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Khan MK, Nasti T, Kleber T, Qian JY, Switchenko J, Hess CB, Jonathan K, Nooka A, Lonial S, Ahmed R. Phase 2 Trial of Anti-PD1 and 8 Gy in 1 Fraction for Relapse/Refractory Myeloma. Int J Radiat Oncol Biol Phys 2023; 117:S108. [PMID: 37784285 DOI: 10.1016/j.ijrobp.2023.06.071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Relapsed, refractory multiple myeloma is associated with poor outcome. Role of radiotherapy is mainly for palliation. Anti-PD1 inhibitors have failed to show efficacy in relapsed refractory myeloma patients. A phase 2 trial (NCT03267888) was conducted to see if radiotherapy (8 Gy in 1 fraction) and anti-PD1 (Pembrolizumab) could provide early signals of safety and response. MATERIALS/METHODS A prospective single-center phase 2 trial involving patients >18 years of age with ECOG 0-1 was conducted after obtaining IRB approval. Patients had to have ISS stage I-III multiple myeloma that was either relapsed or refractory, an osseous and/or extraosseous lesion that could be radiated, and who were candidates for pembrolizumab. Patients had to have either measurable disease per the International Myeloma Working Group Criteria (IMWG) and/or had to have progressive disease on imaging. Radiotherapy was given on day 0, cycle 1 followed by pembrolizumab (200 mg/kg iv on day 2 or 3, then every 3 weeks +/- 7 days) on day 2-3 for at least 2 years or until progression. Primary endpoint was toxicity. Secondary endpoints were IMWG response, abscopal response, overall survival, and immunological changes in patient's blood. Patients were assessed at 3 months, 6 months, and 12 months IMWG criteria as well as serial PET/CT based imaging. Patients with stable disease or better were continued on the trial. Patients that progressive were removed. Standard statistical analysis was performed, and included Kaplan-Meier to estimate OS and PFS. RESULTS From June, 2018 until October, 2021, 32 patients were screened and 25 were enrolled. Of the enrolled patients, 76% were Caucasian, 64% had ECOG 1, and the mean age was 60 years. Prior to enrollment, the mean number of prior lines of therapy that the patients had failed was 5.20 (range: 2 - 11), suggesting a cohort with poor expected outcome. These cohort also had limited alternative options. Toxicity, as its primary endpoint, was acceptable. There were no grade 2 or higher radiation related toxicity within the irradiated volume. Only one case of grade 3 or higher pembrolizumab-related toxicity was noted amongst the 25 patients. Abscopal response was noted in 5 of 25 patients (20% patients). Several patients showed robust reductions in the paraproteins and other myeloma labs, suggesting response to radiotherapy and anti-PD1 combination. These patients were also associated to have a robust CD 8 T cell activation and an abscopal response. The secondary outcomes were better than expected for this cohort. CONCLUSION Combination therapy of single-fraction, low-dose radiation therapy with pembrolizumab in patients with relapsed or refractory multiple myeloma is worth assessing in future trials.
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Affiliation(s)
| | - T Nasti
- Department of Microbiology/Immunology, Emory University, Atlanta, GA
| | | | | | | | - C B Hess
- Grass Valley Radiation Oncology, Grass Valley, CA
| | | | - A Nooka
- Emory University, Atlanta, GA
| | | | - R Ahmed
- Department of Microbiology/Immunology, Emory University, Atlanta, GA
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Ali N, Martin KS, Tobillo R, McCook A, Switchenko J, Shelton JW, Patel AB, Patel PR, Eng TY, Remick JS. Risk Factors and Clinical Features of Fistula after Concurrent Chemoradiation and Brachytherapy for Locally Advanced Cervical Cancer. Int J Radiat Oncol Biol Phys 2023; 117:e547-e548. [PMID: 37785686 DOI: 10.1016/j.ijrobp.2023.06.1849] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) The standard treatment for locally advanced cervical cancer (LACC) is concurrent chemoradiation and brachytherapy (CRT-B). Fistula formation is a serious complication of treatment; however, risk factors and clinical outcomes are not well described. We sought to identify the incidence, risk factors and prognosis of radiation-induced fistula in women who underwent CRT-B for LACC. MATERIALS/METHODS A single institution retrospective review of patients treated with CRT-B for LACC from July 2013 to August 2022 across 3 centers was performed. Inclusion criteria were Stage IB-IVB cervical cancer treated with definitive intent. Patients with upfront or adjuvant surgery were excluded. Cox-proportional hazards model was performed to assess factors associated with fistula. Local control and fistula-free survival were estimated using the Kaplan-Meyer method. Clinical significance was defined as p < 0.05. RESULTS A total of 105 patients met the inclusion criteria and were included in this analysis. Patients consisted of FIGO Stage I (n = 20, 19%), Stage II (n = 22, 21%), Stage III (n = 46, 43.8%) or Stage IV disease (n = 17, 16.2%). 12 (11.4%) patients developed fistula following CRT-B; 1/12 patients (8.3%) had fistula present at time of diagnosis. Median time to fistula development was 12 months. Fistula was characterized as vesicovaginal/urethrovaginal in 58.3% (n = 7) and rectovaginal/intestinovaginal in 83.3% (n = 10), including 8 patients (66.7%) who had more than one type of fistula. 4/12 (33.3%) of patients with fistula had concurrent local recurrence. Patients were treated with conservative management (41.7%), hyperbaric oxygen (16.7%) and/or surgery (83.3%). Complications included infection (50.0%), urinary/bowel diversion (83.3%), hospitalization (50.0%) and death (8.3%). Fistula was resolved in 7/12 patients (58.3%) at time of last follow up. Higher BMI (p = 0.04) and use of hybrid applicators (p = 0.02) were associated with decreased likelihood of fistula development. Disease extension into bladder was associated with increased likelihood of fistula development (p = 0.03). Compared to former and never smoking, current smoking was associated with a higher risk of developing fistula (p = 0.04, OR 4.42, CI:1.07-18.34). Compared to intracavitary and hybrid applicators, the use of a Syed applicator was associated with increased likelihood of fistula development (p = 0.02, OR 8.00, CI: 1.37-46.55). Two-year local control was 82.5% (CI: 64.5-91.9) for Stage I-II, 80.7% (CI: 62.8-90.6) for Stage III, and 62.2% (CI: 30.1-82.9) for Stage IV. Two-year fistula free survival was 89.9% (CI: 80.6 - 94.9). CONCLUSION Women who undergo definitive chemoradiation for treatment of LACC have a 11.4% risk of fistula formation overall. The risk is higher amongst patients with current smoking, disease extension into bladder and Syed applicators. Overall two-year local control was 78.7% and fistula free survival was 89.9%.
