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Lin H, Yu F, Gorovets D, Kabarriti R, Alektiar KM, Ohri N, Hasan S, Tsai P, Shim A, Kang M, Barker CA, Wolden SL, Hajj C, Mehta KJ, Lee NY, Chhabra AM, Shepherd AF, Choi IJ, Yamada Y, Simone CB. Pencil Beam Scanning Proton Stereotactic Body Radiation Therapy (SBRT): A Robust Single Institution Experience. Int J Radiat Oncol Biol Phys 2023; 117:e686-e687. [PMID: 37786018 DOI: 10.1016/j.ijrobp.2023.06.2155] [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: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) To describe the feasibility of treating a complex and diverse group of patients using pencil beam scanning (PBS) proton stereotactic body radiation therapy (SBRT: 5 or fewer fractions, with a fraction size of at least 5 Gy). MATERIALS/METHODS Our center treats on average 105-120 PBS proton treatments daily, of which 9.5% of treatment courses are proton SBRT. Statistics of disease sites, treatment planning parameters (target volume, prescriptions, number of fields, SFO vs. MFO), and treatment efficiencies (scheduled time slots, actual treatment time) are presented for 305 consecutive SBRT patients receiving 1507 fractions in the past three years. Thermoplastic masks or Vacuum-lock bags are used to immobilize SBRT patients and index the patients' treatment position. Imaging guidance of orthogonal kV images and volumetric cone-beam CT is routinely used for patient setup. RESULTS SBRT patients are grouped based on the target locations: pelvis (31%), liver (17%), thoracic (13%), spine (8%), abdominal (8%), brain (7%), non-spine bone (7%), ocular (6%), and head and neck (2%). Only 112 patients (37%) were receiving their 1st RT course, whereas 113 (37%) had one prior in-field RT course, and 80 (26%) had multiple prior in-field RT courses. The median [IQR] target volume was 65.4 [29.3, 168] cc (range: 0.3-2475 cc). 72% of cases were planned with SFO and 28% with MFO. On average, 3.76 fields (range: 2 to 12) were planned for each treatment. 44% of the treatments were planned with three or fewer fields, and 10% received more than five fields, most of which involved repainting for moving targets. Over 97% of treatments were delivered in 5 fractions, with ∼3% delivered in 3 fractions. The median [IQR] prescription per treatment was 8 [7, 10] Gy (range: 5-18 Gy per treatment). 85% (84%) of the SBRT treatments were scheduled (delivered) in a 45-minute or shorter slot, and 6% (7%) of treatments were scheduled (delivered) in over a one-hour slot, most commonly for multiple isocenter treatments. 93% of treatments were delivered within 15 minutes of the planned treatment time or shorter. Deep-inspiration breath-hold (DIBH) was applied to 45% of liver SBRT cases, with the remaining 55% planned on 4D CT with (14%) or without (86%) abdominal compression. DIBH was applied in 13% of lung SBRT cases. The application of other motion mitigation approaches, such as volumetric repainting, was determined by the target motion amplitude and whether the patient could tolerate DIBH. CONCLUSION In the most diverse and largest proton SBRT experience delivered in the world over the past 3 years, over 300 patients were treated, demonstrating the feasibility and efficiency of delivering proton SBRT in a very busy center. The planning and treatment parameter statistics reported serve as a helpful reference for the proton community.
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Affiliation(s)
- H Lin
- New York Proton Center, New York, NY; Memorial Sloan Kettering Cancer Center, New York, NY
| | - F Yu
- New York Proton Center, New York, NY
| | - D Gorovets
- Memorial Sloan Kettering Cancer Center, New York, NY
| | - R Kabarriti
- Department of Radiation Oncology, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY
| | - K M Alektiar
- Memorial Sloan Kettering Cancer Center, New York, NY
| | - N Ohri
- Department of Radiation Oncology, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY
| | - S Hasan
- New York Proton Center, New York, NY; Department of Radiation Oncology, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY
| | - P Tsai
- New York Proton Center, New York, NY
| | - A Shim
- New York Proton Center, New York, NY
| | - M Kang
- New York Proton Center, New York, NY
| | - C A Barker
- Memorial Sloan Kettering Cancer Center, New York, NY
| | - S L Wolden
- Memorial Sloan Kettering Cancer Center, New York, NY
| | - C Hajj
- Memorial Sloan Kettering Cancer Center, New York, NY
| | - K J Mehta
- Department of Radiation Oncology, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY
| | - N Y Lee
- Memorial Sloan Kettering Cancer Center, New York, NY
| | - A M Chhabra
- New York Proton Center, New York, NY; Department of Radiation Oncology, Icahn School of Medicine at Mount Sinai, New York, NY
| | - A F Shepherd
- Memorial Sloan Kettering Cancer Center, New York, NY
| | - I J Choi
- New York Proton Center, New York, NY; Memorial Sloan Kettering Cancer Center, New York, NY
| | - Y Yamada
- Memorial Sloan Kettering Cancer Center, New York, NY
| | - C B Simone
- New York Proton Center, New York, NY; Memorial Sloan Kettering Cancer Center, New York, NY
