Medicine and Health Sciences Commons^™

Dosimetric Evaluation Of Left-Sided Chest Wall Vmat Treatment With And Without Jaw Tracking; Dose Comparison Of Left Anterior Descending Artery Versus Heart Mean Dose, Jacqueline J. Emus

Culminating Experience Projects

Radiation therapy has significantly improved breast cancer survival rates; however, it can still lead to long-term side effects, particularly affecting the heart. Left-side breast cancer patients face higher risks due to the proximity of the heart to the treatment area. To mitigate cardiac toxicity, various strategies, including jaw tracking and Volumetric Modulated Arc Therapy (VMAT), have been proposed. This study investigates the dosimetric impact of VMAT plans with and without jaw tracking on the left anterior descending artery (LAD) dose and heart mean dose in post-mastectomy breast cancer patients. Ten patients previously treated with VMAT were evaluated, and the results …

A Retrospective Comparison Of Dose Distribution Within Density Override And Avoidance Structures In Volumetric Arc Therapy Prostate Plans With Hip Prosthetics: A Dosimetric Evaluation, Jared Richard Brinkman

Culminating Experience Projects

Introduction

Prostate cancer is one of the most common cancers among men, and its incidence is a significant health concern. The optimal radiation treatment for prostate cancer patients needs to be tailored to reduce toxicities to organs at risk within the treated area. This study aims to retrospectively evaluate the dose distribution to organs at risk (OARs) in patients with hip prosthetics for volumetric modulated arc therapy (VMAT) prostate cancer plans.

Methods

The study included ten prostate cancer patients with at least one prosthetic hip who received VMAT plans at a Midwest Radiation Oncology Center. Various data points, including target …

What Effect Does Flexible Work Arrangements Have On Efficiency And Job Satisfaction In Medical Dosimetry?, Michelle Walters

Culminating Experience Projects

Abstract

The purpose of this research study is to determine new trends in the medical dosimetry profession that relate to when and where work is being completed. It is also of interest to understand efficiencies within radiation oncology departments as well as how medical dosimetrists work arrangements impact job satisfaction. A voluntary survey of current medical dosimetrists was conducted which asked close-ended questions about simulation to treatment time frames, employment type, hours worked, departmental efficiency and perceived job satisfaction. It was established that the resulting 185 responses provided statistically significant results. Greater than half of participants answered yes to either …

Dosimetric Comparison Of Glioblastoma Radiotherapy Treatment Plans On A Low-Field Mri-Guided Linear Accelerator Compared To Conventional C-Arm Linear Accelerator, Emily J. Moats

Culminating Experience Projects

Introduction

MRI-guided radiation therapy has proven to provide many benefits such as real-time tracking, dose escalation, and the ability to perform online adaptive therapy. The objective of this study is to compare curative treatment plans for glioblastoma tumors on a low-field MR-guided linac vs a C-Arm linac and evaluate if they are comparable in terms of coverage, organ at risk sparing, delivery time, and deliverability.

Methods

This is a retrospective study that consisted of 15 previously treated patients who received radiation therapy for glioblastoma on a C-Arm linac. The CT simulation data that was used for the original treated plans …

An Existential Punchline: How Humor Functions In A Young Adult Friendship Facing Advanced Cancer, Megan E. Solberg

Electronic Theses and Dissertations

Young adults (i.e., age 18-39) only comprise 4% of the total cancer population, yet cancers in this group are commonly found at more advanced stages due to situational factors influencing delayed diagnosis including access to healthcare, quality health insurance and competing life demands that may hinder prioritization of healthcare. Young adults with cancer also face unique challenges including higher rates of psychological distress, which may contribute to increased risk of social disconnection in response to cancer. Research suggests that humor may be a helpful coping approach and communication mechanism for mitigating distress and discussing difficult topics. Grounded within the frameworks …

