Medicine and Health Sciences Commons^™

Jefferson Kimmel Cancer Center Support Groups

Bodine Journal

Listing of Jefferson Kimmel Cancer Center Support Groups.

Research Department Of Radiation Oncology

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Listing of Basic Research Studies/Grants and Clinical Research Studies/Grants.

Young Investigator Awards

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Robert Den, MD, Laura Doyle, MS, Nitin Ohri, MD and Evan Wuthrick, MD

New Faculty Members

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New faculty members: Voichita (Voika) Bar Ad, MD and Wenyin Shi, MD, PhD.

The Gucy2c Tumor Suppressor Is The Nexus Of A Paracrine Hormone Axis Preventing Radiotherapy-Induced Gastrointestinal (Gi) Toxicity, E. J. Wuthrick, P. Li, J. E. Lin, A. P. Dicker, D. Leeper, S. A. Waldman

Bodine Journal

Purpose/Objective: Radiation-induced GI toxicity is the primary dose limitation compromising therapy in cancer patients treated with radiation therapy. GUCY2C is the intestinal receptor for diarrheagenic bacterial enterotoxins and the endogenous paracrine hormones guanylin and uroguanylin. Following genomic insult, cyclic (c)GMP produced by ligand activation of GUCY2C enhances DNA damage sensing and repair in intestinal cells. Here, we show that the GUCY2C-cGMP axis mediates p53-dependent radioprotection of intestinal epithelial cells.

American Society for Therapeutic Radiation Oncology (ASTRO) 52nd Annual Meeting October 31 - November 4, San Diego, CA

Departmental Information-Thomas Jefferson University, Jefferson Medical College, Department Of Radiation Oncology

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Directory of Attending Physicians, Division of Molecular Radiology, Division of Medical Physics, Radiation Oncology Residents, Medical Physics Residents/Research Staff and Administration.

Chart Rounds In The Digital Age: A Survey Of North American Institutions, M. A. Whiton, A. P. Dicker, E. J. Wuthrick, L. Doyle, A. S. Harrison, Y. R. Lawrence

Bodine Journal

Purpose/Objective(s): In light of public concerns regarding the quality of radiation treatment delivery, we surveyed the utilization of “chart rounds” or peer-review quality assurance meetings, within North American academic institutions.

American Society for Therapeutic Radiation Oncology (ASTRO) 52nd Annual Meeting October 31 - November 4, San Diego, CA

Potential For Dose-Escalation In The Post-Prostatectomy Setting With Intensitymodulated Radiation Therapy: A Dosimetric Study Using Eortc Consensus Guidelines For Target Volume Contours, M. Studenski, A. Harrison, S. Anamalayil, A. Harvey, E. Trabulsi, Y. Xiao, Y. Yu, A. P. Dicker, T. N. Showalter

Bodine Journal

Purpose: Radiation therapy (RT) is delivered after radical prostatectomy (RP) for prostate cancer (PC). Although intensity modulated radiation therapy (IMRT) has become standard in definitive RT for PC, dosimetric data in support of post-RP IMRT are limited. This study was designed to quantify benefits of IMRT versus 3D conformal RT (3DCRT) with respect to dose sparing of rectum and bladder and target volume coverage. Motivated by the desire to deliver higher radiation doses and to quantify the dosimetric impact of IMRT, we retrospectively analyzed images in order to: 1) identify a preferred IMRT beam arrangement; 2) evaluate the dosimetric advantages …

Costs Of Early Adjuvant Radiation Therapy After Radical Prostatectomy: A Decision Analysis, T. N. Showalter, K. A. Foley, E. Jutkowitz, C. Lallas, A. J. Harvey, E. J. Trabulsi, L. G. Gomella, A. P. Dicker, L. T. Pizzi

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Purpose/Objective(s): Prospective, randomized trials support adjuvant radiation therapy (RT) for adverse pathologic features after radical prostatectomy (RP). However, adjuvant RT is not universally delivered in this setting. Criticisms of adjuvant RT include toxicity, financial costs, potential overtreatment, and effectiveness of salvage RT. The objective of this study was to construct a decision analytic model to estimate real world cost of RT vs. no RT within the context of the effectiveness of early adjuvant RT for prostate patients based on published clinical results of the Southwest Oncology Group prospective trial of adjuvant RT (SWOG 8794).

