1
|
Baydoun A, Pereira IJ, Turner S, Siva S, Albert AA, Andrew Loblaw D, Simcock RA, Zaorsky NG, Katz MS. Development and dissemination of structured hashtags for radiation oncology: Two-Year trends. Clin Transl Radiat Oncol 2023; 39:100524. [PMID: 36935852 PMCID: PMC10014325 DOI: 10.1016/j.ctro.2022.09.007] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2022] [Revised: 09/22/2022] [Accepted: 09/25/2022] [Indexed: 11/06/2022] Open
Abstract
Purpose For radiation oncology, social media is a favored communication platform, but it uses non-structured hashtags, which limits communication. In this work, we created a set of structured hashtags with key opinion leaders in radiation oncology, and we report on their use after two years post-deployment. Materials/Methods Hashtags were created, voted on, and refined by crowdsourcing 38 international experts, including physicians, physicists, patients, and organizations from North America, Europe, and Australia. The finalized hashtag set was shared with the radiation oncology community in September 2019. The number of tweets for each hashtag was quantified via Symplur through December 2021. For the top five tweeted hashtags, we captured the number of yearly tweets in the pre-deployment and post-deployment periods from 09/01/2019 to 08/31/2021. Results The initial 2019 list contained 39 hashtags organized into nine categories. The top five hashtags by total number of tweets were: #Radonc, #PallOnc, #MedPhys, #SurvOnc, and #SuppOnc. Six hashtags had less than 10 total tweets and were eliminated. Post-deployment, there was an increase in the yearly tweets, with the following number of tweets by the second year post-deployment: #RadOnc (98,189 tweets), #MedPhys (15,858 tweets), and #SurvOnc (6,361 tweets). Two popular radiation oncology-related hashtags were added because of increased use: #DEIinRO (1,603 tweets by year 2) and #WomenWhoCurie (7,212 tweets by year 2). Over the two years, hashtags were used mostly by physicians (131,625 tweets, 34.8%). Conclusion We created and tracked structured social media hashtags in radiation oncology. These hashtags disseminate information among a diverse oncologic community. To maintain relevance, regular updates are needed.
Collapse
Affiliation(s)
- Atallah Baydoun
- Department of Radiation Oncology, University Hospitals of Cleveland, Cleveland, OH 44106, USA
| | | | - Sandra Turner
- Crown Princess Mary Cancer Centre, Westmead 2145, Australia
| | - Shankar Siva
- University of Melbourne, Melbourne 3010, Australia
| | | | - D. Andrew Loblaw
- Department of Radiation Oncology, Sunnybrook Odette Cancer Centre, University of Toronto, Toronto, ON M4N 3M5, Canada
| | - Richard A. Simcock
- Brighton and Sussex University Hospitals NHS Trust, Brighton BN2 1DH, UK
| | - Nicholas G. Zaorsky
- Department of Radiation Oncology, University Hospitals of Cleveland, Cleveland, OH 44106, USA
- School of Medicine, Case Western Reserve University, Cleveland, OH 44106, USA
- Corresponding authors at: Department of Radiation Oncology, UH Cleveland Medical Center, Seidman Cancer Center, 11100 Euclid Avenue, Cleveland, OH 44106, USA (N.G. Zaorsky). Department of Radiation Oncology, The Cancer Center at Lowell General Hospital, 295 Varnum Avenue, Lowell, MA 01854, USA (M. Katz).
| | - Matthew S. Katz
- Radiation Oncology Associates, PA, Lowell, MA 01854, USA
- Corresponding authors at: Department of Radiation Oncology, UH Cleveland Medical Center, Seidman Cancer Center, 11100 Euclid Avenue, Cleveland, OH 44106, USA (N.G. Zaorsky). Department of Radiation Oncology, The Cancer Center at Lowell General Hospital, 295 Varnum Avenue, Lowell, MA 01854, USA (M. Katz).
