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American Journal of Clinical Oncology

Eleanor M Osborne, Cathy Eng, John M Skibber, Miguel A Rodriguez-Bigas, George J Chang, Yi-Qian Nancy You, Brian K Bednarski, Bruce D Minsky, Marc E Delclos, Eugene Koay, Sunil Krishnan, Christopher H Crane, Prajnan Das
OBJECTIVES: Although chemoradiation is the standard of care for anal cancer, limited data exist regarding pelvic reirradiation (re-RT) for recurrent disease. We investigated toxicity and outcomes in patients who received prior pelvic radiation therapy (RT), and subsequently underwent hyperfractionated accelerated re-RT to the pelvis for recurrent anal cancer. MATERIALS AND METHODS: We reviewed records of 10 patients with recurrent anal squamous cell carcinoma who previously received pelvic RT to at least 30 Gy as a component of their chemoradiation and underwent re-RT in 1...
October 17, 2016: American Journal of Clinical Oncology
Ashish A Deshmukh, Hui Zhao, Prajnan Das, Elizabeth Y Chiao, Yi-Qian Nancy You, Luisa Franzini, David R Lairson, Michael D Swartz, Sharon H Giordano, Scott B Cantor
OBJECTIVE: A comparative assessment of treatment alternatives for T1N0 anal canal cancer has never been conducted. We compared the outcomes associated with the treatment alternatives-chemoradiotherapy (CRT), radiotherapy (RT), and surgery or ablation techniques (surgery/ablation)-for T1N0 anal canal cancer. MATERIALS AND METHODS: This retrospective cohort study was conducted using the Surveillance, Epidemiology and End Results (SEER) registries linked with Medicare longitudinal data (SEER-Medicare database)...
October 17, 2016: American Journal of Clinical Oncology
Yulia Kundel, Nicola J Nasser, Lea Rath-Wolfson, Ofer Purim, Natalia Yanichkin, Ronen Brenner, Tanya Zehavi, Yuval Nardi, Eyal Fenig, Aaron Sulkes, Baruch Brenner
OBJECTIVES: To determine whether the expression of specific molecular markers in the rectal cancer biopsies prior to treatment, can correlate with complete tumor response to chemoradiotherapy (CRT) as determined by the pathology of the surgical specimen. METHODS: We retrospectively examined pretreatment rectal biopsies of patients aged 18 years or older with locally advanced rectal cancer who had been treated with neoadjuvant CRT and surgical resection in our tertiary-care, university-affiliated medical center, between January 2001 and December 2011...
October 12, 2016: American Journal of Clinical Oncology
Al V Taira, Gregory S Merrick, Robert W Galbreath, Wayne M Butler, Edward Adamovich
OBJECTIVES: To evaluate whether the use of androgen deprivation therapy (ADT) in prostate brachytherapy patients impacts overall mortality (OM) in patients with lower pretreatment serum testosterone levels compared with those with normal or high baseline serum testosterone. MATERIALS AND METHODS: From October 2001 to May 2014, 1916 patients underwent brachytherapy and had a pretreatment serum testosterone. Baseline serum testosterone values were collected prospectively before initiation of therapy...
October 12, 2016: American Journal of Clinical Oncology
Florence K Keane, Jennifer Y Wo, Cristina R Ferrone, Jeffrey W Clark, Lawrence S Blaszkowsky, Jill N Allen, Eunice L Kwak, David P Ryan, Keith D Lillemoe, Carlos Fernandez-Del Castillo, Theodore S Hong
OBJECTIVES: Improved outcomes with FOLFIRINOX or gemcitabine with nab-paclitaxel in the treatment of metastatic pancreatic adenocarcinoma (PDAC) have prompted incorporation of these regimens into neoadjuvant treatment of locally advanced unresectable PDAC. Whereas some patients remain unresectable on surgical exploration, others are able to undergo resection after intensive neoadjuvant treatment. We evaluated outcomes and toxicity associated with use of intensive neoadjuvant treatment followed by intraoperative radiotherapy (IORT) in combination with resection or exploratory laparotomy...
October 12, 2016: American Journal of Clinical Oncology
Mitchell Kamrava, Robert R Kuske, Bethany Anderson, Peter Chen, John Hayes, Coral Quiet, Pin-Chieh Wang, Darlene Veruttipong, Margaret Snyder, David J Demanes
OBJECTIVES: To report outcomes for breast-conserving therapy using adjuvant accelerated partial breast irradiation (APBI) with interstitial multicatheter brachytherapy in node-positive compared with node-negative patients. MATERIALS AND METHODS: From 1992 to 2013, 1351 patients (1369 breast cancers) were treated with breast-conserving surgery and adjuvant APBI using interstitial multicatheter brachytherapy. A total of 907 patients (835 node negative, 59 N1a, and 13 N1mic) had >1 year of data available and nodal status information and are the subject of this analysis...