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Yaparpalvi R, Rivera A, Viswanathan S, Tang J, Tome WA, Mehta KJ. Total Reference Air Kerma (TRAK) is Associated with Dosimetric Parameters in Template-Based High Dose-Rate (HDR) Interstitial Brachytherapy in Advanced Gynecologic Cancers. Int J Radiat Oncol Biol Phys 2023; 117:e557. [PMID: 37785709 DOI: 10.1016/j.ijrobp.2023.06.1870] [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: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) To study TRAK and its association with dosimetric parameters in template-based high dose-rate interstitial brachytherapy in advanced gynecologic cancers. MATERIALS/METHODS Brachytherapy treatment plans of 53 patients treated between 2012 and 2022 at our institution with template-based Iridium-192 HDR brachytherapy, post-external beam RT, for locally advanced cancers of the cervix and vagina were retrospectively reviewed. Brachytherapy dose ranged from 25 to 30-Gy delivered in 4 to 6 fractions. The median number of flexi-guide catheters implanted was 18 (range 10-30). Clinical Target Volume (CTV) values were mean (±SD): 72.2 (±40.4) cm3 (high-risk, HR) and 182.2 (±73.7) cm3 (intermediate-risk, IR) respectively. TRAK per fraction (cGy at 1m), dose-volume information for the implant, target, and organ-at-risk (OAR) were recorded. Indices for dose coverage (CI), homogeneity (DHI), non-uniformity (DNR), overdose volume (ODI) were computed. Regression and correlation tests were used to study the TRAK relationship with various dosimetric parameters. The false discovery rate at a 5% level was corrected using the Benjamini-Hochberg procedure. RESULTS The average TRAK per fraction was 0.365 (±0.12) cGy. Mean and range values of plan quality indices were - CI 0.92 (0.7- 1.0), DHI 0.57 (0.41 - 0.77), DNR 0.43 (0.23 - 0.59) and ODI 0.22 (0.11 - 0.38), respectively Correlation results for TRAK with various dosimetric indices are presented in Table 1. TRAK showed a weak correlation with the number of flexi-guide catheters implanted (r = 0.35, p = 0.013). TRAK correlated strongly with target volumes (CTV_HR and CTV_IR and CTV_HR V100%) and with isodose volumes at both high (V300, V200, V150), and low dose levels (V90, V85, V50) (p<0.00001). TRAK correlated moderately with OAR 2-cm3 doses (p<0.00001). A weak correlation was observed between TRAK and plan quality indices. CONCLUSION TRAK correlates positively with target volume and volumes enclosed by isodoses at various dose levels in interstitial HDR brachytherapy of advanced Gynecologic Cancers. Interestingly, our study observed a comparatively stronger positive correlation between TRAK and Sigmoid 2-cm3 dose, equated to TRAK correlation with bladder, rectum, and small bowel 2-cm3 doses. This finding could interest future studies utilizing TRAK as a surrogate for treatment outcome and toxicity.
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Affiliation(s)
- R Yaparpalvi
- Department of Radiation Oncology, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY
| | - A Rivera
- Department of Radiation Oncology, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY
| | - S Viswanathan
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY
| | - J Tang
- Department of Radiation Oncology, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY
| | - W A Tome
- Institute for Onco-Physics, Albert Einstein College of Medicine, Bronx, NY
| | - K J Mehta
- Department of Radiation Oncology, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY
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Mutyala S, Patel G, Rivera AC, Brodin PN, Saigal K, Thawani N, Mehta KJ. High Dose Rate Brachytherapy for Inoperable Endometrial Cancer: a Case Series and Systematic Review of the Literature. Clin Oncol (R Coll Radiol) 2021; 33:e393-e402. [PMID: 34312020 DOI: 10.1016/j.clon.2021.06.014] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [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: 02/01/2021] [Revised: 06/14/2021] [Accepted: 06/30/2021] [Indexed: 11/27/2022]
Abstract
Endometrial cancer is a common gynaecological cancer, is typically early stage and treated with surgery. For patients where surgery is difficult or dangerous, definitive radiation therapy is the next best option. This study included a single institution case series (step 1) and a systematic review of the literature (step 2). In step 1, all endometrial cancer cases that were treated with definitive image-guided brachytherapy at a single institution from 2008 to 2020 were retrospectively analysed. In step 2, a systematic review of Medline (PubMed) from 1975 to 2020 was carried out using the key words around endometrial cancer and brachytherapy, followed by a narrative synthesis. In total, in step 1, 31 cases were included in this study, stages I-IV, with 96.7% receiving external beam radiation. All patients received three fractions of 7.5 Gy or five fractions of 6 Gy high dose rate brachytherapy, with a median EQD2 of 75.55 (40-84.3). The 2-year Kaplan-Meier (KM) local control was 83.1% and the 2-year KM overall survival was 77.4%. There was no late toxicity ≥grade 3. In step 2, 19 articles were included in the final analysis, with between six and 280 patients. The local control ranged from 70 to 100%, with low toxicity. Definitive radiation therapy with image-guided brachytherapy seems to have good local control with low toxicity for patients who are poor surgical candidates.
