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A Telehealth Clinical Workflow For Academic Radiation Oncology Programs During The Covid19 Pandemic, Gregor Manukian, MD, PhD, Christian Fernandez, MD, Paul Forrest, Adam Dicker, MD, PhD, Mark D. Hurwitz, MD 2020 Thomas Jefferson University

A Telehealth Clinical Workflow For Academic Radiation Oncology Programs During The Covid19 Pandemic, Gregor Manukian, Md, Phd, Christian Fernandez, Md, Paul Forrest, Adam Dicker, Md, Phd, Mark D. Hurwitz, Md

House Staff Quality Improvement and Patient Safety Conference (2020-)

  • COVID19 has resulted in drastic measures to decrease exposure risks within healthcare systems, with cancer patients at increased risk of infection and death (Liang. Lancet Oncol. 2020).
  • Telehealth is the delivery of medical care via interactive audio and/or video telecommunication services.
  • Telehealth was previously used sparingly within the department of radiation oncology but has suddenly become the preferred method of contact.
  • In order to maintain quality of care, patient satisfaction, resident learning, and reimbursement, a robust telehealth clinical workflow is critical.
  • Our department engaged various stakeholder to quickly develop a clinical workflow.


The Effects Of Total Body Proton Irradiation On Mouse Myometrium, Lillith Bulawa 2020 East Tennessee State University

The Effects Of Total Body Proton Irradiation On Mouse Myometrium, Lillith Bulawa

Undergraduate Honors Theses

The boundaries of human space exploration continue to expand with new technology and discoveries making it even more important to investigate the effects of space on biological systems. Although humans have explored space in small increments, reproductive studies must be conducted to determine if stable short- or long-term residences for humans can exist in space. This study explored the effects of whole-body proton radiation on uterine smooth muscle known as the myometrium. Two types of mice utilized in this study were C57BL/6 and B6.129S6Cybbtm1Din/J NOX2 knockout mice. C57BL/6 mice are standard laboratory mice that were used ...


Development Of Fully Balanced Ssfp And Computer Vision Applications For Mri-Assisted Radiosurgey (Mars), Jeremiah Wayne Sanders 2020 The University of Texas MD Anderson Cancer Center UTHealth Graduate School of Biomedical Sciences

Development Of Fully Balanced Ssfp And Computer Vision Applications For Mri-Assisted Radiosurgey (Mars), Jeremiah Wayne Sanders

The University of Texas MD Anderson Cancer Center UTHealth Graduate School of Biomedical Sciences Dissertations and Theses (Open Access)

Prostate cancer is the second most common cancer in men and the second-leading cause of cancer death in men. Brachytherapy is a highly effective treatment option for prostate cancer, and is the most cost-effective initial treatment among all other therapeutic options for low to intermediate risk patients of prostate cancer. In low-dose-rate (LDR) brachytherapy, verifying the location of the radioactive seeds within the prostate and in relation to critical normal structures after seed implantation is essential to ensuring positive treatment outcomes.

One current gap in knowledge is how to simultaneously image the prostate, surrounding anatomy, and radioactive seeds within the ...


Development Of Fully Balanced Ssfp And Computer Vision Applications For Mri-Assisted Radiosurgey (Mars), Jeremiah Sanders 2020 The University of Texas MD Anderson UTHealth Graduate School of Biomedical Sciences

Development Of Fully Balanced Ssfp And Computer Vision Applications For Mri-Assisted Radiosurgey (Mars), Jeremiah Sanders

The University of Texas MD Anderson Cancer Center UTHealth Graduate School of Biomedical Sciences Dissertations and Theses (Open Access)

Prostate cancer is the second most common cancer in men and the second-leading cause of cancer death in men. Brachytherapy is a highly effective treatment option for prostate cancer, and is the most cost-effective initial treatment among all other therapeutic options for low to intermediate risk patients of prostate cancer. In low-dose-rate (LDR) brachytherapy, verifying the location of the radioactive seeds within the prostate and in relation to critical normal structures after seed implantation is essential to ensuring positive treatment outcomes.

One current gap in knowledge is how to simultaneously image the prostate, surrounding anatomy, and radioactive seeds within the ...