| |
Collapse
|
2
|
Vengaloor Thomas T, Kanakamedala MR, Bhanat E, Abraham A, Mundra E, Albert AA, Giri S, Bhandari R, Vijayakumar S. Predictors of Extracapsular Extension in Patients With Squamous Cell Carcinoma of the Head and Neck and Outcome Analysis. Cureus 2021; 13:e16680. [PMID: 34466317 PMCID: PMC8392822 DOI: 10.7759/cureus.16680] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/27/2021] [Indexed: 11/25/2022] Open
Abstract
Introduction Extracapsular extension (ECE) in the lymph nodes for patients with head and neck cancer has been found to be a poor prognostic factor in multiple studies. The purpose of the study is to evaluate the predictive factors for ECE on computer tomography (CT) imaging for patients undergoing surgery and to analyze outcomes. Methods We conducted an Institutional Review Board-approved, Health Insurance Portability and Accountability Act (HIPAA)-compliant retrospective review of 82 patients with biopsy-proven squamous cell carcinomas of the head and neck who underwent definitive surgery without neoadjuvant chemotherapy or radiation therapy. CT scans were evaluated for the level of involvement, size, and presence or absence of central necrosis. Extracapsular extension in lymph nodes on the postoperative pathology was correlated with the central necrosis in the lymph nodes appreciated on the CT neck with contrast. Survival estimates were evaluated using the Kaplan-Meier test. Results ECE on postoperative pathology was seen in 74.07% of patients who had evidence of central necrosis in lymph nodes on preoperative CT neck compared to 46.43% without CT necrosis (p=0.013). The incidence of ECE is higher in poorly differentiated tumors and also nodal stages >N2c at presentation. Patents with ECE had inferior disease-free and overall survival (OS). Conclusions Our results reveal that patients with necrosis on CT and with moderately to poorly differentiated tumors have a high incidence of extracapsular extension. There was no difference in local control (LC) between the groups of patients, but the OS was inferior in patients with ECE. Predicting extracapsular extension upfront helps to formulate the appropriate treatment. We propose to study additional chemotherapy to improve outcomes in patients with positive extracapsular extension.
Collapse
Affiliation(s)
| | | | - Eldrin Bhanat
- Orthopaedic Surgery, University of Mississippi Medical Center, Jackson, USA
| | - Anu Abraham
- Pathology, Universtiy of Mississippi Medical Center, Jackson, USA
| | - Eswar Mundra
- Radiation Oncology, University of Mississippi Medical Center, Jackson, USA
| | - Ashley A Albert
- Radiation Oncology, University of Mississippi Medical Center, Jackson, USA
| | - Shankar Giri
- Radiation Oncology, G.V. (Sonny) Montgomery VA Medical Center, Jackson, USA
| | - Rahul Bhandari
- Radiation Oncology, G.V. (Sonny) Montgomery VA Medical Center, Jackson, USA
| | | |
Collapse
|
3
|
King ML, Nittala MR, Gordy XZ, Roberts P, Lirette ST, Thomas TV, Gordy DP, Albert AA, Vijayakumar V, Vijayakumar S. Prostate Cancer Screening Recommendations for General and Specific Populations in the
Western Nations. EMJ 2020. [DOI: 10.33590/emj/20-00042] [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: 12/24/2022] Open
Abstract
There is a chaotic scenario that exists in the field of prostate cancer (PCa) screening. To balance goals, such as decreasing mortality, avoiding unnecessary procedures, and decreasing the cost of medical care, the pendulum seems to have swung to the side of more restricted screening. The decrease in PCa screening has led to a slowly creeping decline in the favourable outcomes that existed among patients with PCa. If a potential patient or a family member is trying to get clear guidance about PCa screening by searching the internet, they will end up confused by several recommendations from many organisations. It is even more challenging to obtain any clarity about PCa screening for special populations, such as those with a family history of PCa, those of African descent/African Americans, and the elderly. The advent of genomic medicine and precision medicine is an opportunity to identify those at a very high risk of developing aggressive PCa, so that PCa screening can be more actively undertaken among them. In this paper, the authors review the current recommendations by different entities and summarise emerging molecular markers that may help bring clarity to PCa screening. The authors predict that concrete, consensual guidelines will emerge in less than one decade. Meanwhile, this article suggests intermediary steps that will help save lives from PCa mortality, especially for under-represented populations. This paper is a catalyst to stimulate further discussion and serves as a guide to noncancer-specialists for the near future as precision medicine progresses to better understand risk–benefit and cost–benefit ratios in PCa screening.