The Development Of Artificial Intelligence-Based Tools For Expert Peer Review Of Radiotherapy Treatment Plans, Mary Gronberg

Dissertations & Theses (Open Access)

Creating a patient-specific radiation treatment plan is a time-consuming and operator-dependent manual process. The treatment planner adjusts the planning parameters in a trial-and-error fashion in an effort to balance the competing clinical objectives of tumor coverage and normal tissue sparing. Often, a plan is selected because it meets basic organ at risk dose thresholds for severe toxicity; however, it is evident that a plan with a decreased risk of normal tissue complication probability could be achieved. This discrepancy between “acceptable” and “best possible” plan is magnified if either the physician or treatment planner lacks focal expertise in the disease site. …

A Comparison Of Hypofractionated Radiation Therapy Breast Plans For Large Breasted Patients - Hybrid 3d Conformal, And Volumetric Modulated Arc Therapy Vs Standard Hypofractionated 3d Conformal, Kelsie Wentland

Culminating Experience Projects

Abstract

Introduction

Patients with a large breast volume are more at risk of adverse skin effects with radiation therapy. Studies concerning these patients are very limited, especially in regard to comparison of planning techniques. While traditional tangent 3D conformal radiation therapy has been the standard of care, recent literature has shown possible benefits of hybrid planning for average breast volume patients. Little has been studied regarding breast cancer patients with large breast volumes and the possible benefits of hybrid planning of this patient demographic. Creating a hybrid plan could have the benefits of both different treatment modalities to provide a …

Development And Testing Of A Mapcheck3-Based Patient-Specific Qa Method For Prime Intensity Modulators Used With Bolus Electron Conformal Therapy, James T. Crist

LSU Master's Theses

Purpose: Irregular surfaces in bolus electron conformal therapy (BECT) create target volume dose inhomogeneity, which off-axis intensity modulation (IM) can reduce. This research developed and tested a patient-specific clinical quality assurance (QA) procedure for fabricated Passive Radiotherapy Intensity Modulation for Electrons (PRIME) devices used for IM-BECT delivery.

Methods: To evaluate MapCheck3 (MC3) diode array accuracy, electron dose measurements beneath PRIME devices were compared with scanned measurements in a water phantom. Lateral dose profile comparisons were made for 35 combinations of five beam energies (7-20MeV) and seven PRIME devices - converging and diverging island blocks (pins) having 100-68.8% intensities. To evaluate …

Understanding How Cancer Adapts To Stress And Therapy Using Evolutionary Game Theory, Mariyah Pressley

USF Tampa Graduate Theses and Dissertations

Adaptive responses in cancer promote disease initiation, progression, and resistance to treatment. Understanding the underlying evolutionary dynamics behind these adaptive responses is crucial for developing effective therapeutic strategies. Evolutionary game theory (EGT) has proven a useful tool in analyzing how different cellular behaviors and evolutionary forces shape the dynamics of tumor growth, response to therapy, and the emergence of resistance. In this dissertation, we utilize EGT to understand the adaptive responses of cancer through the lens of ecology and evolution. By employing fitness-generating models and exploring various ecological contexts, we aimed to unveil critical factors influencing aggressive cell phenotypes, treatment …

Withaferin A And Immune Checkpoint Blocker Therapy For The Treatment Of Non-Small Cell Lung Cancer, Roukiah Khalil

USF Tampa Graduate Theses and Dissertations

Lung cancer is the first cause of cancer-related deaths in both men and women with an overall five-year survival rate of 28%. Although immune checkpoint blockers (ICBs) are currently FDA-approved for the treatment of non-small cell lung cancer (NSCLC), only 17-20% of patients achieve durable responses by the induction of immunologic memory. The lack of response in most patients can be attributed to the tumor-intrinsic or tumor-extrinsic immune resistance mechanisms. A biomarker of importance is the Programmed Death Ligand-1 (PD-L1), as higher PD-L1 expression is usually associated with a better response to ICBs. Although studies have attempted to combine ICBs …

