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https://www.readbyqxmd.com/read/28629952/analysis-of-outcomes-using-hypofractionated-tumor-bed-boost-combined-with-hypofractionated-whole-breast-irradiation-for-early-stage-breast-cancer
#1
Esther Yu, David Huang, Kara Leonard, Thomas Dipetrillo, David Wazer, Jaroslaw Hepel
INTRODUCTION: Tumor bed boost improves local control and is an important part of breast-conserving therapy. Data on the use of a hypofractioned tumor bed boost are needed. We performed a retrospective analysis of patients treated with hypofractionated whole breast irradiation (WBI) and hypofractionated boost to examine acute and delayed outcomes. MATERIALS AND METHODS: We examined the records of patients treated with hypofractionated WBI and tumor bed boost after lumpectomy for Stage 0 to II breast cancer...
May 25, 2017: Clinical Breast Cancer
https://www.readbyqxmd.com/read/28463158/postmastectomy-radiation-therapy-is-associated-with-improved-survival-in-node-positive-male-breast-cancer-a-population-analysis
#2
Matthew J Abrams, Paul P Koffer, David E Wazer, Jaroslaw T Hepel
PURPOSE: Because of its rarity, there are no randomized trials investigating postmastectomy radiation therapy (PMRT) in male breast cancer. This study retrospectively examines the impact of PMRT in male breast cancer patients in the National Cancer Institute's Surveillance, Epidemiology, and End Results (SEER) database. METHODS AND MATERIALS: The SEER database 8.3.2 was queried for men ages 20+ with a diagnosis of localized or regional nonmetastatic invasive ductal/lobular carcinoma from 1998 to 2013...
June 1, 2017: International Journal of Radiation Oncology, Biology, Physics
https://www.readbyqxmd.com/read/28068233/multi-institutional-nomogram-predicting-survival-free-from-salvage-whole-brain-radiation-after-radiosurgery-in-patients-with-brain-metastases
#3
Daniel Gorovets, Diandra Ayala-Peacock, David J Tybor, Paul Rava, Daniel Ebner, Deus Cielo, Georg Norén, David E Wazer, Michael Chan, Jaroslaw T Hepel
PURPOSE: Optimal patient selection for stereotactic radiosurgery (SRS) as the initial treatment for brain metastases is complicated and controversial. This study aimed to develop a nomogram that predicts survival without salvage whole brain radiation therapy (WBRT) after upfront SRS. METHODS AND MATERIALS: Multi-institutional data were analyzed from 895 patients with 2095 lesions treated with SRS without prior or planned WBRT. Cox proportional hazards regression model was used to identify independent pre-SRS predictors of WBRT-free survival, which were integrated to build a nomogram that was subjected to bootstrap validation...
February 1, 2017: International Journal of Radiation Oncology, Biology, Physics
https://www.readbyqxmd.com/read/27745983/stereotactic-body-radiation-therapy-boost-after-concurrent-chemoradiation-for-locally-advanced-non-small-cell-lung-cancer-a-phase-1-dose-escalation-study
#4
Jaroslaw T Hepel, Kara Lynne Leonard, Howard Safran, Thomas Ng, Angela Taber, Humera Khurshid, Ariel Birnbaum, David E Wazer, Thomas DiPetrillo
PURPOSE: Stereotactic body radiation therapy (SBRT) boost to primary and nodal disease after chemoradiation has potential to improve outcomes for advanced non-small cell lung cancer (NSCLC). A dose escalation study was initiated to evaluate the maximum tolerated dose (MTD). METHODS AND MATERIALS: Eligible patients received chemoradiation to a dose of 50.4 Gy in 28 fractions and had primary and nodal volumes appropriate for SBRT boost (<120 cc and <60 cc, respectively)...
