Radiation Medicine Commons^™

Clinical Outcomes Of Neoadjuvant Chemoimmunotherapy Vs. Chemoradiotherapy In Operable Non-Small Cell Lung Cancer, Tal Sherman, Nikta Nair, Marli Meller, Raleigh Anderson, Guillermo Jimenez, Elizaveta Flevora, Charalambos Solomides, Rita Axelrod, Sarah Gordon, Ida Micaily, Maria Werner-Wasik, Sung Whang, Tyler Grenda, Olugbenga Okusanya, Nathaniel R. Evans, Iii, Nilanjan Haldar, Erik Blomain

Department of Radiation Oncology Posters

Introduction

• Non-small cell lung cancer (NSCLC) accounts for ~85% of lung cancers and remains the leading cause of cancer death.
• Surgery is curative for early-stage disease, but recurrence rates remain high.
• CheckMate-816 trial established neoadjuvant chemo-immunotherapy (chemo-IO) as a new standard for resectable NSCLC, demonstrating improved pathologic response and event-free survival.
• PACIFIC trial showed the survival benefit of consolidative immunotherapy after chemoradiotherapy (chemo-RT) in unresectable stage III NSCLC, highlighting the synergy between radiation and immune checkpoint blockade.
• Despite these advances, there is little comparative data on the role of chemo-IO versus chemo-RT in the neoadjuvant, operable setting.
• Objective: To compare …

Anatomically Accurate, Low-Cost 3d-Printed Nasopharynx Simulator For Nasolaryngoscopy Training, Tal Sherman, Robert Walker, Voichita Bar-Ad, Firas Mourtada

Department of Radiation Oncology Posters

Introduction

- Flexible nasopharyngolaryngoscopy (NPL) is a core diagnostic and procedural skill in otolaryngology, radiation oncology, and related specialties. Early mastery is essential for safe patient care, but traditional training is limited by:

• Reliance on patient encounters, which may cause discomfort and restrict practice opportunities.
• High cost of commercial simulators(often $3,000–$5,000), restricting access across many programs.
• Lack of anatomical accuracyin available models, limiting their educational value.

- Gap: There is currently no accessible, anatomically faithful, and affordable tool for widespread trainee use.

- Objective: To design, fabricate, and validate a low-cost, anatomically accurate 3D-printed simulator for training in flexible NPL

Development And Validation Of An Ai-Based Lung Lobe Auto-Contouring Tool Using Radiation Therapy Planning Free-Breathing Images, Peter Ciaccio, Joseph Lombardo, Andrew Fuquay, Soroush Pahlavian, Rachel Grimm, Jun Kang, Wookjin Choi, Paul Sullivan, Yevgeniy Vinogradskiy

Department of Radiation Oncology Faculty Papers

BACKGROUND: Pulmonary toxicity can occur during radiation therapy of the lungs. Dose metrics evaluated at the lobar level can improve the ability to predict toxicity. Contouring lung lobes is challenging and time consuming. Currently there are limited dosimetry studies evaluating the dose to lung lobes. The purpose of this work was to develop and validate an artificial intelligence (AI) lung lobe auto-contouring algorithm using radiation therapy planning images.

MATERIALS AND METHODS: Fifty lung cancer patients from two institutions were analyzed, and a clinician contoured all five lung lobes [left upper lobe (LUL), left lower lobe (LLL), right upper lobe (RUL), …

Evaluating Dosimetric Outcomes In A Prostate Rapid Plan Model: A Comparison Of Prostate Treatment Plans With And Without Standardized Planning Structures, Erica Wartman

Masters Projects

Abstract

Knowledge-based planning (KBP) using RapidPlan (RP) has demonstrated the ability to produce high quality radiation therapy treatment plans while reducing time. This study evaluated whether the inclusion of department specific standardized planning structures, including rings and other optimization tools, improves plan quality when using a prostate and lymph node RP model, or if the model alone is sufficient to provide a quality plan without the use of these additional planning structures.

