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Davies RM, Knoll MA, Kyranides MN. A moderated mediation analysis on the influence of social support and cognitive flexibility in predicting mental wellbeing in elite sport. Psychol Sport Exerc 2024; 70:102560. [PMID: 37951453 DOI: 10.1016/j.psychsport.2023.102560] [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] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Revised: 11/01/2023] [Accepted: 11/06/2023] [Indexed: 11/14/2023]
Abstract
The purpose of this study was to examine the mechanism by which social support influences mental wellbeing. Using the thriving through relationships model to provide a theoretical underpinning, cognitive flexibility was hypothesised as a mediator. Additionally, the research examined the consistency of this pathway between elite athletes, retired athletes, and non-athletes. Survey responses from a sample of 247 participants (n = 49 elite athletes, n = 61 retired athletes, n = 137 convenience sample; of which 127 (51.4%) were males were included in the analysis. Initial mediation analysis revealed a significant indirect pathway from social support to mental wellbeing through cognitive flexibility. Moderated mediation analysis revealed this pathway was significant for retired athletes and the convenience sample, but not for elite athletes. Results provide additional insight into the mechanisms by which social support influences wellbeing. Cognitive flexibility interventions may not be as effective for elite athletes.
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Affiliation(s)
- R M Davies
- School of Health in Social Sciences, University of Edinburgh, Edinburgh, United Kingdom.
| | - M A Knoll
- School of Health in Social Sciences, University of Edinburgh, Edinburgh, United Kingdom
| | - M N Kyranides
- School of Health in Social Sciences, University of Edinburgh, Edinburgh, United Kingdom
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2
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Fine E, Knoll MA, Maslow BSL. Fertility Considerations for Reproductive-Aged Carriers of Deleterious BRCA Mutations: A Call for Early Intervention. JCO Oncol Pract 2021; 18:165-168. [PMID: 34606330 DOI: 10.1200/op.21.00389] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- Eliana Fine
- Jewish Orthodox Women's Medical Association (JOWMA), New York, NY.,Department of OBGYN, Renaissance School of Medicine at Stonybrook University, Stonybrook, NY
| | - Miriam A Knoll
- Jewish Orthodox Women's Medical Association (JOWMA), New York, NY.,Department of Radiation Oncology, Montefiore Nyack Hospital, Nyack, NY
| | - Bat-Sheva L Maslow
- Jewish Orthodox Women's Medical Association (JOWMA), New York, NY.,Extend Fertility Medical Practice, New York, NY
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3
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Huber S, Knoll MA, Berktold M, Würzner R, Brindlmayer A, Weber V, Posch AE, Mrazek K, Lepuschitz S, Ante M, Beisken S, Orth-Höller D, Weinberger J. Genomic and Phenotypic Analysis of Linezolid-Resistant Staphylococcus epidermidis in a Tertiary Hospital in Innsbruck, Austria. Microorganisms 2021; 9:1023. [PMID: 34068744 PMCID: PMC8150687 DOI: 10.3390/microorganisms9051023] [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] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Revised: 05/06/2021] [Accepted: 05/07/2021] [Indexed: 11/17/2022] Open
Abstract
Whole genome sequencing is a useful tool to monitor the spread of resistance mechanisms in bacteria. In this retrospective study, we investigated genetic resistance mechanisms, sequence types (ST) and respective phenotypes of linezolid-resistant Staphylococcus epidermidis (LRSE, n = 129) recovered from a cohort of patients receiving or not receiving linezolid within a tertiary hospital in Innsbruck, Austria. Hereby, the point mutation G2603U in the 23S rRNA (n = 91) was the major resistance mechanism followed by the presence of plasmid-derived cfr (n = 30). The majority of LRSE isolates were ST2 strains, followed by ST5. LRSE isolates expressed a high resistance level to linezolid with a minimal inhibitory concentration of ≥256 mg/L (n = 83) in most isolates, particularly in strains carrying the cfr gene (p < 0.001). Linezolid usage was the most prominent (but not the only) trigger for the development of linezolid resistance. However, administration of linezolid was not associated with a specific resistance mechanism. Restriction of linezolid usage and the monitoring of plasmid-derived cfr in LRSE are potential key steps to reduce linezolid resistance and its transmission to more pathogenic Gram-positive bacteria.
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Affiliation(s)
- Silke Huber
- Institute of Hygiene and Medical Microbiology, Medical University of Innsbruck, 6020 Innsbruck, Austria; (S.H.); (M.A.K.); (M.B.); (R.W.)
| | - Miriam A. Knoll
- Institute of Hygiene and Medical Microbiology, Medical University of Innsbruck, 6020 Innsbruck, Austria; (S.H.); (M.A.K.); (M.B.); (R.W.)
| | - Michael Berktold
- Institute of Hygiene and Medical Microbiology, Medical University of Innsbruck, 6020 Innsbruck, Austria; (S.H.); (M.A.K.); (M.B.); (R.W.)
| | - Reinhard Würzner
- Institute of Hygiene and Medical Microbiology, Medical University of Innsbruck, 6020 Innsbruck, Austria; (S.H.); (M.A.K.); (M.B.); (R.W.)
| | - Anita Brindlmayer
- Center for Biomedical Technology, Department for Biomedical Research, Danube University Krems, 3500 Krems, Austria; (A.B.); (V.W.)
