baer S, Espay A, Rouleau G, Alcalay R, Fon E, Gan-Or Z. Sequencing the entire exome of REM sleep behavior and progression to neurodegenerative diseases. Parkinsonism Relat Disord 2020. [DOI: 10.1016/j.parkreldis.2020.06.119] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Mufti K, Rudakou U, Yu E, Ruskey J, Asavesh F, Laurent S, Arnulf I, Hu M, Dauvilliers Y, Högl B, Stefani A, Holzknecht E, Monaca C, Abril B, Plazzi G, Antelmi E, Ferini-Strambi L, Heidbreder A, Young P, De Cock VC, Mollenhauer B, Sixel-Döring F, Trenkwalder C, Sonka K, Kemlink D, Figorilli M, Puligheddu M, Dijkstra F, Viaene M, Oertel W, Boeve B, Gigli G, Valente M, Gagnon JF, Desautels A, Montplaisir J, Postuma R, Rouleau G, Gan-Or Z. Analysis of dominant and recessive parkinsonism genes in REM sleep behavior disorder. Parkinsonism Relat Disord 2020. [DOI: 10.1016/j.parkreldis.2020.06.121] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Yu E, Krohn L, Rudakov U, Mufti K, Ruskey J, Asayesh F, Estiar M, Spiegelman D, Greenbaum L, Dauvilliers Y, Dupre N, Rouleau G, Hassin-Baer S, Fon E, Alcalay R, Gan-Or Z. Analysis of heterozygous PRKN variants and copy number variations in Parkinson's disease. Parkinsonism Relat Disord 2020. [DOI: 10.1016/j.parkreldis.2020.06.123] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Estiar M, Yu E, Ruskey J, Leveille E, Asayesh F, Spiegelman D, Trempe J, Tarnopolsky M, Suchowersky O, Dupré N, Boycott K, Yoon G, Rouleau G, Gan-Or Z. The genetic landscape of hereditary spastic paraplegia in Canada. Parkinsonism Relat Disord 2020. [DOI: 10.1016/j.parkreldis.2020.06.400] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Demiya S, Neumann C, Chu C, Chand K, Yu E. PNS2 Voice Technology - an Opportunity to Broaden Participation in Patient Reported Outcomes Research. Value Health Reg Issues 2020. [DOI: 10.1016/j.vhri.2020.07.421] [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: 10/23/2022]
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Mitsuo R, Matsuda H, Krishant C, Yu E, Demiya S, De Moor R. PCV24 Health Technology Assessment Submissions for Cardiovascular Interventions in the ASIA-Pacific Region. Value Health Reg Issues 2020. [DOI: 10.1016/j.vhri.2020.07.042] [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: 10/23/2022]
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Marchioni M, Mir M, Zargar H, Grivas P, Dall’era M, Spiess P, Van Rhijn B, Lotan Y, Bivalacqua T, Holzbeierlein J, Thorpe A, Yu E, Shariat S, Kassouf W, Barocas D, Daneshmand S, Dinney C, Mcgrath J, Sridhar S, Wright J, North S, Stephenson A, Xylinas E, Black P. Nomogram predicting bladder cancer specific mortality after neoadjuvant chemotherapy and radical cystectomy for muscle-invasive bladder cancer: Results of an international consortium. EUR UROL SUPPL 2020. [DOI: 10.1016/s2666-1683(20)33692-2] [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: 10/23/2022] Open
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Baekey J, Brunault R, Safran H, Breakstone R, Vrees M, DiPetrillo TA, Leonard KL, Yu E, Almhanna K. Complete neoadjuvant treatment for rectal cancer: A single institution experience. J Clin Oncol 2020. [DOI: 10.1200/jco.2020.38.4_suppl.148] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
148 Background: Full dose adjuvant chemotherapy following preoperative chemoradiation and surgery is poorly tolerated in stage II and III rectal cancer. We reviewed our institution’s experience with complete neoadjuvant treatment for rectal cancer since publication of the BrUOG R-224 trial results. Methods: After obtaining IRB approval, Data on patients with stage II and III rectal cancer who underwent complete neoadjuvant therapy were collected.. Patients who were planned to receive 8 cycles of modified FOLFOX6, chemoradiation with capecitabine 825 mg/m2 twice daily and 50.4 Gy intensity-modulated radiation therapy, then surgery were included. Results: Thirty-five patients were treated with complete neoadjuvant therapy between January 2014 and December 2017. Median age was 58 years (27 to 75 y); 1 patient (3%) was clinical stage II and 34 (97%) stage III. Twenty-seven patients (77%) received all 8 cycles of mFOLFOX6, of whom 24 completed subsequent chemoradiation. Therefore 69% of patients completed therapy according to the BrUOG R-224 protocol. Pathologic complete response (ypT0N0) was observed in 9 patients (26%). Treatment related toxicities resulted in dose reductions or treatment interruption in 57% and 29% of patients receiving chemotherapy and chemoradiation respectively. Conclusions: Complete neoadjuvant therapy for clinical stage II to III rectal cancer is well-tolerated in routine practice and offers an alternative to preoperative chemoradiation, surgery, then adjuvant full dose chemotherapy.