December 1, 2016: International Journal of Radiation Oncology, Biology, Physics
https://www.readbyqxmd.com/read/27720585/updated-feasibility-and-reproducibility-results-of-multi-institutional-study-of-noninvasive-breast-tumor-bed-boost
#5
Jessica Schuster, Christopher Chipko, Michael Kasper, Sandra Sha, Douglas Ciuba, James Petrikas, Anand Kuruvilla, Ravichandra Sandrapaty, Coral Quiet, Cynthia Anderson, Rashmi Benda, David Wazer, Jaroslaw Hepel, Douglas Arthur
PURPOSE: To report updated feasibility and reproducibility results for high-dose-rate noninvasive breast brachytherapy (NIBB) for tumor bed boost with whole breast radiation therapy (WBRT) in the setting of expanded patient and treatment facility number. METHODS AND MATERIALS: Fifteen independent community-based and academic centers reported 518 early-stage breast cancer patients from July 2007 to February 2015 on a privacy-encrypted online data registry. All patients' treatment included lumpectomy followed by combination of WBRT and NIBB...
October 6, 2016: Brachytherapy
https://www.readbyqxmd.com/read/27557828/adjuvant-radiotherapy-in-early-stage-breast-cancer-evidence-based-options
#6
REVIEW
Chirag Shah, Rahul Tendulkar, Timothy Smile, Anish Nanavati, Bindu Manyam, Ehsan Balagamwala, Yvonne Pham, Radhika Takiar, Jessica Wobb, Atif Khan, Douglas Arthur, David Wazer, Frank Vicini
BACKGROUND: Patients with a diagnosis of early-stage breast cancer are offered the option of either mastectomy or breast-conserving therapy (BCT) secondary to multiple randomized trials demonstrating equivalent long-term outcomes. Traditionally, BCT has used standard whole-breast irradiation (SWBI) after breast-conserving surgery, although several alternatives have emerged during the past few decades. METHODS: This report reviews key studies supporting each radiation technique and its respective eligibility criteria to assist clinicians in deciding which adjuvant radiotherapy options are appropriate for their patients...
November 2016: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/27475478/accelerated-partial-breast-irradiation-an-update-on-published-level-i-evidence
#7
REVIEW
Frank Vicini, Chirag Shah, Rahul Tendulkar, Jessica Wobb, Douglas Arthur, Atif Khan, David Wazer, Martin Keisch
Multiple adjuvant radiation therapy options currently exist for women following breast-conserving surgery including standard fractionated whole breast irradiation (WBI), accelerated whole breast irradiation (AWBI), and accelerated partial breast irradiation (APBI). The recent publication of several randomized trials comparing APBI to standard WBI provides Level I evidence supporting APBI. The purpose of this review is to summarize the Level I data supporting APBI in an effort to provide guidance when to offer this treatment approach vs...
September 2016: Brachytherapy
https://www.readbyqxmd.com/read/27203824/the-role-of-mri-in-the-follow-up-of-women-undergoing-breast-conserving-therapy
#8
Chirag Shah, Stuti Ahlawat, Atif Khan, Rahul D Tendulkar, David E Wazer, Shilpi S Shah, Frank Vicini
OBJECTIVES: Breast-conserving therapy (BCT) represents a standard of care in the management of breast cancer. However, unlike mastectomy, women treated with BCT require follow-up imaging of the treated breast as well as the contralateral breast as part of posttreatment surveillance. Traditionally, surveillance has consisted of clinical exams and mammograms. However, magnetic resonance imaging (MRI) has emerged as a breast imaging technique utilized as part of high-risk screening programs as well as part of the initial diagnosis and workup of women considered for BCT...
June 2016: American Journal of Clinical Oncology
https://www.readbyqxmd.com/read/26993371/the-impact-of-early-detection-and-intervention-of-breast-cancer-related-lymphedema-a-systematic-review
#9
REVIEW
Chirag Shah, Douglas W Arthur, David Wazer, Atif Khan, Sheila Ridner, Frank Vicini
Breast cancer-related lymphedema (BCRL) has become an increasingly important clinical issue as noted by the recent update of the 2015 NCCN breast cancer guidelines which recommends to "educate, monitor, and refer for lymphedema management." The purpose of this review was to examine the literature regarding early detection and management of BCRL in order to (1) better characterize the benefit of proactive surveillance and intervention, (2) clarify the optimal monitoring techniques, and (3) help better define patient groups most likely to benefit from surveillance programs...
