Oncology Commons^™

Risk Of Secondary Malignancies After Pelvic Radiation: A Population-Based Analysis, Connor Mcpartland, Andrew Salib, Joshua Banks, James R. Mark, Costas D. Lallas, Edouard J. Trabulsi, Leonard G. Gomella, Hannan Goldberg, Benjamin Leiby, Robert Den, Thenappan Chandrasekar

Department of Urology Faculty Papers

Background and objective

Radiation therapy has increasingly been used in the management of pelvic malignancies. However, the use of radiation continues to pose a risk of a secondary malignancy to its recipients. This study investigates the risk of secondary malignancy development following radiation for primary pelvic malignancies.

Methods

A retrospective cohort review of the Surveillance, Epidemiology, and End Results database from 1975 to 2016 was performed. Primary pelvic malignancies were subdivided based on the receipt of radiation, and secondary malignancies were stratified as pelvic or nonpelvic to investigate the local effect of radiation.

Key findings and limitations

A total of …

Temporal Considerations In Brain Metastases Radiation Therapy: The Intersection Of Chronobiology And Patient Profiles, Nicolas Nelson, Sara Burke, Louis Cappelli, Lauren Matlack, Alexandria Smith, Noelle Francois, Joseph Lombardo, Yash Shah, Kuang-Yi Wen, Ayesha A Shafi, Nicole Simone

Department of Radiation Oncology Faculty Papers

The circadian system, a vital temporal regulator influencing physiological processes, has implications for cancer development and treatment response. Our study assessed circadian timing’s impact on whole-brain radiotherapy outcomes in brain metastases for personalized cancer therapy insights. The aim of the study was to evaluate circadian influence on radiation treatment timing and its correlation with clinical outcomes and to identify patient populations benefiting from interventions synchronizing circadian rhythms, considering subgroup differences and potential disparities. An IRB-approved retrospective analysis of 237 patients undergoing whole-brain radiotherapy for brain metastases (2017–2021), receiving over 80% of treatments in the morning or afternoon, was performed. Survival …

Innate Immune System In The Context Of Radiation Therapy For Cancer, Boopathi Ettickan, Robert Den, Chellappagounder Thangavel

Department of Radiation Oncology Faculty Papers

Radiation therapy (RT) remains an integral component of modern oncology care, with most cancer patients receiving radiation as a part of their treatment plan. The main goal of ionizing RT is to control the local tumor burden by inducing DNA damage and apoptosis within the tumor cells. The advancement in RT, including intensity-modulated RT (IMRT), stereotactic body RT (SBRT), image-guided RT, and proton therapy, have increased the efficacy of RT, equipping clinicians with techniques to ensure precise and safe administration of radiation doses to tumor cells. In this review, we present the technological advancement in various types of RT methods …

Auto-Segmentation In Pancreatic And Liver Radiation Therapy, Cenji Yu

Dissertations & Theses (Open Access)

Background

Gastrointestinal cancers exhibit a high mortality rate compared to other cancer types. Among these, pancreatic cancer ranks as the fourth leading cause of cancer-related deaths worldwide. The five-year survival rate remains alarmingly low at a mere 9%. Hepatocellular carcinoma (HCC), another aggressive form of cancer, is rapidly becoming the primary cause of cancer-related deaths in the United States. The treatment of both liver cancer and pancreatic cancer heavily relies on a multidisciplinary approach. Innovative treatment strategies involving dose-escalated regimens, such as stereotactic body radiation therapy (SBRT), are emerging as an important pillar of the management of liver and pancreatic …

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 …

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 …

The Effects Of Exercise On The Body’S Tolerance To Breast Cancer Treatments, Lindsay C. Lim

Nursing | Student Research Posters

Background: Breast cancer is known as one of the most common types of cancer. Treatments for this cancer include chemotherapy, radiation therapy, and surgery. These treatments, however, can cause negative side effects such as extra pain and fatigue. Exercise is a common intervention that is used in order to keep the body strong while these treatments are occurring.