Meeting Radiation Dosimetry Capacity Requirements Of Population-Scale Exposures By Geostatistical Sampling., Peter K Rogan, Eliseos J Mucaki, Ruipeng Lu, Ben C Shirley, Edward Waller, Joan H M Knoll 2020 Western University

Meeting Radiation Dosimetry Capacity Requirements Of Population-Scale Exposures By Geostatistical Sampling., Peter K Rogan, Eliseos J Mucaki, Ruipeng Lu, Ben C Shirley, Edward Waller, Joan H M Knoll

Biochemistry Publications

BACKGROUND: Accurate radiation dose estimates are critical for determining eligibility for therapies by timely triaging of exposed individuals after large-scale radiation events. However, the universal assessment of a large population subjected to a nuclear spill incident or detonation is not feasible. Even with high-throughput dosimetry analysis, test volumes far exceed the capacities of first responders to measure radiation exposures directly, or to acquire and process samples for follow-on biodosimetry testing.

AIM: To significantly reduce data acquisition and processing requirements for triaging of treatment-eligible exposures in population-scale radiation incidents.

METHODS: Physical radiation plumes modelled nuclear detonation scenarios of simulated exposures at ...


Stereotactic Body Radiation Therapy For Hepatocellular Carcinoma In Patients With Child-Pugh B Or C Cirrhosis, Peter L. Lee, Yunsheng Ma, Isabel Zacharias, Adel Bozorgzadeh, Sean Wilson, Kim Foley, Paul Rava, Mark Masciocchi, Linda Ding, Jacob R. Bledsoe, Thomas J. Fitzgerald, Shirin Sioshansi 2020 University of Massachusetts Medical School

Stereotactic Body Radiation Therapy For Hepatocellular Carcinoma In Patients With Child-Pugh B Or C Cirrhosis, Peter L. Lee, Yunsheng Ma, Isabel Zacharias, Adel Bozorgzadeh, Sean Wilson, Kim Foley, Paul Rava, Mark Masciocchi, Linda Ding, Jacob R. Bledsoe, Thomas J. Fitzgerald, Shirin Sioshansi

Radiology Publications

Purpose: Our purpose was to report outcomes in patients with Child-Pugh B or C (CP B/C) hepatocellular carcinoma (HCC) treated with stereotactic body radiation therapy (SBRT).

Methods and Materials: Patients with HCC suitable for SBRT were prospectively enrolled in the study from 2012 to 2018. Outcomes in patients with CP B/C were analyzed. Cox proportional hazard models were used to compare survival outcomes between baseline CP score and post-SBRT CP score.

Results: Twenty-three patients with CP B/C with a total of 29 HCC tumors were treated with SBRT. Eighty-seven percent of patients were CP B8-C10. Median tumor ...


Organ Preservation For Advanced Laryngeal Cancer: Experience With Concurrent Chemoradiation Therapy, Asif Ali Arain, Muhammad Shaheryar Ahmed Rajput, Shabbir Akhtar, Arsalan A. Rajput, Mohammad Adeel, Ahmad Hatem, Ahmed Nadeem Abbasi 2020 The Indus Hospital, Karachi, PAK.

Organ Preservation For Advanced Laryngeal Cancer: Experience With Concurrent Chemoradiation Therapy, Asif Ali Arain, Muhammad Shaheryar Ahmed Rajput, Shabbir Akhtar, Arsalan A. Rajput, Mohammad Adeel, Ahmad Hatem, Ahmed Nadeem Abbasi

Section of Otolaryngology, Head & Neck Surgery

Introduction: The larynx is a part of the upper respiratory tract that performs many essential functions including breathing, speaking, and swallowing. For this reason, the quality of life is significantly affected by laryngeal cancer and its treatment. Therefore, the focus of management for the last few decades has been on preserving the function of a larynx without compromising survival. This study was done with the purpose of reviewing our experience of organ preservation approach with concurrent chemoradiation therapy (CCRT) for locally advanced cancers of larynx.
Methods: A retrospective chart review was carried out for the data of pathology reports and ...


Dietary Alterations Modulate The Microrna 29/30 And Igf-1/Akt Signaling Axis In Breast Cancer Liver Metastasis., Anuradha A. Shastri, Anthony Saleh, Jason E. Savage, Tiziana DeAngelis, Kevin Camphausen, Nicole L. Simone 2020 Thomas Jefferson University

Dietary Alterations Modulate The Microrna 29/30 And Igf-1/Akt Signaling Axis In Breast Cancer Liver Metastasis., Anuradha A. Shastri, Anthony Saleh, Jason E. Savage, Tiziana Deangelis, Kevin Camphausen, Nicole L. Simone

Department of Radiation Oncology Faculty Papers

Background: Metastatic cancer is incurable and understanding the molecular underpinnings is crucial to improving survival for our patients. The IGF-1/Akt signaling pathway is often impaired in cancer leading to its progression and metastases. Diet modification is known to alter the IGF-1/Akt pathway and affect the expression of microRNA involved in tumor initiation, growth and metastases. Liver metastases are one of the most common type of metastases in breast and colon cancer. In the present study, we looked at the effect of diet modification on the expression of microRNA in normal liver and liver with breast cancer metastases using ...