June 2016: Cancer Medicine
https://www.readbyqxmd.com/read/26617203/introduction-the-changing-spectrum-of-breast-cancer
#10
David E Wazer
No abstract text is available yet for this article.
January 2016: Seminars in Radiation Oncology
https://www.readbyqxmd.com/read/26600011/regional-nodal-irradiation-examining-the-clinical-implications-of-randomized-trials
#11
Chirag Shah, Atif Khan, Douglas Arthur, David Wazer, Constantine Mantz, Vivek Verma, Frank Vicini
No abstract text is available yet for this article.
February 2016: American Journal of Clinical Oncology
https://www.readbyqxmd.com/read/26029666/predictors-for-long-term-survival-free-from-whole-brain-radiation-therapy-in-patients-treated-with-radiosurgery-for-limited-brain-metastases
#12
Daniel Gorovets, Paul Rava, Daniel K Ebner, David J Tybor, Deus Cielo, Yakub Puthawala, Timothy J Kinsella, Thomas A DiPetrillo, David E Wazer, Jaroslaw T Hepel
PURPOSE: To identify predictors for prolonged survival free from salvage whole brain radiation therapy (WBRT) in patients with brain metastases treated with stereotactic radiosurgery (SRS) as their initial radiotherapy approach. MATERIALS AND METHODS: Patients with brain metastases treated with SRS from 2001 to 2013 at our institution were identified. SRS without WBRT was typically offered to patients with 1-4 brain metastases, Karnofsky performance status ≥70, and life expectancy ≥3 months...
2015: Frontiers in Oncology
https://www.readbyqxmd.com/read/25900392/prescription-dose-evaluation-for-apbi-with-noninvasive-image-guided-breast-brachytherapy-using-equivalent-uniform-dose
#13
Kara Lynne Leonard, Mark J Rivard, David E Wazer, Jessica R Hiatt, Shirin Sioshansi, Thomas A DiPetrillo, Jaroslaw T Hepel
PURPOSE: Noninvasive image-guided breast brachytherapy (NIBB) is an attractive novel approach to deliver accelerated partial breast irradiation (APBI). Calculations of equivalent uniform dose (EUD) were performed to identify the appropriate APBI dose for this technique. METHODS AND MATERIALS: APBI plans were developed for 15 patients: five with three-dimensional conformal APBI (3D-CRT), five with multi-lumen intracavitary balloons (m-IBB), and five simulating NIBB treatment...
July 2015: Brachytherapy
https://www.readbyqxmd.com/read/25667278/brachytherapy-where-has-it-gone
#14
Daniel G Petereit, Steven J Frank, Akila N Viswanathan, Beth Erickson, Patricia Eifel, Paul L Nguyen, David E Wazer
No abstract text is available yet for this article.
March 20, 2015: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/25636752/a-flawed-study-should-not-define-a-new-standard-of-care
#15
EDITORIAL
Jaroslaw Hepel, David E Wazer
No abstract text is available yet for this article.
February 1, 2015: International Journal of Radiation Oncology, Biology, Physics
https://www.readbyqxmd.com/read/25413429/local-recurrence-and-survival-following-stereotactic-radiosurgery-for-brain-metastases-from-small-cell-lung-cancer
#16
Paul Rava, Shirin Sioshansi, Thomas DiPetrillo, Rees Cosgrove, Christopher Melhus, Julian Wu, John Mignano, David E Wazer, Jaroslaw T Hepel
PURPOSE: Stereotactic radiosurgery (SRS) represents a treatment option for patients with brain metastases from small cell lung cancer (SCLC) following prior cranial radiation. Inferior local control has been described. We reviewed our failure patterns following SRS treatment to evaluate this concern. METHODS AND MATERIALS: Individuals with SCLC who received SRS for brain metastases from 2004 to 2011 were identified. Central nervous system (CNS) disease was detected and followed by gadolinium-enhanced, high-resolution magnetic resonance (MR) imaging...