| | - Viktoria Weber
- Center for Biomedical Technology, Department for Biomedical Research, Danube University Krems, 3500 Krems, Austria; (A.B.); (V.W.)
| | - Andreas E. Posch
- Ares Genetics GmbH, 1030 Vienna, Austria; (A.E.P.); (K.M.); (S.L.); (M.A.); (S.B.); (J.W.)
| | - Katharina Mrazek
- Ares Genetics GmbH, 1030 Vienna, Austria; (A.E.P.); (K.M.); (S.L.); (M.A.); (S.B.); (J.W.)
| | - Sarah Lepuschitz
- Ares Genetics GmbH, 1030 Vienna, Austria; (A.E.P.); (K.M.); (S.L.); (M.A.); (S.B.); (J.W.)
| | - Michael Ante
- Ares Genetics GmbH, 1030 Vienna, Austria; (A.E.P.); (K.M.); (S.L.); (M.A.); (S.B.); (J.W.)
| | - Stephan Beisken
- Ares Genetics GmbH, 1030 Vienna, Austria; (A.E.P.); (K.M.); (S.L.); (M.A.); (S.B.); (J.W.)
| | | | - Johannes Weinberger
- Ares Genetics GmbH, 1030 Vienna, Austria; (A.E.P.); (K.M.); (S.L.); (M.A.); (S.B.); (J.W.)
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4
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Smith SM, Wachter K, Burris HA, Schilsky RL, George DJ, Peterson DE, Johnson ML, Markham MJ, Mileham KF, Beg MS, Bendell JC, Dreicer R, Keedy VL, Kimple RJ, Knoll MA, LoConte N, MacKay H, Meisel JL, Moynihan TJ, Mulrooney DA, Mulvey TM, Odenike O, Pennell NA, Reeder-Hayes K, Smith C, Sullivan RJ, Uzzo R. Clinical Cancer Advances 2021: ASCO's Report on Progress Against Cancer. J Clin Oncol 2021; 39:1165-1184. [DOI: 10.1200/jco.20.03420] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Affiliation(s)
| | - Kerri Wachter
- American Society of Clinical Oncology, Alexandria, VA
| | | | | | | | | | | | | | | | | | | | - Robert Dreicer
- University of Virginia Cancer Center, Charlottesville, VA
| | | | | | | | - Noelle LoConte
- University of Wisconsin Carbone Cancer Center, Madison, WI
| | - Helen MacKay
- Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
| | | | | | | | | | | | | | - Katherine Reeder-Hayes
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC
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5
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Offenbacher R, Knoll MA, Loeb DM. Delayed presentations of pediatric solid tumors at a tertiary care hospital in the Bronx due to COVID-19. Pediatr Blood Cancer 2021; 68:e28615. [PMID: 32725878 DOI: 10.1002/pbc.28615] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Revised: 07/09/2020] [Accepted: 07/11/2020] [Indexed: 11/08/2022]
Affiliation(s)
- Rachel Offenbacher
- Department of Pediatrics, Albert Einstein College of Medicine, Bronx, New York.,Division of Pediatric Hematology, Oncology and Cellular Therapy, Children's Hospital at Montefiore, Bronx, New York
| | - Miriam A Knoll
- Department of Radiation Oncology, Montefiore Nyack, Nyack, New York
| | - David M Loeb
- Department of Pediatrics, Albert Einstein College of Medicine, Bronx, New York.,Division of Pediatric Hematology, Oncology and Cellular Therapy, Children's Hospital at Montefiore, Bronx, New York
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Huang CC, Lapen K, Shah K, Kantor J, Tsai CJ, Knoll MA, Duma N, Gillespie EF, Chino F. Evaluating Bias in Speaker Introductions at the American Society for Radiation Oncology Annual Meeting. Int J Radiat Oncol Biol Phys 2020; 110:303-311. [PMID: 33373658 DOI: 10.1016/j.ijrobp.2020.12.027] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2020] [Revised: 12/15/2020] [Accepted: 12/17/2020] [Indexed: 12/27/2022]
Abstract
PURPOSE Introducing a physician without a professional title may reinforce bias in medicine by influencing perceived credibility. We evaluated differences in the use of professional titles in introductions of speakers at recent American Society for Radiation Oncology (ASTRO) Annual Meetings. METHODS AND MATERIALS We reviewed recordings from the 2017 to 2019 ASTRO Annual Meetings and included complete introductions of speakers with a doctoral degree. Professional introduction was defined as "Doctor" or "Professor" followed by the speaker's full or last name. We collected use of professional introduction, introducer gender, speaker gender, and speaker professional and demographic variables. Identified speakers were sent surveys to collect self-reported demographic data. Analysis was performed using χ2 tests and multivariable logistic regression (MVA). RESULTS Of 3267 presentations reviewed, 1226 (38%) met the inclusion criteria. Overall, 805 (66%) speakers and 710 (58%) introducers were men. Professional introductions were used in 74% (2017), 71% (2018), and 69% (2019) of the presentations. There was no difference in the use of professional introductions for male and female speakers (71% vs 73%; P = .550). On MVA, male introducers were associated with decreased use of professional address (odds ratio [OR], 0.36; 95% confidence interval [CI], 0.26-0.49; P < .001). At the 2019 conference, professional introduction was less likely to be used (2019 vs 2017: OR, 0.68; 95% CI, 0.49-0.96; P = 0.026). Those who self-identified as Asian/Pacific Islander were twice as likely to receive a professional introduction compared with those who identified as white (OR, 1.95; 95% CI, 1.07-3.64; P = .033). CONCLUSION Male introducers were significantly less likely to introduce any speaker, regardless of gender, by their professional title, and overall use of professional introductions decreased from 2017 to 2019. Furthermore, no difference in professional introduction use by speaker gender was identified at the recent ASTRO meetings. Implementing speaker guidelines could increase the use of professional introductions and raise awareness of unconscious bias at future ASTRO meetings.
