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Nitin Ohri, William R Bodner, Rafi Kabarriti, Viswanathan Shankar, Haiying Cheng, Tony Abraham, Balazs Halmos, Rasim Gucalp, Roman Perez-Soler, Shalom Kalnicki, Madhur Garg
PURPOSE: To perform a prospective trial examining positron emission tomography (PET)-based, dose-painted intensity modulated radiation therapy (IMRT) in the setting of locally advanced non-small cell lung cancer (NSCLC). METHODS AND MATERIALS: Patients with stage IIB-III NSCLC were treated with 25 fractions of dose-painted IMRT. Tumors or lymph nodes with metabolic tumor volume exceeding 25 cm3 were deemed "high risk" and received 65 Gy. Smaller lesions were treated with 57 Gy or 52...
October 28, 2017: International Journal of Radiation Oncology, Biology, Physics
Nitin Ohri, Wolfgang Tomé, Shalom Kalnicki, Madhur Garg
BACKGROUND: Stereotactic body radiation therapy (SBRT) is increasingly used to treat early-stage non-small cell lung cancer (NSCLC). A previous report introduced the term size-adjusted biologically effective dose (sBED), which accounts for tumor diameter and biologically effective dose (BED) and may be used to predict the likelihood of local control following SBRT. Here we seek to replicate those findings using a separate dataset. METHODS AND MATERIALS: We queried the RSSearch Patient Registry for patients treated with SBRT for stage I NSCLC...
October 7, 2017: Practical Radiation Oncology
Ravindra Yaparpalvi, Madhur K Garg, Jin Shen, William R Bodner, Dinesh K Mynampati, Aleiya Gafar, Hsiang-Chi Kuo, Amar K Basavatia, Nitin Ohri, Linda X Hong, Shalom Kalnicki, Wolfgang A Tomé
OBJECTIVES: Several dose metrics in the categories - homogeneity, coverage, conformity and gradient have been proposed in literature for evaluating treatment plan quality. In this study, we applied these metrics to characterize and identify the plan quality metrics that would merit plan quality assessment in Lung SBRT dose distributions. METHODS: Treatment plans of 90 Lung SBRT patients, comprising 91 targets, treated in our institution were retrospectively reviewed...
December 11, 2017: British Journal of Radiology
Evan Landau, Shalom Kalnicki
Pancreatic cancer is an aggressive malignancy with a poor long-term survival and only mild improvement in outcomes over the past 30 years. Local failure remains a problem and radiation can help improve control. The role of radiation therapy in has been controversial and is still evolving. This article reviews the trials of pancreatic cancer and radiation in adjuvant, neoadjuvant, and unresectable lesions. The article reviews the impact and outcomes of evolving radiation technology.
February 2018: Surgical Clinics of North America
Rafi Kabarriti, Thomas J Quinn, Michelle R Ewart, Keyur J Mehta, Craig Lomita, David S Geller, Shalom Kalnicki, Jana L Fox
Myoepithelial tumors of the soft tissue are a rare tumor displaying myoepithelial elements and lacking obvious ductal differentiation. The rarity of these precludes any evidence-based consensus regarding optimal management. Nevertheless, the current approach to these lesions begins with amputation or complete excision. The efficacy of neoadjuvant or adjuvant radiation therapy or chemotherapy has not been established. Here, we present the first report to the authors' knowledge of neoadjuvant radiation therapy for the treatment of this rare soft tissue neoplasm and review the management and outcomes of published cases of myoepithelial carcinoma...
October 12, 2017: International Journal of Cancer. Journal International du Cancer
Emma B Holliday, James A Bonner, Silvia C Formenti, Stephen M Hahn, Shalom Kalnicki, Fei-Fei Liu, Benjamin Movsas, Clifton D Fuller, Charles R Thomas
The importance of emotional intelligence (EI) in physicians has attracted attention as researchers begin to focus on the relationship of EI to retention, promotion, and productivity among academic physicians. However, to date, no formal evaluation of EI has been conducted among current department chairs. The objectives of this study were to assess the EI of current chairs of academic radiation oncology departments and to correlate EI with a self-reported assessment of burnout.The authors invited 95 chairs of academic radiation oncology departments to participate in a survey, approved by an institutional review board, consisting of the Trait Emotional Intelligence Questionnaire Short Form (TEIQue-SF) and the abbreviated Maslach Burnout Inventory (a-MBI)...