January 2015: Practical Radiation Oncology
https://www.readbyqxmd.com/read/25232190/bending-the-cost-curve-a-unique-collaboration-between-radiation-oncologists-and-blue-cross-blue-shield-of-massachusetts-to-optimize-the-use-of-advanced-technology
#17
Lee Steingisser, Brian Acker, Stuart Berman, Mark J Brenner, Bruce A Bornstein, Paul Busse, Thomas J FitzGerald, Joseph O Jacobson, Eliot Jekowsky, Lisa A Kachnic, Harvey Mamon, Andrea McKee, Lawrence N Shulman, Mary Ann Stevenson, David Wazer, John A Fallon
PURPOSE: Intensity-modulated radiation therapy (IMRT) limits the dose of radiation to critical normal tissue structures and can be applied to the management of most cancers treated with radiation therapy. Because of increased treatment planning time and quality assurance, IMRT is costly. Blue Cross Blue Shield of Massachusetts (BCBSMA) and the Massachusetts Radiation Oncology Physicians Advisory Council (PAC) developed a strategy to develop standards for the appropriate use of IMRT. METHODS: Normal tissue volume guidelines were established in multiple oncology disease areas and body site regions...
September 2014: Journal of Oncology Practice
https://www.readbyqxmd.com/read/25160734/intraoperative-radiation-therapy-a-critical-analysis-of-the-eliot-and-targit-trials-part-1-eliot
#18
RANDOMIZED CONTROLLED TRIAL
Melvin J Silverstein, Gerd Fastner, Sergio Maluta, Roland Reitsamer, Donald A Goer, Frank Vicini, David Wazer
INTRODUCTION: Two randomized intraoperative radiation therapy trials for early-stage breast cancer were recently published. The ELIOT Trial used electrons (IOERT), and the TARGIT-A Trial Update used 50-kV X-rays (IORT). These studies were compared for similarities and differences. The results were analyzed and used to determine which patients might be suitable for single-dose treatment. METHOD: The primary sources of data were the ELIOT Trial and TARGIT-A Trial, as well as a comprehensive analysis of the peer-reviewed literature of accelerated partial breast irradiation (APBI) using 50-kV X-rays or electrons...
November 2014: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/25138079/intraoperative-radiation-therapy-a-critical-analysis-of-the-eliot-and-targit-trials-part-2-targit
#19
RANDOMIZED CONTROLLED TRIAL
Melvin J Silverstein, Gerd Fastner, Sergio Maluta, Roland Reitsamer, Donald A Goer, Frank Vicini, David Wazer
BACKGROUND: Two randomized intraoperative radiation therapy trials for early-stage breast cancer were recently published. The ELIOT Trial used electrons (IOERT), and the TARGIT-A Trial Update used 50-kV X-rays (IORT). These studies were compared for similarities and differences. The results were analyzed and used to determine which patients might be suitable for single-dose treatment. METHODS: The primary sources of data were the ELIOT Trial and TARGIT-A Trial, as well as a comprehensive analysis of the peer-reviewed literature of accelerated partial breast irradiation (APBI) using 50-kV X-rays or electrons...
November 2014: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/25129613/factors-influencing-eligibility-for-breast-boost-using-noninvasive-image-guided-breast-brachytherapy
#20
Jaroslaw T Hepel, Kara L Leonard, Jessica R Hiatt, Thomas A DiPetrillo, David E Wazer
PURPOSE: Noninvasive image-guided breast brachytherapy (NIBB) allows for accurate targeting of the tumor bed (TB) for breast boost by using breast immobilization and image guidance. However, not all patients are candidates for this technique. METHODS: Consecutive patients treated for breast cancer were evaluated. Patients with very small breast size (cup ≤ A) for whom immobilization could not be achieved were treated with electrons. All others underwent simulation for NIBB boost...
November 2014: Brachytherapy
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