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Affiliation(s)
| | | | - Howard Safran
- Brown University Oncology Research Group, Providence, RI
| | | | - Matthew Vrees
- The Warren Alpert Medical School of Brown University, Providence, RI
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Guyer D, Birnbaum AE, Leonard KL, Yu E. Pain management in patients undergoing treatment for head and neck cancer with opiate use disorder on medication-assisted treatment. J Clin Oncol 2019. [DOI: 10.1200/jco.2019.37.31_suppl.120] [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
120 Background: Buprenorphine, a partial agonist at the mu opiate receptor, is an effective pain medication and use has increased for patients with cancer pain, especially those with concurrent opiate use disorder (OUD). Substance use disorder is common in head and neck cancer patients since alcohol and tobacco are predisposing factors. Definitive chemoradiation (chemoRT) for head and neck cancer is a difficult treatment with a high burden of symptoms, including mucositis pain, dysphagia and odynophagia. Patients undergoing concurrent chemoRT routinely require systemic opiates to manage pain and tolerate treatment. This is a review of our institution’s experience using buprenorphine and methadone for pain management in patients with OUD during chemoRT for head and neck cancer. Methods: We reviewed all cases seen in the Lifespan Cancer Institute head and neck cancer multidisciplinary clinic between July 2018 and June 2019. Approximately 40% of patients had a history of opiate use disorder and one-fifth of those were on medication-assisted treatment with buprenorphine or methadone. The charts of patients with OUD were reviewed with respect to history of buprenorphine or methadone use, pain scores during chemoRT, effectiveness of pain medications during chemoRT, and change of pain medication during treatment. Results: 5 patients on buprenorphine and 4 patients on methadone underwent treatment with chemoRT for head and neck cancer. Despite effectiveness for pain with other cancer patients, we did not find that buprenorphine was an effective opiate for patients undergoing chemoRT for head and neck cancer. All patients on buprenorphine had to be rotated off to another opiate (generally methadone) to achieve adequate pain relief. Median time to pain medication change was 3 weeks (range: prior to starting to week 5/7). The patients on methadone generally were able to tolerate treatment with minor adjustments to their methadone. Conclusions: The ceiling effect of buprenorphine that makes it effective for OUD is a barrier to managing the severe pain from chemoRT for head and neck cancer, while methadone is effective for both pain control and maintenance of sobriety during a taxing treatment.
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Affiliation(s)
- Dana Guyer
- Brown University School of Medicine, Providence, RI
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Yu E, Xu L, Kim J, Antonarakis E. KEYLYNK-010: Phase III study of pembrolizumab (pembro) plus olaparib (OLA) vs enzalutamide (ENZA) or abiraterone (ABI) in ENZA- or ABI-pretreated patients (pts) with metastatic castration-resistant prostate cancer (mCRPC) who had progression on chemotherapy (CTx). Ann Oncol 2019. [DOI: 10.1093/annonc/mdz248.050] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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McGregor B, O’Donnell P, Balar A, Petrylak D, Rosenberg J, Yu E, Quinn D, Shah S, Pinelli J, Hepp Z, Galsky M. Quality of life of metastatic urothelial cancer (mUC) patients treated with enfortumab vedotin (EV) following platinum-containing chemotherapy and a checkpoint inhibitor (CPI): Data from EV-201 cohort 1. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz249.020] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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32
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Yu E, Allan A, Sanatani M, Lewis D, Warner A, Dar A, Yaremko B, Bierer J, Lowes L, Palma D, Vincent M, Rodrigues G, Fortin D, Inculet R, Frechette E, Law J, Raphael J, Younus J, Malthaner R. Circulating Tumor Cells Predict Outcome in Trimodality Management of Advanced Non-Metastatic Esophageal Cancer: A Pre-planned Correlative Study from a Randomized Trial. Int J Radiat Oncol Biol Phys 2019. [DOI: 10.1016/j.ijrobp.2019.06.2038] [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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MacDuffie E, Gelissen J, Castagneri D, Yu E. Clinical Outcomes of Endometrial Cancer Patients By Microsatellite Instability Status. Int J Radiat Oncol Biol Phys 2019. [DOI: 10.1016/j.ijrobp.2019.06.1678] [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: 10/26/2022]
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Wu J, Zan X, Gao L, Zhao J, Fan J, Shi H, Wan Y, Yu E, Li S, Xie X. A Machine Learning Method for Identifying Lung Cancer Based on Routine Blood Indices: Qualitative Feasibility Study. JMIR Med Inform 2019; 7:e13476. [PMID: 31418423 PMCID: PMC6714502 DOI: 10.2196/13476] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2019] [Revised: 05/12/2019] [Accepted: 07/19/2019] [Indexed: 12/14/2022] Open
Abstract