Collapse
Affiliation(s)
- Maurice L. King
- Department of Radiation Oncology, University of Mississippi Medical Center, Jackson, Mississippi, USA
| | - Mary R. Nittala
- Department of Radiation Oncology, University of Mississippi Medical Center, Jackson, Mississippi, USA
| | - Xiaoshan Z. Gordy
- Department of Health Science, University of Mississippi Medical Center, Jackson, Mississippi, USA
| | - Paul Roberts
- Department of Radiation Oncology, University of Mississippi Medical Center, Jackson, Mississippi, USA
| | - Seth T. Lirette
- Department of Data Science, University of Mississippi Medical Center, Jackson, Mississippi, USA
| | - Toms V. Thomas
- Department of Radiation Oncology, University of Mississippi Medical Center, Jackson, Mississippi, USA
| | - David P. Gordy
- Department of Radiology, University of Mississippi Medical Center, Jackson, Mississippi, USA
| | - Ashley A. Albert
- Department of Radiation Oncology, University of Mississippi Medical Center, Jackson, Mississippi, USA
| | - Vani Vijayakumar
- Department of Radiology, University of Mississippi Medical Center, Jackson, Mississippi, USA
| | - Srinivasan Vijayakumar
- Department of Radiation Oncology, University of Mississippi Medical Center, Jackson, Mississippi, USA
| |
Collapse
|
4
|
Vengaloor Thomas T, Gordy XZ, Lirette ST, Albert AA, Gordy DP, Vijayakumar S, Vijayakumar V. Lack of Racial Survival Differences in Metastatic Prostate Cancer in National Cancer Data Base (NCDB): A Different Finding Compared to Non-metastatic Disease. Front Oncol 2020; 10:533070. [PMID: 33072567 PMCID: PMC7531281 DOI: 10.3389/fonc.2020.533070] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [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: 02/06/2020] [Accepted: 08/17/2020] [Indexed: 12/24/2022] Open
Abstract
Background: Inconsistent findings have been reported in the literature regarding racial differences in survival outcomes between African American and white patients with metastatic prostate cancer (mPCa). The current study utilized a national database to determine whether racial differences exist among the target population to address this inconsistency. Methods: This study retrospectively reviewed prostate cancer (PCa) patient data (N = 1,319,225) from the National Cancer Database (NCDB). The data were divided into three groupings based on the metastatic status: (1) no metastasis (N = 318,291), (2) bone metastasis (N = 29,639), and (3) metastases to locations other than bone, such as brain, liver, or lung (N = 952). Survival probabilities of African American and white PCa patients with bone metastasis were examined through parametric proportional hazards Weibull models and Bayesian survival analysis. These results were compared to patients with no metastasis or other types of metastases. Results: No statistically supported racial disparities were observed for African American and white men with bone metastasis (p = 0.885). Similarly, there were no racial disparities in survival for those men suffering from other metastases (liver, lung, or brain). However, racial disparities in survival were observed among the two racial groups with non-metastatic PCa (p < 0.001) or when metastasis status was not taken into account (p < 0.001). The Bayesian analysis corroborates the finding. Conclusion: This research supports our previous findings and shows that there are no racial differences in survival outcomes between African American and white patients with mPCa. In contrast, racial disparities in the survival outcome continue to exist among non-metastatic PCa patients. Further research is warranted to explain this difference.
Collapse
Affiliation(s)
- Toms Vengaloor Thomas
- Department of Radiation Oncology, University of Mississippi Medical Center, Jackson, MS, United States
| | - Xiaoshan Z Gordy
- Department of Health Sciences, University of Mississippi Medical Center, Jackson, MS, United States
| | - Seth T Lirette
- Department of Data Science, University of Mississippi Medical Center, Jackson, MS, United States
| | - Ashley A Albert
- Department of Radiation Oncology, University of Mississippi Medical Center, Jackson, MS, United States
| | - David P Gordy
- Department of Radiology, University of Mississippi Medical Center, Jackson, MS, United States
| | - Srinivasan Vijayakumar
- Department of Radiation Oncology, University of Mississippi Medical Center, Jackson, MS, United States
| | - Vani Vijayakumar
- Department of Radiology, University of Mississippi Medical Center, Jackson, MS, United States
| |
Collapse
|
5
|
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.