Design And Analysis Of A Novel Long-Distance Double Tendon-Sheath Transmission Device For Breast Intervention Robots Under Mri Field, Xiaohong Jia, Yongde Zhang, Jingang Jiang, Haiyan Du, Yan Yu 2020 Harbin University of Science and Technology

Design And Analysis Of A Novel Long-Distance Double Tendon-Sheath Transmission Device For Breast Intervention Robots Under Mri Field, Xiaohong Jia, Yongde Zhang, Jingang Jiang, Haiyan Du, Yan Yu

Department of Radiation Oncology Faculty Papers

Cancer represents a major threat to human health. Magnetic resonance imaging (MRI) provides superior performance to other imaging-based examination methods in the detection of tumors and offers distinct advantages in biopsy and seed implantation. However, because of the MRI environment, the material requirements for actuating devices for the medical robots used in MRI are incredibly demanding. This paper describes a novel double tendon-sheath transmission device for use in MRI applications. LeBus grooves are used in the original transmission wheels, thus enabling the system to realize long-distance and large-stroke transmission with improved accuracy. The friction model of the transmission system and ...


Atrx Loss In Pediatric Glioma Results In Epigenetic Dysregulation Of G2/M Checkpoint Maintenance And Sensitivity To Atm Inhibition, Brendan Mullan, Tingting Qin, Ruby Siada, Carla Danussi, Jacqueline Brosnan-Cashman, Drew Pratt, Taylor Garcia, Viveka Nand Yadav, Xinyi Zhao, Meredith Morgan, Sriram Venneti, Alan Meeker, Alnawaz Rehemtulla, Pedro Lowenstein, Maria Castro, Carl Koschmann 2020 Wayne State University School of Medicine

Atrx Loss In Pediatric Glioma Results In Epigenetic Dysregulation Of G2/M Checkpoint Maintenance And Sensitivity To Atm Inhibition, Brendan Mullan, Tingting Qin, Ruby Siada, Carla Danussi, Jacqueline Brosnan-Cashman, Drew Pratt, Taylor Garcia, Viveka Nand Yadav, Xinyi Zhao, Meredith Morgan, Sriram Venneti, Alan Meeker, Alnawaz Rehemtulla, Pedro Lowenstein, Maria Castro, Carl Koschmann

Medical Student Research Symposium

ATRX is a histone chaperone protein recurrently mutated in pediatric glioma. The mechanism which mediates the proliferative advantage of ATRX loss in pediatric glioma remains unexplained. Recent data revealed a distinct pattern of DNA binding sites of the ATRX protein using ChIP-seq in mouse neuronal precursor cells (mNPCs). Using the ATRX peaks identified in p53-/- mNPCs, we confirmed that ATRX binding sites were significantly enriched in gene promoters (p < 0.0001) and CpG islands (p < 0.0001) compared with random regions. Gene set enrichment (GSE) analysis identified that cell cycle and regulation of cell cycle were among the most significantly enriched gene sets (p=2.52e-16 and 1.61e-9, respectively). We found that ATRX loss resulted in dysfunction of G2/M checkpoint maintenance: (1) ATRX-deficient pediatric glioblastoma (GBM) cells exhibited a seven-fold increase in mitotic index at 16 hours after sub-lethal radiation, and (2) murine GBM cells with ATRX knockdown demonstrated impaired pChk1 signaling on western blot at multiple time points after radiation compared to controls (p=0.0187). Notably, the ATM signaling (pChk2) remained intact in those cells, suggesting a potential therapeutic target. ATRX-deficient mouse cells were uniquely sensitive to ATM inhibitors at 1 uM alongside 8 Gy radiation compared to controls with intact ATRX (AZD0156: p=0.0027 and AZD01390: p=0.0436). Mice intra-cranially implanted with ATRX-deficient GBM cells showed improved survival (n=10, p=0.0018) when treated with AZD0156 combined with radiation. Our findings suggest that ATRX loss in glioma results in unique sensitivity to ATM inhibition via epigenetic dysregulation of G2/M checkpoint maintenance.