Background Liquid biopsies based on blood samples have been widely accepted as a diagnostic and monitoring tool for cancers, but extremely high sensitivity is frequently needed due to the very low levels of the specially selected DNA, RNA, or protein biomarkers that are released into blood. However, routine blood indices tests are frequently ordered by physicians, as they are easy to perform and are cost effective. In addition, machine learning is broadly accepted for its ability to decipher complicated connections between multiple sets of test data and diseases. Objective The aim of this study is to discover the potential association between lung cancer and routine blood indices and thereby help clinicians and patients to identify lung cancer based on these routine tests. Methods The machine learning method known as Random Forest was adopted to build an identification model between routine blood indices and lung cancer that would determine if they were potentially linked. Ten-fold cross-validation and further tests were utilized to evaluate the reliability of the identification model. Results In total, 277 patients with 49 types of routine blood indices were included in this study, including 183 patients with lung cancer and 94 patients without lung cancer. Throughout the course of the study, there was correlation found between the combination of 19 types of routine blood indices and lung cancer. Lung cancer patients could be identified from other patients, especially those with tuberculosis (which usually has similar clinical symptoms to lung cancer), with a sensitivity, specificity and total accuracy of 96.3%, 94.97% and 95.7% for the cross-validation results, respectively. This identification method is called the routine blood indices model for lung cancer, and it promises to be of help as a tool for both clinicians and patients for the identification of lung cancer based on routine blood indices. Conclusions Lung cancer can be identified based on the combination of 19 types of routine blood indices, which implies that artificial intelligence can find the connections between a disease and the fundamental indices of blood, which could reduce the necessity of costly, elaborate blood test techniques for this purpose. It may also be possible that the combination of multiple indices obtained from routine blood tests may be connected to other diseases as well.
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Affiliation(s)
- Jiangpeng Wu
- State Key Laboratory of Applied Organic Chemistry, Lanzhou University, Lanzhou, China.,College of Chemistry and Chemical Engineering, Lanzhou University, Lanzhou, China
| | - Xiangyi Zan
- Department of Pneumology, Lanzhou University Second Hospital, Lanzhou, China
| | - Liping Gao
- Department of Pneumology, Lanzhou University Second Hospital, Lanzhou, China
| | - Jianhong Zhao
- Department of Radiology, Lanzhou University Second Hospital, Lanzhou, China
| | - Jing Fan
- College of Chemistry and Chemical Engineering, Lanzhou University, Lanzhou, China
| | - Hengxue Shi
- College of Chemistry and Chemical Engineering, Lanzhou University, Lanzhou, China
| | - Yixin Wan
- Department of Pneumology, Lanzhou University Second Hospital, Lanzhou, China
| | - E Yu
- National Demonstration Centre for Experimental Chemistry Education, Lanzhou University, Lanzhou, China
| | - Shuyan Li
- State Key Laboratory of Applied Organic Chemistry, Lanzhou University, Lanzhou, China.,College of Chemistry and Chemical Engineering, Lanzhou University, Lanzhou, China
| | - Xiaodong Xie
- School of Basic Medical Science, Lanzhou University, Lanzhou, China
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Nack E, Iyengar V, Yu E, DiPetrillo T, Kinsella T, Wazer D, Cielo D, Toms S, Hepel J, Koffer P. RADI-40. STEREOTACTIC RADIOSURGERY FOR BRAINSTEM METASTASES: AN ANALYSIS OF SINGLE FRACTION AND MULTI FRACTION TECHNIQUES. Neurooncol Adv 2019. [PMCID: PMC7213228 DOI: 10.1093/noajnl/vdz014.131] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
PURPOSE: Utilization of stereotactic radiosurgery (SRS) for brainstem metastases (BSM) is increasing. Multi-fraction SRS (MF-SRS) is a potential means of obtaining therapeutic gain while limiting toxicity. However, most available data assesses only single-fraction SRS (SF-SRS). This study aims to evaluate the efficacy and safety of SF-SRS and MF-SRS for BSM. METHODS: Data was retrospectively collected for patients with BSM treated with SRS between 2003–2018 at a single institution. Kaplan-Meier method was used to evaluate overall survival (OS) and local control (LC). Independent t-test was used for correlations between groups. RESULTS: 29 patients (31 lesions) were identified; 13 patients (15 lesions) underwent SF-SRS and 16 patients (16 lesions) underwent MF-SRS. Median follow-up was 6.8 months (1–80.8 months). Post-SRS MRI was available for 78% of patients. Median dose was 16Gy (12–18 Gy) for SF-SRS and 24 Gy (18–30 Gy) for MF-SRS. MF-SRS was delivered in a median of 3 fractions (3–5). There was a trend toward larger mean tumor volume with MF-SRS (1.297 vs 0.302mL, p=0.055). OS was 64.8% at 6 months and 49.3% at 12 months. LC was 90.9% at 6 months and 69.9% at 12 months. LC was similar between SF-SRS and MF-SRS at 6 months (100% vs 79.5%, p=0.143) and 12 months (50.0% vs 79.5%, p=0.812). Among the 4 patients who experienced local recurrence, 3 received salvage whole brain radiation and median OS was 8.1 months after LF. Distant CNS failures occurred in 40.3% of patients at 6 months and 72.4% at 12 months. Tumor volume >0.5 mL was associated with worse LC at 6 months (64.3% vs 100%, p=0.022). One patient developed symptomatic radiation necrosis (1/29 lesions, 3.4%) after MF-SRS. CONCLUSION: SRS is a safe and effective treatment for small BSM. Outcomes were not different between SF-SRS and MF-SRS but analysis is limited by small sample size.