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Affiliation(s)
- N Ali
- Department of Radiation Oncology, Winship Cancer Institute of Emory University, Atlanta, GA
| | - K Sykes Martin
- Department of Radiation Oncology, Winship Cancer Institute of Emory University, Atlanta, GA
| | - R Tobillo
- Department of Radiation Oncology, Winship Cancer Institute of Emory University, Atlanta, GA
| | - A McCook
- Department of Biostatistics & Bioinformatics, Winship Cancer Institute of Emory University, Atlanta, GA; Winship Cancer Institute at Emory University, Atlanta, GA
| | | | - J W Shelton
- Department of Radiation Oncology, Winship Cancer Institute of Emory University, Atlanta, GA
| | - A B Patel
- Winship Cancer Institute at Emory University, Atlanta, GA
| | - P R Patel
- Department of Radiation Oncology, Winship Cancer Institute of Emory University, Atlanta, GA
| | - T Y Eng
- Department of Radiation Oncology, Winship Cancer Institute of Emory University, Atlanta, GA
| | - J S Remick
- Winship Cancer Institute of Emory University, Department of Radiation Oncology, Atlanta, GA
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Janopaul-Naylor J, Corriher TJ, Switchenko J, Hanasoge S, Esdaille A, Mahal BA, Filson CP, Patel SA. Disparities in Time to Prostate Cancer Treatment Initiation before and after the Affordable Care Act. Int J Radiat Oncol Biol Phys 2023; 117:e28. [PMID: 37785048 DOI: 10.1016/j.ijrobp.2023.06.709] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Delayed access to care may contribute to disparities in prostate cancer (PCa). The Affordable Care Act (ACA) aimed at increasing access and reducing healthcare disparities, but its impact on timely treatment initiation for men with PCa is unknown. MATERIALS/METHODS Men with intermediate- and high-risk PCa diagnosed 2010-2016 and treated with curative surgery or radiotherapy were identified in the National Cancer Database. Multivariable logistic regression modeled the effect of race and insurance type on treatment delay >180 days after diagnosis to start of surgery, radiotherapy, or hormonal therapy. Cochran-Armitage test measured annual trends in delays, and join point regression assessed if 2014, the year the ACA became fully operationalized, was significant for inflection in crude rates of major delays. RESULTS Of 422,506 eligible men, 18,720 (4.4%) experienced >180-day delay in treatment initiation. Compared to White patients, Black (OR 1.79, 95% CI 1.72-1.87, p<.001) and Hispanic (OR 1.37, 95% CI 1.28-1.48, p<.001) patients had higher odds of delay. These disparities persisted when analyzing only patients treated after 2014 or for patients who had Medicare or Private insurance. Compared to uninsured patients, those with Medicaid had no difference in odds of delay (OR 0.94, 95% CI 0.84-1.06, p = .31), while those with private insurance (OR 0.57, 95% CI 0.52-0.63, p<.001) or Medicare (OR 0.64, 95% CI 0.58-0.70, p<.001) had lower odds of delay. These disparities persisted when analyzing only patients treated after 2014. Mean time to treatment significantly increased from 2010 to 2016 across all racial/ethnic groups (trend p<.001); 2014 was associated with a significant inflection for increase in rates of major delays. CONCLUSION The impact of race and insurance status were independently associated with longer delays to PCa treatment in the US. These disparities were unaffected by implementation of the ACA. In fact, implementation of ACA was associated with increased delays in treatment initiation for all men, regardless of race. As the epidemiology of newly diagnosed prostate cancer in the United States continues to shift due to tempered screening and the COVID pandemic, further work will be needed to increase equity in prostate cancer care.
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Affiliation(s)
- J Janopaul-Naylor
- Department of Radiation Oncology, Winship Cancer Institute of Emory University, Atlanta, GA
| | - T J Corriher
- Department of Radiation Oncology, Winship Cancer Institute of Emory University, Atlanta, GA
| | | | - S Hanasoge
- Department of Radiation Oncology, Winship Cancer Institute of Emory University, Atlanta, GA
| | - A Esdaille
- Department of Urology, Emory University School of Medicine, Atlanta, GA
| | - B A Mahal
- Department of Radiation Oncology, University of Miami/Sylvester Comprehensive Cancer Center, Miami, FL
| | - C P Filson
- Department of Urology, Emory University School of Medicine, Atlanta, GA
| | - S A Patel
- Department of Radiation Oncology, Winship Cancer Institute of Emory University, Atlanta, GA
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Hess CB, Eng TY, Nasti T, Dhere VR, Kleber T, Switchenko J, Weinberg BD, Rouphael N, Tian S, Rudra S, Olabode K, Samuel E, Ahmed R, Khan MK. Combined Analysis of a Phase III Randomized Trial and Phase II Prospective Trial with Blind Control Matching of Patients Receiving Whole-Lung, Low-Dose Radiation for COVID-19: Full Results and Immunologic Correlates of the RESCUE 1-19 Trial. Int J Radiat Oncol Biol Phys 2023; 117:e179. [PMID: 37784798 DOI: 10.1016/j.ijrobp.2023.06.1029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Whole-lung, low-dose radiation (LD-RT) for COVID-19 requires randomization and biologic correlates to determine causality and mechanism. MATERIALS/METHODS A phase III trial randomized COVID-19 patients to physician's choice of drug therapy with or without LD-RT. Primary endpoint was intubation-free survival (IFS). The trial was designed with 80% power (two-sided log rank, alpha 0.05) to detect a hazard ratio of 0.3 after 12 intubation events. Estimating a 25% event rate, the planned sample size was 84 patients plus 25 to account for declining intubation rates and screen failures. Due to hospitalization declines and other barriers, the trial closed prematurely. Available randomized data were analyzed by intention-to-treat and combined with phase II results and immunologic correlates, using one-sided significance and an alpha of 0.1 to inform future trial design. RESULTS From Jun 2020-Jun 2022, 14 patients were randomized on a phase III trial. From Apr 2020-Dec 2020, 42 patients were enrolled on a phase II trial and blindly matched to 40 controls from contemporaneous trials. 96 total patients and 193 blood samples were available for analysis. Mean hospital duration with LD-RT was 12.9 vs 15.4 days in controls (p = 0.12). Oxygen flow rate >15 L/min (26% vs 38%, p = .27), high-flow oxygen >30 L/min (24% vs 38%, p = 0.18), non-invasive positive-pressure >60 L/min (9% vs 27%, p = 0.03), and mechanical ventilation (9% vs 24%, p = 0.05) reduced with LD-RT. Mean supplemented oxygen volume was 171,759 vs 547,626 liters in controls, with daily means of 10 vs 23 L/min (p = 0.03). Radiographs worsened in 43% vs 71% of controls (p = 0.03). Arterial blood gas mean P/F ratios improved 22% after LD-RT vs declined 8% in controls (p = 0.12). Mean days febrile were 1.8 vs 2.9 in controls (p = 0.10). Rate of myocardial injury was 47% vs 40% in controls (p = 0.77). Flow cytometry revealed 4-fold and 30-fold larger expansions, respectively, in CD8- and CD4-positive CD3+PD1+Ki67-high proliferating cytotoxic T-cells (300% vs 75% expansion, p = 0.07) and helper T-cells (200% expansion vs 6% contraction, p = 0.03) at day 7. In the randomized cohort, mean oxygen volume fell 75% with LD-RT to 78,336 vs 316,786 liters in controls (p = 0.13), mean flow rates were 5.1 vs 18.4 L/min (p = 0.13), radiographs worsened in 50% vs 100% (p = .17), P/F ratios improved 31% vs declined 68% in controls (p = 0.03), hospital duration was 8.9 vs 11.5 days (p = 0.22), and zero LD-RT patients vs one control intubated. CONCLUSION Combined analysis of a phase II/III randomized trial suggests that LD-RT prevents ventilation, reduces supplemental oxygen need, improves clinical course, and enhances immune response. LD-RT may have both immediate direct effects and delayed enhanced immunity in COVID-19. Larger multi-institutional trials are justified.