Collapse
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
| |
Collapse
|
6
|
Vengaloor Thomas T, Perekattu Kuruvilla T, Holliday E, Bhanat E, Parr A, Albert AA, Page B, Schuster J, Chapman C, Vijayakumar S. Cross-Sectional Gender Analysis of US Radiation Oncology Residency Programs in 2019: More Than a Pipeline Issue? Adv Radiat Oncol 2020; 5:1099-1103. [PMID: 33305070 PMCID: PMC7718546 DOI: 10.1016/j.adro.2020.07.008] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [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: 04/16/2020] [Revised: 06/18/2020] [Accepted: 07/06/2020] [Indexed: 10/26/2022] Open
Abstract
Purpose The purpose of this study is to assess the current status of gender disparities in academic radiation oncology departments in the United States and the associated factors. Methods and Materials The data were collected from publicly available resources, including websites of individual radiation oncology programs, the Fellowship and Residency Electronic Interactive Database, the Accreditation Council for Graduate Medical Education, and the Association of American Medical Colleges. We collected data on the gender information of residents in each year (postgraduate years 2-5) and of the faculty (attendings, program director, and chair) during the academic year 2018 to 2019. Spearman's rho test, Pearson's chi-squared test, and Fisher exact tests were used for evaluating the correlation among variables using SPSS version 24. Results Women constituted 30.8% of radiation oncology residents in the United States in 2019. Eight programs (12.5%) did not have any female residents in their programs, whereas 6 programs (9%) had women constituting more than half of their resident class. The fraction of female medical students applying to radiation oncology over the last 7 years varied between 27% and 33%. Female attending physicians accounted for 30.5% of all the attending physicians in the academic programs. In the leadership positions of the department, the gender gap was wider where only 19 (20%) and 11 (12%) of programs had female program director or chair, respectively. There was a positive correlation between the number of attending physicians and the number of female residents in programs (P = .01). Conclusions A significant gender disparity continues to exist among the residents and physicians in the academic radiation oncology departments in the US. This disparity is pronounced in the leadership positions. The results of this study could be used as a benchmark to evaluate the progress that has been made by the efforts to improve gender disparities in radiation oncology.
Collapse
Affiliation(s)
| | | | - Emma Holliday
- University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Eldrin Bhanat
- University of Mississippi Medical Center, Jackson, Mississippi
| | - Amy Parr
- University of Mississippi Medical Center, Jackson, Mississippi
| | - Ashley A Albert
- University of Mississippi Medical Center, Jackson, Mississippi
| | - Brandi Page
- Johns Hopkins University, Baltimore, Maryland
| | - Jessica Schuster
- University of Wisconsin School of Medicine and Public Health, Madison, Wsconsin
| | | | | |
Collapse
|
7
|
Thomas TV, Nittala MR, Mehta D, Kanakamedala MR, Abraham A, Weatherall L, Bhanat E, Albert AA, Vijayakumar S. Abstract B20: Hypopharyngeal carcinoma management: 25-year experience from a tertiary care medical center in United States. Clin Cancer Res 2020. [DOI: 10.1158/1557-3265.aacrahns19-b20] [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: 11/16/2022]
Abstract
Abstract
Introduction: The purpose of this study is to evaluate the incidence, management, and prognosis of hypopharyngeal carcinoma in a tertiary care institution over the past 25 years.
Methods: We retrospectively analyzed patients from 1995 to 2019 from the head and neck cancer data base of our institution. The data regarding the demographics, stage, treatment, and follow-up were collected. Outcomes including median survival and overall survival were evaluated using the Kaplan Meier method. All analyses were performed using SPSS version 24.
Results: We identified 144 hypopharyngeal carcinoma patients, and the incidence was almost 4% of all head and neck cancers. All patients had squamous cell carcinoma. Sixty-one percent of patients were African Americans and 36% were Caucasians. Ninety percent of the patients were males, and 10% were females. Pyriform sinus was the subsite most commonly affected (67%), followed by posterior pharyngeal wall (10%) and postcricoid area (5%). Ninety-six percent of patients presented with advanced-stage disease (stages III and IV), with only 4% of patients presenting with early-stage disease (Stages I and II). Fifty-one percent of patients underwent definitive chemoradiotherapy with or without induction chemotherapy and 23% of patients underwent surgical management, followed by adjuvant radiation or chemoradiation, depending on risk factors. Ten percent of patients received only palliative chemotherapy and 15% did not receive any treatments. Induction chemotherapy was used in 31% of patients prior to initiation of definitive chemoradiation treatment. The median overall survival of early-stage patients and of advanced-stage patients was 56 months and 15 months, respectively. The median survival of the patients with advanced-stage patients who received definitive treatment was 26 months. The patients who underwent definitive operative management followed by adjuvant treatments had an improved median survival as compared to those undergoing definitive chemoradiation treatment (38 months vs. 16 months, p=0.05). Similarly, the overall survival at 3 years (30% vs. 54%, p=0.05) and 5 years (13% vs. 34%, p=0.05) was also better for surgery patients. The patients who received induction chemotherapy had clinically worse median survival as compared to those who did not, but this was not statistically significant (14 months vs. 21 months, p=0.2).