Objective: The objective of this thesis is to find a correlation between exercise and how it can decrease negative side effects in patients with breast cancer. This thesis includes a literature review which talks about what types of exercise are best, if …

Experiences Of Participants In A Clinical Trial Of A Novel Radioactive Treatment For Advanced Prostate Cancer: A Nested, Qualitative Longitudinal Study, Bianca Viljoen, Michael S. Hofman, Suzanne K. Chambers, Jeff Dunn, Haryana M. Dhillon, Ian D. Davis, Nicholas Ralph

Research outputs 2022 to 2026

Objectives: Qualitative studies nested within clinical trials can provide insight into the treatment experience, how this evolves over time and where improved supportive care is required. The purpose of this qualitative study is to describe the lived experiences of men with advanced prostate cancer participating in the TheraP trial; a randomised trial of 177Lu-PSMA-617 compared with cabazitaxel chemotherapy. Methods: Fifteen men with advanced prostate cancer were recruited from the TheraP clinical trial with interviews conducted at three timepoints during the trial. An interpretative phenomenological approach was used, and interviews analysed using thematic analysis. This research paper reports the results from …

Radiation Therapy For Older Women With Early Breast Cancer: An Unnecessary Hardship, Lauren E. Shawver

Clinical Research in Practice: The Journal of Team Hippocrates

A clinical decision report appraising:

Kunkler IH, Williams LJ, Jack WJ, Cameron DA, Dixon JM; PRIME II investigators. Breast-conserving surgery with or without irradiation in women aged 65 years or older with early breast cancer (PRIME II): a randomised controlled trial [published correction appears in Lancet Oncol. 2015 Mar;16(3):e105]. Lancet Oncol. 2015;16(3):266-273. https://doi.org/10.1016/S1470-2045(14)71221-5

for an older patient seeking treatment for Stage 1 Ductal Breast Carcinoma

Financial Toxicity Tumor Board: A Multi-Disciplinary Team Activity Required In Low And Middle-Income Countries (Lmic), Ahmed Nadeem Abbasi, Sohail Rasool, Laraib Khan

Department of Radiation Oncology

No abstract provided.

Fluoroscopic Demonstration Of Thoracic Tumor Immobilization With High Frequency Percussive Ventilation, Cristian Solano, Ina M. Sala, Beverly Maurer, Ronald Levitin, Thomas M. Guerrero

Posters

INTRODUCTION
High frequency percussive ventilation (HFPV) is a novel immobilization technique that utilizes high frequency low tidal volume ventilation to produce endotracheal percussion. In a previous departmental study of chest wall motion immobilization, it was found that volunteers were able to tolerate HFPV for varying lengths of time – from a few to tens of minutes. By investigating a novel process to immobilize the chest wall, and thus thoracic tumors, it can allow for more localized radiation delivery and reduction of healthy tissue irradiation.

Personalized Nutrition As A Key Contributor To Improving Radiation Response In Breast Cancer, Anuradha A. Shastri, Joseph Lombardo, Samantha C Okere, Stephanie Higgins, Brittany C Smith, Tiziana Deangelis, Ajay Palagani, Kamryn Hines, Daniel A. Monti, Stella Volpe, Edith P. Mitchell, Nicole L Simone

Department of Radiation Oncology Faculty Papers

Understanding metabolic and immune regulation inherent to patient populations is key to improving the radiation response for our patients. To date, radiation therapy regimens are prescribed based on tumor type and stage. Patient populations who are noted to have a poor response to radiation such as those of African American descent, those who have obesity or metabolic syndrome, or senior adult oncology patients, should be considered for concurrent therapies with radiation that will improve response. Here, we explore these populations of breast cancer patients, who frequently display radiation resistance and increased mortality rates, and identify the molecular underpinnings that are, …

Management Of Intracranial Haemangiopericytomas, Noman Ahmad, Saqib Kamran Bakhshi, Muhammad Shahzad Shamim

Section of Neurosurgery

Haemangiopericytomas are rare tumours, commonly mistaken as meningiomas on radiology. These tumours are considered malignant and treatment involves aggressive surgery, followed by adjuvant radiation therapy, and close radiological and clinical follow ups. Herein the authors have reviewed the recent literature on the management of these tumours.

Treatment Of Orbital Lesions Using Cyberknife Stereotactic Radiosurgery, Emily Morahan

Student Research Poster Presentations 2021

The purpose of the research done was to evaluate the use of CyberKnife Stereotactic Radiosurgery (SRS) for treating orbital lesions. Efficacy and tolerability of such treatment was analyzed with data drawn from multiple sources, regarding dose and fractionation, quality of life following treatment(s) and prognosis. CyberKnife SRS is the newest, most advanced model of radiation delivery systems, featuring a robotic arm capable of manipulating the linear accelerator into thousands of unique angles. The addition of new angles allows for a more precise concentration of radiation delivered to the lesions. In the case of optic lesions, it is crucial to minimize …

Bypassing The Blood-Brain Barrier: A Physical And Pharmacological Approach For The Treatment Of Metastatic Brain Tumors, Samuel A. Sprowls

