Medical Specialties Commons^™

High Local Control And Low Ocular Toxicity Using Ultra-Low-Dose “Boom-Boom” Radiotherapy For Indolent Orbital Lymphoma, Sanjna Shelukar, Christian Fernandez, Zeynep Bas, Lydia Komarnicky, Sara E. Lally, Carol L Shields, Adam Binder, Pierluigi Porcu, Onder Alpdogan, Ubaldo Martinez-Outschoorn, Wenyin Shi

Department of Medical Oncology Faculty Papers

Background: The first line definitive treatment for early-stage indolent B-cell lymphoma is radiation therapy (RT). Due to the sensitivity of orbital structures to radiation, ultra-low-dose RT (4 Gy in 2 fractions, "boom-boom") has and been utilized as an attractive option for orbital lymphoma. In this retrospective study, we evaluated the outcome and toxicity of "boom-boom" RT for indolent orbital lymphoma with an emphasis on ophthalmologic toxicity.

Methods: This is a retrospective case series with 17 patients with orbital lymphoma who received boom-boom RT at a single tertiary referral center between January 2017 and June 2022. Medical records, imaging and radiation …

Quantifying The Dosimetric Impact Of Target Margins In The Oligometastatic Setting, Jessica E. Strang

Culminating Experience Projects

Introduction

With advancements in cancer treatment therapies, patients are living longer with oligometastatic disease. These patients may have multiple targets and may be treated in a single isocenter to reduce overall treatment time. However, the most considerable risk of treating multiple lesions in a single isocenter is a geometric miss. It can be challenging to perform daily alignment of multiple lesions creating a need to prioritize one lesion alignment over others or abort treatment.

Methods

This study quantified the dosimetric impact of total lung exposure as the planning target volume (PTV) margin incrementally increased for multiple intrathoracic lesions.

The analysis …

The Role Of The Hypoxia-Inducible Factor 2 In Pancreatic Cancer: Mechanisms Of Tumor Immunosuppression And Intestinal Radioprotection, Carolina Garcia Garcia

Dissertations & Theses (Open Access)

Pancreatic ductal adenocarcinoma (PDAC) is a devastating disease with dismal prognosis. The only curative option for patients is surgery, but over 80% of patients are not surgical candidates. Unfortunately, PDAC is resistant to the three remaining options. PDAC is characterized by a profoundly hypoxic and immunosuppressive stroma, which contributes to its therapeutic recalcitrance. Alpha-smooth muscle actin+ (αSMA+) cancer-associated fibroblasts (CAFs) are the most abundant stromal component, as well as mediators of stromal deposition. The hypoxia-inducible factors (HIF1 and HIF2) coordinate responses to hypoxia, yet, despite their known association to poor patient outcomes, their functions within the PDAC tumor microenvironment (TME) …

Automating 4dct-Ventilation Imaging Generation Using Ai-Based Advanced Lung Contours, Yingxuan Chen, Sohrab Pahlavan, Paul Jacobs, Farnoush Forghani, Edward Castillo, Richard Castillo, Yevgeniy Vinogradskiy

Conference Presentation Abstracts

Purpose: Functional avoidance radiotherapy uses functional imaging to reduce pulmonary toxicity by designing radiotherapy plans that reduce doses to functional lung. A novel form of lung functional imaging applied for functional avoidance uses 4DCT imaging to calculating 4DCT-based lung ventilation (4DCT-ventilation). The process of generating 4DCT-ventilation images requires advanced lung segmentation (consisting of a standard lung with airway and vasculature removed) which is a manual and time-consuming process. The purpose of this work is to automate 4DCT-ventilation imaging generation using AI-based auto-segmentation techniques for advanced lung contouring.

Methods: 429 patients with 4DCT data from two institutions were used. Three methods …

The Prognostic Significance Of Glucose-6-Phosphate Dehydrogenase As A Biomarker In Head And Neck Squamous Cell Carcinomas Treated With Conventional Chemoradiation, Kenneth H. Barker, Barbara L. Pruetz, Jessica D. Arden, Thomas J. Quinn, George D. Wilson

Posters

INTRODUCTION
The prognosis of patients with head and neck squamous cell carcinoma (HNSCC) treated with chemoradiation can be predicted using p16 as a surrogate biomarker of Human Papilloma Virus (HPV) status, but a subset of patients continues to do poorly despite a positive or negative p16 status. This project attempted to identify another biomarker, glucose-6-phosphate dehydrogenase (G6PD) as a marker for prognosis in HNSCC patients. Radiation induces oxidative damage to destroy tumor cells, and G6PD is a key enzyme involved in protecting cells from oxidative damage. The goal of this project was to identify a prognostic biomarker that would aid …

Integration Of Biomedical Imaging And Translational Approaches For Management Of Head And Neck Cancer, Abdallah Mohamed, Abdallah Mohamed