Meditation-Type Exercise For The Management Of Chemotherapy Related Cognitive Impairment In Breast Cancer Patients, Christine Cain

Evidence-Based Practice Project Reports

Chemotherapy-related cognitive impairment (CRCI), or “chemobrain”, is one of the most troublesome side effects of chemotherapy (Dijkshoorn et al., 2020). Ongoing CRCI may negatively affect relationships, confidence, sleep, fatigue, anxiety, and the ability to return to work activities leading to a decreased quality of life (Johns et al., 2016; Gokal et al., 2018). The purpose of this evidence-based practice (EBP) project was to assess the efficiency of a meditation-type exercise intervention, chair yoga, on decreasing perceived cognitive impairment (PCI) in breast cancer patients. The PICOT question for this project was: In breast cancer patients with chemotherapy related cognitive impairment (P), …

Improving Dose-Response Correlations For Locally Advanced Nsclc Patients Treated With Imrt Or Pspt, Yulun He

Dissertations & Theses (Open Access)

The standard of care for locally advanced non-small cell lung cancer (NSCLC) is concurrent chemo-radiotherapy. Despite recent advancements in radiation delivery methods, the median survival time of NSCLC patients remains below 28 months. Higher tumor dose has been found to increase survival but also a higher rate of radiation pneumonitis (RP) that affects breathing capability. In fear of such toxicity, less-aggressive treatment plans are often clinically preferred, leading to metastasis and recurrence. Therefore, accurate RP prediction is crucial to ensure tumor coverage to improve treatment outcome. Current models have associated RP with increased dose but with limited accuracy as they …

Automating The Radiation Therapy Treatment Planning Process For Pediatric Patients With Medulloblastoma, Soleil Hernandez

Dissertations & Theses (Open Access)

Over the past 50 years, pediatric cancer 5-year survival rates increased from 20% to 80% in high-income countries, however, these trends have not been mirrored in low-and-middle-income countries (LMICs). This is due in part to delayed diagnosis, higher rates of advanced disease at presentation and a growing lack of access to high quality medical personnel and technology necessary to deliver complex treatments.

The long-term goal of this study was to alleviate demanding workflows and increase global access to high-quality pediatric radiation therapy by harnessing the power of artificial intelligence to automate the radiation therapy treatment planning process for pediatric patients …

Examining Ndufab1 Expression In Head And Neck Squamous Cell Carcinoma, Addison L. Stevens

Honors Theses

Head and neck squamous cell carcinoma (HNSCC) accounts for around 4% of all cancers in the USA. HNSCC includes cancers of the oral cavity, oropharynx, nasopharynx, hypopharynx, and larynx. Reprogramming of mitochondrial metabolism has been known to promote oncogenesis. NDUFAB1, a nuclear encoded subunit of respiratory complex I (RCI) in the inner mitochondrial membrane, is abundantly expressed at the mRNA level in HNSCC patients. Based on this finding, we hypothesize that NDUFAB1 protein expression is high in HNSCC and that NDUFAB1 expression predicts a poor prognosis in HNSCC patients. We determined NDUFAB1 expression in HNSCC using immunohistochemistry and pathology guided …

Application Of Informatics Tools To Facilitate The Practice Of Precision Medicine With Genomic Testing And Clinical Data, Michael Sayer

Pharmaceutical Sciences (PhD) Dissertations

The practice of precision medicine considers a variety of sources of information to optimize patient care. Factors such as patient demographics, clinical history, and lab test values have well understood effects on treatment outcomes and influence decision making. However, effective inclusion of biomolecular data such as protein expression and DNA sequencing data within the practice of precision medicine needs continued study. Informatics tools offer solutions to allow these complex data sources to be effectively embraced. Utilization of informatics tools to visualize data pertaining to the gene selection practices of pharmacogenomic (PGx) tests effectively communicated large amounts of information into concise …