Ten previously treated Prostate+LN patients were replanned using the departmental RP model in Varian Eclipse treatment planning system.1 For each patient, two plans were created, one with standardized …

Evaluating Coplanar And Noncoplanar Treatment Plans For The Varian Halcyon And Varian Truebeam For Intact Prostate Patients., Ashley Coppage

Masters Projects

Prostate cancer is among the most treated malignancies with radiation therapy, where precise dose delivery is critical for tumor control and minimizing toxicity. VMAT is widely adopted due to its efficiency and conformity; however, the choice between coplanar and non-coplanar beam arrangements remains an area of ongoing investigation, especially with newer platforms like Halcyon and TrueBeam. This retrospective dosimetric study compares coplanar and non-coplanar volumetric modulated arc therapy (VMAT) treatment plans for intact prostate cancer patients using the Varian Halcyon and Varian TrueBeam systems. Plans were created using a standardized protocol within Eclipse v16.1, with all Halcyon plans employing coplanar …

Radiation Induced Vaporization Of Exoskeletal Droplets As Potential X-Ray Acoustic Contrast Agents, Mohamed E. Eldib, William N. Frantz, Mark A. Borden, Ryan Lanning, Moyed Miften, David H. Thomas

Department of Radiation Oncology Faculty Papers

BACKGROUND: In vivo dosimetry is a crucial component of ensuring accurate and safe radiation therapy (RT) delivery, but many existing techniques face challenges such as low signal-to-noise ratio (SNR), which can limit their clinical applicability.

PURPOSE: In this study, we investigate a novel contrast agent sensitive to megavoltage (MV) radiation in vitro, ultimately aiming for in vivo dosimetry.

METHODS: Vaporizable exoskeletal droplets were engineered to phase-change into ultrasound-responsive microbubbles upon exposure to MV photon radiation. These droplets comprised a hydrocarbon (HC) exoskeleton doped with gold nanoparticles (GNPs) surrounding a liquid fluorocarbon (FC) core. Radiation absorbed by the GNPs induced localized …

Dosimetric Effects Of Pinnacle³ Version 18.0 Advanced Auto-Planning Settings In Oropharyngeal Vmat Optimization, Emily Sanden

Masters Projects

This study evaluated the impact of Pinnacle³ version 18.0 auto-planning advanced settings modulation amount, monitor unit (MU) level, and dose fall-off priority on volumetric modulated arc therapy (VMAT) plan quality for bilateral oropharyngeal cancer. A total of 64 plans were generated using all possible combinations of low, medium, high, and very high settings for each parameter. A standardized base of tongue case was optimized once per plan using a single-time point approach, with planned target volume 1 (PTV1) (6996 cGy) and planned target volume 2 (PTV2) (5412 cGy) coverage evaluated. Each parotid gland, the spinal cord, brainstem, and the oral …

Impact Of Prostate Volume On Dose Fall-Off And Organ-At-Risk Exposure In Vmat For Prostate Cancer, Zhikang Jiang

Masters Projects

Prostate cancer remains one of the most prevalent malignancies among men, with radiotherapy, particularly VMAT—playing a central role in its management. VMAT allows for highly conformal dose delivery, but treatment planning must strike a careful balance between achieving steep dose gradients around the prostate and minimizing radiation exposure to nearby organs at risk (OARs), such as the bladder and rectum. This study aimed to evaluate how prostate volume influences dose fall-off characteristics and OAR dose exposure in VMAT treatment plans, providing insights into optimizing radiotherapy for patients with varying prostate sizes. A retrospective analysis was conducted on 50 prostate cancer …

Comparing Dosimetric Outcomes Of Static Imrt And Vmat In Accelerated Partial Breast Irradiation For Medially Located, Left-Sided Tumor Beds, Rani Jamil

Masters Projects

Abstract

Introduction: Accelerated partial breast irradiation (APBI) has emerged as a targeted alternative to whole-breast irradiation for early-stage breast cancer, particularly for patients with medially located, left-sided tumors. Static intensity-modulated radiation therapy (IMRT) and volumetric modulated arc therapy (VMAT) offer advanced dose conformity, yet no direct comparisons between static IMRT and VMAT have been conducted specifically for medially located, left-sided APBI, a uniquely challenging anatomical subgroup. This study evaluates dosimetric differences between static IMRT and VMAT plans to determine which modality provides superior target coverage and organ-at-risk (OAR) sparing in left-sided APBI.