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Affiliation(s)
- Elana Nack
- Department of Radiation Oncology, Warren Alpert School of Medicine of Brown University, Providence, RI, USA
| | - Varun Iyengar
- Department of Radiation Oncology, Warren Alpert School of Medicine of Brown University, Providence, RI, USA
| | - Esther Yu
- Department of Radiation Oncology, Warren Alpert School of Medicine of Brown University, Providence, RI, USA
| | - Thomas DiPetrillo
- Department of Radiation Oncology, Warren Alpert School of Medicine of Brown University, Providence, RI, USA
| | - Timothy Kinsella
- Department of Radiation Oncology, Warren Alpert School of Medicine of Brown University, Providence, RI, USA
| | - David Wazer
- Department of Radiation Oncology, Warren Alpert School of Medicine of Brown University, Providence, RI, USA
| | - Deus Cielo
- Department of Neurosurgery, Warren Alpert School of Medicine of Brown University, Providence, RI, USA
| | - Steven Toms
- Department of Neurosurgery, Warren Alpert School of Medicine of Brown University, Providence, RI, USA
| | - Jaroslaw Hepel
- Department of Radiation Oncology, Warren Alpert School of Medicine of Brown University, Providence, RI, USA
| | - Paul Koffer
- Department of Radiation Oncology, Warren Alpert School of Medicine of Brown University, Providence, RI, USA
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36
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I T, N D, S A, S O, B L, A T, Yu E, Sh S, V A. Some Genetic Determinants of Vascular Responses in Simulated Human Diving. J EVOL BIOCHEM PHYS+ 2019. [DOI: 10.1134/s0022093019030086] [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: 11/23/2022]
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37
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Guidolin K, Yaremko B, Lynn K, Gaede S, Kornecki A, Muscedere G, BenNachum I, Shmuilovich O, Mouawad M, Yu E, Sexton T, Gelman N, Moiseenko V, Brackstone M, Lock M. Stereotactic image-guided neoadjuvant ablative single-dose radiation, then lumpectomy, for early breast cancer: the SIGNAL prospective single-arm trial of single-dose radiation therapy. ACTA ACUST UNITED AC 2019; 26:e334-e340. [PMID: 31285677 DOI: 10.3747/co.26.4479] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [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: 11/15/2022]
Abstract
Background and Purpose Adjuvant whole-breast irradiation after breast-conserving surgery, typically delivered over several weeks, is the traditional standard of care for low-risk breast cancer. More recently, hypofractionated, partial-breast irradiation has increasingly become established. Neoadjuvant single-fraction radiotherapy (rt) is an uncommon approach wherein the unresected lesion is irradiated preoperatively in a single fraction. We developed the signal (Stereotactic Image-Guided Neoadjuvant Ablative Radiation Then Lumpectomy) trial, a prospective single-arm trial to test our hypothesis that, for low-risk carcinoma of the breast, the preoperative single-fraction approach would be feasible and safe. Methods Patients presenting with early-stage (T < 3 cm), estrogen-positive, clinically node-negative invasive carcinoma of the breast with tumours at least 2 cm away from skin and chest wall were enrolled. All patients received prone breast magnetic resonance imaging (mri) and prone computed tomography simulation. Treatable patients received a single 21 Gy fraction of external-beam rt (as volumetric-modulated arc therapy) to the primary lesion in the breast, followed by definitive surgery 1 week later. The primary endpoints at 3 weeks, 6 months, and 1 year were toxicity and cosmesis (that is, safety) and feasibility (defined as the proportion of mri-appropriate patients receiving rt). Results Of 52 patients accrued, 27 were successfully treated. The initial dosimetric constraints resulted in a feasibility failure, because only 57% of eligible patients were successfully treated. Revised dosimetric constraints were developed, after which 100% of patients meeting mri criteria were treated according to protocol. At 3 weeks, 6 months, and 1 year after the operation, toxicity, patient- and physician-rated cosmesis, and quality of life were not significantly different from baseline. Conclusions The signal trial presents a feasible method of implementing single-dose preoperative rt in early-stage breast cancer. This pilot study did not identify any significant toxicity and demonstrated excellent cosmetic and quality-of-life outcomes. Future randomized multi-arm studies are required to corroborate these findings.