Graduate Theses, Dissertations, and Problem Reports

This dissertation (a) provided an in depth literature review of methods to disrupt the BBB/BTB and improve therapeutic distribution to brain tumors, (b) evaluated the use of azacitidine as a single agent therapy for the treatment of brain metastasis of breast cancer and a potential molecular mechanism by which brain tropic cells are sensitized to hypomethylating agents, (c) determined the impact cannabidiol has on P-glycoprotein mediated efflux at the blood-brain barrier and its potential for use as a single agent treatment for metastatic brain tumors, (d) developed a preclinical radiation therapy protocol for use in small animals and in vitro …

Analysis Of Racial/Ethnic Disparities And Language Barriers In Radiation Therapy, Carrie Warner

Honors Projects

It is important for every patient within healthcare to have access to and receive quality care no matter their race, ethnicity, and/or primary language. Focusing on cancer care in the United States, there are racial and ethnic disparities as well as language barriers, both within the English language itself and with foreign languages, that prevent patients from receiving high quality care. This meta-analysis provides evidence of current disparities within healthcare that can be applied to the radiation oncology department and reveals suggestions for advancements including the use of language-concordant physicians and medical interpreters. Some of the policies, plans, and resources …

The Impact Of Prostate Cancer Treatment On Quality Of Life: A Narrative Review With A Focus On Randomized Data., James M Taylor, Victor E. Chen, Ryan C. Miller, Benjamin A. Greenberger

Department of Radiation Oncology Faculty Papers

Despite excellent oncologic outcomes, the management of localized prostate cancer remains complex and is dependent on multiple factors, including patient life expectancy, medical comorbidities, tumor characteristics, and genetic risk factors. Decades of iterative clinical trials have improved the optimization and utilization of surgical and radiation-based modalities, as well as their combinatorial use with anti-androgen and systemic therapies. While cure rates are high and converging on equivalent disease control should an upfront surgical or radiotherapeutic approach be optimized, the long-term side effects of surgical and radiation-based treatments can differ significantly in nature. Decisions regarding the selection of therapy are therefore best …

Impact Of Immunotherapy On The Survival Of Pancreatic Adenocarcinoma Patients: An Analysis Of The National Cancer Database, Saber A. Amin

Theses & Dissertations

Pancreatic adenocarcinoma (PDAC) represents 7.2% of all cancer deaths, and by 2030, it will become the second leading cause of death due to cancer. The median overall survival (OS) is 17-23 months in resectable and 4-6 months in metastatic PC [8-9]. The 5-year survival of resectable PC is 22%, and unresectable PC is 8%. A majority of patients treated with standard treatments such as surgery, chemotherapy, and radiation therapy eventually succumb to the disease due to widespread micrometastases at the time of diagnosis. Due to the minimal effect of the current treatments, novel treatment strategies such as immunotherapeutics have been …

Breast Cancer Treatment: Basics For The Primary Care Provider, Sarah Hirsh, Md

Department of Family & Community Medicine Presentations and Grand Rounds

Learning Objectives

1. To review the prevalence of breast cancer and the mortality rate of breast cancer in the United States.
2. To understand breast cancer staging and its role in prognostication.
3. To understand the therapies offered for the treatment of non-metastatic, invasive breast cancer and their side effects.
4. To review the role of the PCP in caring for patients undergoing treatment for breast cancer and those in remission.

How Can We Stop Cancer?, Joseph R. Current

The Review: A Journal of Undergraduate Student Research

Cancer is a disease that humans have been struggling to combat for centuries. It originates from the accumulation of several mutations over the life of a cell that causes it to evade cell death and multiply rapidly. It can affect any tissue in the body and can spread to other parts of the body through metastasis. Cancer comes in numerous shapes and sizes with different levels of aggression, growth speeds, and health risks. Many treatments for cancer exist today, three of the most popular being surgery, chemotherapy, and radiation therapy, which can be used in combinations with other treatments to …

Blood Cancers And Oral Health, Silvia Spivakovsky Dds, Gwen Nichols Md, Laura Romundstad Crnp, Msn, Elizabeth Kitlas Lmsw

The Journal of the Michigan Dental Association

Managing Blood Cancer Patients' Oral Complications: Preventive Strategies during and after Treatment

Blood cancers, encompassing leukemia, lymphoma, myeloma, myelodysplastic syndromes (MDS), and myeloproliferative neoplasms (MPN), bring complex challenges to patient management due to their impact on hematopoiesis, immunity, and overall health. This review focuses on equipping dental practitioners with essential insights into preventing and managing intricate oral manifestations during and after treatment. Patient care strategies are outlined for leukemia subtypes such as acute lymphoblastic leukemia (ALL), acute myeloid leukemia (AML), chronic lymphocytic leukemia (CLL), and chronic myeloid leukemia (CML), emphasizing the need for tailored dental approaches. In lymphomas encompassing Hodgkin …