Methods: Ten patients with medially located left-sided breast …

Investigating The Necessity Of Adaptive Radiotherapy In Tomotherapy Of Head And Neck Cancer Patients, Ali Chaparian, Mahsa Kianinia, Mahnaz Roayaei, Nadia Najafizade, Abolfazl Kanani, Leili Mahani, Hamidreza Nourzadeh

Department of Radiation Oncology Faculty Papers

BACKGROUND: Anatomical variations that occur during radiation therapy in head and neck cancer (HNC) patients can lead to significant dosimetric changes. The purpose of this study is to evaluate dosimetric and volume changes in key anatomical structures for different treatment sites in HNC patients, and to determine the percentage of patients who need adaptive radiotherapy (ART) per treatment site.

METHODS: A total of 1,740 megavoltage computed tomography (MVCT) images from 58 HNC patients treated with helical tomotherapy (HT) were exported to the PreciseART™ (Accuray) software. Volume changes in the planning target volume (PTV) and the organs at risk (OARs) in …

Dosimetric Comparisons For Determining Optimal Arc Geometry In Multi Target Thoracic Vmat Sbrt Treatment Plans For Patients With Locally Advanced Inoperable Nsclc, Alexandrea M. Reeves

Masters Projects

Non-coplanar beam arrangements have been used for many years in radiation treatment planning. Their use has been known to show an increase in target conformity and gradient index. However, by using non-coplanar beam arrangements, the treatment planning time as well as the treatment delivery time can increase. Despite the increase in treatment planning and delivery complexity and time, previous studies have shown a decrease in OAR doses resulting in a desire to use non-coplanar beams. Previous studies have looked at various body sites and target locations, though no research has been found specifically studying non-coplanar beam arrangement in multi-target treatment …

First Quantitative Investigation On The Dosimetric Perturbation From Dental Hardware In Spot-Scanning Proton Arc (Sparc®) Therapy And Planning Strategies In Head Neck Cancer Patient Population, Evan Harbert

Masters Projects

Purpose

There has been a tremendous interest in applying Spot-scanning Proton Arc (SPArc^®) to benefit head and neck cancer (HNC) patient population. However, the dental hardware materials effects on the beam distribution are not well understood, and placing spots through the dental hardware may cause an unnecessary degradation of target coverage if the material components differ from the nominal plan. The purpose of this study is to provide a quantitative dose perturbation analysis of the uncertainties caused by dental hardware and introduce a SPArc^® planning strategy to mitigate such impacts.

Methods and Materials

A published in-house developed …

Cone Beam Ct Dose Optimisation: A Review And Expert Consensus By The 2022 Estro Physics Workshop Igrt Working Group, Lydia J. Wilson, Andria Hadjipanteli, Daniella E. Østergaard, Evelien Bogaert, Kirstie F. Brown, Rianne Dejong, James Earley, Magali Edouard, Marina Khan, Josh Lindsay, Jessica Van Der Himst, George X. Ding, Tim Wood, Marianne C. Aznar, Nuria Jornet, Georgios Ntentas

Department of Radiation Oncology Faculty Papers

Image guided radiotherapy (IGRT) using kilovoltage cone-beam CT (CBCT) has become an indispensable tool to ensure the geometric accuracy of radiotherapy treatment delivery. Although significant technical advances have been made in reducing imaging dose, the repeated imaging procedures can still accumulate significant dose to healthy tissues. Despite the widespread use, we still lack clear guidance for optimisation and widely accepted frameworks for evaluating the quality and suitability of CBCT imaging protocols. To address this gap, the 2022 European Society for Radiotherapy and Oncology (ESTRO) Physics Workshop focused on image-quality and imaging-dose optimisation for IGRT using CBCT. This publication represents a …

A Semiclassical Model Of The Immediate Temperature Distribution Surrounding The Track Of Heavy Ions With Therapeutic Energies, Martin Rädler, Niayesh Afshordi, Reza Taleei, Katia Parodi, Ramin Abolfath, Julie Lascaud

Department of Radiation Oncology Faculty Papers

Objective. Spikes of high temperature and pressure are created in the vicinity of heavy ions, especially at the Bragg peak. The expected subsequent thermoacoustic effects are however not well understood. In particular, the distribution of the densely packed primary interactions has not been considered in molecular dynamics (MDs) simulations or shock wave solutions. In this work, we derive a dedicated model to describe the primary interactions and their radial distribution, applicable to the modeling of acoustic and thermodynamic effects at the nanoscale. Approach. Starting from first principles, we assemble a semiclassical model of the energy loss of the primary heavy …