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Affiliation(s)
- S Mutyala
- University of Arizona College of Medicine - Phoenix, Arizona Oncology Associates, Phoenix, Arizona, USA.
| | - G Patel
- Department of Radiation Oncology, Montefiore Medical Center, Bronx, New York, USA
| | - A C Rivera
- Department of Radiation Oncology, Montefiore Medical Center, Bronx, New York, USA
| | - P N Brodin
- Department of Radiation Oncology, Montefiore Medical Center, Bronx, New York, USA
| | - K Saigal
- Florida Cancer Specialists and Research Institute, Sarasota Memorial, Brian D. Jellison Cancer Center, Sarasota, Florida, USA
| | - N Thawani
- University of Arizona College of Medicine - Phoenix, Creighton University School of Medicine, Dignity Health Cancer Institute, Phoenix, Arizona, USA
| | - K J Mehta
- Department of Radiation Oncology, Montefiore Medical Center, Bronx, New York, USA
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4
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Rivera A, Wassel M, Brodin PN, Yaparpalvi R, Velten C, Kabarriti R, Garg M, Kalnicki S, Mehta KJ. Hybrid tandem and ovoids brachytherapy in locally advanced cervical cancer: impact of dose and tumor volume metrics on outcomes. J Contemp Brachytherapy 2021; 13:158-166. [PMID: 33897789 PMCID: PMC8060962 DOI: 10.5114/jcb.2021.105283] [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] [Received: 10/19/2020] [Accepted: 02/21/2021] [Indexed: 11/17/2022] Open
Abstract
PURPOSE To report the impact of dose and tumor volume metrics at brachytherapy on outcomes for locally advanced cervical cancer treated with tandem and ovoids intracavitary/interstitial brachytherapy. MATERIAL AND METHODS FIGO stage IB1-IIIB locally advanced cervical cancer treated with intracavitary/interstitial brachytherapy via a tandem and ovoids hybrid applicator were analyzed. Median high-risk clinical target volume (HR-CTV), rate of tumor volume reduction, EQD2 D90, organ at risk doses, and outcomes were recorded. Univariable and multivariable Cox regression was applied for survival analysis, and logistic regression was used for toxicity analysis. RESULTS Seventy-one patients were identified. Median follow-up was 24.9 months, with a 2-year local control of 83.6%, loco-regional control of 72.0%, and overall survival of 88.6%. Median HR-CTV D90 was 87.4 Gy (IQR = 85.7-90.2). Median HR-CTV D90 > 90 Gy10 showed a trend toward improved local control (LC) (p = 0.19). Median HR-CTV was 37.9 cm3, and median V100 was 86.5%. A median HR-CTV of ≥ 40 cm3 demonstrated worse loco-regional control (LRC) (p = 0.018) and progression-free survival (p = 0.021). Two-year LC and LRC for stage IIB patients with a median HR-CTV < 40 cm3 were significantly improved as compared to ≥ 40 cm3 at 100% and 71.8%, respectively (p = 0.019) and 100% and 56.5%, respectively (p = 0.001). However, this trend was not statistically significant for stage IIIB patients. Higher percent per day reduction in HR-CTV during brachytherapy showed improved LRC (p = 0.045). Four percent of patients experienced acute grade 3 genitourinary toxicity, 1% late grade 3 genitourinary and 1% late grade 3 gastrointestinal toxicity. CONCLUSIONS Tandem and ovoids intracavitary/interstitial brachytherapy provides satisfactory outcomes with modest toxicity. Higher HR-CTV D90 coverage demonstrated a trend toward improved tumor control. Tumor volume based on median HR-CTV ≥ 40 cm3 at brachytherapy was prognostic for poor outcomes, even within initial FIGO stage groups warranting caution.
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Affiliation(s)
- Amanda Rivera
- Department of Radiation Oncology, Montefiore Medical Center/Albert Einstein College of Medicine, New York, USA
| | | | - Patrik N. Brodin
- Department of Radiation Oncology, Montefiore Medical Center/Albert Einstein College of Medicine, New York, USA
- Albert Einstein College of Medicine, New York, USA
| | - Ravindra Yaparpalvi
- Department of Radiation Oncology, Montefiore Medical Center/Albert Einstein College of Medicine, New York, USA
| | - Christian Velten
- Department of Radiation Oncology, Montefiore Medical Center/Albert Einstein College of Medicine, New York, USA
| | - Rafi Kabarriti
- Department of Radiation Oncology, Montefiore Medical Center/Albert Einstein College of Medicine, New York, USA
| | - Madhur Garg
- Department of Radiation Oncology, Montefiore Medical Center/Albert Einstein College of Medicine, New York, USA
| | - Shalom Kalnicki
- Department of Radiation Oncology, Montefiore Medical Center/Albert Einstein College of Medicine, New York, USA
| | - Keyur J. Mehta
- Department of Radiation Oncology, Montefiore Medical Center/Albert Einstein College of Medicine, New York, USA
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5
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Hasan S, Lazarev S, Garg M, Press RH, Chhabra A, Choi I, Simone CB, Gorovets D, Mehta KJ. Social disparities in the diagnosis and management of bladder cancer. J Clin Oncol 2021. [DOI: 10.1200/jco.2021.39.6_suppl.403] [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