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Affiliation(s)
| | - Kaitlyn Lapen
- Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Kanan Shah
- Grossman School of Medicine, New York University, New York, New York
| | - Jolie Kantor
- Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Chiaojung Jillian Tsai
- Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Miriam A Knoll
- Department of Radiation Oncology, Montefiore Nyack Hospital, Nyack, New York
| | - Narjust Duma
- Division of Hematology, Medical Oncology, and Palliative Care, Department of Medicine, University of Wisconsin, Madison, Wisconsin; University of Wisconsin Carbone Cancer Center, Madison, Wisconsin
| | - Erin F Gillespie
- Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Fumiko Chino
- Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, New York
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7
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Albert A, Kahn JM, Knoll MA, Lirette S, Yechieli R, Gerber NK, Jagsi R, Katz MS. Current Social Media Use Among Radiation Oncology Trainees. Adv Radiat Oncol 2020; 6:100642. [PMID: 33851064 PMCID: PMC8022140 DOI: 10.1016/j.adro.2020.100642] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2020] [Revised: 11/20/2020] [Accepted: 12/09/2020] [Indexed: 12/03/2022] Open
Abstract
Purpose Resident physicians use social media (SM) for many reasons. We sought to characterize current SM use by radiation oncology (RO) trainees for education and professional development. Methods and Materials An anonymous 40-question survey was sent by e-mail to RO residents in the 2018 to 2019 academic year. SM platform use, time spent on SM, professional use, and opinions regarding SM use were assessed. Descriptive statistics and a univariate logistic regression analysis were performed to identify factors associated with perceptions of SM and spending >25% of SM time for academic or professional purposes. Results Of the 615 residents surveyed, 149 responded (24% response rate). Facebook (73%), theMednet (62%), Instagram (59%), Twitter (57%), and Doximity (50%) were the top SM platforms used. Most respondents (53%) reported <25% of overall SM time on professional/academic purposes, and 21% reported using SM >60 minutes per day over the past week. Residents with an RO mentor on SM (n = 35; 24%; odds ratio [OR]: 2.79; 95% confidence interval [CI], 1.29-6.08; P = .010), those participating in RO discussions on SM (n = 71; 48%; OR: 2.85; 95% CI, 1.42-5.72; P = .003), and those interacting with professional societies (n = 69; 46%; OR: 7.11; 95% CI, 3.32-15.24; P < .001) were more likely to spend >25% of their SM time on professional/academic purposes. The vast majority of respondents agreed that SM exposed them to novel educational content (82%) and was helpful for career development (65%). In addition, 69% agreed that SM can improve clinical skills and knowledge. A substantial minority agreed that SM distracts them from studying (38%) or they felt pressure to have a SM presence (29%). Conclusions Most RO residents reported that SM provides novel educational content and can help with career development. Potential disadvantages of SM for trainees may include distraction and pressure to maintain a SM presence. SM use by RO trainees merits further research to optimize its potential for education and professional development.
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Affiliation(s)
| | - Jenna M Kahn
- Department of Radiation Medicine, Oregon Health and Science University, Portland, Oregon
| | | | - Seth Lirette
- Department of Data Science, University of Mississippi Medical Center, Jackson, Mississippi
| | - Raphael Yechieli
- Department of Radiation Oncology, University of Miami, Miami, Florida
| | - Naamit K Gerber
- Department of Radiation Oncology, NYU Langone Medical Center, New York, New York
| | - Reshma Jagsi
- Department of Radiation Oncology, University of Michigan, Ann Arbor, Michigan
| | - Matthew S Katz
- Department of Radiation Oncology, Lowell General Hospital, Andover, Massachusetts
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8
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Knoll MA, Chowdhary M, Dicker A, Eichler T. Virtual Connectivity During Quarantine: The Role of Social Media for Radiation Oncology During COVID-19. Int J Radiat Oncol Biol Phys 2020; 108:506-508. [PMID: 32890544 PMCID: PMC7462933 DOI: 10.1016/j.ijrobp.2020.06.044] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Accepted: 06/21/2020] [Indexed: 11/26/2022]
Affiliation(s)
| | | | - Adam Dicker
- Thomas Jefferson University, Philadelphia, Pennsylvania
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9
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Paradis N, Knoll MA, Shah C, Lambert C, Delouya G, Bahig H, Taussky D. 162: Twitter: A Platform for Dissemination and Discussion of Scientific Papers in Radiation Oncology. Radiother Oncol 2020. [DOI: 10.1016/s0167-8140(20)31054-9] [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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10
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Kahn JM, Campbell SR, Albert AA, Knoll MA, Shah C. #ThisIsBrachytherapy: Increasing awareness of brachytherapy. Brachytherapy 2020; 20:232-236. [PMID: 32811760 DOI: 10.1016/j.brachy.2020.07.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [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: 03/02/2020] [Revised: 06/08/2020] [Accepted: 07/08/2020] [Indexed: 10/23/2022]
Abstract