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Affiliation(s)
- K Guidolin
- Department of Surgery, University of Toronto, Toronto, ON
| | - B Yaremko
- Division of Radiation Oncology, Department of Oncology, London Regional Cancer Program, London, ON.,Schulich School of Medicine and Dentistry, Western University, London, ON
| | - K Lynn
- London Tumour Biobank, St. Joseph's Health Care, London, ON
| | - S Gaede
- Medical Physics, London Regional Cancer Program, London, ON
| | - A Kornecki
- Division of Radiation Oncology, Department of Oncology, London Regional Cancer Program, London, ON.,Department of Medical Imaging, St. Joseph's Health Care, London, ON
| | - G Muscedere
- Division of Radiation Oncology, Department of Oncology, London Regional Cancer Program, London, ON.,Department of Medical Imaging, St. Joseph's Health Care, London, ON
| | - I BenNachum
- Division of Radiation Oncology, Department of Oncology, London Regional Cancer Program, London, ON.,Department of Medical Imaging, St. Joseph's Health Care, London, ON
| | - O Shmuilovich
- Division of Radiation Oncology, Department of Oncology, London Regional Cancer Program, London, ON.,Department of Medical Imaging, St. Joseph's Health Care, London, ON
| | - M Mouawad
- Division of Radiation Oncology, Department of Oncology, London Regional Cancer Program, London, ON
| | - E Yu
- Department of Surgery, University of Toronto, Toronto, ON.,Division of Radiation Oncology, Department of Oncology, London Regional Cancer Program, London, ON
| | - T Sexton
- Department of Surgery, University of Toronto, Toronto, ON.,Division of Radiation Oncology, Department of Oncology, London Regional Cancer Program, London, ON.,Schulich School of Medicine and Dentistry, Western University, London, ON.,London Tumour Biobank, St. Joseph's Health Care, London, ON.,Medical Physics, London Regional Cancer Program, London, ON.,Department of Medical Imaging, St. Joseph's Health Care, London, ON.,Department of Radiation Medicine and Applied Sciences, School of Medicine, University of California-San Diego, San Diego, U.S.A.,Division of Surgical Oncology, Department of Surgery, London Health Sciences Centre, London, ON
| | - N Gelman
- Department of Medical Imaging, St. Joseph's Health Care, London, ON
| | - V Moiseenko
- Department of Radiation Medicine and Applied Sciences, School of Medicine, University of California-San Diego, San Diego, U.S.A
| | - M Brackstone
- Division of Radiation Oncology, Department of Oncology, London Regional Cancer Program, London, ON.,Division of Surgical Oncology, Department of Surgery, London Health Sciences Centre, London, ON
| | - M Lock
- Department of Surgery, University of Toronto, Toronto, ON.,Division of Radiation Oncology, Department of Oncology, London Regional Cancer Program, London, ON
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Huang S, Yu E, Billfalk-Kelly A, Su J, Waldron J, Bartlett E, Bayley A, Bratman S, Cho J, Giuliani M, Hope A, Hosni A, Kim J, Ringash J, Hansen A, De Almeida J, Tong L, Xu W, O’Sullivan B. OC-007 Radiologic extranodal extension portends worse outcome in TNM-8 cT1-T2N1 HPV + oropharyngeal cancer. Radiother Oncol 2019. [DOI: 10.1016/s0167-8140(19)30173-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Reyzelman AM, Koelewyn K, Murphy M, Shen X, Yu E, Pillai R, Fu J, Scholten HJ, Ma R. Continuous Temperature-Monitoring Socks for Home Use in Patients With Diabetes: Observational Study. J Med Internet Res 2018; 20:e12460. [PMID: 30559091 PMCID: PMC6315272 DOI: 10.2196/12460] [Citation(s) in RCA: 56] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2018] [Revised: 11/01/2018] [Accepted: 11/01/2018] [Indexed: 12/30/2022] Open
Abstract
Background Over 30 million people in the United States (over 9%) have been diagnosed with diabetes. About 25% of people with diabetes will experience a diabetic foot ulcer (DFU) in their lifetime. Unresolved DFUs may lead to sepsis and are the leading cause of lower-limb amputations. DFU rates can be reduced by screening patients with diabetes to enable risk-based interventions. Skin temperature assessment has been shown to reduce the risk of foot ulceration. While several tools have been developed to measure plantar temperatures, they only measure temperature once a day or are designed for clinic use only. In this report, wireless sensor-embedded socks designed for daily wear are introduced, which perform continuous temperature monitoring of the feet of persons with diabetes in the home environment. Combined with a mobile app, this wearable device informs the wearer about temperature increases in one foot relative to the other, to facilitate early detection of ulcers and timely intervention. Objective A pilot study was conducted to assess the accuracy of sensors used in daily wear socks, obtain user feedback on how comfortable sensor-embedded socks were for home use, and examine whether observed temperatures correlated with clinical observations. Methods Temperature accuracy of sensors was assessed both prior to incorporation in the socks, as well as in the completed design. The measured temperatures were compared to the reference standard, a high-precision thermostatic water bath in the range 20°C-40°C. A total of 35 patients, 18 years of age and older, with diabetic peripheral neuropathy were enrolled in a single-site study conducted under an Institutional Review Board–approved protocol. This study evaluated the usability of the sensor-embedded socks and correlated the observed temperatures with clinical findings. Results The temperatures measured by the stand-alone sensors were within 0.2°C of the reference standard. In the sensor-embedded socks, across multiple measurements for each of the six sensors, a high agreement (R2=1) between temperatures measured and the reference standard was observed. Patients reported that the socks were easy to use and comfortable, ranking them at a median score of 9 or 10 for comfort and ease of use on a 10-point scale. Case studies are presented showing that the temperature differences observed between the feet were consistent with clinical observations. Conclusions We report the first use of wireless continuous temperature monitoring for daily wear and home use in patients with diabetes and neuropathy. The wearers found the socks to be no different from standard socks. The temperature studies conducted show that the sensors used in the socks are reliable and accurate at detecting temperature and the findings matched clinical observations. Continuous temperature monitoring is a promising approach as an early warning system for foot ulcers, Charcot foot, and reulceration.