403 Background: The socioeconomic characteristics associated with the diagnosis and management of bladder cancer are not well described. Methods: We utilized the National Cancer Database (NCDB) to stratify cases of urothelial cell carcinoma of the bladder by the National Comprehensive Cancer Network (NCCCN) guidelines: early (Tis, Ta, T1), muscle invasive (T2-T3, N0), locally advanced (T4, N1-3), and metastatic. We then used multivariate binomial and multinomial logistic regression analyses to identify demographic characteristics associated with stage at diagnosis and receipt of cancer-directed therapies. Hazard ratios (HR) are reported with 95% confidence intervals. Results: After exclusions, we identified 331,714 early, 72,154 muscle invasive, 15,579 locally advanced, and 15,161 metastatic cases. Relative to diagnosis at early stage, the two strongest independent predictors of diagnosis at muscle invasive, locally advanced, and metastatic disease included black race (HR = 1.19 [1.15-1.23], HR = 1.49 [1.40-1.59], HR = 1.66 [1.56-1.76], respectively), and female gender (HR = 1.21 [1.18-1.21], HR = 1.16 [1.12-1.20], and HR = 1.34 [1.29-1.38], respectively). Additional demographic factors associated with diagnosis at a more advanced stage on multivariable analysis included older age, treatment at an academic center (except for metastasis), Medicaid insurance, and patients from lower income/ less educated/more rural areas (all p < 0.01). The following demographic factors were less likely to receive cancer-directed therapies, signified by odds ratios, per multivariable binomial regression analysis: Additionalyl, female patients (HR = 1.03, 1.02-1.05) and black patients (HR = 1.13, 1.11-1.16) were the only demographic correlates of reduced survival in the entire cohort with multivariable cox regression analysis. Conclusions: In the largest study of its kind, we report that several socioeconomic, racial, and gender factors are associated with the diagnosis of bladder cancer at a later stage, as well as the use of less cancer-directed treatments. Further investigation is warranted to better characterize, and ultimately improve upon, health disparities in bladder cancer. Research Sponsor: None[Table: see text]
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Affiliation(s)
| | | | - Madhur Garg
- Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY
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Hasan S, Gorovets D, Lehrer E, Lazarev S, Press RH, Garg M, Mehta KJ, Chhabra AM, Isabelle Choi J, Simone CB. Optimal timing of radiotherapy in high risk prostate cancer: Do missed days matter? Clin Transl Radiat Oncol 2020; 26:47-54. [PMID: 33305024 PMCID: PMC7718118 DOI: 10.1016/j.ctro.2020.11.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [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: 08/04/2020] [Revised: 11/10/2020] [Accepted: 11/12/2020] [Indexed: 12/19/2022] Open
Abstract
Introduction High-risk prostate cancer is associated with poorer overall survival (OS) and biochemical control compared to more favorable risk groups. External beam radiation therapy (EBRT) is widely used; however, outcomes data are limited with respect to time elapsed between diagnosis and initiation of EBRT. Methods The National Cancer Database was queried from 2004 to 2015 for patients diagnosed with high-risk adenocarcinoma of the prostate who received androgen deprivation therapy (ADT) and definitive EBRT. Logistic regression was utilized to determine covariates associated with missing EBRT treatments. OS was analyzed using multivariate cox proportional hazards models and propensity score matching. Results 9,610 patients met inclusion criteria with median follow-up of 40.6 months and median age of 72 years. Median PSA was 8.7 and median EBRT dose was 78 Gy. ADT was initiated at a median of 36 days and EBRT at a median of 63 days post-diagnosis. Median number of prolonged treatment days was 2.2. Black race (OR: 1.40; p < 0.01), treatment at a community clinic (OR: 1.32; p < 0.01), and living in an urban/densely populated area were associated with prolonged treatment. Time elapsed between ADT and EBRT > 74 days (HR: 1.20; p = 0.01) and prolonged treatment>3 days of EBRT (HR: 1.26; p = 0.005) were associated with an increased hazard of death. The 5-year OS was 79.6% and 82.9% for patients with prolonged treatment of 3 days or more of EBRT and those missing 3 days or less, respectively (p = 0.0006). Conclusion In this hypothesis-generating study, prolonged treatment delays and missing three or more EBRT treatments was associated with poorer OS in patients with high-risk adenocarcinoma of the prostate.
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Affiliation(s)
- Shaakir Hasan
- New York Proton Center, New York, NY, USA
- Corresponding author at: New York Proton Center, 225 East 126 Street, New York, NY 10035, USA.
| | - Daniel Gorovets
- Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Eric Lehrer
- Department of Radiation Oncology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Stanislav Lazarev
- Department of Radiation Oncology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | | | - Madhur Garg
- Department of Radiation Oncology, Montefiore Medical Center, Bronx, NY, USA
| | - Keyur J. Mehta
- Department of Radiation Oncology, Montefiore Medical Center, Bronx, NY, USA
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Goddard LC, Brodin NP, Basavatia A, McEvoy M, Feldman S, Fox J, Mehta KJ, Tomé WA. Interstitial Surgical Cavity Sizing Applicators for the Treatment of the Breast Lumpectomy Cavity with Intraoperative Radiation Therapy. Cureus 2018; 10:e3693. [PMID: 30838165 PMCID: PMC6390889 DOI: 10.7759/cureus.3693] [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: 11/29/2022] Open
Abstract
Surgical cavity sizing applicators were developed for utilization prior to intraoperative radiation therapy (IORT) of the breast lumpectomy cavity with the Zeiss INTRABEAM (Carl Zeiss Meditec AG, Jena, Germany) device. The use of these applicators minimizes the number of sterilizations of the treatment applicator, which is currently limited to 100 sterilizations per applicator. This maximizes the number of patients who can be treated with each applicator, resulting in cost savings for the treating institution.