September 2017: Journal of Healthcare Management / American College of Healthcare Executives
Hsiang-Chi Kuo, Keyur J Mehta, Ravindra Yaparpalvi, Alan Lee, Dinesh Mynampati, William Bodner, Madhur Garg, David Huang, Wolfgang A Tomé, Shalom Kalnicki
BACKGROUND AND PURPOSE: To assess the dosimetric flexibility of a dual balloon brachytherapy applicator developed for the treatment of anorectal lesions. MATERIALS AND METHODS: Different amounts of water were infused into the inner and outer balloon separately to study the asymmetrical distribution of the catheter, the radial distance of the active source channel to the inner surface of the global target volume , the space between the active source channels, and their dosimetric impact to target tissues and uninvolved rectum...
January 1, 2017: Technology in Cancer Research & Treatment
Patricia Lucey, Christos Zouzias, Loren Franco, Sravana K Chennupati, Shalom Kalnicki, Beth N McLellan
PURPOSE: Due to the inconclusive evidence for available treatment options, management of radiation dermatitis (RD) varies among practitioners. This study defines and reviews the current treatment patterns for RD in the USA, providing guidance for practicing physicians as well as directions for future research. METHODS: An online survey of 21 questions was emailed to all 5626 members of the 2013 American Society for Radiation Oncology (ASTRO) directory, which included radiation oncologists, residents, fellows, physician assistants, nurse practitioners, registered nurses and other care providers...
September 2017: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
Nitin Ohri, Rafi Kabarriti, William R Bodner, Keyur J Mehta, Viswanathan Shankar, Balazs Halmos, Missak Haigentz, Bruce Rapkin, Chandan Guha, Shalom Kalnicki, Madhur Garg
PURPOSE: To perform a prospective trial testing the feasibility and utility of acquiring activity data as a measure of health status during concurrent chemoradiotherapy. METHODS AND MATERIALS: Ambulatory patients who were planned for treatment with concurrent chemoradiotherapy with curative intent for cancers of the head and neck, lung, or gastrointestinal tract were provided with activity monitors before treatment initiation. Patients were asked to wear the devices continuously throughout the radiation therapy course...
April 1, 2017: International Journal of Radiation Oncology, Biology, Physics
Hsiang-Chi Kuo, Keyur J Mehta, Ravindra Yaparpalvi, Viswanathan Shankar, William Bodner, Madhur Garg, Amanda Rivera, Wolfgang A Tomé, Shalom Kalnicki
PURPOSE: This study assessed the modeled probability of tumor control and organ at risk toxicities in locally advanced cervical cancer in patients treated by external beam radiation plus brachytherapy using intracavitary combined with interstitial brachytherapy (IC/IS) vs. intracavitary brachytherapy (IC) alone. MATERIAL AND METHODS: Twenty cervical cancer patients with a mean HR-CTV volume of 47.4 cm(3) and a mean width of 54 mm were planned with both IC/IS and IC brachytherapy alone...
December 2016: Journal of Contemporary Brachytherapy
Nitin Ohri, William R Bodner, Balazs Halmos, Haiying Cheng, Roman Perez-Soler, Steven M Keller, Shalom Kalnicki, Madhur Garg
BACKGROUND: We previously reported that pretreatment positron emission tomography (PET) identifies lesions at high risk for progression after concurrent chemoradiation therapy (CRT) for locally advanced non-small cell lung cancer (NSCLC). Here we validate those findings and generate tumor control probability (TCP) models. METHODS: We identified patients treated with definitive, concurrent CRT for locally advanced NSCLC who underwent staging (18)F-fluorodeoxyglucose/PET/computed tomography...
February 1, 2017: International Journal of Radiation Oncology, Biology, Physics
Madhur K Garg, Fengmin Zhao, Joseph A Sparano, Joel Palefsky, Richard Whittington, Edith P Mitchell, Mary F Mulcahy, Karin I Armstrong, Nassim H Nabbout, Shalom Kalnicki, Bassel F El-Rayes, Adedayo A Onitilo, Daniel J Moriarty, Thomas J Fitzgerald, Al B Benson
Purpose Squamous cell carcinoma of the anal canal (SCCAC) is characterized by high locoregional failure (LRF) rates after sphincter-preserving definitive chemoradiation (CRT) and is typically associated with anogenital human papilloma virus infection. Because cetuximab enhances the effect of radiation therapy in human papilloma virus-associated oropharyngeal squamous cell carcinoma, we hypothesized that adding cetuximab to CRT would reduce LRF in SCCAC. Methods Sixty-one patients with stage I to III SCCAC received CRT including cisplatin, fluorouracil, and radiation therapy to the primary tumor and regional lymph nodes (45 to 54 Gy) plus eight once-weekly doses of concurrent cetuximab...