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Affiliation(s)
- Alexander M Reyzelman
- California School of Podiatric Medicine, Samuel Merritt University, San Francisco, CA, United States
| | | | | | - Xuening Shen
- Siren Care (Shanghai) Information Technology Co Ltd, Shanghai, China
| | - E Yu
- Siren Care (Shanghai) Information Technology Co Ltd, Shanghai, China
| | - Raji Pillai
- Medical Affairs Consulting Inc, Menlo Park, CA, United States
| | - Jie Fu
- Siren Care (Shanghai) Information Technology Co Ltd, Shanghai, China
| | | | - Ran Ma
- Siren Care Inc, San Francisco, CA, United States
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40
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Yaremko B, Brackstone M, Guidolin K, Lynn K, Gaede S, Yu E, Sexton T, Dinniwell R, Kornecki A, Muscedere G, BenNachum I, Shmuilovich O, Gelman N, Lock M. Results of a Prospective Cohort Trial: Stereotactic Image-Guided Neoadjuvant Ablative Radiation Then Lumpectomy (SIGNAL) for Early-Stage Breast Cancer. Int J Radiat Oncol Biol Phys 2018. [DOI: 10.1016/j.ijrobp.2018.06.188] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [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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41
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Nguyen N, Tran E, Waldron J, Su J, Xu W, Yu E, Kim J, Ringash J, Bayley A, Hope A, Giuliani M, Cho J, Bratman S, Hansen A, de Almeida J, Irish J, Perez-Ordonez B, Weinreb I, O'Sullivan B, Huang S. Comparison of the Clinical Behaviour of N3 HPV Related and Unrelated Head and Neck Cancer in the IMRT Era. Int J Radiat Oncol Biol Phys 2018. [DOI: 10.1016/j.ijrobp.2018.07.1052] [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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Narayan R, Wage J, Marston T, Roth T, Leonard K, Wazer D, Hepel J, Yu E. Dosimetric Comparison of Deep Inspiration Breath-Hold versus Free Breathing for Right-Sided Breast Cancer with Comprehensive Nodal Radiation. Int J Radiat Oncol Biol Phys 2018. [DOI: 10.1016/j.ijrobp.2018.07.1678] [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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43
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Chun S, Meloche J, Woo A, Yu E. COMPETENCE IN ADULT ECHOCARDIOGRAPHY OF GRADUATING CARDIOLOGY TRAINEES: TWO-YEAR STUDY. Can J Cardiol 2018. [DOI: 10.1016/j.cjca.2018.07.276] [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] Open
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Yu E, Choe S, Kim J, Hwang J, Hur Y, Kim R, Lee Y, Kim M, Kim Y, Kim J, Kim Y, Kang I, Koong M, Yoon T. Higher risk of delayed menarche in girls at school located in more deprived areas. Fertil Steril 2018. [DOI: 10.1016/j.fertnstert.2018.07.509] [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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Choe S, Yu E, Hwang J, Kim J, Hur Y, Kim R, Lee Y, Kim M, Kim J, Kim Y, Kim Y, Koong M, Kang I, Yoon T. Success of fresh IVF cycles and area-level deprivation index. Fertil Steril 2018. [DOI: 10.1016/j.fertnstert.2018.07.781] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [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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Weimar EAM, Huang SH, Lu L, O'Sullivan B, Perez-Ordonez B, Weinreb I, Hope A, Tong L, Goldstein D, Irish J, de Almeida JR, Bratman S, Xu W, Yu E. Radiologic-Pathologic Correlation of Tumor Thickness and Its Prognostic Importance in Squamous Cell Carcinoma of the Oral Cavity: Implications for the Eighth Edition Tumor, Node, Metastasis Classification. AJNR Am J Neuroradiol 2018; 39:1896-1902. [PMID: 30166432 DOI: 10.3174/ajnr.a5782] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2018] [Accepted: 07/09/2018] [Indexed: 12/16/2022]