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Affiliation(s)
- Lee C Goddard
- Radiation Oncology, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, USA
| | - N Patrik Brodin
- Radiation Oncology, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, USA
| | - Amar Basavatia
- Radiation Oncology, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, USA
| | - Maureen McEvoy
- Surgery, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, USA
| | - Sheldon Feldman
- Surgery, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, USA
| | - Jana Fox
- Radiation Oncology, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, USA
| | - Keyur J Mehta
- Radiation Oncology, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, USA
| | - Wolfgang A Tomé
- Radiation Oncology, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, USA
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Nasser NJ, Mehta KJ, Pirlamarla A, Jorgensen J, Kuo DYS, Kalnicki S. Adjuvant radiation “sandwiched” between 6 cycles of carboplatin and paclitaxel for FIGO stage III endometrioid adenocarcinoma. J Clin Oncol 2018. [DOI: 10.1200/jco.2018.36.15_suppl.e17567] [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)
| | | | - Aneesh Pirlamarla
- Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY
| | | | - Dennis Yi-Shin Kuo
- Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY
| | - Shalom Kalnicki
- Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY
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Kuo HC, Mehta KJ, Yaparpalvi R, Lee A, Mynampati D, Bodner W, Garg M, Huang D, Tomé WA, Kalnicki S. Dosimetric Evaluation of a Flexible Dual Balloon-Constructed Applicator in Treating Anorectal Cancer. Technol Cancer Res Treat 2017; 16:879-884. [PMID: 28481175 PMCID: PMC5762043 DOI: 10.1177/1533034617707433] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
Background and Purpose: Materials and Methods: Results: Conclusion:
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Affiliation(s)
- Hsiang-Chi Kuo
- Department of Radiation Oncology, Montefiore Medical Center, Bronx, NY, USA
- Albert Einstein College of Medicine, Bronx, NY, USA
| | - Keyur J. Mehta
- Department of Radiation Oncology, Montefiore Medical Center, Bronx, NY, USA
- Albert Einstein College of Medicine, Bronx, NY, USA
| | - Ravindra Yaparpalvi
- Department of Radiation Oncology, Montefiore Medical Center, Bronx, NY, USA
- Albert Einstein College of Medicine, Bronx, NY, USA
| | - Alan Lee
- Department of Radiation Oncology, Montefiore Medical Center, Bronx, NY, USA
| | - Dinesh Mynampati
- Department of Radiation Oncology, Montefiore Medical Center, Bronx, NY, USA
| | - William Bodner
- Department of Radiation Oncology, Montefiore Medical Center, Bronx, NY, USA
- Albert Einstein College of Medicine, Bronx, NY, USA
| | - Madhur Garg
- Department of Radiation Oncology, Montefiore Medical Center, Bronx, NY, USA
- Albert Einstein College of Medicine, Bronx, NY, USA
| | - David Huang
- Medical Physics Graduate Program, Duke Kunshan University, Shan-Hai, China
| | - Wolfgang A. Tomé
- Department of Radiation Oncology, Montefiore Medical Center, Bronx, NY, USA
- Albert Einstein College of Medicine, Bronx, NY, USA
| | - Shalom Kalnicki
- Department of Radiation Oncology, Montefiore Medical Center, Bronx, NY, USA
- Albert Einstein College of Medicine, Bronx, NY, USA
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10
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Kabarriti R, Quinn TJ, Ewart MR, Mehta KJ, Lomita C, Geller DS, Kalnicki S, Fox JL. Neoadjuvant radiation therapy for the management of myoepithelial carcinoma of the upper extremity. Int J Cancer 2017; 142:854-862. [PMID: 29023697 DOI: 10.1002/ijc.31101] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2017] [Revised: 08/14/2017] [Accepted: 08/29/2017] [Indexed: 11/08/2022]
Abstract
Myoepithelial tumors of the soft tissue are a rare tumor displaying myoepithelial elements and lacking obvious ductal differentiation. The rarity of these precludes any evidence-based consensus regarding optimal management. Nevertheless, the current approach to these lesions begins with amputation or complete excision. The efficacy of neoadjuvant or adjuvant radiation therapy or chemotherapy has not been established. Here, we present the first report to the authors' knowledge of neoadjuvant radiation therapy for the treatment of this rare soft tissue neoplasm and review the management and outcomes of published cases of myoepithelial carcinoma. A patient with a soft tissue myoepithelial carcinoma that declined both amputation and chemotherapy was treated with neoadjuvant radiation therapy and wide surgical excision followed by a brachytherapy boost to the resected tumor bed. Neoadjuvant radiation therapy resulted in an excellent response with extensive treatment-related changes consisting predominantly of fibrosis, hyalinization and hemorrhage and only 10% residual viable myoepithelial carcinoma present in the surgical specimen.