Impact Of Peer Review In The Radiation Treatment Planning Process: Experience Of A Tertiary Care University Hospital In Pakistan, Bilal Mazhar Qureshi, Muhammad Atif Mansha, Muneeb Uddin Karim, Asim Hafiz, Nasir Ali, Benazir Mir, Fatima Shaukat, Maria Tariq, Ahmed Nadeem Abbasi

Department of Radiation Oncology

Purpose: To evaluate and report the frequency of changes in radiation therapy treatment plans after peer review in a simulation review meeting once a week.
Materials and Methods: Between July 1 and August 31, 2016, the radiation plans of 116 patients were discussed in departmental simulation review meetings. All plans were finalized by the primary radiation oncologist before presenting them in the meeting. A team of radiation oncologists reviewed each plan, and their suggestions were documented as no change, major change, minor change, or missing contour. Changes were further classified as changes in clinical target volume, treatment field, or dose. …

Solitary Brain Metastasis: A Rare Initial Presentation Of Prostate Carcinoma, Asim Hafiz, Muneeb Uddin Karim, Bilal Mazhar Qureshi, Adnan Jabbar, Zubair Ahmad

Department of Radiation Oncology

Cerebral metastasis as an initial clinical presentation of prostate carcinoma is extremely rare. Usually, patients have widespread metastasis in the body before presenting with brain metastasis. In the absence of extensive metastasis, especially without bony metastasis, only brain metastasis is an unusual presentation of the disease. We report a case of a 59-years-old patient who presented with a lack of concentration and decreased vision. Magnetic resonance imaging (MRI) of the brain revealed a large right parietal-occipital space-occupying lesion. He underwent surgery and the pathological diagnosis of the tumor turned out to be metastatic prostate carcinoma. Further evaluation by a whole-body …

Sub-Region Based Radiomics Analysis For Survival Prediction In Oesophageal Tumours Treated By Definitive Concurrent Chemoradiotherapy, Congying Xie, Pengfei Yang, Xuebang Zhang, Lei Xu, Xiaoju Wang, Xiadong Li, Luhan Zhang, Ruifei Xie, Ling Yang, Zhao Jing, Hongfang Zhang, Lingyu Ding, Yu Kuang, Tianye Niu, Shixiu Wu

Health Physics & Diagnostic Sciences Faculty Publications

Background: Evaluating clinical outcome prior to concurrent chemoradiotherapy remains challenging for oesophageal squamous cell carcinoma (OSCC) as traditional prognostic markers are assessed at the completion of treatment. Herein, we investigated the potential of using sub-region radiomics as a novel tumour biomarker in predicting overall survival of OSCC patients treated by concurrent chemoradiotherapy. Methods: Independent patient cohorts from two hospitals were included for training (n = 87) and validation (n = 46). Radiomics features were extracted from sub-regions clustered from patients' tumour regions using K-means method. The LASSO regression for ‘Cox’ method was used for feature selection. The survival prediction model …

Combining Radiation And Immune Checkpoint Blockade In The Treatment Of Head And Neck Squamous Cell Carcinoma., Gregor Manukian, Voichita Bar-Ad, Bo Lu, Athanassios Argiris, Jennifer M. Johnson

Department of Radiation Oncology Faculty Papers

Head and neck squamous cell carcinoma (HNSCC) is a significant cause of morbidity and mortality worldwide. Current treatment options, even though potentially curative, have many limitations including a high rate of complications. Over the past few years immune checkpoint inhibitors (ICI) targeting cytotoxic lymphocyte antigen-4 (CTLA-4), programmed cell death protein 1 (PD-1), and programmed cell death ligand 1 (PD-L1) have changed treatment paradigms in many malignancies and are currently under investigation in HNSCC as well. Despite improvements in treatment outcomes and the implementation of combined modality approaches long-term survival rates in patients with locally advanced HNSCC remain suboptimal. Accumulating evidence …

Mv-626, A Potent And Selective Inhibitor Of Enpp1 Enhances Sting Activation And Augments T-Cell Mediated Anti-Tumor Activity In Vivo, Jason Baird, Gregory Dietsch, Vincent Florio, Michael Gallatin, Clayton Knox, Joshua Odingo, Marka Crittenden, Michael J. Gough