PURPOSE The use of brachytherapy continues to be a vital application of radiation oncology for various cancers. Despite this, there has been a decrease in the utilization of brachytherapy in many cancers. Social media in medicine facilitates engagement and advocacy. We launched a social media campaign to bring awareness of brachytherapy throughout the world with #ThisIsBrachytherapy hashtag on July 17, 2019. METHODS AND MATERIALS #ThisIsBrachytherapy hashtag was registered with Symplur Healthcare Hashtag Project. We collected total tweet counts, retweet counts, impression counts, geolocation, top 10 influencers, associated hashtags, associated words, and word sentiment score. RESULTS The campaign launched on July 17, 2019, had a total of 145 tweets on that day with 213,416 impressions. Twenty-seven accounts (45%) were identified as physicians. Top countries which tweeted, among those with information available, included the United States, United Kingdom, and Australia. Since July 17, 2019, there has been an increase in tweets using #ThisIsBrachytherapy, with 1990 total tweets with 1,999,248 impressions. Fifty-four percent (1030) of the tweets contained photos and 319 contained links. This was from 462 unique users. Word sentiment was overwhelmingly positive. Associated hashtags with #ThisIsBrachytherapy included most commonly #radonc, #brachytherapy, #brachy, #prostatecancer, and #pcsm. CONCLUSIONS The #ThisIsBrachytherapy inaugural campaign was successful and has continued to grow throughout the months after the initiation. By continuing to advocate for brachytherapy through the social media campaign #ThisIsBrachytherapy, we can empower radiation oncologists, especially trainees, and patients to address underutilization.
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Affiliation(s)
- Jenna M Kahn
- Department of Radiation Medicine, Oregon Health and Science University, Portland, OR.
| | - Shauna R Campbell
- Department of Radiation Oncology, Taussig Cancer Institute, Cleveland Clinic, Cleveland, OH
| | | | | | - Chirag Shah
- Department of Radiation Oncology, Taussig Cancer Institute, Cleveland Clinic, Cleveland, OH
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11
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Rivera A, Ohri N, Thomas E, Miller R, Knoll MA. The Impact of COVID-19 on Radiation Oncology Clinics and Patients With Cancer in the United States. Adv Radiat Oncol 2020; 5:538-543. [PMID: 32292841 PMCID: PMC7118653 DOI: 10.1016/j.adro.2020.03.006] [Citation(s) in RCA: 43] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2020] [Revised: 03/18/2020] [Accepted: 03/19/2020] [Indexed: 01/08/2023] Open
Affiliation(s)
- Amanda Rivera
- Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York
| | - Nitin Ohri
- Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York
| | | | | | - Miriam A. Knoll
- John Theurer Cancer Center, Hackensack University Medical Center, Hackensack, New Jersey
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12
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Knoll MA, Jagsi R, Wallner P. Gender Diversity in Radiation Oncology Board Certification. Int J Radiat Oncol Biol Phys 2020; 106:690-692. [PMID: 32092342 DOI: 10.1016/j.ijrobp.2019.11.025] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2019] [Revised: 11/14/2019] [Accepted: 11/19/2019] [Indexed: 10/25/2022]
Affiliation(s)
- Miriam A Knoll
- John Theurer Cancer Center, Hackensack University Medical Center, Hackensack, New Jersey.
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13
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Chowdhary M, Chowdhary A, Royce TJ, Patel KR, Chhabra AM, Jain S, Knoll MA, Vapiwala N, Pro B, Marwaha G. Women's Representation in Leadership Positions in Academic Medical Oncology, Radiation Oncology, and Surgical Oncology Programs. JAMA Netw Open 2020; 3:e200708. [PMID: 32159809 PMCID: PMC7066474 DOI: 10.1001/jamanetworkopen.2020.0708] [Citation(s) in RCA: 70] [Impact Index Per Article: 17.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
IMPORTANCE Women are underrepresented in medical leadership positions; however, representation of women among academic oncology leadership is unknown. OBJECTIVES To evaluate representation of women overall and in leadership positions in academic medical oncology (MO), radiation oncology (RO), and surgical oncology (SO) programs and to examine the association of women leadership with overall faculty representation of women per program. DESIGN, SETTING, AND PARTICIPANTS In this cross-sectional study, MO, RO, and SO training program websites were queried from October 2018 through June 2019. All faculty from 265 of 273 accredited MO, RO, and SO training programs (97.1%) were included. EXPOSURE Gender. MAIN OUTCOMES AND MEASURES Observed proportions of women in leadership positions compared with the expected proportion of overall women faculty in MO, RO, and SO were assessed. Rates of representation of women across each MO, RO, and SO program's faculty based on the presence or absence of a woman in a leadership position were compared. RESULTS Of 6030 total faculty, only 2164 (35.9%) were women. Total representation of women among MO, RO, and SO faculty was 37.1% (1563 of 4215), 30.7% (389 of 1269), and 38.8% (212 of 546), respectively. Women composed only 21.7% (30 of 138), 11.7% (11 of 94), and 3.8% (1 of 26) of MO, RO, and SO chair positions, respectively. The observed proportion of women in chair positions was significantly lower than the expected proportion for MO, RO, and SO. In all, 47.9%, 33%, and 18.5% of MO, RO, and SO programs, respectively, had at least 1 woman in a leadership position (program director or chair). Programs with 1 or more women in a leadership position were associated with a higher mean (SD) percentage of women faculty than those without at least 1 woman leader in MO (40.7% [12.5%] vs 33.1% [11.0%]; P < .001) and RO (36.2% [13.3%] vs 23.4% [12.3%]; P < .001) but not SO (40.2% [15.4%] vs 31.4% [16.9%]; P = .29). CONCLUSIONS AND RELEVANCE Gender disparity exists in academic MO, RO, and SO faculty, which is magnified at the chair level. Programs in MO and RO with a woman physician in a leadership position were associated with a higher percentage of women faculty, but this was not true for SO. These data will serve as a benchmark to monitor progress toward a more balanced workforce.