American Society for Therapeutic Radiation Oncology …

Mirab: An Image-Guided Multichannel Robot For Prostate Brachytherapy, T. Podder, I. Buzurovic, K. Huang, Y. Yu

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Purpose: To date, twelve robotic systems have been developed worldwide for brachytherapy, especially for seed implantation. However, the only system that has provision for simultaneous insertion of multiple needles is the MIRAB system. This article reports the feasibility and efficacy of the MIRAB robot as ultrasound image-guided autonomous delivery of radioactive seeds for treating prostate cancers.

American Society for Therapeutic Radiation Oncology (ASTRO) 52nd Annual Meeting October 31 - November 4, San Diego, CA

Intensity Modulated Radiation Therapy Compared With 3d Conformal Radiotherapy For Craniospinal Irradiation In Adults – Do We Gain Anything?, X. Shen, M. Studenski, A. Harrison, Y. Xiao, T. Biswas

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Purpose: Craniospinal irradiation (CSI) remains one of the most technically challenging planning processes in radiation oncology due to its long shape especially in adults and complex target volume. In addition, CSI is associated with significant acute and late morbidities. We undertook a dosimetric analysis to determine if intensity modulated radiation therapy (IMRT) could improve target coverage while sparing normal tissue structures compared to classic 3D conformal radiation (3D‐CRT) planning.

American Society for Therapeutic Radiation Oncology (ASTRO) 52nd Annual Meeting October 31 - November 4, San Diego, CA

Reirradiation For Recurrent Meningioma, N. Ohri, A. Wojcieszynski, J. J. Evans, D. W. Andrews, M. Werner-Wasik

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Purpose/Objective(s): Management options for meningioma include observation, surgical resection, and radiation therapy (RT). In cases of progressive or recurrent disease after RT, similar options exist. The control rate following a second course of RT is unknown.

American Society for Therapeutic Radiation Oncology (ASTRO) 52nd Annual Meeting October 31 - November 4, San Diego, CA

Prophylactic Radiation Therapy Is Safe And Effective Treatment For The Prevention Of Recurrent Heterotopic Ossification In Elbow And Knee Joints, M. V. Mishra, L. Austin, J. Parvisi, M. Ramsey, T. N. Showalter

Bodine Journal

Background: Background Prophylactic radiation therapy (RT) is an established adjuvant therapy for heterotopic ossification (HO) of the hip when delivered in the immediate pre- or post-operative setting. Its role in prevention of recurrence after excision of HO is supported by randomized trials for HO of the hip, but there is scant evidence to support a similar approach in non-hip joints. In the current study, we evaluate radiologic and functional outcomes after prophylactic radiation therapy (RT) for prevention of HO of the knee and upper extremity [elbow and metacarpophalangeal (MCP) joints].

American Society for Therapeutic Radiation Oncology (ASTRO) 52nd Annual Meeting …

Evolving Role Of Vorinostat Combined With Radiation Therapy In The Treatment Of Brain Tumors, From The Lab To The Clinic, Y. R. Lawrence, P. Wachsberger, Y. Liu, B. Andersen, A. P. Dicker

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Purpose/Objective(s): Radiation therapy (RT) is a critical element in the treatment of both brain metastases and glioblastoma (GBM). Temozolomide (TMZ) has an established role in the upfront treatment of GBM. Down-regulated mismatch repair (MMR) is a known mechanism of resistance to TMZ. Vorinostat (SAHA), an HDAC inhibitor, has successfully been combined with a number of cytotoxic agents, including ionizing radiation (IR). We performed a series of preclinical and clinical studies to examine the role of SAHA in the treatment of brain tumors.