Society for Immunotherapy of Cancer 2018 Annual Meeting Posters

Background: STING is an endogenous sensor of cGAMP, which is synthesized by cGAS following detection of cytoplasmic DNA. STING activation leads to interferon production and activation of inflammatory pathways that facilitate cytolytic T cell priming. STING agonists administered intratumorally show potent anti-tumor efficacy in a range of preclinical models; several agonists are in clinical development. Radiation therapy also increases cytoplasmic DNA levels in cancer cells, resulting in STING activation and secretion of inflammatory cytokines. Ectonucleotide pyrophosphatase/phosphodiesterase 1 (ENPP1) is the phosphodiesterase that negatively regulates STING by hydrolyzing cGAMP. MV-626, a highly potent and selective ENPP1 inhibitor with 100% oral bioavailability …

Inducible T Cell Co-Stimulator (Icos) Is Upregulated On Lymphocytes Following Radiation Of Tumors And Icos Agonism In Combination With Radiation Results In Enhanced Tumor Control, Michael J. Gough, Shelly Bambina, Monica Gostissa, Christopher Harvey, David Friedman, Marka R Crittenden

Society for Immunotherapy of Cancer 2018 Annual Meeting Posters

Background: Radiation and co-stimulatory ligands or checkpoint inhibitors have demonstrated improved anti-tumor immunity and overall survival in preclinical animal studies. However, the results of human trials suggest we have not yet found the optimal combination. Here we demonstrate upregulation of ICOS expression on T cells following focal tumor radiation and test the hypothesis that ICOS agonism in combination with radiation will enhance the immunologic effect of radiation resulting in increased survival.

Methods: BALB/c mice bearing CT26 tumors or C57BL/6 mice bearing Panc02 tumors were treated at d14 with 20Gy CT guided radiation therapy and anti-ICOS antibody or isotype control antibody …

Nktr-214 (Cd122-Biased Agonist) And Nktr-262 (Tlr7/8 Agonist) Combination Treatment Pairs Local Innate Immune Activation With Systemic Cd8+ T Cell Expansion To Enhance Anti-Tumor Immunity, Annah S. Rolig, Daniel Rose, Saul Kivimäe, Deborah Charych, Werner Rubas, Jonathan Zalevsky, William L. Redmond

Society for Immunotherapy of Cancer 2018 Annual Meeting Posters

Background: Radiation therapy (RT) remains the standard of care for many human cancers. Combining NKTR-214, a CD122-biased cytokine agonist conjugated with releasable polyethylene-glycol (PEG) chains, with local RT significantly enhanced therapeutic efficacy in preclinical models. Mechanistically, NKTR-214 provides sustained signaling through the IL-2 receptor pathway (IL-2Rβγ) to preferentially activate and expand effector CD8+ T and NK cells and RT modulates the tumor microenvironment (TME) to induce antigen-release. Together, NKTR-214/RT treatment resulted in improved therapeutic responses compared to either treatment alone. However, abscopal responses in murine tumors were modest, leading us to explore alternative approaches with the potential to elicit more …

Mertk Is A Therapeutic Target In Combination With Radiation To Promote Adaptive Immune Tumor Responses, Garth Tormoen, Jason R Baird, Gwen Kramer, Shelly Bambina, Marka R Crittenden, Michael J. Gough

Society for Immunotherapy of Cancer 2018 Annual Meeting Posters

Background: Mertk is a member of the Tyro3-Axl-Mertk (TAM) family of receptors and regulates phagocytosis of dying cells by macrophages. Cancer cells killed by radiation therapy direct repolarization of macrophages into immune suppressive phenotypes. Mertk-/- mice grafted with immunogenic tumors have enhanced tumor control following ionizing radiation compared to Mertkwt mice. Gas6 is the endogenous ligand for Mertk and its ability to signal through Mertk requires a post-translational vitamin k-dependent modification that is inhibited by warfarin.

Methods: Mertk-/- and WT mice were injected subcutaneously in the flank with 5E4 CT26 cells (BALB/c) or 5E6 Panc02-SIY cells (C57BL/6) and allowed to …

Investigation Of Stereotactic Body Radiation Therapy Delivery Accuracy On An Elekta Linear Accelerator, Addie Barron

LSU Master's Theses

Purpose: This work investigated the delivery accuracy of high-dose lung and spine stereotactic treatments delivered with the Elekta Infinity and Versa HD platforms. The accuracy of these platforms will be used for consideration in implementing a spine stereotactic radiosurgery (SSRS) program at Mary Bird Perkins Cancer Center.

Methods: A geometric phantom was used to perform Winston-Lutz type tests that assessed the relevant degrees of freedom (gantry, collimator, and couch) of the delivery system. A lung stereotactic body radiation therapy (SBRT) and spine SRS treatment plan were generated for use in end-to-end testing. Delivery accuracy was tested using a novel diode …