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Affiliation(s)
- Mudit Chowdhary
- Department of Radiation Oncology, Rush University Medical Center, Chicago, Illinois
| | - Akansha Chowdhary
- Robert H. Lurie Comprehensive Cancer Center, Division of Hematology and Medical Oncology, Northwestern University, Chicago, Illinois
| | - Trevor J. Royce
- Department of Radiation Oncology, University of North Carolina School of Medicine, Chapel Hill
| | - Kirtesh R. Patel
- Department of Radiation Oncology, Kaiser Permanente, Atlanta, Georgia
| | - Arpit M. Chhabra
- Department of Radiation Oncology, New York Proton Center, New York
| | - Shikha Jain
- Division of Hematology, Oncology and Stem Cell Transplant, Rush University Medical Center, Chicago, Illinois
| | - Miriam A. Knoll
- John Theurer Cancer Center, Department of Radiation Oncology, Hackensack University Medical Center, Hackensack, New Jersey
| | - Neha Vapiwala
- Department of Radiation Oncology, University of Pennsylvania School of Medicine, Philadelphia
| | - Barbara Pro
- Robert H. Lurie Comprehensive Cancer Center, Division of Hematology and Medical Oncology, Northwestern University, Chicago, Illinois
| | - Gaurav Marwaha
- Department of Radiation Oncology, Rush University Medical Center, Chicago, Illinois
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Markham MJ, Wachter K, Agarwal N, Bertagnolli MM, Chang SM, Dale W, Diefenbach CSM, Rodriguez-Galindo C, George DJ, Gilligan TD, Harvey RD, Johnson ML, Kimple RJ, Knoll MA, LoConte N, Maki RG, Meisel JL, Meyerhardt JA, Pennell NA, Rocque GB, Sabel MS, Schilsky RL, Schneider BJ, Tap WD, Uzzo RG, Westin SN. Clinical Cancer Advances 2020: Annual Report on Progress Against Cancer From the American Society of Clinical Oncology. J Clin Oncol 2020; 38:1081. [PMID: 32013670 DOI: 10.1200/jco.19.03141] [Citation(s) in RCA: 92] [Impact Index Per Article: 23.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
A MESSAGE FROM ASCO’S PRESIDENT Shortly before I was elected President of ASCO, I attended the 65th birthday party of a current patient. She had been diagnosed 10 years earlier with metastatic breast cancer and hadn't been sure she wanted to move forward with further treatment. With encouragement, she elected to participate in a clinical trial of an investigational drug that is now widely used to treat breast cancer. Happily, here we were, celebrating with her now-married daughters, their husbands, and three beautiful grandchildren, ages 2, 4, and 8. Such is the importance of clinical trials and promising new therapies.Clinical research is about saving and improving the lives of individuals with cancer. It's a continuing story that builds on the efforts of untold numbers of researchers, clinicians, caregivers, and patients. ASCO's Clinical Cancer Advances report tells part of this story, sharing the most transformative research of the past year. The report also includes our latest thinking on the most urgent research priorities in oncology.ASCO's 2020 Advance of the Year-Refinement of Surgical Treatment of Cancer-highlights how progress drives more progress. Surgery has played a fundamental role in cancer treatment. It was the only treatment available for many cancers until the advent of radiation and chemotherapy. The explosion in systemic therapies since then has resulted in significant changes to when and how surgery is performed to treat cancer. In this report, we explore how treatment successes have led to less invasive approaches for advanced melanoma, reduced the need for surgery in renal cell carcinoma, and increased the number of patients with pancreatic cancer who can undergo surgery.Many research advances are made possible by federal funding. With the number of new US cancer cases set to rise by roughly a third over the next decade, continued investment in research at the national level is crucial to continuing critical progress in the prevention, screening, diagnosis, and treatment of cancer.While clinical research has translated to longer survival and better quality of life for many patients with cancer, we can't rest on our laurels. With ASCO's Research Priorities to Accelerate Progress Against Cancer, introduced last year and updated this year, we've identified the critical gaps in cancer prevention and care that we believe to be most pressing. These priorities are intended to guide the direction of research and speed progress.Of course, the effectiveness or number of new treatments is meaningless if patients don't have access to them. High-quality cancer care, including clinical trials, is out of reach for too many patients. Creating an infrastructure to support patients is a critical part of the equation, as is creating connections between clinical practices and research programs. We have much work to do before everyone with cancer has equal access to the best treatments and the opportunity to participate in research. I know that ASCO and the cancer community are up for this challenge.Sincerely,Howard A. "Skip" Burris III, MD, FACP, FASCOASCO President, 2019-2020.