Decoding Resistance To Immune Checkpoint Inhibitors In Non-Small Cell Lung Cancer: A Comprehensive Analysis Of Plasma Proteomics And Therapeutic Implications, Michal Harel, Nili Dahan, Coren Lahav, Eyal Jacob, Yehonatan Elon, Igor Puzanov, Ronan J. Kelly, Yuval Shaked, Raya Leibowitz, David P. Carbone, David R. Gandara, Adam P. Dicker

Department of Radiation Oncology Faculty Papers

BACKGROUND: Immune checkpoint inhibitors (ICIs) have shown substantial benefit for patients with advanced non-small cell lung cancer (NSCLC). However, resistance to ICIs remains a major clinical challenge. Here, we perform a comprehensive bioinformatic analysis of plasma proteomic profiles to explore the underlying biology of treatment resistance in NSCLC.

METHODS: The analysis was performed on 388 "resistance-associated proteins" (RAPs) that were previously described as pretreatment plasma proteomic predictors within the PROphet computational model designed to predict ICI clinical benefit in NSCLC. Putative tissue origins of the RAPs were explored using publicly available datasets. Enrichment analyses were performed to investigate RAP-related biological …

Treatment Outcomes Following Tme For Biologically Unfavorable Locally Advanced Rectal Cancer, Maryam Aleissa, Amr Aref, Hussein Gharib, Ernesto R. Drelichman, Amer Zeni, Amer Alame, Jasneet S. Bhullar

Conference Presentation Abstracts

Purpose/Background: Many centers now offer organ preservation for selected patients with locally advanced rectal cancer. Our group initiated three Phase II trials to assess the safety of this approach in various clinical scenarios. Nonoperative management was recommended only for patients achieving complete clinical response CCR)after total neoadjuvant therapy TNT. Total mesorectal excision TME was advised when CCR was not achieved (primary TME), following residual cancer after Limited Local Excision LLE (completion TME), or after tumor recurrence/regrowth post-LLE or watchful waiting WW (salvage TME). This study examines treatment outcomes following primary or salvage TME in these biologically unfavorable cases.

Methods/Interventions: Each …

Comparison Of Magnetic Resonance Imaging (Mri) And Endoluminal Endoscopic Ultrasound (Eus) For Restaging Rectal Cancer After Neoadjuvant Chemotherapy, Judy Sheffeh, Amr Aref, Mohammed Barawi, Amer Alame, Amer Zeni, Ernesto R. Drelichman, Jasneet S. Bhullar

Conference Presentation Abstracts

Purpose/Background: Given the high incidence and mortality of rectal cancer, accurate staging and restaging are crucial for guiding optimal interventions. However, no consensus exists on the best imaging modality for restaging after neoadjuvant chemoradiotherapy. This study aims to compare MRI and EUS in the restaging of rectal cancer following neoadjuvant chemoradiotherapy.

Methods/Interventions: We conducted a prospective observational study and enrolled patients with rectal cancer. EUS and MRI were performed at diagnosis for initial staging and repeated after neoadjuvant chemotherapy and chemoradiotherapy for restaging. A total of 43 patients were enrolled, with 25 patients (10 males, 15 females) with rectal cancer …

Can Anemia Be A Prognostic Indicator To Scope For Gastroesophageal Junction Adenocarcinoma?, Ryan Tam, Neha Narayanan, Evan Basha, Joel Thompson

Advances in Clinical Medical Research and Healthcare Delivery

Gastroesophageal junction adenocarcinoma is a rapidly progressive disease that has a poor prognosis with a 5-year survival rate of 20%. It commonly presents with major symptoms of dysphagia and weight loss in addition to a long-standing history of reflux. As of now, screening for esophageal adenocarcinoma (EAC) is dependent on identifying risk factors which include a family history of Barrett’s esophagus and esophageal adenocarcinoma or patients with gastroesophageal reflux disease and at least one other risk factory for EAC such as age greater than 50 years, obesity or central adiposity, history of smoking, or male gender. Here, we present a …