Apoptosis Induction In Jurkat T-Lymphocytes By Proton Pump Inhibitors (Ppis), Shreya Murali, Randall Reif

Student Research Submissions

Apoptosis, commonly known as programmed cell death, constantly occurs in humans. As a cancer cell increases in acidity, apoptosis is induced. In healthy cells, proton pump proteins allow for H⁺ ions to permeate cellular membranes, regulating pH. However, proton pump inhibitors (PPIs), such as omeprazole, prevent proton movement. In previous studies, omeprazole induced cell death in Jurkat T lymphocytes; however, there was no confirmation of whether the cells died through apoptosis, or through necrosis, where the cell bursts. By using Annexin-V staining, the effects of omeprazole, dexlansoprazole, and esomeprazole on apoptosis induction can be measured. Cell death was observed …

Increasing Colorectal Cancer Screening Uptake Among Hispanic/Latino Patients: A Quality Improvement Initiative, Erick Hernandez Campos, Elizabeth Morse, David Phillippi

DNP Scholarly Projects

Background: In 2021, cancer (CRC) screening rates for Latino men (42%) and women (47.5%) remain well below the Health People 2020 target (70.5%). Extensive documentation of barriers for screening include language, insurance status, and other sociocultural barriers which contribute to delays in diagnosis and/or diagnosis at advanced stages of the disease, and worse health outcomes. Latinos need culturally and linguistically appropriate health promotion interventions aimed to increase CRC screening rates with any modality (FIT, Cologuard, or Colonoscopy).

Methods: The Donabedian Structure-Process-Outcome (S-P-O) Model for quality improvement was used to develop and target a provider-driven, language-concordant communication interventions for …

Pectoralis Nerve Block Compared To Thoracic Paravertebral Nerve Block In The Mastectomy Patient: Evidence-Based Practice Recommendations, Eric Boyer

Doctor of Nursing Practice Scholarly Projects

Patients undergoing a mastectomy are at increased risk of becoming opioid dependent. Most patients undergoing a mastectomy are diagnosed with breast cancer, and the use of opioids is known to aid in cancer metastasizing due to the suppression of the body's natural killer cells. In addition, regional anesthesia, also known as a nerve block, has long provided a reduction in sensation by blocking the nerve pathway, thus numbing the feeling of pain in the operative area. The Pectoralis nerve block (PECS) and the Thoracic Paravertebral block (TPVB) are used in patients undergoing a mastectomy to help reduce the severity of …

Role Of Hla-Drb1 Fucosylation In Anti-Melanoma Immunity, Daniel K. Lester

USF Tampa Graduate Theses and Dissertations

Melanoma is the one of the most lethal skin malignancies due to its ability to rapidly metastasize and evade the immune system. One factor that influences melanoma’s ability to metastasize and evade the immune system is the tumor microenvironment. The tumor microenvironment is a complex ecosystem that consists of melanoma cells interacting with different proteins and cell types such as cytokines, extra cellular matrix proteins, and various immune cells. While different immune cells can have various implications in the tumor microenvironment, some tumor infiltrating lymphocytes (TIL) have the potential to suppress these tumors. Recent therapeutic strategies aim to enhance TILs …

Histone Deacetylase 8 Is A Novel Therapeutic Target For Mantle Cell Lymphoma And Preserves Natural Killer Cell Cytotoxic Function, January M. Watters

USF Tampa Graduate Theses and Dissertations

This study demonstrates for the first time that HDAC8 function is critical for MCL survival, and abrogating its activity in human primary NK cells does not interfere with NK IgG antibody directed ADCC therapies ex vivo. Human NK cells, isolated from healthy donors, are highly resistant to HDAC8 inhibitor treatment with PCI-34051. Even at the highest concentration, 20uM, no toxicity was observed. Conversely, MCL cell lines representative of the aggressive MCL subtype, classical MCL, were especially sensitive to PCI-34051, an HDAC8 selective inhibitor, treatment. Blocking HDAC8 activity and/or abrogating expression through shRNA silencing induced significant DNA damage, hyperacetylation of SMC3, …