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Affiliation(s)
- C B Hess
- Grass Valley Radiation Oncology, Grass Valley, CA
| | - T Y Eng
- Department of Radiation Oncology, Winship Cancer Institute of Emory University, Atlanta, GA
| | - T Nasti
- Department of Microbiology/Immunology, Emory University, Atlanta, GA
| | - V R Dhere
- Department of Radiation Oncology, Winship Cancer Institute of Emory University, Atlanta, GA
| | | | - J Switchenko
- Department of Biostatistics and Bioinformatics, Winship Cancer Institute of Emory University, Atlanta, GA
| | | | | | - S Tian
- Department of Radiation Oncology, Winship Cancer Institute of Emory University, Atlanta, GA
| | - S Rudra
- Winship Cancer Institute of Emory University, Department of Radiation Oncology, Atlanta, GA
| | | | | | - R Ahmed
- Department of Microbiology/Immunology, Emory University, Atlanta, GA
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McClary T, Blee S, Avinger A, Dai Q, Switchenko J, Dixon M, Pentz R. Accounting for the High Enrollment of African Americans on Winship Cancer Institute's Myeloma Clinical Trials. Ethics Med Public Health 2023; 27:100877. [PMID: 37007841 PMCID: PMC10062432 DOI: 10.1016/j.jemep.2023.100877] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/06/2023]
Abstract
Background Thirty-four percent of Multiple Myeloma (MM) clinical trial participants at Winship Cancer Institute (Winship) are African American (AA); however, AAs make up only 4.5 percent of myeloma clinical trial participants in the United States. Given our high enrollment, we aimed to measure AAs' trust in providers and identify if clinical trial enrollment barriers exist. Methodology A member of the ethics research team surveyed AA patients who had consented to a MM clinical trial at Winship. Three validated surveys were used: Trust in Medical Research (TMR); Human Connection (THC) which measures how much patients feel they are heard and valued by their physicians; and the Duke Intrinsic Religiosity Scale (DUREL) which measures strength of religious engagement and belief. The survey also included questions about the impact of side effects, distance to the trial center and trial related costs on the decision to participate in clinical trial. Results Ninety-two percent (61/67) of patients approached consented. The mean TMR score and the mean THC score were significantly higher (P-value < 0.001) than the results obtained in key national surveys (TMR 14.9 compared to 11.65; THC 57.7 compared to 54.6). These two surveys were significantly correlated, meaning trust and human connection increase or decrease in tandem. The 3 religiosity subscale results showed high religiosity (3.84, 4.36, and 4.35 with 5 being the highest score). The mean scores of the importance of the investigational agent's side effects, trial costs, and distance to trial center on the decision to enroll in a clinical trial were also high (8.5, 7.8, and 6.5, respectively, with 10 being the most important). Conclusion In our study population, high trust and human connection overcame other trial participation barriers: strong religious beliefs and concerns about side effects, costs, and travel distance. We present a roadmap to guide investigators to increase human connection, and hopefully trust.
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Affiliation(s)
- T.S. McClary
- Emory University, Winship Cancer Institute, 1365, Clifton Road, 30322 Atlanta, GA, USA
- South University Orlando Campus5900 Lake Ellenor Dr, Orlando Fl 32809
| | - S.M. Blee
- Emory University, Winship Cancer Institute, 1365, Clifton Road, 30322 Atlanta, GA, USA
- Creighton University Medical School2621 Burt Street, Omaha, Nebraska 68178
| | - A.M. Avinger
- Emory University, Winship Cancer Institute, 1365, Clifton Road, 30322 Atlanta, GA, USA
- Wake Forest University School of Medicine, 475 Vine St, Winston-Salem, NC 27101
| | - Q. Dai
- School of Public Health, Emory University Rollins, 1518, Clifton Road, 30322 Atlanta, GA, USA
| | - J. Switchenko
- School of Public Health, Emory University Rollins, 1518, Clifton Road, 30322 Atlanta, GA, USA
| | - M.D. Dixon
- Emory University, Winship Cancer Institute, 1365, Clifton Road, 30322 Atlanta, GA, USA
| | - R.D. Pentz
- Emory University, Winship Cancer Institute, 1365, Clifton Road, 30322 Atlanta, GA, USA
- Emory University School of Medicine, 100, Woodruff Circle, 30322 Atlanta, GA, USA
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Janopaul-Naylor J, Rupji M, Switchenko J, Stokes W, Patel M, Bates J. O2.2 Ninety-day mortality following TORS or definitive radiotherapy for oropharyngeal cancer at American commission on cancer-accredited facilities. Oral Oncol 2022. [DOI: 10.1016/j.oraloncology.2022.106173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Singh V, Gillespie TW, Lane O, Spektor B, Zarrabi AJ, Egan K, Curseen K, Tsvetkova M, Beumer JH, Sniecinski R, Shteamer J, Switchenko J, Harvey RD. A dose‐escalation clinical trial of intranasal ketamine for uncontrolled cancer‐related pain. Pharmacotherapy 2022; 42:298-310. [DOI: 10.1002/phar.2669] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2021] [Revised: 01/20/2022] [Accepted: 01/21/2022] [Indexed: 11/10/2022]
Affiliation(s)
- Vinita Singh
- Department of Anesthesiology Emory University School of Medicine Atlanta Georgia USA
| | - Theresa W. Gillespie
- Department of Hematology and Medical Oncology Emory University School of Medicine Atlanta Georgia USA
- Department of Surgery Emory University School of Medicine Atlanta Georgia USA
| | - Olabisi Lane