American Society for Therapeutic Radiation Oncology (ASTRO) 52nd Annual Meeting October 31 - November 4, San Diego, CA

Early Stage Testicular Seminoma: A Multicenter Review Of Treatment Outcomes And Patterns Of Recurrence, M. Kim, E. Wuthrick, A. Lin

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Purpose/Objective(s): Although overall survival for early stage testicular seminoma is generally excellent, certain pathologic factors can increase recurrence risk for those undergoing observation, while radiation therapy (RT) can be associated with long-term morbidity. We sought to identify disease-related and treatment-related factors that influenced the outcomes, with particular emphasis on recurrence risk, patterns and timing of recurrence, as well as RT-induced malignancy.

American Society for Therapeutic Radiation Oncology (ASTRO) 52nd Annual Meeting October 31 - November 4, San Diego, CA

Substantial Dose-Response Relationship With Clinical Outcome For Lung Stereotactic Body Radiotherapy (Sbrt) Delivered Via Online Image Guidance, L. Kestin, I. Grills, M. Guckenberger, J. Belderbos, A. J. Hope, M. Werner-Wasik, J. J. Sonke, J. P. Bissonnette, Y. Xiao, D. Yan

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Purpose: To examine potential tumor dose-response relationships with various non-small cell lung cancer (NSCLC) SBRT fractionation regimens delivered with online CT-based image guidance.

American Society for Therapeutic Radiation Oncology (ASTRO) 52nd Annual Meeting October 31 - November 4, San Diego, CA

Poor Pulmonary Function Is Not Associated With Increased Rates Of Toxicity Or Decreased Overall Survival After Stereotactic Body Radiotherapy For Early Stage Non-Small Cell Lung Cancer: Results Of A Multi-Institutional Analysis, M. Guckenberger, J. Belderbos, A. Hope, L. L. Kestin, M. Werner-Wasik, J. J. Sonke, Y. Xiao, D. Yan, J. Wilbert, I. S. Grills

Bodine Journal

Purpose/Objective(s): Stereotactic body radiotherapy (SBRT) is considered as the treatment of choice for stage I non-small cell lung cancer (NSCLC) in medically inoperable patients. It was the purpose of this study to evaluate whether pretreatment pulmonary function is predictive for survival and toxicity after SBRT.

American Society for Therapeutic Radiation Oncology (ASTRO) 52nd Annual Meeting October 31 - November 4, San Diego, CA

A Multi-National Pooled Analysis Of 434 Cases Of Stage I Non-Small Cell Lung Cancer (Nsclc) Treated With Volumetrically Image-Guided Stereotactic Lung Radiotherapy: Results From The Elekta Collaborative Lung Research Group, I. S. Grills, A. J. Hope, M. Guckenberger, L. L. Kestin, M. Werner-Wasik, D. Yan, J. J. Sonke, J. P. Bissonnette, Y. Xiao, J. Belderbos

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Background: Published lung SBRT outcomes/dose response data for inoperable NSCLC come from small phase I-II studies or larger datasets not requiring image-guided radiotherapy (IGRT) or volumetric prescriptions. This entire cohort of SBRT patients had daily online cone-beam CT.

American Society for Therapeutic Radiation Oncology (ASTRO) 52nd Annual Meeting October 31 - November 4, San Diego, CA

Toxicity Of Phase I Radiation Oncology Trials: Worldwide Experience, C. Glass, R. B. Den, A. P. Dicker, Y. R. Lawrence

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Introduction: Informed consent involves understanding the risks and benefits of trial enrollment. This is challenging in the phase I setting since true quantitative information is never known. We therefore performed an analysis of published radiation oncology (RO) phase I trials emphasizing patient outcomes. To our knowledge, no such systemic analysis has previously been published.

American Society for Therapeutic Radiation Oncology (ASTRO) 52nd Annual Meeting October 31 - November 4, San Diego, CA

Pathologic Correlation Of Pet-Ct Based Auto Contouring For Radiation Planning In Lung Cancer, S. E. Fogh, A. Farach, C. Intenzo, R. Axelrod, P. Mccue, A. Harper, A. Nelson, M Werner-Wasik

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Purpose/Objective(s): Radiation therapy in lung cancer relies on CT and functional imaging (FDG-PET) to delineate tumor volumes. Semi-automatic contouring tools have been developed for PET to improve on the inter-observer bias of manual contouring and intrinsic differences in imaging equipment. A common method involves using a threshold at a given percentage of the max activity, which may be less accurate with smaller tumors and tumors with low source to background ratio. To overcome this deficiency, a gradient algorithm, which detects changes in image counts at the border of the tumor, has been developed. Few studies have correlated these methods to …