Deciphering The N-Glycomic And Collagen Proteomic Molecular Signatures Towards Breast Cancer Control And Prevention, Denys Rujchanarong

MUSC Theses and Dissertations

Breast cancer is the most diagnosed cancer among women worldwide and the incidence rates are rising annually. The rates of metastatic breast cancer are projected to increase by 54.3% from 2015 to 2030. Breast stroma plays a significant role in breast cancer risk and progression yet remains poorly understood. In breast stroma, regulation of post-translational modifications (PMTs) is representative of the health state of the local microenvironment. Two abundant PTMs in the extracellular matrix include hydroxylation of prolines (HYP) and N-glycosylation in collagen and non-collagen proteins, respectively. Here, mass spectrometry imaging (MSI) was used to investigate the spatial N-glycomic and …

Apkcs Role In Neuroblastoma Cell Signaling Cascades And Implications Of Apkcs Inhibitors As Potential Therapeutics, Sloan Breedy

USF Tampa Graduate Theses and Dissertations

Neuroblastoma (NB) is a cancer that develops in the neuroblasts. It is the most common cancer in children under the age of 1 year, accounting for approximately 6% of all cancers. The prognosis of NB is linked to both age and degree of cell differentiation. This results in a range of survival rates for patients, with outcomes ranging from recurrence and mortality to high survival rates and tumor regression. Our previous work indicated that PKC-ι promotes cell proliferation in NB cells through the PKC-ι/Cdk7/Cdk2 cascade. We report on two atypical protein kinase inhibitors as potential therapeutic candidates against BE(2)-C and …

Young Adult Cancer Patients And Survivors’ Adherence To Healthy Eating And Physical Activity Guidelines, Sandra Soca Lozano

USF Tampa Graduate Theses and Dissertations

Many Adolescents and Young Adult (AYA) cancer patients/survivors do not engage in healthy eating and physical activity recommendations. The present study assessed the role of race/ethnicity, health literacy, and home environmental influences and its association with adherence to healthy eating and physical activity. AYA patients/survivors from Moffitt Cancer Center (n = 273) completed an anonymous online survey. Self-reported measures about eating habits, physical activity, health literacy, and social support were used. Black/African Americans reported worse eating habits than White and Hispanic participants. Obese participants showed a similar trend compared to all other Body Mass Index groups. Adherence to physical activity …

Sarcopenia In Head And Neck Cancer: A Prognostic Analysis, Nedeljko Jovanovic

Electronic Thesis and Dissertation Repository

Introduction: In head and neck cancer (HNC), loss of skeletal muscle mass (SMM), or sarcopenia, is a strong prognostic factor for outcomes. However, inconsistencies in its assessment limit our understanding of the relationship between sarcopenia and nutrition-related outcomes. This project evaluated the significance of sarcopenia as described in the literature and as demonstrated in a cohort of HNC patients.

Methods: A scoping review was first conducted followed by a retrospective cohort study with data collected from 194 oropharyngeal carcinoma patients treated with definitive radiation/chemoradiation. Sarcopenia was assessed from computed tomography (CT) imaging at the third cervical vertebra (C3) and the …

Synthesis And Biomedical Applications Of Hollow Iron Oxide Nanoparticles, Aloka S. Paragoda Arachchilage

Dissertations, Theses, and Capstone Projects

Nano-scale materials have gained much attention during the past few decades due to the stark differences in their properties compared to bulk material. Thus, they are being studied for a myriad of applications ranging from harnessing solar energy to diagnostics. This thesis focuses on the synthesis of hollow iron oxide nanoparticles using Galvanic replacement reactions and their application in drug delivery. Moreover, the use of a peptide precursor for the enhancement of exosomes is also discussed.