- Department of Anesthesiology Emory University School of Medicine Atlanta Georgia USA
| | - Boris Spektor
- Department of Anesthesiology Emory University School of Medicine Atlanta Georgia USA
| | - Ali John Zarrabi
- Department of Family Medicine Emory University School of Medicine Atlanta Georgia USA
| | - Katherine Egan
- Department of Anesthesiology Emory University School of Medicine Atlanta Georgia USA
| | - Kimberly Curseen
- Department of Family Medicine Emory University School of Medicine Atlanta Georgia USA
| | - Maya Tsvetkova
- Cancer Therapeutics Program UPMC Hillman Cancer Center Pittsburgh Pennsylvania USA
- Department of Pharmaceutical Sciences School of Pharmacy University of Pittsburgh Pittsburgh Pennsylvania USA
| | - Jan H. Beumer
- Cancer Therapeutics Program UPMC Hillman Cancer Center Pittsburgh Pennsylvania USA
- Department of Pharmaceutical Sciences School of Pharmacy University of Pittsburgh Pittsburgh Pennsylvania USA
- Division of Hematology‐Oncology Department of Medicine University of Pittsburgh School of Medicine Pittsburgh Pennsylvania USA
| | - Roman Sniecinski
- Department of Anesthesiology Emory University School of Medicine Atlanta Georgia USA
| | - Jack W. Shteamer
- Department of Anesthesiology Emory University School of Medicine Atlanta Georgia USA
| | - Jeffery Switchenko
- Department of Biostatistics and Bioinformatics Rollins School of Public Health Emory University Atlanta Georgia USA
| | - R. Donald Harvey
- Department of Hematology and Medical Oncology Emory University School of Medicine Atlanta Georgia USA
- Department of Pharmacology Emory University School of Medicine Atlanta Georgia USA
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Janopaul-Naylor J, Rupji M, Lorenz J, Switchenko J, Bates J, McDonald M, Shin D, Boyce B, Stokes W. Adjuvant Oropharynx Cancer Management in the Era of Tors and HPV: A Recursive Partitioning Analysis. Int J Radiat Oncol Biol Phys 2022. [DOI: 10.1016/j.ijrobp.2021.12.037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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McCall N, Eng T, Shelton J, Hanasoge S, Patel P, Patel A, McCook A, Switchenko J, Cole T, Khanna N, Han C, Gordon A, Starbuck K, Remick J. Severe Toxicity and Provider-Reported Subjective Symptoms in Patients With Vulvar Cancer Receiving Curative-Intent Radiotherapy. Int J Radiat Oncol Biol Phys 2021. [DOI: 10.1016/j.ijrobp.2021.07.1686] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Behera M, Jiang R, Huang Z, Bunn B, Wynes M, Switchenko J, Scagliotti G, Belani C, Ramalingam S. P50.05 Natural History and Real-World Treatment Outcomes for NSCLC Patients with EGFR Exon 20 Insertion Mutation: An IASLC- ASCO CancerLinQ Study. J Thorac Oncol 2021. [DOI: 10.1016/j.jtho.2021.08.533] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Tian S, Kazzi B, Mccook A, Switchenko J, Stokes W, Shelton J, Kahn S, Carlisle J, Steuer C, Owonikoko T, Ramalingam S, Bradley J, Higgins K. FP08.01 Lung Stereotactic Body Radiation Therapy for Treatment of Oligoprogressive and Oligorecurrent Metastatic Disease: A Multi-Center Analysis. J Thorac Oncol 2021. [DOI: 10.1016/j.jtho.2021.08.231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Taylor MA, Switchenko J, Stokes W, Patel MR, McDonald M, Steuer C, Aiken A, Beitler JJ, Shin DM, Saba NF. Incidence trends of squamous cell carcinoma of the head and neck (SCCHN) in the aging population--A SEER-based analysis from 2000 to 2016. Cancer Med 2021; 10:6070-6077. [PMID: 34288563 PMCID: PMC8419769 DOI: 10.1002/cam4.4134] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Revised: 06/15/2021] [Accepted: 06/16/2021] [Indexed: 11/30/2022] Open
Abstract
Background Tobacco and alcohol use are risk factors for Squamous Cell Carcinoma of the Head and Neck (SCCHN); however, there is growing recognition of HPV as a risk factor for SCCHN. HPV‐related SCCHN is thought to affect mostly middle‐aged individuals but as the US population ages, it is important to evaluate the change in incidence of HPV‐ and non‐HPV‐related SCCHN in individuals who are ≥65 years old. Methods This was a retrospective study using data from a population‐based cancer registry (SEER) to identify individuals ≥65 years old diagnosed with SCCHN between 2000 and 2016 also stratified by sex, race, and birth cohort. The subgroups of HPV‐associated and non‐HPV associated sites were analyzed independently. The incidence per year was calculated and joinpoint detection was used to identity significant changes in incidence trends and annual percent change (APC). Results For HPV‐associated sites from 2000 to 2016, there was an average annual rate of 10.8 per 100,000 individuals with an APC of 2.92% (p = <0.05). For HPV‐ and non‐HPV‐related SCCHN males had a higher annual rate compared to females, 54.5 versus 18.0 in non‐HPV‐related and 19.1 versus 4.4 in HPV‐related sites. For non‐HPV‐related sites there was a decrease in APC across all stratified groups. For HPV‐related sites there was an increase in APC across all stratified groups, especially males (APC 8.82% 2006–2016 p < 0.05) and White individuals (APC 8.19% 2006–2016 p < 0.05). When stratified by birth cohort, HPV‐related SCCHN sites had a higher APC in ages 65–69 (8.38% p < 0.05) and 70–74 (8.54% p < 0.05). Conclusion Among the population ≥65 years old from 2000 to 2016, the incidence rate for HPV‐related SCCHN sites has increased across all stratified groups, especially in White individuals, males, and age groups 65–74. The incidence rate for non‐HPV‐related sites has decreased across all stratified groups during this time.