Conclusions: Our results agree with the published literature regarding the low incidence of hypopharyngeal cancer, presentation in advanced stages, and poor long-term outcomes. Selection of patients for laryngeal preservation should be done very carefully. Our results suggest that trimodality treatment may be more efficacious than definitive chemoradiotherapy for locally advanced disease. Future studies are warranted to evaluate if neoadjuvant chemoradiotherapy followed by surgery might be able to improve the current poor outcomes for advanced hypopharyngeal cancer patients who are not eligible for laryngeal preservation.
Citation Format: Toms Vengaloor Thomas, Mary R. Nittala, Divyang Mehta, Madhava Rao Kanakamedala, Anu Abraham, Lacey Weatherall, Eldrin Bhanat, Ashley A. Albert, Srinivasan Vijayakumar. Hypopharyngeal carcinoma management: 25-year experience from a tertiary care medical center in United States [abstract]. In: Proceedings of the AACR-AHNS Head and Neck Cancer Conference: Optimizing Survival and Quality of Life through Basic, Clinical, and Translational Research; 2019 Apr 29-30; Austin, TX. Philadelphia (PA): AACR; Clin Cancer Res 2020;26(12_Suppl_2):Abstract nr B20.
Collapse
Affiliation(s)
| | | | - Divyang Mehta
- University of Mississippi Medical Center, Jackson, MS
| | | | - Anu Abraham
- University of Mississippi Medical Center, Jackson, MS
| | | | - Eldrin Bhanat
- University of Mississippi Medical Center, Jackson, MS
| | | | | |
Collapse
|
8
|
Vengaloor Thomas T, Nittala MR, Bhanat E, Albert AA, Vijayakumar S. Management of Advanced-stage Hypopharyngeal Carcinoma: 25-Year Experience from a Tertiary Care Medical Center. Cureus 2020; 12:e6679. [PMID: 32104619 PMCID: PMC7026862 DOI: 10.7759/cureus.6679] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Introduction Due to conflicting data in the literature, there is a continuing debate on whether advanced hypopharyngeal carcinoma patients should be treated with definitive surgery or chemoradiotherapy. The purpose of this study is to evaluate the management and outcomes of advanced hypopharyngeal carcinoma in a tertiary care institution over the last 25 years. Methods An Institutional Review Board (IRB)-approved and HIPPA-compliant retrospective analysis was performed of patients with advanced-stage squamous cell carcinoma of the hypopharynx treated at our institution between January 1994 and December 2018. Data regarding demographics, stage, treatment, and follow-up were collected. Outcomes including median survival and overall survival were calculated using the Kaplan Meier method. All analyses were performed using SPSS v. 24. Results This study included a total of 103 advanced stage hypopharyngeal cancer patients. The median age for this cohort is 61 years (range: 41-88, SD 9.3). Of the total 103 eligible patients treated, 92 (89.3%) were male and 11 (10.7%) female; 61 (59.2%) were African Americans, 39 (37.9%) were Caucasians and three (2.9%) were other races. Seventeen patients (16.5%) had stage III disease, whereas 86 (83.5%) patients were diagnosed with Stage IV A or B disease. Seventy-two patients (69.9%) were treated with definitive chemoradiotherapy (ChemoRT group), and 31 patients (30.1%) underwent primary surgery with or without adjuvant treatments (Surgery group). The two treatment groups were similar in terms of age, gender, ethnicity, alcohol status, N staging, and subsites but were significantly different for smoking status (p = 0.035) and T staging (p = 0.024). The median follow-up was 17 months. The median survival of the overall cohort was 26 months, and five-year overall survival was 25.5%. The median survival was found to be significantly better for the surgery group as compared to the definitive chemoradiotherapy group (43 months vs 16 months, p = 0.049). The five-year overall survival (OS; 41.5% vs 18.5%, p = 0.049) and disease-free survival (DFS; 75.3% vs 56%; p = 0.029) were significantly better for patients in the surgery group compared to the chemoradiotherapy group. On multivariate Cox-regression analysis, lymph nodal status (HR = 1.27, CI: 1.00-1.62, p = 0.047) and chemoradiation treatment (HR = 1.82, CI: 1.00-3.29, p = 0.048) were associated with higher risk of mortality. Conclusion In our single institutional experience of advanced hypopharyngeal carcinoma management, the five-year overall survival rate was found to be 25.5 % and was the poorest among head and neck cancers. The patients with advanced hypopharyngeal cancer treated with surgery followed by adjuvant radiation or chemoradiation have significantly improved overall survival compared to those treated with definitive chemoradiotherapy. Further research warranted for early detection and better treatment to improve the cure rate in hypopharyngeal carcinoma patients.
