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david wazer

Peter J Zavitsanos, David E Wazer, Jaroslaw T Hepel, Yihong Wang, Kamaljeet Singh, Kara L Leonard
BACKGROUND: Brain metastases (BM) occur in ∼5% of breast cancer patients. BRCA1-associated cancers are often basal-like and basal-like cancers are known to have a predilection for central nervous system metastases. We performed a matched-pair analysis of breast cancer patients with and without BRCA mutations and compared the frequency of BM in both groups. MATERIALS AND METHODS: From a database of 1935 patients treated for localized breast cancer at our institution from 2009 to 2014 we identified 20 patients with BRCA1 or BRCA2 mutations and manually matched 40 patients without BRCA mutations accounting for age, stage, estrogen receptor expression, and human epidermal growth factor receptor 2 (HER2) expression...
May 18, 2018: American Journal of Clinical Oncology
Chirag Shah, Frank Vicini, Simona F Shaitelman, Jaroslaw Hepel, Martin Keisch, Douglas Arthur, Atif J Khan, Robert Kuske, Rakesh Patel, David E Wazer
PURPOSE: Adjuvant radiation after breast-conserving surgery remains the standard-of-care treatment for patients with ductal carcinoma in situ and early-stage invasive breast cancer. Multiple alternatives to standard whole-breast irradiation exist including accelerated partial-breast irradiation (APBI). Therefore, the purpose of this APBI guideline is to provide updated data for clinicians as well as recommendations regarding appropriate patient selection and techniques to deliver APBI...
January 2018: Brachytherapy
Jaroslaw T Hepel, Douglas Arthur, Simona Shaitelman, Csaba Polgár, Dorin Todor, Imran Zoberi, Mitchell Kamrava, Tibor Major, Catheryn Yashar, David E Wazer
PURPOSE: To develop a consensus report for the quality practice of accelerated partial breast irradiation (APBI) using interstitial multicatheter brachytherapy (IMB). METHODS AND MATERIALS: The American Brachytherapy Society Board appointed an expert panel with clinical and research experience with breast brachytherapy to provide guidance for the current practice of IMB. This report is based on a comprehensive literature review with emphasis on randomized data and expertise of the panel...
September 2017: Brachytherapy
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
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
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
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
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...
November 2016: Brachytherapy
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
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
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
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
David E Wazer
No abstract text is available yet for this article.
January 2016: Seminars in Radiation Oncology
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
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
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
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
Jaroslaw Hepel, David E Wazer
No abstract text is available yet for this article.
February 1, 2015: International Journal of Radiation Oncology, Biology, Physics
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
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
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