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Affiliation(s)
| | - Jeffery Switchenko
- Department of Biostatistics and Bioinformatics, Emory University, Atlanta, GA, USA
| | - William Stokes
- Emory University, Winship Cancer Institute, Atlanta, GA, USA
| | - Mihir R Patel
- Emory University, Winship Cancer Institute, Atlanta, GA, USA
| | - Mark McDonald
- Emory University, Winship Cancer Institute, Atlanta, GA, USA
| | - Conor Steuer
- Emory University, Winship Cancer Institute, Atlanta, GA, USA
| | - Ashley Aiken
- Emory University, Winship Cancer Institute, Atlanta, GA, USA
| | | | - Dong M Shin
- Emory University, Winship Cancer Institute, Atlanta, GA, USA
| | - Nabil F Saba
- Emory University, Winship Cancer Institute, Atlanta, GA, USA
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Shanmugasundaram K, Goyal S, Switchenko J, Calzada O, Churnetski MC, Kolla B, Bachanova V, Gerson JN, Barta SK, Gordon MJ, Danilov AV, Grover NS, Mathews S, Burkart M, Karmali R, Sawalha Y, Hill BT, Ghosh N, Park SI, Epperla N, Bond DA, Badar T, Blum KA, Hamadani M, Fenske TS, Malecek M, Kahl BS, Martin P, Guo J, Flowers CR, Cohen JB. Intensive induction regimens after deferring initial therapy for mantle cell lymphoma are not associated with improved survival. Eur J Haematol 2021; 107:301-310. [PMID: 33973276 DOI: 10.1111/ejh.13649] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Revised: 04/24/2021] [Accepted: 04/27/2021] [Indexed: 01/05/2023]
Abstract
INTRODUCTION While most patients with mantle cell lymphoma (MCL) receive therapy shortly after diagnosis, a subset of patients with indolent-behaving disease can safely defer treatment. In this subgroup, we evaluated the importance of treatment intensity in patients with MCL who defer initial therapy. METHODS Out of 1134 patients with MCL from 12 academic centers, we analyzed 219 patients who initiated therapy at least 90 days after diagnosis. Patients who received induction with high-dose cytarabine and/or autologous stem cell transplantation (ASCT) in first remission were considered to have received intensive therapy (n = 88) while all other approaches were non-intensive (n = 131). RESULTS There was no difference in progression-free (PFS; P = .224) or overall survival (OS; P = .167) in deferred patients who received non-intensive vs. intensive therapy. Additionally, univariate and multivariate Cox proportional hazards models were performed for PFS and OS. Treatment at an academic center (HR 0.43, P = .015) was associated with improved OS in both univariate and multivariate models, while intensity of treatment was not associated with improved OS in either model. CONCLUSIONS These results indicate that intensified initial treatment is not associated with improved survival after deferring initial therapy, although prospective studies are needed to determine which of these patients with MCL may benefit from intensive therapy.
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Affiliation(s)
| | - Subir Goyal
- Winship Cancer Institute, Biostatistics and Bioinformatics, Emory University, Atlanta, GA, US
| | - Jeffery Switchenko
- Winship Cancer Institute, Biostatistics and Bioinformatics, Emory University, Atlanta, GA, US
| | - Oscar Calzada
- Department of Hematology and Medical Oncology, Winship Cancer Institute, Emory University Hospital, Atlanta, GA, US
| | - Michael C Churnetski
- Department of Hematology and Medical Oncology, Winship Cancer Institute, Emory University Hospital, Atlanta, GA, US
| | - Bhaskar Kolla
- Division of Hematology Oncology and Transplantation, University of Minnesota, Minneapolis, MN, US
| | - Veronika Bachanova
- Division of Hematology Oncology and Transplantation, University of Minnesota, Minneapolis, MN, US
| | - James N Gerson
- Hematology and Oncology, Hospital of the University of Pennsylvania, Philadelphia, PA, US
| | - Stefan K Barta
- Hematology and Oncology, Hospital of the University of Pennsylvania, Philadelphia, PA, US
| | - Max J Gordon
- Knight Cancer Institute, Oregon Health and Science University, Portland, OR, US
| | - Alexey V Danilov
- Knight Cancer Institute, Oregon Health and Science University, Portland, OR, US
| | - Natalie S Grover
- Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC, US
| | - Stephanie Mathews
- Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC, US
| | - Madelyn Burkart
- Division of Hematology, Northwestern University, Chicago, IL, US
| | - Reem Karmali
- Division of Hematology, Northwestern University, Chicago, IL, US
| | - Yazeed Sawalha
- Department of Hematology and Medical Oncology, Taussig Cancer Institute, Cleveland Clinic Foundation, Cleveland, OH, US
| | - Brian T Hill
- Department of Hematology and Medical Oncology, Taussig Cancer Institute, Cleveland Clinic Foundation, Cleveland, OH, US
| | | | | | - Narendranath Epperla
- Division of Hematology, The Ohio State University Cancer Center, Columbus, OH, US.,Mayo Clinic, Jacksonville, FL, US
| | - David A Bond
- Division of Hematology, The Ohio State University Cancer Center, Columbus, OH, US
| | | | - Kristie A Blum
- Department of Hematology and Medical Oncology, Winship Cancer Institute, Emory University Hospital, Atlanta, GA, US
| | - Mehdi Hamadani
- Division of Hematology and Oncology, Medical College of Wisconsin, Milwaukee, WI, US
| | - Timothy S Fenske
- Division of Hematology and Oncology, Medical College of Wisconsin, Milwaukee, WI, US
| | - Mary Malecek
- Siteman Cancer Center, Washington University, St. Louis, MO, US
| | - Brad S Kahl
- Siteman Cancer Center, Washington University, St. Louis, MO, US
| | | | - Jin Guo
- Division of Cancer Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, US
| | - Christopher R Flowers
- Division of Cancer Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, US
| | - Jonathon B Cohen
- Department of Hematology and Medical Oncology, Winship Cancer Institute, Emory University Hospital, Atlanta, GA, US
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Hess CB, Buchwald ZS, Stokes WA, Nasti T, Switchenko J, Weinberg BD, Rouphael N, Steinberg JP, Godette KD, Murphy DJ, Ahmed R, Curran WJ, Khan MK. Immunomodulatory Low-Dose Whole-Lung Radiation for Patients with COVID-19-Related Pneumonia. Int J Radiat Oncol Biol Phys 2020; 108:1401. [PMID: 33427662 PMCID: PMC7671923 DOI: 10.1016/j.ijrobp.2020.09.025] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- C B Hess
- Department of Radiation Oncology, Winship Cancer Institute, Emory University, Atlanta, GA
| | - Z S Buchwald
- Department of Radiation Oncology, Winship Cancer Institute of Emory University, Atlanta, GA
| | - W A Stokes
- Department of Radiation Oncology, Winship Cancer Institute of Emory University, Atlanta, GA