Collapse
Affiliation(s)
| | - Mary R Nittala
- Radiation Oncology, University of Mississippi Medical Center, Jackson, USA
| | - Eldrin Bhanat
- Radiation Oncology, University of Mississippi Medical Center, Jackson, USA
| | - Ashley A Albert
- Radiation Oncology, University of Mississippi Medical Center, Jackson, USA
| | | |
Collapse
|
9
|
King ML, Vengaloor Thomas T, Albert AA, Joseph S, Ramachandran Nair L, Lam JT, Woods WC, Nittala M, Vijayakumar S. A Case of Transformation of Primary Cutaneous Follicle Center Lymphoma to Diffuse Large B-Cell Lymphoma Involving the Parotid Gland and Cervical Lymph Nodes. Am J Case Rep 2019; 20:1273-1278. [PMID: 31462626 PMCID: PMC6735615 DOI: 10.12659/ajcr.917389] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [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] [Indexed: 11/09/2022]
Abstract
Patient: Male, 40 Final Diagnosis: Primary cutaneous follicular lymphoma Symptoms: Scalp mass Medication: — Clinical Procedure: Radiation Specialty: Oncology
Collapse
Affiliation(s)
- Maurice L King
- Department of Radiation Oncology, The University of Mississippi Medical Center, Jackson, MS, USA
| | - Toms Vengaloor Thomas
- Department of Radiation Oncology, The University of Mississippi Medical Center, Jackson, MS, USA
| | - Ashley A Albert
- Department of Radiation Oncology, The University of Mississippi Medical Center, Jackson, MS, USA
| | - Sanjay Joseph
- Department of Radiation Oncology, The University of Mississippi Medical Center, Jackson, MS, USA
| | - Lakshmi Ramachandran Nair
- Department of Pathology and Clinical Laboratories, The University of Mississippi Medical Center, Jackson, MS, USA
| | - John T Lam
- Department of Pathology and Clinical Laboratories, The University of Mississippi Medical Center, Jackson, MS, USA
| | - William C Woods
- Department of Radiation Oncology, The University of Mississippi Medical Center, Jackson, MS, USA
| | - Mary Nittala
- Department of Radiation Oncology, The University of Mississippi Medical Center, Jackson, MS, USA
| | - Srinivasan Vijayakumar
- Department of Radiation Oncology, The University of Mississippi Medical Center, Jackson, MS, USA
| |
Collapse
|
10
|
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.
Collapse
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
| | | |
Collapse
|
11
|
Albert AA, Duggar WN, Bhandari RP, Vengaloor Thomas T, Packianathan S, Allbright RM, Kanakamedala MR, Mehta D, Yang CC, Vijayakumar S. Analysis of a real time group consensus peer review process in radiation oncology: an evaluation of effectiveness and feasibility. Radiat Oncol 2018; 13:239. [PMID: 30509283 PMCID: PMC6276205 DOI: 10.1186/s13014-018-1190-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2018] [Accepted: 11/20/2018] [Indexed: 11/10/2022] Open
Abstract
Background Peer review systems within radiation oncology are important to ensure quality radiation care. Several individualized methods for radiation oncology peer review have been described. However, despite the importance of peer review in radiation oncology barriers may exist to its effective implementation in practice. The purpose of this study was to quantify the rate of plan changes based on our group peer review process as well as the quantify amount of time and resources needed for this process. Methods Data on cases presented in our institutional group consensus peer review conference were prospectively collected. Cases were then retrospectively analyzed to determine the rate of major change (plan rejection) and any change in plans after presentation as well as the median time of presentation. Univariable logistic regression was used to determine factors associated with major change and any change. Results There were 73 cases reviewed over a period of 11 weeks. The rate of major change was 8.2% and the rate of any change was 23.3%. The majority of plans (53.4%) were presented in 6–10 min. Overall, the mean time of presentation was 8 min. On univariable logistic regression, volumetric modulated arc therapy plans were less likely to undergo a plan change but otherwise there were no factors significantly associated with major plan change or any type of change. Conclusion Group consensus peer review allows for a large amount of informative clinical and technical data to be presented per case prior to the initiation of radiation treatment in a thorough yet efficient manner to ensure plan quality and patient safety.