Don’T Call Me In The Morning: Why It Might Be Best To See Patients In-Person, A Case Report, Johnny Jarnagin, Jennifer Baima, Mathew J. Most, David A. Mazin 2020 University of Massachusetts Medical School

Don’T Call Me In The Morning: Why It Might Be Best To See Patients In-Person, A Case Report, Johnny Jarnagin, Jennifer Baima, Mathew J. Most, David A. Mazin

Orthopedics and Physical Rehabilitation Publications

Case Diagnosis: Post-irradiation Sarcoma

Case Description: A 58-year-old woman with a history of stage IIIB squamous cell carcinoma of the cervix who was treated with chemoradiation, considered in remission 5 years prior on PET CT, and was under every 6-months surveillance for recurrence by gynecology. She presented to the Emergency Department for severe back pain, left sided sciatica, and paresthesias. In the absence of fracture or cord compression, she was discharged with recommendations for primary care follow-up. This took place over the telephone with referral to the spine center. One week later, her pain progressed to 10+/10 with dense ...


Prehabilitation To Improve Positioning Reproducibility In Patients Undergoing Pelvic Radiation Therapy, Alexander Lukez, Lauren O'Loughlin 2020 University of Massachusetts Medical School

Prehabilitation To Improve Positioning Reproducibility In Patients Undergoing Pelvic Radiation Therapy, Alexander Lukez, Lauren O'Loughlin

Capstone Presentations

Prehabilitation to improve patient positioning: pelvic exercises assist in reducing sacral slope variability during radiation therapy

Purpose/Objective(s):

Reproducible patient positioning is essential for precision in radiation therapy (RT) delivery. However, a retrospective review of pre-treatment imaging demonstrated variability in daily patient set-up. We tested the hypothesis that a structured daily pre-treatment stretching regimen is both feasible and effective for minimizing variability in positioning, as measured by sacral slope angles (SSA).

Materials/Methods:

After obtaining IRB approval, we had 8 female patients undergoing pelvic radiotherapy perform a structured daily hip exercise regimen (extension and external rotation) immediately prior to ...


The Pivotal Role Of Patient-Centred Approaches In Successful Outcome Of Evidence-Based High Quality Cancer Care, Ahmed Nadeem Abbasi 2020 Aga Khan University

The Pivotal Role Of Patient-Centred Approaches In Successful Outcome Of Evidence-Based High Quality Cancer Care, Ahmed Nadeem Abbasi

Department of Radiation Oncology

No abstract provided.


Implementation Of Telehealth In Radiation Oncology: Rapid Integration During Covid-19 And Its Future Role In Our Practice., A. Goenka, Daniel Ma, S. Teckie, C. Alfano, B. Bloom, J. Hwang, L. Potters 2020 Zucker School of Medicine at Hofstra/Northwell

Implementation Of Telehealth In Radiation Oncology: Rapid Integration During Covid-19 And Its Future Role In Our Practice., A. Goenka, Daniel Ma, S. Teckie, C. Alfano, B. Bloom, J. Hwang, L. Potters

Journal Articles

Introduction: The widespread coronavirus disease 2019 (COVID-19) has resulted in significant changes in care delivery among radiation oncology practices and demanded the rapid incorporation of telehealth. However, the impact of a large-scale transition to telehealth in radiation oncology on patient access to care and the viability of care delivery are largely unknown. In this manuscript, we review our implementation and report data on patient access to care and billing implications. As telehealth is likely to continue after COVID-19, we propose a radiation oncology-specific algorithm for telehealth.

Material and Methods: In March 2020, our department began to use telehealth for all ...


Treating Covid-19 Positive Cancer Patients With Radiation Therapy: A Case Report From Epicenter Of The Pandemic., B. Parashar, L. Lee, C. Madu, A. Narayana, L. Potters 2020 Zucker School of Medicine at Hofstra/Northwell

Treating Covid-19 Positive Cancer Patients With Radiation Therapy: A Case Report From Epicenter Of The Pandemic., B. Parashar, L. Lee, C. Madu, A. Narayana, L. Potters

Journal Articles

The coronavirus disease 2019 (SARS-Cov-2 or COVID-19) pandemic has resulted in unprecedented clinical challenges across the globe. Outcomes of patients with this infection are likely dependent on underlying comorbidities that predict worse outcome in older patients. However, it is unknown whether COVID-19 infected cancer patients receiving radiation therapy (RT) have any different outcome than non-infected patients. We present the first series from our center of COVID-19 infected patients who received RT for malignancy, their outcome, and toxicities.