Chapter 1 discusses a simple and economical Galvanic approach used for the synthesis of hollow one-dimensional iron oxide nanotubes. In the initial reaction, the …

Role Of Ripk3 In The Pathogenesis Of Tet2 Mutant Hematopoietic Malignancies, Kanak Joshi

Dissertations

Hematopoiesis is dynamically controlled by an epigenetic landscape that regulates gene transcription. Ten-eleven translocation 2 (TET2) is a Fe2+ and α-ketoglutarate (α-KG)-dependent dioxygenase that regulates the transcriptional status of genes associated with hematopoietic stem cell self-renewal and multiple stages of lineage commitment and differentiation. TET2 mutations are commonly detected in almost all types of hematopoietic malignancies, including myeloproliferative disorder, acute myeloid leukemia, and peripheral T-cell lymphomas. In most cases, TET2 is a founder mutation that occurred in hematopoietic stem/progenitor cells (HSPCs). The mutant HSCs undergo clonal expansion and evolution with the accumulation of additional mutations for malignant transformation. Microbial-stimulated inflammatory …

Promoting Healthier Treatment Outcomes In Obese Cancer Patients Taking High Dose Methotrexate, Carly Dell'ova

Walden Dissertations and Doctoral Studies

Cancer and obesity rates continue to rise, creating enormous public heath burdens to the individual and at the national and global levels, reducing quality of life, and increasing spending. Moreover, the relationships between cancer and obesity are not well understood. A commonly used chemotherapy for several types of cancer is high dose methotrexate (HDMTX). Along with chemotherapy, especially at high doses, comes toxicity to specific organs and the entire body. However, limited research has been conducted on obese cancer patients as they are often excluded from clinical studies. Practitioners need to better understand how to dose these patients to provide …

Survival Rates And Clinical Trial Participation Among Rural Cancer Patients, Tatiana Kurilo

Walden Dissertations and Doctoral Studies

The literature indicates that cancer patients in rural areas lack adequate access to clinical trials and may experience more harmful consequences than patients residing in urban areas. The purpose of the study was to compare cancer survival rates among patients living in rural and urban counties in a southeastern U.S. state with breast cancer and lung cancer. Analysis was conducted using secondary data from the National Cancer Institute’s Surveillance, Epidemiology and End Results (SEER) Program tumor registry, Comprehensive Cancer Center (CCC) tumor registry, and CCC OnCore Subject Accrual Data. A series of independent samples t-tests and factorial ANOVA were conducted …

Oncology Nurses, Compassion Fatigue And General Health: A Mixed-Methods Study, Michelle Rampersad

Walden Dissertations and Doctoral Studies

Current literature on compassion fatigue is expansive, but there is a lack on the relationship between compassion fatigue and general health complaints in oncology nurses; how they perceive compassion fatigue and its relation to their general health. Using Pender’s health promotion model, this mixed methods study addressed how oncology nurses perceive compassion fatigue and whether a correlation exists between compassion fatigue and general health complaints. Data were collected from a sample of 55 oncology nurses through two separate Survey Monkey links. All 55 participants completed quantitative data points including a demographic questionnaire, the Professional Quality of Life 5 tool, and …

Survival Rates And Clinical Trial Participation Among Rural Cancer Patients, Tatiana Kurilo

Walden Dissertations and Doctoral Studies

The literature indicates that cancer patients in rural areas lack adequate access to clinical trials and may experience more harmful consequences than patients residing in urban areas. The purpose of the study was to compare cancer survival rates among patients living in rural and urban counties in a southeastern U.S. state with breast cancer and lung cancer. Analysis was conducted using secondary data from the National Cancer Institute’s Surveillance, Epidemiology and End Results (SEER) Program tumor registry, Comprehensive Cancer Center (CCC) tumor registry, and CCC OnCore Subject Accrual Data. A series of independent samples t-tests and factorial ANOVA were conducted …