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Affiliation(s)
- Rafi Kabarriti
- Department of Radiation Oncology, Albert-Einstein College of Medicine-Montefiore Medical Center, Bronx, NY
| | - Thomas J Quinn
- Department of Radiation Oncology, Albert-Einstein College of Medicine-Montefiore Medical Center, Bronx, NY
| | - Michelle R Ewart
- Department of Pathology, Albert-Einstein College of Medicine-Montefiore Medical Center, Bronx, NY
| | - Keyur J Mehta
- Department of Radiation Oncology, Albert-Einstein College of Medicine-Montefiore Medical Center, Bronx, NY
| | - Craig Lomita
- Department of Orthopaedic Surgery, Albert-Einstein College of Medicine-Montefiore Medical Center, Bronx, NY
| | - David S Geller
- Department of Orthopaedic Surgery, Albert-Einstein College of Medicine-Montefiore Medical Center, Bronx, NY
| | - Shalom Kalnicki
- Department of Radiation Oncology, Albert-Einstein College of Medicine-Montefiore Medical Center, Bronx, NY
| | - Jana L Fox
- Department of Radiation Oncology, Albert-Einstein College of Medicine-Montefiore Medical Center, Bronx, NY
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Kuo HC, Mehta KJ, Yaparpalvi R, Lee A, Mynampati D, Bodner W, Garg M, Huang D, Tomé WA, Kalnicki S. A Flexible Dual Balloon Constructed Applicator in Treating Anorectal Cancer - Dosimetric Considerations. Brachytherapy 2017. [DOI: 10.1016/j.brachy.2017.04.199] [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: 10/19/2022]
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12
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Rivera A, Mehta KJ, Yaparpalvi R, Kuo HC, Baliga S, Kalnicki S. Outcomes of Locally Advanced Cervical Cancer Patients Following the Use of the Hybrid Intracavitary and Interstitial Utrecht Tandem and Ovoids Applicator in an Outpatient Setting. Brachytherapy 2017. [DOI: 10.1016/j.brachy.2017.04.100] [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: 10/19/2022]
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13
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Ohri N, Kabarriti R, Bodner WR, Mehta KJ, Shankar V, Halmos B, Haigentz M, Rapkin B, Guha C, Kalnicki S, Garg M. Continuous Activity Monitoring During Concurrent Chemoradiotherapy. Int J Radiat Oncol Biol Phys 2016; 97:1061-1065. [PMID: 28332990 DOI: 10.1016/j.ijrobp.2016.12.030] [Citation(s) in RCA: 43] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2016] [Revised: 11/30/2016] [Accepted: 12/19/2016] [Indexed: 11/29/2022]
Abstract
PURPOSE To perform a prospective trial testing the feasibility and utility of acquiring activity data as a measure of health status during concurrent chemoradiotherapy. METHODS AND MATERIALS Ambulatory patients who were planned for treatment with concurrent chemoradiotherapy with curative intent for cancers of the head and neck, lung, or gastrointestinal tract were provided with activity monitors before treatment initiation. Patients were asked to wear the devices continuously throughout the radiation therapy course. Step count data were downloaded weekly during radiation therapy and 2 and 4 weeks after radiation therapy completion. The primary objective was to demonstrate feasibility, defined as collection of step counts for 80% of the days during study subjects' radiation therapy courses. Secondary objectives included establishing step count as a dynamic predictor of unplanned hospitalization risk. RESULTS Thirty-eight enrolled patients were treated with concurrent chemoradiotherapy. Primary diagnoses included head and neck cancer (n=11), lung cancer (n=13), and a variety of gastrointestinal cancers (n=14). Step data were collected for 1524 of 1613 days (94%) during patients' radiation therapy courses. Fourteen patients were hospitalized during radiation therapy or within 4 weeks of radiation therapy completion. Cox regression modeling demonstrated a significant association between recent step counts (3-day average) and hospitalization risk, with a 38% reduction in the risk of hospitalization for every 1000 steps taken each day (hazard ratio 0.62, 95% confidence interval 0.46-0.83, P=.002). Inferior quality of life scores and impaired performance status were not associated with increased hospitalization risk. CONCLUSION Continuous activity monitoring during concurrent chemoradiotherapy is feasible and well-tolerated. Step counts may serve as powerful, objective, and dynamic indicators of hospitalization risk.
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Affiliation(s)
- Nitin Ohri
- Department of Radiation Oncology, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York.
| | - Rafi Kabarriti
- Department of Radiation Oncology, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York
| | - William R Bodner
- Department of Radiation Oncology, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York
| | - Keyur J Mehta
- Department of Radiation Oncology, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York
| | - Viswanathan Shankar
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York
| | - Balazs Halmos
- Department of Oncology, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York
| | - Missak Haigentz
- Department of Oncology, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York
| | - Bruce Rapkin
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York
| | - Chandan Guha
- Department of Radiation Oncology, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York
| | - Shalom Kalnicki
- Department of Radiation Oncology, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York
| | - Madhur Garg
- Department of Radiation Oncology, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York
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14
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Patel S, Mehta KJ, Kuo HCG, Ohri N, Patel R, Yaparpalvi R, Garg MK, Guha C, Kalnicki S. Do changes in interfraction organ at risk volume and cylinder insertion geometry impact delivered dose in high-dose-rate vaginal cuff brachytherapy? Brachytherapy 2016; 15:185-90. [PMID: 26796601 DOI: 10.1016/j.brachy.2015.11.004] [Citation(s) in RCA: 3] [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] [Subscribe] [Scholar Register] [Received: 09/08/2015] [Revised: 11/07/2015] [Accepted: 11/20/2015] [Indexed: 11/30/2022]
Abstract
PURPOSE Within a multifraction high-dose-rate vaginal cuff brachytherapy course, we determined if individual variations in organ at risk (OAR) volume and cylinder insertion geometry (CIG) impacted dose and whether planned minus fractional (P - F) differences led to a discrepancy between planned dose and delivered dose. METHODS AND MATERIALS We analyzed vaginal cuff brachytherapy applications from consecutive patients treated with three fractions of 5 Gy after each undergoing a planning CT and three repeat fractional CTs (fCTs). Rectal and bladder D2ccs and volumes were recorded in addition to the x (in relationship to midplane) and y (in relationship to the table) angles of CIG. Paired t-tests and multiple regression analyses were performed. RESULTS Twenty-seven patients were identified. In comparing the planning CT vs. mean fCT rectal volumes, bladder volumes, x angles, and y angles, only bladder volume was significantly different (planned volume higher, t = 2.433, p = 0.017). The cumulative mean planned OAR D2cc vs. delivered D2cc was only significantly different for the bladder (planned dose lower, t = -2.025, p = 0.053). Regression analysis revealed planned rectal D2cc (p < 0.0003) and a positive (posterior) y insertion angle (p = 0.015) to significantly impact delivered rectal D2cc. Additionally, P - F rectal volume (p = 0.037) was significant in determining rectal delivered dose. CONCLUSIONS A more posterior y angle of insertion was found to increase rectal D2cc leading us to believe that angling the vaginal cylinder anteriorly may reduce rectal dose without significantly increasing bladder dose. Although attention should be paid to OAR volume and CIG to minimize OAR dose, the clinical significance of P - F changes remains yet to be shown.