Toxicity And Clinical Outcomes Following Brachytherapy Using 3-D Dosimetric Planning In Patients With Cervical Cancer: An Institutional Experience, Nikita M. Patel, Jacob F. Oyeniyi, Maha Saada Jawad

Posters

• Cervical cancer is the most common gynecological cancer worldwide.1

• The standard of care for locally advanced cervical cancer (LACC) includes primary chemoradiation, brachytherapy, and external-beam radiotherapy.2

• Brachytherapy (BT) involves the targeted delivery of radiation to the cervix (Fig 1). However, radiation can be toxic to surrounding structures, most commonly affecting the gynecological, genitourinary, and gastrointestinal systems.3

• Historically, brachytherapy was planned using a 2-D approach, which had limitations in accuracy and increased toxicity to the adjacent bowel and bladder. 3-D planning using CT or MRI has been shown to have improved dose precision and reduced toxicity.4

• …

Comparison Of Two Adjuvant High-Dose Rate Vaginal Cuff Brachytherapy Dose Fractionation Regimens For Treatment Of Early-Stage Uterine Cancer, Catherine Raciti, Hong Ye, Allison J. Hazy, Maha Saada Jawad

Posters

• Endometrial cancer is the most common gynecologic malignancy in the United States, with peak incidence at 63 years of age.¹

• PORTEC-2 trial established VBT alone as an effective modality for select high-intermediate risk patients.2

• There was no strict ABS guideline for dose fractionation; our institution adopted a 30Gy in 6 fractions regimen based on radiobiological calculations.3,4

• COVID-19 pandemic led to a shift towards 22Gy in 4 fractions

• Objective: Compare oncologic outcomes and toxicity between the 30Gy/6fx and 22Gy/4fx regimens.

• Hypothesis: Both regimens are well-tolerated and equally effective.

• Impact: Findings will inform clinical practice …

Primary Central Nervous System Lymphoma: Predictors Of Response To Induction Therapy And Patterns Of Progression, Louis Cappelli, Allison Kayne, Jennifer Newman, Ahmed Elguindy, Narendranath Epperla, Joshua D. Palmer, Ubaldo E. Martinez-Outshoorn, Pierluigi Porcu, Wenyin Shi, Iyad Alnahhas

Department of Radiation Oncology Faculty Papers

BACKGROUND: Primary central nervous system lymphoma (PCNSL) is a rare and aggressive variant of non-Hodgkin lymphoma. While PCNSL is often sensitive to induction high-dose methotrexate (HDMTX) based chemotherapy, recurrence rates remain high, approaching 50% within 5 years. The most common molecular alterations in PCNSL include mutations in MYD88 and CD79 and CDKN2A homozygous deletion. There are no predictive or prognostic molecular markers in PCNSL.

METHODS: We conducted a retrospective review of 40 patients with PCNSL treated at Thomas Jefferson University and Ohio State University between 2011 and 2023. We created a clinically annotated database of patient characteristics and outcomes. For …

Desmoplastic Small Round Cell Tumor: An Update Of Current Management Practices, Ahmed Gawash, Alexa Simonetti, Brandon J Goodwin, Alissa Brotman O'Neill

Rowan-Virtua School of Osteopathic Medicine Departmental Research

BACKGROUND: Desmoplastic small round cell tumor (DSRCT) poses a diagnostic challenge, initiating with imaging techniques like ultrasound, CT, MRI, and PET scans, with CT being the primary choice for abdominal tumor visualization. Despite advances, the absence of a standardized staging system complicates the diagnostic process.

METHODS: A comprehensive literature review and search strategy, encompassing databases like PubMed and Cochrane was performed.

RESULTS: Systemic chemotherapy, notably the P6 regimen, is the cornerstone of DSRCT treatment, while other options, including CDK4/6 inhibitors, antibody-drug conjugates, and anlotinib present varying efficacy. A novel chemotherapeutic agent, ONC-201, exhibits promise, inhibiting tumor growth in preclinical models. …

3d-Printed Organ-Realistic Phantoms To Verify Quantitative Spect/Ct Accuracy For 177lu-Psma-617 Treatment Planning, Lydia J. Wilson, Sara Belko, Eric L. Gingold, Shuying Wan, Rachel Monane, Robert S. Pugliese, Firas Mourtada