Igrt After Prostatectomy: Evaluation Of Corrective Shifts And Toxicity Using Online Cone Beam Ct Vs. Weekly Port Films For Target Localization, H. B. Eldredge, M. Studenski, S. Keith, E. J. Trabulsi, A. Harvey, C. Lallas, L. Gomella, A. P. Dicker, T. N. Showalter

Bodine Journal

Purpose/Objective(s): Image guidance (IG) may permit higher radiotherapy (RT) doses (>65 Gy) after radical prostatectomy (RP) without increased toxicity, with improved accuracy and smaller margins. Conebeam (CBCT) allows IGRT with volumetric images. This study evaluated CBCT shifts and toxicity after conformal IGRT, compared to RT with port films.

American Society for Therapeutic Radiation Oncology (ASTRO) 52nd Annual Meeting October 31 - November 4, San Diego, CA

Dosimetric Comparison Of Vmat, Imrt And Proton Therapy For Post- Prostatectomy Radiation Therapy For Prostate Cancer, L. A. Doyle, M. Studenski, A. Harvey, A. P. Dicker, Y. Xiao, Y. Yu, T. N. Showalter, A. Harrison

Bodine Journal

Purpose/Objectives: Radiation therapy (RT) for the treatment of prostate cancer after radical prostatectomy (RP) is widely accepted. With technological advances, radiation treatment technique and dosimetry may vary. The purpose of this study is to quantify dosimetric difference of proton therapy versus VMAT and IMRT focusing on bladder and rectal dose sparing and target coverage.

American Society for Therapeutic Radiation Oncology (ASTRO) 52nd Annual Meeting October 31 - November 4, San Diego, CA

Should Hypopharynx Cancer Continue To Be Included In “Multi-Head And Neck” Trials Within The Rtog?, R. Den, Q. Zhang, D. Cognetti, M. Machtay, J. S. Cooper, A. S. Garden, C. U. Jones, S. Yom, K. K. Ang

Bodine Journal

Purpose/Objective(s): It is becoming increasingly evident that the behavior of cancers from different subsites of the head and neck varies greatly despite similar histologic appearance. As current head and neck trials are focusing more on a risk-based approach, it is unclear into which trials patients with hypopharyngeal primaries (HP) should be included. Thus, we undertook to examine whether patients with HP perform as well as oropharyngeal primaries (OP) in the definitive setting and whether HP perform as well as larynx primaries (LX) in the post-operative setting in the multi-institutional setting. American Society for Therapeutic Radiation Oncology (ASTRO) 52nd Annual Meeting …

Uncertainty And Margin Study For Imrt, Vmat, And Proton Beam Therapy For Treatment After Radical Prostatectomy, Y. Cui, A. S. Harrison, M T. Studenski, T. N. Showalter, J. O. Deasy, Y. Yu, J. M. Galvin, Y. Xiao

Bodine Journal

Purpose/Objective(s): To compare the uncertainties of 3D dose distributions, caused by the geometrical uncertainty of patient setup, in IMRT, VMAT, and proton plans for post-prostatectomy treatment. To test the effectiveness of a common margin recipe in these three types of treatment plans.

American Society for Therapeutic Radiation Oncology (ASTRO) 52nd Annual Meeting October 31 - November 4, San Diego, CA

Dosimetric Evaluation Of Tumor Tracking In 4d Radiotherapy, I. Buzurovic, M. Werner-Wasik, T. Biswas, J. Galvin, A. Dicker, Y. Yu, T. Podder

Bodine Journal

Purpose: In some patients the tumors in lung, pancreas, liver, breast, and other organs move significantly during cardiac and breathing cycles. In this study we have investigated the dosimetric benefits of real-time tumor tracking for patients who were diagnosed with lung cancer.