| | - T Nasti
- Department of Microbiology/Immunology, Emory University, Atlanta, GA
| | - J Switchenko
- Department of Biostatistics & Bioinformatics, Rollins School of Public Health, Emory University, Atlanta, GA
| | | | | | | | - K D Godette
- Glenn Family Breast Center, Winship Cancer Institute of Emory University, Atlanta, GA
| | | | - R Ahmed
- Department of Microbiology/Immunology, Emory University, Atlanta, GA
| | - W J Curran
- Department of Radiation Oncology, Winship Cancer Institute of Emory University, Atlanta, GA
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Tian S, Switchenko J, Patel M, Saba N, Shin D, Steuer C, Dhere V, McDonald M, Higgins K, Beitler J, Curran W, Gillespie T, Stokes W, Boyce B. Impact of Postoperative Radiation Therapy Timing on Survival in HPV-Associated Oropharyngeal Squamous Cell Carcinoma. Int J Radiat Oncol Biol Phys 2020. [DOI: 10.1016/j.ijrobp.2020.07.296] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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16
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Tian S, Switchenko J, Yang X, Sethi I, Da Silva A, Huntzinger C, Shirvani S, Owonikoko T, Schuster D, Curran W, Higgins K. Increased 18F-FDG Metabolic Activity during Lung SBRT Predicts Risk of Disease Progression: Results from a Prospective Study of Serial Inter-Fraction PET/CTs. Int J Radiat Oncol Biol Phys 2020. [DOI: 10.1016/j.ijrobp.2020.07.2188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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17
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Westergaard S, Abugideiri M, Switchenko J, Khan M. Immunotherapy in Combination with Surgery and Radiation Improves Local Control for Primary Mucosal Melanomas. Int J Radiat Oncol Biol Phys 2020. [DOI: 10.1016/j.ijrobp.2020.07.998] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Sudmeier L, Morgan T, Mendoza P, Switchenko J, Schreibmann E, Esiashvili N, Eaton B. Pediatric High-Grade Glioma Patterns of Failure by Molecular Subgroup. Int J Radiat Oncol Biol Phys 2020. [DOI: 10.1016/j.ijrobp.2020.07.1522] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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19
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Baddour H, Ochsner M, Patel M, Switchenko J, Beitler J, Magliocca K, Solares C, Steuer C, Baugnon K, El-Deiry M. Surgical Resection is Justifiable for Oral T4b Squamous Cell Cancers with Masticator Space Invasion. Int J Radiat Oncol Biol Phys 2020. [DOI: 10.1016/j.ijrobp.2019.11.239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Tian S, Switchenko J, Patel P, Shelton J, Kahn S, Pillai R, Steuer C, Owonikoko T, Behera M, Curran W, Higgins K. MA01.02 Lung Stereotactic Body Radiotherapy and Concurrent Immunotherapy: A Multi-Center Safety and Toxicity Analysis. J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.08.494] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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21
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Tian S, Switchenko J, Sethi I, Yang X, Da Silva A, Owonikoko T, Schuster D, Curran W, Higgins K. P1.17-03 Inter-Fraction Variability of 18-FDG PET During Lung SBRT and the Effect of Systemic and Immunotherapy: Results of a Prospective Pilot Study. J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.08.1277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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22
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Escott C, Madden N, Schreibmann E, Tian S, Cassidy R, Sutter A, Whitaker D, Switchenko J, Pfister N, Xu K, Force S, Ramalingam S, Curran W, Higgins K, Patel P. Radiomic Analysis of Radiation Induced Fibrosis Following Stereotactic Body Radiation Therapy. Int J Radiat Oncol Biol Phys 2019. [DOI: 10.1016/j.ijrobp.2019.06.1327] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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23
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Syed Y, Jiang C, Switchenko J, Kirmani K, Kelsey C, Khan M. Bi-Institutional Analysis of Stage III/IV Diffuse Large B Cell Lymphomas (DLBCL) Patients Undergoing Consolidative Radiotherapy: Potential for Improved Overall Survival (OS) and Progression Free Survival (PFS). Int J Radiat Oncol Biol Phys 2019. [DOI: 10.1016/j.ijrobp.2019.06.370] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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24
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Tian S, Sethi I, Yang X, Da Silva A, Switchenko J, Owonikoko T, Schuster D, Curran W, Higgins K. Characterization of Inter-Fraction 18-FDG PET Variability During Lung SBRT: Results of a Prospective Pilot Study. Int J Radiat Oncol Biol Phys 2019. [DOI: 10.1016/j.ijrobp.2019.06.2449] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Bond D, Switchenko J, Maddocks K, Churnetski M, Goyal S, Shanmugasundaram K, Calzada O, Kolla B, Bachanova V, Gerson J, Barta S, Hill B, Salwaha Y, Martin P, Maldonado E, Gordon M, Danilov A, Grover N, Mathews S, Burkart M, Karmali R, Ghosh N, Park S, Epperla N, Badar T, Guo J, Hamadani M, Fenske T, Malecek M, Kahl B, Flowers C, Blum K, Cohen J. OUTCOMES FOR PATIENTS WITH MANTLE CELL LYMPHOMA EXPERIENCING FRONTLINE TREATMENT FAILURE: A MULTICENTER RETROSPECTIVE STUDY. Hematol Oncol 2019. [DOI: 10.1002/hon.77_2631] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
- D.A. Bond
- Division of Hematology; Ohio State University Comprehensive Cancer Center; Columbus United States
| | - J. Switchenko
- Department of Biostatistics and Bioinformatics; Rollins School of Public Health, Emory University; Atlanta United States
| | - K. Maddocks
- Division of Hematology; Ohio State University Comprehensive Cancer Center; Columbus United States
| | - M. Churnetski
- Department of Hematology and Medical Oncology; Winship Cancer Institute; Atlanta United States
| | - S. Goyal
- Department of Biostatistics and Bioinformatics; Rollins School of Public Health, Emory University; Atlanta United States
| | - K. Shanmugasundaram
- Department of Internal Medicine; Emory University School of Medicine; Atlanta United States
| | - O. Calzada
- Department of Hematology and Medical Oncology; Winship Cancer Institute; Atlanta United States
| | - B. Kolla
- Department of Hematology; University of Minnesota; Minneapolis United States
| | - V. Bachanova
- Department of Hematology; University of Minnesota; Minneapolis United States
| | - J. Gerson
- Hematology; Abramson Cancer Center, University of Pennsylvania; Pennsylvania United States
| | - S. Barta
- Hematology; Abramson Cancer Center, University of Pennsylvania; Pennsylvania United States