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Affiliation(s)
| | - Kerri Wachter
- American Society of Clinical Oncology, Alexandria, VA
| | | | | | | | - William Dale
- City of Hope National Medical Center, Duarte, CA
| | | | | | | | | | | | | | | | | | | | - Robert G Maki
- Northwell Health/Monter Cancer Center and Cold Spring Harbor Laboratory, Lake Success, NY
| | | | | | | | | | | | | | | | - William D Tap
- Memorial Sloan Kettering Cancer Center, New York, NY
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Knoll MA, Jagsi R. Additional Factors in the Association of Gender and Parenthood With Conference Attendance—Reply. JAMA Oncol 2020; 6:160. [DOI: 10.1001/jamaoncol.2019.5022] [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: 11/14/2022]
Affiliation(s)
- Miriam A. Knoll
- Department of Radiation Oncology, John Theurer Cancer Center, Hackensack Meridian Health–Memorial Sloan Kettering Cancer Center Partnership, Hackensack, New Jersey
| | - Reshma Jagsi
- Center for Bioethics and Social Sciences in Medicine, University of Michigan, Ann Arbor
- Department of Radiation Oncology, University of Michigan, Ann Arbor
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Duma N, Durani U, Woods CB, Kankeu Fonkoua LA, Cook JM, Wee C, Fuentes HE, Gonzalez-Velez M, Murphy MC, Jain S, Marshall AL, Graff SL, Knoll MA. Evaluating Unconscious Bias: Speaker Introductions at an International Oncology Conference. J Clin Oncol 2019; 37:3538-3545. [PMID: 31603705 DOI: 10.1200/jco.19.01608] [Citation(s) in RCA: 41] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
PURPOSE In a professional setting, the introduction of female speakers without their professional title may have an impact on the public's perception of the female speaker. We examined how professional titles were used during speakers' introductions at the ASCO Annual Meeting. METHODS We conducted a retrospective, observational study of video-archived speaker introductions at the 2017 and 2018 ASCO Annual Meetings. A "professional address" was defined as the professional title followed by the speaker's full name or last name. Multivariable logistic regressions were used to identify factors associated with the form of address. RESULTS Of 2,511 videos reviewed, 781 met inclusion criteria. Female speakers were addressed less often by their professional title compared with male speakers (62% v 81%; P < .001). Males were less likely to use a professional address when introducing female speakers compared with females when introducing male speakers (53% v 80%; P < .01). When women performed speaker introductions, no gender differences in professional address were observed (75% v 82%; P = .13). Female speakers were more likely to be introduced by first name only (17% v 3%; P < .001). Male introducers were more likely to address female speakers by first name only compared with female introducers (24% v 7%; P < .01). In a multivariable regression including gender, degree, academic rank, and geographic location of the speaker's institution, male speakers were more likely to receive a professional address compared with female speakers (odds ratio, 2.43; 95% CI, 1.71 to 3.47; P < .01). CONCLUSION When introduced by men, female speakers were less likely to receive a professional address and more likely to be introduced by first name only compared with their male peers.
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Affiliation(s)
- Narjust Duma
- University of Wisconsin Carbone Cancer Center, Madison, WI
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Affiliation(s)
- Miriam A Knoll
- Radiation oncologist, Department of Radiation Oncology, John Theurer Cancer Center, Hackensack, New Jersey; . Newman Family Professor and deputy chair, Department of Radiation Oncology, and director, Center for Bioethics and Social Sciences in Medicine, University of Michigan, Ann Arbor, Michigan
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Knoll MA, Griffith KA, Jones RD, Jagsi R. Association of Gender and Parenthood With Conference Attendance Among Early Career Oncologists. JAMA Oncol 2019; 5:1503-1504. [PMID: 31318379 DOI: 10.1001/jamaoncol.2019.1864] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Affiliation(s)
- Miriam A Knoll
- Department of Radiation Oncology, John Theurer Cancer Center, a Hackensack Meridian Health-Memorial Sloan Kettering Center partnership, Hackensack, New Jersey
| | - Kent A Griffith
- Center for Cancer Biostatistics, University of Michigan, Ann Arbor
| | - Rochelle D Jones
- Center for Bioethics and Social Science in Medicine, University of Michigan, Ann Arbor
| | - Reshma Jagsi
- Center for Bioethics and Social Science in Medicine, University of Michigan, Ann Arbor.,Department of Radiation Oncology, University of Michigan, Ann Arbor
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Affiliation(s)
- Miriam A Knoll
- John Theurer Cancer Center, Hackensack University Medical Center, Hackensack, New Jersey.
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Albert AA, Knoll MA, Doke K, Masters A, Lee A, Dover L, Hentz C, Puckett L, Goodman CR, Osborn VW, Barry P, Jagsi R. #WomenWhoCurie: Leveraging Social Media to Promote Women in Radiation Oncology. Adv Radiat Oncol 2019; 4:218-225. [PMID: 31011664 PMCID: PMC6460226 DOI: 10.1016/j.adro.2019.01.003] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2018] [Accepted: 01/09/2019] [Indexed: 11/29/2022] Open
Abstract
The proportion of female trainees in radiation oncology has generally declined despite increasing numbers of female medical students; as a result, radiation oncology is among the bottom 5 specialties in terms of the percentage of female applicants. Recently, social media has been harnessed as a tool to bring recognition to underrepresented groups within medicine and other fields. Inspired by the wide-reaching social media campaign of #ILookLikeASurgeon to promote female physicians, members of the Society for Women in Radiation Oncology penned a new hashtag and launched the #WomenWhoCurie social media campaign on Marie Curie's birthday November 7th, as part of their strategy to raise public awareness. From November 6, 2018 until November 10, 2018, the #WomenWhoCurie hashtag delivered 1,135,000 impressions, including 408 photos from all over the world including United States, Spain, Canada, France, Australia, Ireland, the United Kingdom, Mexico, Japan, the Netherlands, India, Ecuador, Panama, Brazil, and Nigeria. Alongside continued gender disparity research, social media should continue to be used as a tool to engage the community and spur conversations to formulate solutions for gender inequity.