September 26, 2016: American Journal of Clinical Oncology
Benhua Xu, Yuangui Chen, Yuyan Guo, Debao Zhou, Zhicao Yue, Qing Duan, Yinghong Yang, Guoxian Guan, Pan Chi, Chi Lin
OBJECTIVES: To evaluate pretreatment tumor thickness in predicting pathologic complete response (pCR) of stage II/III rectal adenocarcinoma to neoadjuvant chemoradiation (chemoradiotherapy [CRT]). METHODS: We retrospectively analyzed 185 patients who were diagnosed with stage II or III rectal adenocarcinoma from January 2011 to July 2013 and treated with neoadjuvant intensity-modulated radiation therapy (45 Gy in 1.8-Gy fractions to pelvis and 50 Gy in 2-Gy fractions to rectal tumor as an integrated boost) or 3 dimensionally conformal radiation therapy (45 Gy in 1...
September 26, 2016: American Journal of Clinical Oncology
Sughosh Dhakal, Ranjana Advani, Leslie K Ballas, Bouthaina S Dabaja, Christopher R Flowers, Chul S Ha, Bradford S Hoppe, Nancy P Mendenhall, Monika L Metzger, John P Plastaras, Kenneth B Roberts, Ronald Shapiro, Sonali M Smith, Stephanie A Terezakis, Karen M Winkfield, Anas Younes, Louis S Constine
This topic addresses the treatment of newly diagnosed patients with favorable prognosis stage I and II Hodgkin lymphoma. In most cases, combined modality therapy (chemotherapy followed by involved site radiation therapy) constitutes the current standard of care. The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revision include an extensive analysis of current medical literature from peer-reviewed journals and the application of well-established methodologies (RAND/UCLA Appropriateness Method and Grading of Recommendations Assessment, Development, and Evaluation or GRADE) to rate the appropriateness of imaging and treatment procedures for specific clinical scenarios...
September 16, 2016: American Journal of Clinical Oncology
Karen E Hoffman, Heath Skinner, Thomas J Pugh, Khinh R Voong, Lawrence B Levy, Seungtaek Choi, Steven J Frank, Andrew K Lee, Usama Mahmood, Sean E McGuire, Pamela J Schlembach, Weiliang Du, Jennifer Johnson, Rajat J Kudchadker, Deborah A Kuban
OBJECTIVES: Hypofractionated prostate radiotherapy may increase biologically effective dose delivered while shortening treatment duration, but information on patient-reported urinary, bowel, and sexual function after dose-escalated hypofractionated radiotherapy is limited. We report patient-reported outcomes (PROs) from a randomized trial comparing hypofractionated and conventional prostate radiotherapy. METHODS: Men with localized prostate cancer were enrolled in a trial that randomized men to either conventionally fractionated intensity-modulated radiation therapy (CIMRT, 75...
September 15, 2016: American Journal of Clinical Oncology
Rohann J M Correa, George B Rodrigues, Hanbo Chen, Andrew Warner, Belal Ahmad, Alexander V Louie
OBJECTIVES: Metastatic renal cell carcinoma represents a clinical scenario where aggressive treatment to the primary tumor (ie, cytoreductive nephrectomy) is associated with a survival benefit. We hypothesized that stereotactic ablative radiotherapy (SABR) could be a safe alternative local modality for inoperable metastatic renal cell carcinoma patients. Our study objectives were to report on technical considerations, toxicity, and clinical outcomes of our institutional experience with renal SABR...
September 15, 2016: American Journal of Clinical Oncology
Bindu V Manyam, Rahul Tendulkar, Sheen Cherian, Frank Vicini, Shahed N Badiyan, Chirag Shah
PURPOSE/OBJECTIVE(S): After breast conserving surgery, adjuvant radiation therapy represents the standard of care for most patients. However, multiple options exist beyond standard fractionated whole breast irradiation including hypofractionated whole breast irradiation (HFRT), accelerated partial breast irradiation (APBI), and endocrine therapy (ET) alone, which can limit treatment duration, and potentially reduce morbidity and cost. Limited data are available on the percentage of patients eligible for these alternatives; therefore, a Surveillance Epidemiology and End Results (SEER) analysis was performed to assess candidacy for these alternative options in women with early stage breast cancer...
September 15, 2016: American Journal of Clinical Oncology
Sharon M Lu, Shawn Iganej, Iman A Abdalla, Gary L Buchschacher
PURPOSE OF THE STUDY: In 2003, our institution adopted triweekly carboplatin (tCb) area under the curve (AUC) 5 as an alternative to high-dose cisplatin (100 mg/m) for select patients receiving definitive concurrent chemoradiation for locally advanced laryngeal carcinoma (LALC). Here, we present our experience and outcomes with this definitive concurrent chemoradiation regimen. METHODS: From January 2003 through December 2013, 53 patients with stage III (60%) or IVA (40%) LALC were treated with tCb AUC 5 and concurrent radiotherapy to 70 Gy without neoadjuvant chemotherapy...
September 15, 2016: American Journal of Clinical Oncology
Paul L Moots, Anne O'Neill, Harold Londer, Minesh Mehta, Deborah T Blumenthal, Geoffrey R Barger, Margaret L Grunnet, Stuart Grossman, Mark R Gilbert, David Schiff
OBJECTIVES: To assess the long-term outcomes and objective response (OR) to preradiation chemotherapy and radiation in adult high-risk medulloblastoma. MATERIALS AND METHODS: In this prospective phase II trial, adults with high-risk medulloblastoma were treated with 3 cycles of preradiation cisplatin, etoposide, cyclophosphamide, and vincristine followed by craniospinal radiation (CSI). OR, progression-free survival (PFS), overall survival (OS), and toxicities were assessed...