| | - B. Hill
- Hematology and Oncology; Cleveland Clinic Taussig Cancer Institute; Cleveland United States
| | - Y. Salwaha
- Hematology and Oncology; Cleveland Clinic Taussig Cancer Institute; Cleveland United States
| | - P. Martin
- Department of Medicine; Weil Cornell Medicine; New York United States
| | - E. Maldonado
- Hematology and Oncology; Oregon Health and Science University, Knight Cancer Institute; Portland United States
| | - M. Gordon
- Hematology and Oncology; Oregon Health and Science University, Knight Cancer Institute; Portland United States
| | - A. Danilov
- Hematology and Oncology; Oregon Health and Science University, Knight Cancer Institute; Portland United States
| | - N. Grover
- Hematology and Oncology; University of North Carolina Lineberger Comprehensive Cancer Center; Chapel Hill United States
| | - S. Mathews
- Hematology and Oncology; University of North Carolina Lineberger Comprehensive Cancer Center; Chapel Hill United States
| | - M. Burkart
- Hematology and Oncology; Northwestern University, Feinberg School of Medicine; Chicago United States
| | - R. Karmali
- Hematology and Oncology; Northwestern University, Feinberg School of Medicine; Chicago United States
| | - N. Ghosh
- Hematology and Oncology; Atrium Health; Charlotte United States
| | - S. Park
- Hematology and Oncology; Atrium Health; Charlotte United States
| | - N. Epperla
- Division of Hematology; Ohio State University Comprehensive Cancer Center; Columbus United States
| | - T. Badar
- Hematology and Oncology; Medical College of Wisconsin; Milwaukee United States
| | - J. Guo
- Department of Medicine; Weil Cornell Medicine; New York United States
| | - M. Hamadani
- Hematology and Oncology; Medical College of Wisconsin; Milwaukee United States
| | - T. Fenske
- Hematology and Oncology; Medical College of Wisconsin; Milwaukee United States
| | - M. Malecek
- Hematology and Oncology; Siteman Cancer Center, Washington University; St. Louis United States
| | - B. Kahl
- Hematology and Oncology; Siteman Cancer Center, Washington University; St. Louis United States
| | - C. Flowers
- Department of Hematology and Medical Oncology; Winship Cancer Institute; Atlanta United States
| | - K. Blum
- Department of Hematology and Medical Oncology; Winship Cancer Institute; Atlanta United States
| | - J. Cohen
- Department of Hematology and Medical Oncology; Winship Cancer Institute; Atlanta United States
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Chowdhary M, Dhawan R, Switchenko J, Tian S, King K, Batus M, Fidler M, Bonomi P, Sen N, Patel K, Khan M, Gaurav M. PO-0776 Neutrophil-to-lymphocyte ratio dynamics predict for survival in lung cancer treated with SBRT. Radiother Oncol 2019. [DOI: 10.1016/s0167-8140(19)31196-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Ferris M, Switchenko J, Xiao C, McDonald M, Eaton B, Higgins K, Press R, Tian S, Steuer C, Baddour H, Miller A, Bruner D, Beitler J. Medulla Dose is Positively Associated with Sensation of Thirst & Midbrain Dose is Inversely Associated with Pain: Prospectively-Collected Patient-Reported Toxicities and Brainstem Dose in Head and Neck Cancer Radiation Therapy. Int J Radiat Oncol Biol Phys 2018. [DOI: 10.1016/j.ijrobp.2018.07.708] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Subramanian K, Switchenko J, Flowers C, Esiashvili N, Khan M. Consolidative Radiation Therapy (RT) for Advanced Stage Hodgkin’s Lymphoma (HL) May Improve Progression Free Survival Than ABVD Alone for Adult Patients. Int J Radiat Oncol Biol Phys 2018. [DOI: 10.1016/j.ijrobp.2018.07.898] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Tian S, Switchenko J, Fei T, Press R, Abugideiri M, Saba N, Owonikoko T, Chen A, Beitler J, Curran W, Gillespie T, Higgins K. Survival Advantage to Combined Modality Therapy Seen in Multiple Subgroups Within Anaplastic Thyroid Carcinoma: A Propensity-Score Matched Analysis of the National Cancer Data Base. Int J Radiat Oncol Biol Phys 2018. [DOI: 10.1016/j.ijrobp.2018.07.1077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Abugideiri M, Switchenko J, Tian S, Madden N, Press R, Buchwald Z, Zhong J, Jhaveri J, Ferris M, Behera M, Monson D, Lin J, Landry J, Godette K, Patel P. Outcomes and Practice Patterns for Aggressive Local Therapy in Newly Diagnosed Stage IV Soft Tissue Sarcoma: An NCDB Analysis. Int J Radiat Oncol Biol Phys 2018. [DOI: 10.1016/j.ijrobp.2018.07.779] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Madden N, Danish H, Cassidy R, Abugideiri M, Switchenko J, Rai A, Flowers C, Esiashvili N, Jegadeesh N, Khan M. In Patients Over 65, Consolidative Radiation for Early Stage Diffuse Large B Cell Lymphoma is Associated with Decreased Hematologic Toxicity and Hospitalizations after RCHOP Compared with RCHOP Alone. Int J Radiat Oncol Biol Phys 2018. [DOI: 10.1016/j.ijrobp.2018.07.078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Ferris M, Sykes K, Kayode O, Wolf J, Press R, Switchenko J, Curran W, Higgins K. MA05.05 Photon-Based Cardiac Sparing Via Volumetric Modulated Arc Therapy in Thoracic Radiation Therapy for Locally Advanced Non-Small Cell Lung Cancer. J Thorac Oncol 2018. [DOI: 10.1016/j.jtho.2018.08.352] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Cassidy R, Switchenko J, El-Deiry M, Belcher R, Zhong J, Steuer C, Saba N, McDonald M, Yu D, Gillespie T, Beitler J. Postoperative Therapy for Salivary Gland Adenoid Cystic Carcinomas. Int J Radiat Oncol Biol Phys 2018. [DOI: 10.1016/j.ijrobp.2017.12.193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Trivedi S, Switchenko J, Patel M, Steuer C, El-Deiry M, Higgins K, Solares C, McDonald M, Shin D, Gillespie T, Beitler J, Saba N. The Effect of Hospital Volume and Insurance Status on Overall Survival in Sinonasal Carcinoma: A National Cancer Database (NCDB) Analysis. Int J Radiat Oncol Biol Phys 2018. [DOI: 10.1016/j.ijrobp.2017.12.202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Chowdhary M, Switchenko J, Marwaha G, Abrams R, Jhaveri J, Olson J, Shu H, Curran W, Khan M, Patel K. Post-treatment Neutrophil-to-Lymphocyte Ratio as a Predictor of Overall Survival in Melanoma Brain Metastases treated with Stereotactic Radiosurgery. Int J Radiat Oncol Biol Phys 2017. [DOI: 10.1016/j.ijrobp.2017.06.428] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Chowdhary M, Chhabra A, Switchenko J, Jhaveri J, Sen N, Curran W, Abrams R, Patel K, Marwaha G. A Quantitative Analysis of the Current Radiation Oncologist Job Market. Int J Radiat Oncol Biol Phys 2017. [DOI: 10.1016/j.ijrobp.2017.06.1541] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Tian S, Ferris M, Switchenko J, Magliocca K, Cassidy R, Kendi ATK, Tanenbaum D, Aiken A, Baugnon