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Affiliation(s)
- Ashley A Albert
- University of Mississippi Medical Center, Jackson, Mississippi
| | - Miriam A Knoll
- John Theurer Cancer Center (Hackensack Meridian Health-MSKCC Partnership), Hackensack, New Jersey
| | | | - Adrianna Masters
- Wake Forest University School of Medicine, Winston-Salem, North Carolina
| | - Anna Lee
- SUNY Downstate Medical Center, Brooklyn, New York
| | - Laura Dover
- University of Alabama at Birmingham, Birmingham, Alabama
| | | | | | - Chelain R Goodman
- Northwestern University, Feinberg School of Medicine, Chicago, Illinois
| | | | - Parul Barry
- Rush University Medical Center, Chicago, Illinois
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Affiliation(s)
- Miriam A. Knoll
- Department of Radiation Oncology, John Theurer Cancer Center, a Hackensack Meridian Health-Memorial Sloan Kettering Cancer Center partnership, Hackensack, New Jersey
| | - Reshma Jagsi
- Center for Bioethics and Social Science in Medicine, Department of Radiation Oncology, University of Michigan, Ann Arbor
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Knoll MA, Glucksman E, Tarbell N, Jagsi R. Putting Women on the Escalator: How to Address the Ongoing Leadership Disparity in Radiation Oncology. Int J Radiat Oncol Biol Phys 2018; 103:5-7. [PMID: 30563666 DOI: 10.1016/j.ijrobp.2018.08.011] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2018] [Revised: 07/27/2018] [Accepted: 08/02/2018] [Indexed: 11/18/2022]
Affiliation(s)
- Miriam A Knoll
- Department of Radiation Oncology, John Theurer Cancer Center, a HMH-MSKCC partnership, Hackensack, New Jersey
| | - Eitan Glucksman
- Department of Radiation Oncology, John Theurer Cancer Center, a HMH-MSKCC partnership, Hackensack, New Jersey
| | - Nancy Tarbell
- Department of Radiation Oncology, Massachusetts General Hospital, Harvard Medical School, Waltham, Massachusetts
| | - Reshma Jagsi
- Department of Radiation Oncology, Center for Bioethics and Social Sciences in Medicine, University of Michigan, Ann Arbor, Michigan.
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Knoll MA, Kavanagh B, Katz M. The 2017 American Society of Radiation Oncology (ASTRO) annual meeting: Taking a deeper dive into social media. Adv Radiat Oncol 2018; 3:230-233. [PMID: 30197934 PMCID: PMC6127968 DOI: 10.1016/j.adro.2018.02.009] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2017] [Revised: 02/15/2018] [Accepted: 02/20/2018] [Indexed: 11/28/2022] Open
Affiliation(s)
- Miriam A Knoll
- John Theurer Cancer Center, Memorial Sloan Kettering-Hackensack Meridian Health Partnership, Hackensack, New Jersey
| | - Brian Kavanagh
- Department of Radiation Oncology, University of Colorado, Boulder, Colorado
| | - Matthew Katz
- Department of Radiation Oncology, Lowell General Hospital, Lowell, Massachusetts
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Knoll MA. Defining and Shattering the Glass Ceiling in Radiation Oncology. Int J Radiat Oncol Biol Phys 2017; 98:978-979. [PMID: 28721910 DOI: 10.1016/j.ijrobp.2017.03.027] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2017] [Revised: 03/09/2017] [Accepted: 03/18/2017] [Indexed: 11/19/2022]
Affiliation(s)
- Miriam A Knoll
- Department of Radiation Oncology, John Thuerer Cancer Center, a Memorial Sloan Kettering-Hackensack Meridian Health Partnership, Hackensack, New Jersey.