Disease Site-Specific Guidelines For Curative Radiation Treatment During 'Limited Surgery' And 'Hospital Avoidance': A Radiation Oncology Perspective From The Epicenter Of Covid-19 Pandemic., B Parashar, WC Chen, JM Herman, L Potters 2020 Zucker School of Medicine at Hofstra/Northwell

Disease Site-Specific Guidelines For Curative Radiation Treatment During 'Limited Surgery' And 'Hospital Avoidance': A Radiation Oncology Perspective From The Epicenter Of Covid-19 Pandemic., B Parashar, Wc Chen, Jm Herman, L Potters

Journal Articles

No abstract provided.


Development Of A Robust Treatment Delivery Framework For Stereotactic Body Radiotherapy (Sbrt) Of Synchronous Multiple Lung Lesions, Lana Catherine Critchfield 2020 University of Kentucky

Development Of A Robust Treatment Delivery Framework For Stereotactic Body Radiotherapy (Sbrt) Of Synchronous Multiple Lung Lesions, Lana Catherine Critchfield

Theses and Dissertations--Radiation Medicine

Stereotactic body radiation therapy (SBRT) of lung tumors uses high doses of radiation to deliver high biological effective doses (BED) in very few fractions (1-5). With the use of highly conformal fields to cover the tumor without depositing large doses to non-cancerous structures, this technique has proven time and again to be successful at achieving high local control. However, frequently patients receiving SBRT are elderly with multiple medical comorbidities who may not tolerate long treatment times. Furthermore, many patients present with oligometastatic or multiple primary lung tumors. The success of SBRT on oligometastatic lung disease relies on physician experience with ...


Guidelines To Reduce Hospitalization Rates For Patients Receiving Curative-Intent Radiation Therapy During The Covid-19 Pandemic: Report From A Multicenter New York Area Institution, WC Chen, S Teckie, G Somerstein, N Adair, L Potters 2020 Zucker School of Medicine at Hofstra/Northwell

Guidelines To Reduce Hospitalization Rates For Patients Receiving Curative-Intent Radiation Therapy During The Covid-19 Pandemic: Report From A Multicenter New York Area Institution, Wc Chen, S Teckie, G Somerstein, N Adair, L Potters

Journal Articles

No abstract provided.


Evidence Of Y Chromosome Long Non-Coding Rnas Involved In The Radiation Response Of Male Non-Small Cell Lung Cancer Cells, Tayvia Brownmiller 2020 West Virginia University

Evidence Of Y Chromosome Long Non-Coding Rnas Involved In The Radiation Response Of Male Non-Small Cell Lung Cancer Cells, Tayvia Brownmiller

Graduate Theses, Dissertations, and Problem Reports

Non-small cell lung cancer (NSCLC) is the number one cause of cancer related mortality in the United States and worldwide. Advanced and therapeutically resistant lung tumors contribute to the high rate of mortality from NSCLC, therefore there is a need for new methods of diagnosing and treating this disease. Long non-coding RNAs (lncRNAs) have been shown to be a crucial component of human molecular biology, regulating nearly every cellular pathway from chromatin condensation to transcription and translation. Furthermore, many lncRNAs have been classified as oncogenes or tumor suppressors, highlighting the various molecular mechanisms they are involved in regarding the formation ...


Spatially Fractionated Radiation Therapy: History, Present And The Future, Weisi Yan, Mohammad K. Khan, Xiaodong Wu, Charles B. Simone II, Jiajin Fan, Eric Gressen, Xin Zhang, Charles L. Limoli, Houda Bahig, Slavisa Tubin, Waleed F. Mourad 2020 Thomas Jefferson University

Spatially Fractionated Radiation Therapy: History, Present And The Future, Weisi Yan, Mohammad K. Khan, Xiaodong Wu, Charles B. Simone Ii, Jiajin Fan, Eric Gressen, Xin Zhang, Charles L. Limoli, Houda Bahig, Slavisa Tubin, Waleed F. Mourad

Department of Radiation Oncology Faculty Papers

No abstract provided.


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