American Society for Therapeutic Radiation Oncology (ASTRO) 52nd Annual Meeting October 31 - November 4, San Diego, CA

Decrease Of Morbidity And Cost Of Care With Prophylactic Cranial Irradiation For Non-Small Cell Lung Cancer, C. E. Champ, N. Ohri, M. Werner-Wasik

Bodine Journal

Purpose: While several studies analyze the incidence of brain metastases in patients with non-small cell lung cancer (NSCLC) treated with prophylactic cranial irradiation (PCI), there is little data available on how this treatment can affect medical cost and morbidity. Our goal was to analyze those issues patients encounter secondary to brain metastases, often in the final months of their lives, and to support the hypothesis of economic benefit and cost effectiveness resulting from the use of PCI in this population.

American Society for Therapeutic Radiation Oncology (ASTRO) 52nd Annual Meeting October 31 - November 4, San Diego, CA

Time Interval Between Staging Fdg Positron Emission Tomography (Pet) And Initiation Of Stereotactic Lung Radiotherapy (Sbrt) Impacts The Risk Of Recurrence And Metastasis In Non-Small Cell Lung Cancer (Nsclc), B. Belderbos, A. Hope, L. L. Kestin, M. Guckenberger, M. Werner-Wasik, J. J. Sonke, J. P. Bissonnette, Y. Xiao, D. Yan, I. S. Grills

Bodine Journal

Background: To study influence of time interval from staging PET scanning to RT start time on recurrence and survival in patients with NSCLC undergoing lung SBRT.

American Society for Therapeutic Radiation Oncology (ASTRO) 52nd Annual Meeting October 31 - November 4, San Diego, CA

Results Of A Phase I Trial Of Induction Cisplatin, Docetaxel, 5-Fu And Erlotinib Followed By Cisplatin, Bevacizumab And Erlotinib With Radiotherapy For Advanced Head And Neck Cancer, P. H. Ahn, M. Machtay, P. R. Anné, E. Wuthrick, W. M. Keane, D. Cognetti, A. P. Dicker, R. S. Axelrod

Bodine Journal

Background: A phase I trial of induction cisplatin, docetaxel, 5-FU and erlotinib (TPF-E) followed by cisplatin, bevacizumab and erlotinib (PA-E) with radiotherapy (XRT) for advanced head and neck cancer (HNC) was conducted.

American Society for Therapeutic Radiation Oncology (ASTRO) 52nd Annual Meeting October 31 - November 4, San Diego, CA

Effect Of Cediranib, Temozolamide And Radiotherapy In U87 Gbm Wtegfr And Egfrviii-Expressing Xenografts, P. Wachsberger, R. Y, Lawrence, Y. Liu, B. Andersen, A. P. Dicker

Bodine Journal

Introduction: Glioblastomas (GBM) frequently overexpress the epidermal growth factor receptor (wtEGFR) or its mutant, EGFRvIII contributing to radioresistance. New treatment strategies for GBM include blockade of EGFR signaling and angiogenesis. Cediranib (CD) is a highly potent VEGFR-2 RTKI that inhibits all three VEGF receptors. This study investigated the radiosensitizing potential of CD in combination with temozolamide (TMZ) in U87 GBM xenografts expressing wtEGFR or EGFRvIII.

Radiation Research Society (RRS) 8th Annual Meeting September 25-29, Maui, HI

Control Of Glycolytic Flux By Ampk And P53-Mediated Signaling Pathways In Tumor Cells Grown At Low Ph, D. B. Leeper, E. E. Mendoza, J. Caro, R. Burd

Bodine Journal

Introduction: Tumor cells grow in nutrient and oxygen deprived microenvironments and adapt to the suboptimal growth conditions by altering metabolic pathways. This adaptation process characteristically results in a tumor phenotype that displays upregulated Hif-1α anaerobic glycolysis, chronic acidification, reduced rate of overall protein synthesis, lower rate of cell proliferation and aggressive invasive characteristics. Most transplantable tumors exhibit a pHe of 6.7- 7.0; the DB-1 melanoma xenografts used here have a pHe=6.7. Understanding tumor cell reaction to the microenvironment is a critical factor in predicting the tumor response to radiotherapy. The glucose regulatory molecule, 6-Phosphofructo-2-Kinase/Fructose-2,6- Biphosphatase Isoform-3 (PFKFB3), is a bifunctional …