Department of Radiation Oncology Faculty Papers

Background/Objectives: Accurate patient-specific dosimetry is essential for optimizing radiopharmaceutical therapy (RPT), but current tools lack validation in clinically realistic conditions. This work aimed to develop a workflow for designing and fabricating patient-derived, organ-realistic RPT phantoms and evaluate their feasibility for commissioning patient-specific RPT radioactivity quantification. Methods: We used computed tomographic (CT) and magnetic resonance (MR) imaging of representative patients, computer-aided design, and in-house 3D printing technology to design and fabricate anthropomorphic kidney and parotid phantoms with realistic organ spacing, anatomically correct orientation, and surrounding tissue heterogeneities. We evaluated the fabrication process via geometric verification (i.e., volume comparisons) and leak testing …

Evaluating Artifact-Free Four-Dimensional Computer Tomography With 16 Cm Detector Array, Inhwan Yeo, Wei Nie, Jiajin Fan, Mindy Joo, Michael Correa, Qianyi Xu

Department of Radiation Oncology Faculty Papers

PURPOSE: To evaluate a 16 cm-array axial four-dimensional computer tomography (4DCT) in comparison with a 4 cm-array 4DCT in the presence of respiration irregularity.

METHOD: Ten traces of lung tumor motion from CyberKnife treatments were imported to move the lung cylinder, containing a spherical target, of a phantom. Images were acquired for the lung that moved to each of the 10-positions/phases (1) step-wisely by nominal helical scan at each movement (ground truth), (2) continuously by 4D scan with the 16 cm array, and (3) the same with the 4 cm array, involving table shift. Irregularities, consisting of baseline shift and/or …

Cost-Effectiveness Of Personalized Policies For Implementing Organ-At-Risk Sparing Adaptive Radiation Therapy In Head And Neck Cancer, Seyedmohammadhossein Hosseinian, Daniel Suarez-Aguirre, Cem Dede, Raul Garcia, Lucas Mccullum, Mehdi Hemmati, Aysenur Karagoz, Abdallah S R Mohamed, Stephen Y Lai, Katherine A Hutcheson, Amy C Moreno, Kristy K Brock, Fatemeh Nosrat, Clifton D Fuller, Andrew J Schaefer

Faculty, Staff and Student Publications

Background and purpose: The principle of adaptive radiation therapy (ART) is to adjust radiation plans in response to anatomical changes during treatment. The purpose of this study was to develop a decision-making model for implementation of personalized ART that balances the costs and clinical benefits of radiation plan adaptations in head and neck cancer (HNC).

Materials and methods: Using retrospective imaging data from 52 HNC patients, a Markov decision process (MDP) model was developed to determine optimal timing for plan adaptations based on the difference in normal tissue complication probability (ΔNTCP) between planned and delivered doses to organs-at-risk. To capture …

Differentiation Stage Predicts Radiosensitivity In Mesenchymal-Like Pancreatic Cancer, Tingshi Su, Xinjian Yu, Mojtaba Hoseini-Ghahfarokhi, David B Flint, Scott J Bright, Joana I D S Antunes, David K J Martinus, Mandira Manandhar, Mariam Ben Kacem, Poliana C Marinello, Eurico J G Pereira, Hua-Sheng Chiu, Uwe Titt, David R Grosshans, Jan Schuemann, Henning Willers, Harald Paganetti, Pavel Sumazin, Gabriel O Sawakuchi

Faculty, Staff and Student Publications

Purpose: To derive a genomic classifier to predict radiosensitivity of pancreatic cancer cell lines and patients with pancreatic cancer to allow genomic-guided radiation therapy.

Methods and materials: We collected a comprehensive data set of full clonogenic cell survival curves of 45 pancreatic cancer cell lines irradiated with clinical photon and proton beams. We derived classifiers based on data from human embryonic and fetal pancreas single-cell RNA-sequencing to distinguish between epithelial and mesenchymal cells and to predict pancreas cell-line differentiation stage. Independent testing was done with an embryonic mouse pancreas single-cell RNA-sequencing data set. We then used bulk RNA-seq profiles from …