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Vempati P, Knoll MA, Dharmarajan K, Green S, Tiersten A, Bakst RL. Palliation of Ulcerative Breast Lesions with Radiation. Anticancer Res 2017; 36:4701-5. [PMID: 27630316 DOI: 10.21873/anticanres.11024] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [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: 06/22/2016] [Accepted: 07/29/2016] [Indexed: 11/10/2022]
Abstract
BACKGROUND/AIM Patients with advanced breast cancer may experience ulcerative breast lesions. Breast cancer with ulcerative lesions has been shown to severely affect a patient's quality of life (QoL). The role of palliative radiation therapy (RT) in the management of ulcerative breast lesions needs to be further explored. PATIENTS AND METHODS We retrospectively reviewed the RT records for all patients who underwent palliative RT for breast cancer at our urban academic medical center. A total of 13 patients were identified, and we herein report their demographics, treatment characteristics, and clinical outcomes. RESULTS The mean age of the patients receiving palliative RT for ulcerative breast cancer was 64 years. All patients had stage IV disease when they were evaluated for RT. The mean radiation dose received for palliative RT was 27.54 Gy in 11 fractions, with a median dose of 30 Gy in 15 fractions. Six (46%) patients had received prior RT to the same breast, with a median dose of 59.5 Gy in 31 fractions. Among these six patients, the average interval between initial RT and ulceration was 69.5 months. The median overall survival for the whole patient cohort since ulceration was 5 months and the mean survival did not differ between patients with previous history of RT and RT-naïve patients (4.50 vs. 4.57; p=0.95). Six out of the nine (69%) patients who received 30 Gy or more reported clinical improvement, whereas none of the four patients who received less than 30 Gy reported any benefit. There were no radiation-associated toxicities reported by patients. CONCLUSION These data suggest that palliative RT (≥30 Gy) is an efficacious treatment for ulcerative breast cancer with minimal toxicity. Prior RT should not be a contraindication, as patients with previous history of RT have similar low toxicity rates compared to RT-naïve patients.
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Affiliation(s)
- Prashant Vempati
- Department of Radiation Oncology, Icahn School of Medicine at Mount Sinai, New York, NY, U.S.A
| | - Miriam A Knoll
- Department of Radiation Oncology, Icahn School of Medicine at Mount Sinai, New York, NY, U.S.A
| | - Kavita Dharmarajan
- Department of Radiation Oncology, Icahn School of Medicine at Mount Sinai, New York, NY, U.S.A
| | - Sheryl Green
- Department of Radiation Oncology, Icahn School of Medicine at Mount Sinai, New York, NY, U.S.A
| | - Amy Tiersten
- Department of Medical Oncology, Icahn School of Medicine at Mount Sinai, New York, NY, U.S.A
| | - Richard L Bakst
- Department of Radiation Oncology, Icahn School of Medicine at Mount Sinai, New York, NY, U.S.A.
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Knoll MA, Salvatore M, Sheu RD, Knoll AD, Kerns SL, Lo YC, Rosenzweig KE. The use of isodose levels to interpret radiation induced lung injury: a quantitative analysis of computed tomography changes. Quant Imaging Med Surg 2016; 6:35-41. [PMID: 26981453 DOI: 10.3978/j.issn.2223-4292.2016.02.07] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
BACKGROUND Patients treated with stereotactic body radiation therapy (SBRT) for lung cancer are often found to have radiation-induced lung injury (RILI) surrounding the treated tumor. We investigated whether treatment isodose levels could predict RILI. METHODS Thirty-seven lung lesions in 32 patients were treated with SBRT and received post-treatment follow up (FU) computed tomography (CT). Each CT was fused with the original simulation CT and treatment isodose levels were overlaid. The RILI surrounding the treated lesion was contoured. The RILI extension index [fibrosis extension index (FEI)] was defined as the volume of RILI extending outside a given isodose level relative to the total volume of RILI and was expressed as a percentage. RESULTS Univariate analysis revealed that the planning target volume (PTV) was positively correlated with RILI volume at FU: correlation coefficient (CC) =0.628 and P<0.0001 at 1(st) FU; CE =0.401 and P=0.021 at 2(nd) FU; CE =0.265 and P=0.306 at 3(rd) FU. FEI -40 Gy at 1(st) FU was significantly positively correlated with FEI -40 Gy at subsequent FU's (CC =0.689 and P=6.5×10(-5) comparing 1(st) and 2(nd) FU; 0.901 and P=0.020 comparing 2(nd) and 3(rd) FU. Ninety-six percent of the RILI was found within the 20 Gy isodose line. Sixty-five percent of patients were found to have a decrease in RILI on the second 2(nd) CT. CONCLUSIONS We have shown that RILI evolves over time and 1(st) CT correlates well with subsequent CTs. Ninety-six percent of the RILI can be found to occur within the 20 Gy isodose lines, which may prove beneficial to radiologists attempting to distinguish recurrence vs. RILI.
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Affiliation(s)
- Miriam A Knoll
- 1 Department of Radiation Oncology, 2 Department of Radiology, Mount Sinai School of Medicine, 1 Gustave Levy Place, New York, NY 10029, USA
| | - Mary Salvatore
- 1 Department of Radiation Oncology, 2 Department of Radiology, Mount Sinai School of Medicine, 1 Gustave Levy Place, New York, NY 10029, USA
| | - Ren Dih Sheu
- 1 Department of Radiation Oncology, 2 Department of Radiology, Mount Sinai School of Medicine, 1 Gustave Levy Place, New York, NY 10029, USA
| | - Abraham D Knoll
- 1 Department of Radiation Oncology, 2 Department of Radiology, Mount Sinai School of Medicine, 1 Gustave Levy Place, New York, NY 10029, USA
| | - Sarah L Kerns
- 1 Department of Radiation Oncology, 2 Department of Radiology, Mount Sinai School of Medicine, 1 Gustave Levy Place, New York, NY 10029, USA
| | - Yeh-Chi Lo
- 1 Department of Radiation Oncology, 2 Department of Radiology, Mount Sinai School of Medicine, 1 Gustave Levy Place, New York, NY 10029, USA
| | - Kenneth E Rosenzweig
- 1 Department of Radiation Oncology, 2 Department of Radiology, Mount Sinai School of Medicine, 1 Gustave Levy Place, New York, NY 10029, USA
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