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Affiliation(s)
- Shyamal Patel
- Department of Radiation Oncology, Montefiore Medical Center, Bronx, NY.
| | - Keyur J Mehta
- Department of Radiation Oncology, Montefiore Medical Center, Bronx, NY
| | - Hsiang-Chi G Kuo
- Department of Radiation Oncology, Montefiore Medical Center, Bronx, NY
| | - Nitin Ohri
- Department of Radiation Oncology, Montefiore Medical Center, Bronx, NY
| | - Rajal Patel
- Department of Radiation Oncology, Montefiore Medical Center, Bronx, NY
| | - Ravi Yaparpalvi
- Department of Radiation Oncology, Montefiore Medical Center, Bronx, NY
| | - Madhur K Garg
- Department of Radiation Oncology, Montefiore Medical Center, Bronx, NY
| | - Chandan Guha
- Department of Radiation Oncology, Montefiore Medical Center, Bronx, NY
| | - Shalom Kalnicki
- Department of Radiation Oncology, Montefiore Medical Center, Bronx, NY
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Kuo HC, Mehta KJ, Montgomery L, Shankar V, Yaparpalvi R, Hong L, Fox J, Tomé WA, Kalnicki S. Tumor bed variation during multi-lumen balloon-based accelerated partial breast irradiation: implication of surgical clips. Acta Oncol 2015; 55:526-9. [PMID: 26450856 DOI: 10.3109/0284186x.2015.1088168] [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]
Affiliation(s)
- Hsiang-Chi Kuo
- Department of Radiation Oncology, Montefiore Medical Center, Bronx, NY, USA
- Albert Einstein College of Medicine, Bronx, NY, USA., and
| | - Keyur J. Mehta
- Department of Radiation Oncology, Montefiore Medical Center, Bronx, NY, USA
- Albert Einstein College of Medicine, Bronx, NY, USA., and
| | - Leslie Montgomery
- Department of Surgery, Montefiore Medical Center, Bronx, NY, USA
- Albert Einstein College of Medicine, Bronx, NY, USA., and
| | - Viswanathan Shankar
- Department of Epidemiology and Population Health
- Albert Einstein College of Medicine, Bronx, NY, USA., and
| | - Ravindra Yaparpalvi
- Department of Radiation Oncology, Montefiore Medical Center, Bronx, NY, USA
- Albert Einstein College of Medicine, Bronx, NY, USA., and
| | - Linda Hong
- Department of Medical Physics, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Jana Fox
- Department of Radiation Oncology, Montefiore Medical Center, Bronx, NY, USA
- Albert Einstein College of Medicine, Bronx, NY, USA., and
| | - Wolfgang A. Tomé
- Department of Radiation Oncology, Montefiore Medical Center, Bronx, NY, USA
- Albert Einstein College of Medicine, Bronx, NY, USA., and
| | - Shalom Kalnicki
- Department of Radiation Oncology, Montefiore Medical Center, Bronx, NY, USA
- Albert Einstein College of Medicine, Bronx, NY, USA., and
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Yaparpalvi R, Mehta KJ, Bernstein MB, Kabarriti R, Hong LX, Garg MK, Guha C, Kalnicki S, Tomé WA. Contouring and Constraining Bowel on a Full-Bladder Computed Tomography Scan May Not Reflect Treatment Bowel Position and Dose Certainty in Gynecologic External Beam Radiation Therapy. Int J Radiat Oncol Biol Phys 2014; 90:802-8. [DOI: 10.1016/j.ijrobp.2014.07.016] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2014] [Revised: 06/12/2014] [Accepted: 07/13/2014] [Indexed: 11/25/2022]
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Vainshtein JM, Kabarriti R, Mehta KJ, Roy-Chowdhury J, Guha C. Bone marrow-derived stromal cell therapy in cirrhosis: clinical evidence, cellular mechanisms, and implications for the treatment of hepatocellular carcinoma. Int J Radiat Oncol Biol Phys 2014; 89:786-803. [PMID: 24969793 DOI: 10.1016/j.ijrobp.2014.02.017] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2013] [Revised: 02/09/2014] [Accepted: 02/12/2014] [Indexed: 01/18/2023]
Abstract
Current treatment options for hepatocellular carcinoma (HCC) are often limited by the presence of underlying liver disease. In patients with liver cirrhosis, surgery, chemotherapy, and radiation therapy all carry a high risk of hepatic complications, ranging from ascites to fulminant liver failure. For patients receiving radiation therapy, cirrhosis dramatically reduces the already limited radiation tolerance of the liver and represents the most important clinical risk factor for the development of radiation-induced liver disease. Although improvements in conformal radiation delivery techniques have improved our ability to safely irradiate confined areas of the liver to increasingly higher doses with excellent local disease control, patients with moderate-to-severe liver cirrhosis continue to face a shortage of treatment options for HCC. In recent years, evidence has emerged supporting the use of bone marrow-derived stromal cells (BMSCs) as a promising treatment for liver cirrhosis, with several clinical studies demonstrating sustained improvement in clinical parameters of liver function after autologous BMSC infusion. Three predominant populations of BMSCs, namely hematopoietic stem cells, mesenchymal stem cells, and endothelial progenitor cells, seem to have therapeutic potential in liver injury and cirrhosis. Preclinical studies of BMSC transplantation have identified a range of mechanisms through which these cells mediate their therapeutic effects, including hepatocyte transdifferentiation and fusion, paracrine stimulation of hepatocyte proliferation, inhibition of activated hepatic stellate cells, enhancement of fibrolytic matrix metalloproteinase activity, and neovascularization of regenerating liver. By bolstering liver function in patients with underlying Child's B or C cirrhosis, autologous BMSC infusion holds great promise as a therapy to improve the safety, efficacy, and utility of surgery, chemotherapy, and hepatic radiation therapy in the treatment of HCC.