Abstract
BACKGROUND AND PURPOSE Addressing the performance of an imaging-based parameter compared to a "gold standard" pathologic measurement is essential to achieve accurate clinical T-classification. Our aim was to determine the radiologic-pathologic tumor thickness correlation and its prognostic value in oral squamous cell carcinoma. MATERIALS AND METHODS All pathologic T1-T3 (seventh edition of the Cancer Staging Manual of the American Joint Committee on Cancer) oral squamous cell carcinomas diagnosed between 2010 and 2015 were reviewed. Radiologic tumor thickness was measured on preoperative CT or MR imaging blinded to pathology. The radiologic-pathologic tumor thickness correlation was calculated. The impact of the imaging-to-surgery time interval and imaging technique on the correlation was explored. Intra-/interrater reliability on radiologic tumor thickness was calculated. The correlation of radiologic-versus-pathologic tumor thickness and its performance as the seventh edition T-category modifier was evaluated. Multivariable analysis assessed the prognostic value of the radiologic tumor thickness for overall survival adjusted for age, seventh edition T-category, and performance status. RESULTS For 354 consecutive patients, the radiologic-pathologic tumor thickness correlation was similar for the image-to-surgery interval of ≤4.0 weeks (ρ = 0.76) versus 4-8 weeks (ρ = 0.80) but lower in those with more than an 8-week interval (ρ = 0.62). CT and MR imaging had similar correlations (0.76 and 0.80). Intrarater and interrater reliability was excellent (0.88 and 0.84). Excluding 19 cases with an imaging-to-surgery interval of >8 weeks, 335 patients were eligible for further analysis. The radiologic-pathologic tumor thickness correlation was 0.78. The accuracy for upstaging the T-classification based on radiologic tumor thickness was 83% for pathologic T1 and 74% for pathologic T2 tumors. Multivariable analysis confirmed the prognostic value of radiologic tumor thickness (hazard ratio = 1.5, P = .02) for overall survival. CONCLUSIONS This study demonstrates a good radiologic-pathologic tumor thickness correlation. Intrarater and interrater reliability for radiologic tumor thickness was excellent. Radiologically thicker tumor was predictive of inferior survival.
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Affiliation(s)
- E A M Weimar
- From the Departments of Neuroradiology and Head and Neck Imaging (E.A.M.W., E.Y.)
| | - S H Huang
- Radiation Oncology (S.H.H., B.O., A.H., L.T., S.B.)
| | - L Lu
- Biostatistics (L.L., W.X.)
| | - B O'Sullivan
- Radiation Oncology (S.H.H., B.O., A.H., L.T., S.B.)
| | | | | | - A Hope
- Radiation Oncology (S.H.H., B.O., A.H., L.T., S.B.)
| | - L Tong
- Radiation Oncology (S.H.H., B.O., A.H., L.T., S.B.)
| | - D Goldstein
- Otolaryngology-Head and Neck Surgery/Surgical Oncology (D.G., J.I., J.R.d.A.), Princess Margaret Cancer Centre/University of Toronto, Toronto, Ontario, Canada
| | - J Irish
- Otolaryngology-Head and Neck Surgery/Surgical Oncology (D.G., J.I., J.R.d.A.), Princess Margaret Cancer Centre/University of Toronto, Toronto, Ontario, Canada
| | - J R de Almeida
- Otolaryngology-Head and Neck Surgery/Surgical Oncology (D.G., J.I., J.R.d.A.), Princess Margaret Cancer Centre/University of Toronto, Toronto, Ontario, Canada
| | - S Bratman
- Radiation Oncology (S.H.H., B.O., A.H., L.T., S.B.)
| | - W Xu
- Biostatistics (L.L., W.X.)
| | - E Yu
- From the Departments of Neuroradiology and Head and Neck Imaging (E.A.M.W., E.Y.)