Collapse
Affiliation(s)
- Ashley A Albert
- Department of Radiation Oncology, University of Mississippi Medical Center, 350 W. Woodrow Wilson Drive, Suite 1600, Jackson, MS, 39213, USA.
| | - William N Duggar
- Department of Radiation Oncology, University of Mississippi Medical Center, 350 W. Woodrow Wilson Drive, Suite 1600, Jackson, MS, 39213, USA
| | - Rahul P Bhandari
- Department of Radiation Oncology, University of Mississippi Medical Center, 350 W. Woodrow Wilson Drive, Suite 1600, Jackson, MS, 39213, USA
| | - Toms Vengaloor Thomas
- Department of Radiation Oncology, University of Mississippi Medical Center, 350 W. Woodrow Wilson Drive, Suite 1600, Jackson, MS, 39213, USA
| | - Satyaseelan Packianathan
- Department of Radiation Oncology, University of Mississippi Medical Center, 350 W. Woodrow Wilson Drive, Suite 1600, Jackson, MS, 39213, USA
| | - Robert M Allbright
- Department of Radiation Oncology, University of Mississippi Medical Center, 350 W. Woodrow Wilson Drive, Suite 1600, Jackson, MS, 39213, USA
| | - Madhava R Kanakamedala
- Department of Radiation Oncology, University of Mississippi Medical Center, 350 W. Woodrow Wilson Drive, Suite 1600, Jackson, MS, 39213, USA
| | - Divyang Mehta
- Department of Radiation Oncology, University of Mississippi Medical Center, 350 W. Woodrow Wilson Drive, Suite 1600, Jackson, MS, 39213, USA
| | - Chunli Claus Yang
- Department of Radiation Oncology, University of Mississippi Medical Center, 350 W. Woodrow Wilson Drive, Suite 1600, Jackson, MS, 39213, USA
| | - Srinivasan Vijayakumar
- Department of Radiation Oncology, University of Mississippi Medical Center, 350 W. Woodrow Wilson Drive, Suite 1600, Jackson, MS, 39213, USA
| |
Collapse
|
12
|
Affiliation(s)
- A A Albert
- Department of Mathematics, University of Chicago
| |
Collapse
|
13
|
Affiliation(s)
- A A Albert
- Department of Mathematics, University of Chicago
| |
Collapse
|
14
|
Lauruschkat AH, Arnrich B, Albert AA, Walter JA, Amann B, Rosendahl UP, Alexander T, Ennker J. Die Lunge als Zielorgan diabetischer Mikroangiopathie – Ergebnisse aus der Herzchirurgie. DIABETOL STOFFWECHS 2006. [DOI: 10.1055/s-2006-944038] [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: 10/19/2022]
|
15
|
Albert AA, Walter JA, Arnrich B, Hassanein W, Rosendahl UP, Bauer S, Ennker J. On-line variable live-adjusted displays with internal and external risk-adjusted mortalities. A valuable method for benchmarking and early detection of unfavourable trends in cardiac surgery. Eur J Cardiothorac Surg 2004; 25:312-9. [PMID: 15019654 DOI: 10.1016/j.ejcts.2003.12.009] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2003] [Revised: 12/10/2003] [Accepted: 12/15/2003] [Indexed: 12/01/2022] Open
Abstract
OBJECTIVE Benchmarking and early detection of unfavourable trends. METHODS We implemented a dedicated project-orientated data warehouse, which continuously supplies data for on-line computing of the variable live-adjusted displays (VLADs). To calculate the expected cumulative mortality, we used the multi-variate logistic regression model of the EuroSCORE model. In addition to the external EuroSCORE standard, we calculated a centre-specific risk score for internal standards by analysing the data of 9135 patients, which enables both internal and external comparisons. The VLADs are embedded into the multi-purpose web-based information portal, so that the physicians can investigate several types of VLADs interactively: performance of different types of surgery and individual surgeons for different time intervals. We investigated clinically important events such as modification of operative techniques and personnel changes of the team by the VLADs. RESULTS We found transient declines in the performance curves during major changes in patient management, indicating that systemic--rather than accidental or patient related factors--were involved in the mortality risk. The internal standard line represents these clusters more clearly than the external line. We evaluated examples of how periods of increased risk could be monitored by the VLAD curves: (1) the introduction of OPCAB surgery; (2) training of surgeons; (3) staff changes and staff-related management. CONCLUSIONS On-line VLADs based on a day-to-day updated database, displaying both internal and external standards, are a helpful visualisation tool for earlier detection of unfavourable trends. They enable the surgeon teams and clinical management to take countermeasures at an early stage.