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Affiliation(s)
| | - Rafi Kabarriti
- Department of Radiation Oncology, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York
| | - Keyur J Mehta
- Department of Radiation Oncology, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York
| | - Jayanta Roy-Chowdhury
- Department of Medicine, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York; Department of Genetics, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York
| | - Chandan Guha
- Department of Radiation Oncology, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York; Department of Pathology, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York.
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Kuo HC, Mehta KJ, Yaparpalvi R, Hong L, Tomé WA, Kalnicki S. Can Inverse Planning Further Increase the Dose Coverage to Local Advanced Cervical Cancer Treated with Intracavitary Combined Interstitial Brachytherapy? Brachytherapy 2014. [DOI: 10.1016/j.brachy.2014.02.305] [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: 10/25/2022]
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19
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Mani KM, Yaparpalvi R, Mehta KJ. A Custom-made Urethral Applicator for High-Dose-Rate Brachytherapy in Advanced Vaginal Cancer. Brachytherapy 2014. [DOI: 10.1016/j.brachy.2014.02.372] [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: 10/25/2022]
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20
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Kuo HC, Mehta KJ, Hong L, Yaparpalvi R, Tome WA, Kalnicki S. Day to Day Treatment Uncertainties during Accelerated Partial Breast Irradiation. Brachytherapy 2013. [DOI: 10.1016/j.brachy.2013.01.083] [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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21
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Bernstein MB, Mehta KJ, Yaparpalvi R, Kuo HC, Mutyala S, Garg MK, Kalnicki S. Feasibility of Performing Interstitial Implantation for Locally Advanced Cervical Cancer Using the Utrecht Tandem and Ovoids Applicator on an Outpatient Setting. Brachytherapy 2011. [DOI: 10.1016/j.brachy.2011.02.102] [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: 11/17/2022]
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22
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Yaparpalvi R, Bodner W, Kuo HC, Mehta KJ, Mah D, Kalnicki S, Guha C. Rectal Dose-Volume Dependence on Timing of Post-Seed Imaging for 131Cs Prostate Seed Implants. Brachytherapy 2011. [DOI: 10.1016/j.brachy.2011.02.149] [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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Mehta KJ, Mutyala S, Yaparpalvi R, Weiss P, Kalnicki S, Garg MK. Update of Adjuvant HDR Brachytherapy in the Management of Recurrent Keloids after Surgical Excision and External Radiotherapy. Brachytherapy 2010. [DOI: 10.1016/j.brachy.2010.02.059] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [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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Deota PT, Upadhyay PR, Patel KB, Mehta KJ, Varshney AK, Mehta MH. Effect of some ultraviolet light absorbers on photo-stabilization of azadirachtin-A. Nat Prod Lett 2002; 16:329-34. [PMID: 12434988 DOI: 10.1080/10575630290031981] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
The effect of photo-stabilization of Azadirachtin-A (Aza-A) was examined when exposed to sunlight and ultraviolet light in the presence of four structurally different ultraviolet stabilizers namely 4-aminobenzoic acid, 2,4-dihydroxybenzophenone, 4,4'-dihydroxybenzophenone and phenyl salicylate. The percentages of Aza-A recovered at different time intervals from slides exposed to different light conditions with and without UV stabilizers as well as kinetic studies indicated that the addition of phenyl salicylate in methanolic solution of Aza-A (in 1:1 mole ratio) provides the best photo-stabilization of Aza-A molecule among the four UV stabilizers studied.
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Affiliation(s)
- P T Deota
- Department of Applied Chemistry, Faculty of Technology & Engineering, M.S. University of Baroda, Vadodara, India.
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