March 2017: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
P Brodin, R Kabarriti, I Vogelius, C Guha, S Kalnicki, M Garg, W Tome
PURPOSE: To determine patterns of failure in laryngeal cancer treated with definitive IMRT by comparing two different methods for identifying the recurrence epicenter on follow-up PET/CT. METHODS: We identified 20 patients treated for laryngeal squamous cell carcinoma with definitive IMRT who had loco-regional recurrence diagnosed on PET/CT. Recurrence PET/CT scans were co-registered with the original treatment planning CT using deformable image registration with the VoxAlign deformation engine in MIM Software...
June 2016: Medical Physics
S Hsu, A Basavatia, M Garg, S Kalnicki, W Tome
PURPOSE: To improve the efficiency of a radiotherapy peer-review system using a commercially available software application for plan quality evaluation and documentation. METHODS: A commercial application, FullAccess (Radialogica LLC, Version 1.4.4), was implemented in a Citrix platform for peer-review process and patient documentation. This application can display images, isodose lines, and dose-volume histograms and create plan reports for peer-review process...
June 2016: Medical Physics
R Yaparpalvi, D Mynampati, H Kuo, M Garg, W Tome, S Kalnicki
PURPOSE: To study the influence of superposition-beam model (AAA) and determinant-photon transport-solver (Acuros XB) dose calculation algorithms on the treatment plan quality metrics and on normal lung dose in Lung SBRT. METHODS: Treatment plans of 10 Lung SBRT patients were randomly selected. Patients were prescribed to a total dose of 50-54Gy in 3-5 fractions (10?5 or 18?3). Doses were optimized accomplished with 6-MV using 2-arcs (VMAT). Doses were calculated using AAA algorithm with heterogeneity correction...
June 2016: Medical Physics
K Jeong, A Basavatia, D Mynampati, M Garg, S Kalnicki, W Tome
PURPOSE: To compare VMAT SRS plans, dynamic conformal arc (DCA) plans, and Brainlab iPlan's capability of planning and delivering brain SRS plans by employing HybridArc. HybridArc utilizes both DCA and IMRT. Using HybridArc, the amount of DCA versus IMRT needs to be optimized. METHODS: Four SRS patients with the aim of reducing brainstem dose were selected for this study. All patients were contoured in iPlan and transferred to Eclipse for VMAT planning. In iPlan, DCA plans were created for each case...
June 2016: Medical Physics
Sujith Baliga, Rafi Kabarriti, Nitin Ohri, Hilda Haynes-Lewis, Ravindra Yaparpalvi, Shalom Kalnicki, Madhur K Garg
The management of patients with recurrent head and neck cancers remains a challenging clinical dilemma. Concerns over toxicity with re-irradiation have limited its use in the clinical setting. Stereotactic Body Radiation Therapy (SBRT) has emerged as a highly conformal and precise type of radiotherapy and has the advantage of sparing normal tissue. Although SBRT is an attractive treatment modality, its use in the clinic is limited, given the technically challenging nature of the procedure. In this review, we attempt to provide a comprehensive overview of the role of re-irradiation in patients with recurrent head and neck cancers, with particular attention to the advent of SBRT and its use with systemic therapies such as cetuximab...
December 20, 2016: Head & Neck
Sujith Baliga, Madhur K Garg, Jana Fox, Shalom Kalnicki, Patrick A Lasala, Mary R Welch, Wolfgang A Tomé, Nitin Ohri
OBJECTIVE: Fractionated stereotactic radiotherapy (FSRT) is a relatively new option for the treatment of brain metastases. We performed a quantitative systematic review to determine if local control (LC) following is affected by FSRT dosing regimen. METHODS: We reviewed articles describing LC following FSRT for brain metastases. LC data from each study were extracted from actuarial survival curves and aggregated to form a single data set. LC curves were generated using the Kaplan-Meier method...
February 2017: British Journal of Radiology
R Kabarriti, P Brodin, N Ohri, I Vogelius, T J Ow, A Tassler, S Packer, B A Schiff, R V Smith, M Haigentz, C Guha, S Kalnicki, W A Tome, M K Garg
No abstract text is available yet for this article.
October 1, 2016: International Journal of Radiation Oncology, Biology, Physics
J Purswani, S Baliga, H Haynes, R Kabarriti, N Ohri, B Rapkin, M K Garg, S Kalnicki
No abstract text is available yet for this article.
October 1, 2016: International Journal of Radiation Oncology, Biology, Physics
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