Bridging Gaps In Cancer Care: Utilizing Large Language Models For Accessible Dietary Recommendations, Julia A. Logan, Sriya Sadhu, Cameo Hazlewood, Melissa Denton, Sara Burke, Christina A. Simone-Soule, Caroline Black, Corey Ciaverelli, Jacqueline Stulb, Hamidreza Nourzadeh, Yevgeniy Vinogradskiy, Amy Leader, Adam Dicker, Wookjin Choi, Nicole L Simone

Department of Radiation Oncology Faculty Papers

Background/Objectives: Weight management is directly linked to cancer recurrence and survival, but unfortunately, nutritional oncology counseling is not typically covered by insurance, creating a disparity for patients without nutritional education and food access. Novel ways of imparting personalized nutrition advice are needed to address this issue. Large language models (LLMs) offer a promising path toward tailoring dietary advice to individual patients. This study aimed to assess the capacity of LLMs to offer personalized dietary advice to patients with breast cancer. Methods: Thirty-one prompt templates were designed to evaluate dietary recommendations generated by ChatGPT and Gemini with variations within …

Chemoradiation Treatment With Or Without Concurrent Tumor-Treating Fields (Ttfields) Therapy In Newly Diagnosed Glioblastoma (Gbm) Patients In China, Liping Liang, Lingchao Chen, Chunxia Ni, Wenyin Shi, Zhirui Zhou, Shu Chen, Wenjia Zhu, Jiabing Liu, Xianxin Qiu, Wanzun Lin, Junyan Zhang, Zhiyong Qin, Yang Wang

Department of Radiation Oncology Faculty Papers

BACKGROUND: Tumor-treating fields (TTFields) therapy and radiotherapy may have synergistic anti-glioma effect based on preclinical studies. The combination of chemoradiation therapy (CRT) with TTFields therapy has noticeably attracted clinicians' attention. This study aimed to provide insights into the clinical outcomes of patients with newly diagnosed glioblastoma who received either concurrent CRT and TTFields therapy or adjuvant TTFields therapy following CRT. The findings were based on a cohort of patients who were treated at Huashan Hospital (Shanghai, China).

METHODS: This retrospective study analyzed ndGBM patients' clinical outcomes who were treated at Huashan Hospital and received TTFields therapy. Patients were categorized into …

Robust Automated Method Of Spatial Resolution Measurement In Radiotherapy Ct Simulation Images, Pavel Govyadinov, Rick R Layman, Tucker Netherton, Raymond Mumme, Aaron K Jones, Laurence E Court, Moiz Ahmad

Faculty, Staff and Student Publications

Background: Variation in imaging protocol, patient positioning, and the presence of artifacts can vary image quality in CT images used for radiotherapy planning. Automated methods for spatial resolution (SR) estimation exist but require further investigation and validation for wider adoption.

Purpose: To validated previously existing algorithm for SR estimation and introduce improvements that make it robust to patient positioning, CT protocol, site, and artifacts.

Method: A reference algorithm based on the previous gold standard was recreated and modified to improve robustness. The algorithms were tested on three different datasets: (1) a cylindrical ACR CT QC phantom scanned using a Siemens …

Patient-Reported Outcomes: Comparing Functional Avoidance And Standard Thoracic Radiation Therapy In Lung Cancer, Spencer Poiset, Joseph Lombardo, Edward Castillo, Richard Castillo, Bernard Jones, Moyed Miften, Brian Kavanagh, Adam Dicker, Cullen Boyle, Nicole Simone, Benjamin Movsas, Inga Grills, Chad Rusthoven, Yevgeniy Vinogradskiy, Lydia Wilson

Department of Radiation Oncology Faculty Papers

PURPOSE: Novel methods generate functional images using image processing techniques combined with four-dimensional computed tomography (4DCT) data (4DCT-ventilation). 4DCT-ventilation was implemented in a phase II, multicenter functional avoidance clinical trial. The work compares functional avoidance patient-reported outcomes (PROs) against historical standards.

METHODS: Patients with locally advanced lung cancer undergoing curative-intent chemoradiation were accrued. 4DCT-ventilation imaging was generated and functional avoidance treatment plans created reduced dose to functional lung. PRO instruments included Functional Assessment of Cancer Therapy Lung questionnaire and accompanying subscales (including the Trial Outcome Index [TOI]), EuroQol-5 Dimension (EQ-5D), and EQ-Visual Analog Scale (EQ-VAS). The average change from baseline …