K, Hudgins P, Patel M, Saba N, Curran W, Beitler J. Prognostic Value of Radiographically-Defined Extranodal Extension is Modulated by Human Papillomavirus Status in Locally Advanced Oropharyngeal Carcinoma. Int J Radiat Oncol Biol Phys 2017. [DOI: 10.1016/j.ijrobp.2017.06.1502] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Cassidy R, Nour S, Liu T, Switchenko J, Zhong J, Tian S, Ferris M, Press R, Abugideiri M, Rossi P, Jani A. Reproducibility in Contouring the Neurovascular Bundle for Prostate Cancer Radiotherapy Treatment Planning. Int J Radiat Oncol Biol Phys 2017. [DOI: 10.1016/j.ijrobp.2017.06.260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Buchwald Z, Switchenko J, Jhaveri J, Abugideiri M, Cassidy R, Eaton B, Olson J, Shu H, Crocker I, Curran W, Patel K. Clinical and Dosimetric Factors Related to Radiation Necrosis After Five Fraction Radiosurgery for Resected Brain Metastases. Int J Radiat Oncol Biol Phys 2017. [DOI: 10.1016/j.ijrobp.2017.06.749] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Ferris M, Tian S, Switchenko J, Eaton B, Esiashvili N. Musculoskeletal Outcomes and the Effect of Radiation to the Vertebral Bodies on Growth Trajectories for Long-Term Survivors of High-Risk Neuroblastoma. Int J Radiat Oncol Biol Phys 2017. [DOI: 10.1016/j.ijrobp.2017.06.1964] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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41
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Cassidy R, Patel P, Zhang X, Press R, Switchenko J, Pillai R, Owonikoko T, Ramalingam S, Fernandez F, Force S, Curran W, Higgins K. Stereotactic Body Radiation Therapy for Early Stage Non–Small Cell Lung Cancer in Patients 80 Years and Older: A Multi-Center Analysis. Int J Radiat Oncol Biol Phys 2017. [DOI: 10.1016/j.ijrobp.2017.01.144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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42
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Danish H, Patel K, Switchenko J, Gillespie T, Jhaveri J, Chowdhary M, Abugideiri M, Delman K, Lawson D, Khan M. The Influence of Postoperative Lymph Node Radiation Therapy on Overall Survival of Patients With Stage III Melanoma: A National Cancer Data Base Analysis. Int J Radiat Oncol Biol Phys 2016. [DOI: 10.1016/j.ijrobp.2016.06.381] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Ferris M, Danish H, Switchenko J, Deng C, Esiashvili N. Excellent Local Control for Consolidative Radiation Therapy Without Dose Escalation in High-Risk Neuroblastoma. Int J Radiat Oncol Biol Phys 2016. [DOI: 10.1016/j.ijrobp.2016.06.568] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Ferris M, Zhong J, Switchenko J, Higgins K, McDonald M, Eaton B, Miller A, Bruner DW, Xiao C, Beitler J. CNS Dose Is Not Associated With Treatment-Related Fatigue in Patients Undergoing Radiation Therapy for Head and Neck Cancer. Int J Radiat Oncol Biol Phys 2016. [DOI: 10.1016/j.ijrobp.2016.06.1529] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Schreibmann E, Iwinski Sutter A, Whitaker D, Switchenko J, Elder E, Higgins K, Patel P. SU-F-R-07: Radiomics of CT Features and Associations and Correlation with Outcomes Following Lung SBRT. Med Phys 2016. [DOI: 10.1118/1.4955779] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Okwan-Duodu D, Yang X, Yu D, Patel K, Switchenko J, Beitler J, Curran W, Liu T. Angiotensin Blockade Reduces Quantitative and Qualitative Radiation-Induced Neck Fibrosis: Interim Analysis of Prospective Trial. Int J Radiat Oncol Biol Phys 2016. [DOI: 10.1016/j.ijrobp.2015.12.311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Cassidy RJ, Jegadeesh N, Switchenko J, Danish H, Esiashvili N, Flowers CR, Khan MK. The role of radiotherapy for patients over age 60 with diffuse large B-cell lymphoma in the rituximab era. Leuk Lymphoma 2016; 57:1876-82. [PMID: 26759182 DOI: 10.3109/10428194.2015.1120866] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
The role of consolidative radiotherapy (RT) in patients ≥60 years old with DLBCL in the rituximab era is controversial. We examined the impact on disease control and overall survival by the addition of consolidative RT after completion of chemotherapy, while adjusting for known adverse risk factors. Retrospective chart review from 2004 to 2012 of 83 consecutive patients ≥60 years old with DLBCL treated in the rituximab era, 68 of which had a complete response to chemotherapy, was performed. Amongst patients with a complete response, consolidative RT use was associated with 100% 5-year local control, improved progression-free survival (p = 0.047), and a trend for overall survival (p = .098) on multivariate analysis. Amongst all patients, the use of consolidative RT was associated with improved overall survival (p = 0.03). The use of consolidative RT should be considered for patients ≥60 years old independent of stage and response to chemotherapy.
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Affiliation(s)
- R J Cassidy
- a Department of Radiation Oncology , Winship Cancer Institute of Emory University , Atlanta , GA , USA
| | - N Jegadeesh
- a Department of Radiation Oncology , Winship Cancer Institute of Emory University , Atlanta , GA , USA
| | - J Switchenko
- b Biostatistics Shared Core Resource, Winship Cancer Institute , Atlanta , GA , USA
| | - H Danish
- a Department of Radiation Oncology , Winship Cancer Institute of Emory University , Atlanta , GA , USA
| | - N Esiashvili
- a Department of Radiation Oncology , Winship Cancer Institute of Emory University , Atlanta , GA , USA
| | - C R Flowers
- c Department of Hematology and Medical Oncology , Winship Cancer Institute of Emory University , Atlanta , GA , USA
| | - M K Khan
- a Department of Radiation Oncology , Winship Cancer Institute of Emory University , Atlanta , GA , USA
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Oliver D, Patel K, Switchenko J, Parker D, Lawson D, Delman K, Kudchadkar R, Khan M. Roles of Adjuvant and Salvage Radiation Therapy for Desmoplastic Melanoma. Int J Radiat Oncol Biol Phys 2015. [DOI: 10.1016/j.ijrobp.2015.07.2152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Morgan T, Crocker I, Switchenko J, Ali A, Shu H. Radiation Therapy for MRI Defined Meningiomas: Long-term Outcomes From a Single-Institution. Int J Radiat Oncol Biol Phys 2015. [DOI: 10.1016/j.ijrobp.2015.07.794] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Roper J, Chanyavanich V, Betzel G, Switchenko J, Dhabaan A. TH-A-9A-11: Single-Isocenter Multiple-Target SRS: Risk of Compromised Coverage. Med Phys 2014. [DOI: 10.1118/1.4889581] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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