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Kim E, Choi E, Kim M, Han K, Park Y, Kim C, Na K, No K, Yu E. Analsysis of tumor size between imaging of preoperative ultrasound, MRI and pathologic measurements in early breast carcinoma. Eur J Cancer 2018. [DOI: 10.1016/s0959-8049(18)30680-4] [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: 11/29/2022]
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Zhang TW, Rodrigues GB, Louie AV, Palma D, Dar AR, Dingle B, Kocha W, Sanatani M, Yaremko B, Yu E, Younus J, Vincent MD. Phase I study of concurrent and consolidation cisplatin and docetaxel chemotherapy with thoracic radiotherapy in non-small cell lung cancer. Curr Oncol 2018; 25:22-31. [PMID: 29507480 DOI: 10.347/co.25.3657] [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] [Indexed: 11/20/2022]
Abstract
Background We designed a phase i study of concurrent chemoradiotherapy (ccrt) with docetaxel (D) and cisplatin (C), followed by consolidation dc, for unresectable stage iii non-small cell lung cancer (nsclc). Methods Patients with histologically proven and unresectable stage iii nsclc were eligible. During ccrt, C was given every 3 weeks (75 mg/m2) and D given weekly. The starting dose of D was 20 mg/m2, escalated in cohorts of 3 to define the maximum tolerated dose (mtd). Radiotherapy was prescribed to a dose of 60 Gy in 30 fractions. This was followed by 2 cycles of consolidation dc, which were dose escalated if ccrt was tolerated. Results Twenty-six patients were enrolled, with 1 excluded following evidence of metastatic disease. Nineteen patients completed both phases of treatment. There were 7 grade 3 events during ccrt (5 esophagitis, 2 nausea), and 8 grade 3 events during consolidation (2 neutropenia, 2 leukopenia, 1 esophagitis, 2 nausea, and 1 pneumonitis). Three patients had grade 4 neutropenia. No patients died due to toxicities. The mtd of concurrent weekly D was 20 mg/m2. Consolidation D and C were each dose escalated to 75 mg/m2 in 8 patients. The median overall survival (os) and progression-free survival (pfs) of all patients were 33.6 months and 17.2 months, respectively, with median follow-up of 26.6 months (range 0.43-110.8). Conclusions The use of docetaxel 20 mg/m2 weekly and cisplatin 75 mg/m2 every 3 weeks concurrent with thoracic radiotherapy, followed by consolidation docetaxel and cisplatin, both given at 75 mg/m2 every 3 weeks, appears to be safe in this phase i trial.
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Affiliation(s)
- T W Zhang
- Department of Oncology, London Regional Cancer Program, London, ON
| | - G B Rodrigues
- Department of Oncology, London Regional Cancer Program, London, ON
| | - A V Louie
- Department of Oncology, London Regional Cancer Program, London, ON
| | - D Palma
- Department of Oncology, London Regional Cancer Program, London, ON
| | - A R Dar
- Department of Oncology, London Regional Cancer Program, London, ON
| | - B Dingle
- Department of Oncology, London Regional Cancer Program, London, ON
| | - W Kocha
- Department of Oncology, London Regional Cancer Program, London, ON
| | - M Sanatani
- Department of Oncology, London Regional Cancer Program, London, ON
| | - B Yaremko
- Department of Oncology, London Regional Cancer Program, London, ON
| | - E Yu
- Department of Oncology, London Regional Cancer Program, London, ON
| | - J Younus
- Department of Oncology, London Regional Cancer Program, London, ON
| | - M D Vincent
- Department of Oncology, London Regional Cancer Program, London, ON
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Zhang T, Rodrigues G, Louie A, Palma D, Dar A, Dingle B, Kocha W, Sanatani M, Yaremko B, Yu E, Younus J, Vincent M. Phase I Study of Concurrent and Consolidation Cisplatin and Docetaxel Chemotherapy with Thoracic Radiotherapy in Non-Small Cell Lung Cancer. Curr Oncol 2018. [DOI: 10.3747/co.25.3657] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Background: We designed a phase I study of concurrent chemoradiotherapy (CCRT) with docetaxel (D) and cisplatin (C), followed by consolidation DC, for unresectable stage III non-small cell lung cancer (NSCLC). Methods: Patients with histologically proven and unresectable stage III NSCLC were eligible. During CCRT, C was given every 3 weeks (75 mg/m2) and D given weekly. The starting dose of D was 20 mg/m2, escalated in cohorts of 3 to define the maximum tolerated dose (MTD). Radiotherapy was prescribed to a dose of 60 Gy in 30 fractions. This was followed by 2 cycles of consolidation DC, which were dose escalated if CCRT was tolerated. Results: Twenty-six patients were enrolled, with 1 excluded following evidence of metastatic disease. Nineteen patients completed both phases of treatment. There were 7 grade 3 events during CCRT (5 esophagitis, 2 nausea), and 8 grade 3 events during consolidation (2 neutropenia, 2 leukopenia, 1 esophagitis, 2 nausea, and 1 pneumonitis). Three patients had grade 4 neutropenia. No patients died due to toxicities. The MTD of concurrent weekly D was 20 mg/m2. Consolidation D and C were each dose escalated to 75 mg/m2 in 8 patients. The median overall survival (OS) and progression-free survival (pfs) of all patients were 33.6 months and 17.2 months, respectively, with median follow-up of 26.6 months (range 0.43–110.8). Conclusions: The use of docetaxel 20 mg/m2 weekly and cisplatin 75 mg/m2 every 3 weeks concurrent with thoracic radiotherapy, followed by consolidation docetaxel and cisplatin, both given at 75 mg/m2 every 3 weeks, appears to be safe in this phase I trial.
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Yu E, Huang D, Leonard K, Dipetrillo T, Wazer D, Hepel J. Analysis of Outcomes Using Hypofractionated Tumor Bed Boost Combined With Hypofractionated Whole Breast Irradiation for Early-stage Breast Cancer. Clin Breast Cancer 2017. [DOI: 10.1016/j.clbc.2017.05.010] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
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