September 15, 2016: American Journal of Clinical Oncology
Margarett Shnorhavorian, David R Doody, Vivien W Chen, Ann S Hamilton, Ikuko Kato, Rosemary D Cress, Michele West, Xiao-Cheng Wu, Theresa H M Keegan, Linda C Harlan, Stephen M Schwartz
PURPOSE OF THE STUDY: Adolescent and young adult (AYA) cancer patients are underrepresented in clinical trials, but the reasons for this phenomenon are unknown. PATIENTS AND METHODS: Questionnaire and medical record data from 515 AYA cancer patients (21 acute lymphocytic leukemia [ALL], 201 germ cell tumor, 141 Hodgkin lymphoma, 128 non-Hodgkin lymphoma, 24 sarcoma) from a population-based study were analyzed. We used multivariable models to determine characteristics associated with patient knowledge of the availability of clinical trials for their cancer...
September 15, 2016: American Journal of Clinical Oncology
Amar U Kishan, Gillian Duchesne, Pin-Chieh Wang, Jean-Claude M Rwigema, Christopher Saigal, Matthew Rettig, Michael L Steinberg, Christopher R King
OBJECTIVE: The objective was to query how specialty influences treatment recommendations for high-risk prostate cancer in 3 clinical settings: upfront management, postoperative management, and management of biochemical recurrences (BCRs) after radiotherapy (RT). We hypothesized that specialty bias would manifest in all settings, trumping available evidence. METHODS: A survey of practicing urologists and radiation oncologists was distributed through electronic mail...
August 24, 2016: American Journal of Clinical Oncology
Fiori Alite, Neelam Balasubramanian, William Adams, Murat Surucu, Ibrahim Mescioglu, Matthew M Harkenrider
OBJECTIVES: Angiotensin-converting enzyme inhibitors (ACEi) have demonstrated decreased rates of radiation-induced lung injury in animal models and clinical reports have demonstrated decreased pneumonitis in the setting of conventionally fractionated radiation to the lung. We tested the role of ACEi in diminishing rates of symptomatic (grade ≥2) pneumonitis in the setting of lung stereotactic body radiation therapy (SBRT). METHODS: We analyzed patients treated with thoracic SBRT to 48 to 60 Gy in 4 to 5 fractions from 2006 to 2014...
August 24, 2016: American Journal of Clinical Oncology
Maria K Venetis, Erina L MacGeorge, Dadrie F Baptiste, Ashton Mouton, Lorin B Friley, Rebekah Pastor, Kristen Hatten, Janaka Lagoo, Monet W Bowling, Susan E Clare
OBJECTIVES: The rate of contralateral prophylactic mastectomy (CPM) has risen sharply in the past decade. The current study was designed to examine social network, surgeon, and media influence on patients' CPM decision-making, examining not only who influenced the decision, and to what extent, but also the type of influence exerted. METHODS: Patients (N=113) who underwent CPM at 4 Indiana University-affiliated hospitals between 2008 and 2012 completed structured telephone interviews in 2013...
July 26, 2016: American Journal of Clinical Oncology
Zvi Symon, Guy Ben-Bezalel, Ben Spieler, Lev Tsvang, Dror Alezra, Raanan Berger, Zohar Dotan, Yaacov R Lawrence, Jeffrey Goldstein
PURPOSE: To evaluate salvage pelvic nodal radiation as an alternative to androgen deprivation therapy (ADT) in patients with biochemical failure and lymph node recurrence following salvage prostate fossa radiation. METHODS: Six patients with biochemical failure and lymph node recurrence following prostate fossa radiation were treated with salvage pelvic nodal radiation therapy. A gross target volume was contoured using Choline PET/CT, CT, or MRI imaging. The clinical target volume included pelvic nodes...
October 2016: American Journal of Clinical Oncology
Luther W Brady
No abstract text is available yet for this article.
October 2016: American Journal of Clinical Oncology
Surbhi Grover, Nandita Mitra, Fei Wan, John N Lukens, Sonam Sharma, Jessica Bauman, Farzad Masroor, Roger B Cohen, Arati Desai, Kenneth Algazy, Michelle Alonso-Basanta, Peter Ahn, Boon-Keng Kevin Teo, Ara A Chalian, Gregory S Weinstein, Bert W O'Malley, Alexander Lin
OBJECTIVES: Comparisons of induction chemotherapy (IC) against upfront chemoradiation (CRT) for locally advanced head and neck cancer (LA-HNSCC) have demonstrated no differences except greater toxicity with IC. Effective induction regimens that are less toxic are therefore warranted. To inform future efforts with IC, we present our institutional experience comparing a less toxic IC regimen to CRT. METHODS: We included patients with LA-HNSCC treated with organ-preservation CRT (+/-induction) between 2008 and 2011...
October 2016: American Journal of Clinical Oncology
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