Dissertations & Theses (Open Access)

The aim of the clinical component of this work was to determine whether the currently available clinical imaging tools can be integrated with radiotherapy (RT) platforms for monitoring and adaptation of radiation dose, prediction of tumor response and disease outcomes, and characterization of patterns of failure and normal tissue toxicity in head and neck cancer (HNC) patients with potentially curable tumors. In Aim 1, we showed that the currently available clinical imaging modalities can be successfully used to adapt RT dose based-on dynamic tumor response, predict oncologic disease outcomes, characterize RT-induced toxicity, and identify the patterns of disease failure. We …

Atr-Mediated Cd47 And Pd-L1 Upregulation Restricts Radiotherapy-Induced Immune Priming And Abscopal Responses In Colorectal Cancer, Cheng-En Hsieh, Cheng-En Hsieh

Dissertations & Theses (Open Access)

Radiotherapy of colorectal cancer (CRC) can prime adaptive immunity against tumor-associated antigen (TAA)-expressing CRC cells systemically. However, incidences of abscopal tumor remission are extremely rare, and the post-irradiation immune escape mechanisms in CRC remain elusive. We report that CRC cells utilize a common DNA repair signaling pathway — ATR/Chk1/STAT3 — to upregulate both CD47 and PD-L1 in response to radiotherapy, which through engagement of SIRPα and PD-1 suppresses the capacity of antigen-presenting cells to phagocytose them thereby preventing TAA cross-presentation and innate immune activation. This post-irradiation CD47 and PD-L1 upregulation can be observed across various human solid tumor cells. Concordantly, …

Role Of Surgery In Multifocal Glioblastoma, Syeda Kubra Kishwar Jafri, Syed Sarmad Bukhari, Muhammad Shahzad Shamim

Section of Neurosurgery

The management of multifocal glioblastomas is a point of constant discussion amongst neuro-oncologists. Best outcomes in glioblastoma management come from gross total resection (GTR) followed by concomitant radiation and chemotherapy (CCRT). Multifocal disease is resistant to GTR. Conventional management of these lesion is usually biopsy only followed by CCRT. Recent evidence has shown that there may be some benefit to attempting GTR of the largest lesion whenever safe to do so.

Implementation Barriers To Integrating Exercise As Medicine In Oncology: An Ecological Scoping Review, Mary A. Kennedy, Sara Bayes, Robert U. Newton, Yvonne Zissiadis, Nigel Spry, Dennis Taaffe, Nicolas H. Hart, Daniel A. Galvao

Research outputs 2014 to 2021

Purpose

While calls have been made for exercise to become standard practice in oncology, barriers to implementation in real-world settings are not well described. This systematic scoping review aimed to comprehensively describe barriers impeding integration of exercise into routine oncology care within healthcare systems.

Methods

A systematic literature search was conducted across six electronic databases (since 2010) to identify barriers to implementing exercise into real-world settings. An ecological framework was used to classify barriers according to their respective level within the healthcare system.

Results

A total of 1,376 results were retrieved; 50 articles describing implementation barriers in real-world exercise oncology …

Exosomal Mirnas As Biomarkers For Radiation Toxicity In Breast Cancer Patients, Mina V. Mcginn

Theses and Dissertations

Radiotherapy (RT) is a standard treatment for most breast cancer patients (BCPs), but is often accompanied by acute and late toxic effects in normal tissue. Exosomes are nano vesicles about 30-150nm in size that originate from the endosomal network and are found in most body fluids. Exosomes are a fundamental driver of intercellular communication by transferring proteins, lipids and microRNA (miRNA). Exosomal miRNA (Exo-miRNA) signatures may serve as non-invasive prediction biomarkers of post-radiation toxicities of BCPs. Eighty six BCPs treated in the Radiation Oncology Department were enrolled in an IRB approved study. BCPs were evaluated weekly during RT and at …

Building The Plane While It’S Flying: Implementation Lessons From Integrating A Co-Located Exercise Clinic Into Oncology Care, Mary A. Kennedy, Sara Bayes, Robert U. Newton, Yvonne Zissiadis, Nigel A. Spry, Dennis R. Taaffe, Nicolas H. Hart, Daniel A. Galvão

Research outputs 2022 to 2026

Background:

Despite its therapeutic role during cancer treatment, exercise is not routinely integrated into care and implementation efforts are largely absent from the literature. The aim of this study was to evaluate a strategy to integrate the workflow of a co-located exercise clinic into routine care within a private oncology setting in two clinics in the metropolitan region of Western Australia.

Methods:

This prospective evaluation utilised a mixed methods approach to summarise lessons learned during the implementation of an integrated exercise workflow and supporting implementation plan. Data collection was informed by the RE-AIM (Reach, Effectiveness, Adoption, Implementation, Maintenance) framework. Reports …