Collapse
Affiliation(s)
- A A Albert
- Clinic for Cardiothoracic Surgery, Heart Institute Lahr/Baden, Lahr 77933, Germany.
| | | | | | | | | | | | | |
Collapse
|
16
|
Albert AA, Beller CJ, Arnrich B, Walter JA, Rosendahl UP, Hetzel A, Priss H, Ennker J. Is there any impact of the shape of aortic end-hole cannula on stroke occurrence? clinical evaluation of straight and bent-tip aortic cannulae. Perfusion 2002; 17:451-6. [PMID: 12470037 DOI: 10.1191/0267659102pf613oa] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
OBJECTIVE To compare the impact of straight and bent-tip aortic cannulae on stroke occurrence, location, and severity. METHODS Prospective data were collected on 8,129 patients (coronary artery bypass grafting (CABG) and/or valvular surgery). 'Bent-tip' aortic cannulae were used in 15.6% of cases and 'straight' end-hole cannulae in 84.4% of cases. RESULTS There were a total of 137 strokes: right anterior 52, left anterior 39, bilateral 23, posterior 18, and location not established 5. With the use of bent-tip cannulae, the incidence of strokes was 0.9% versus 1.8% with straight cannulae (chi2, p = 0.026). Bilateral and posterior strokes occurred more often with the use of straight cannulae (chi2, p = 0.015). Straight cannulae also related to the severity of strokes (chi2, p = 0.003). CONCLUSIONS There is an influence of the type of cannula on the occurrence, location, and severity of strokes. Straight cannulae cause significantly more often and more severe bilateral and posterior strokes than bent-tip cannulae.
Collapse
Affiliation(s)
- A A Albert
- Department of Cardiothoracic Surgery, Heart Institute Lahr/Baden, Lahr, Baden-Württemberg, Germany.
| | | | | | | | | | | | | | | |
Collapse
|
17
|
Albert AA, Browder FE, Herstein IN, Kaplansky I, Lane SM. Research and Education: Restoring the Balance. Science 1965; 149:243-4. [PMID: 17838082 DOI: 10.1126/science.149.3681.243-b] [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: 11/02/2022]
|
18
|
|
19
|
Albert AA. THE NORM FORM OF A RATIONAL DIVISION ALGEBRA. Proc Natl Acad Sci U S A 1957; 43:506-9. [PMID: 16590045 PMCID: PMC528485 DOI: 10.1073/pnas.43.6.506] [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: 11/18/2022] Open
|
20
|
|
21
|
Albert AA. ON HERMITIAN OPERATORS OVER THE CAYLEY ALGEBRA. Proc Natl Acad Sci U S A 1955; 41:639-40. [PMID: 16589719 PMCID: PMC528152 DOI: 10.1073/pnas.41.9.639] [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: 11/18/2022] Open
|
22
|
|
23
|
Affiliation(s)
- A A Albert
- Department of Mathematics, The University of Chicago
| |
Collapse
|
24
|
Affiliation(s)
- A A Albert
- Department of Mathematics, University of Chicago
| |
Collapse
|
25
|
Albert AA. Normal Division Algebras of 2
2
m
. Proc Natl Acad Sci U S A 1931; 17:389-92. [PMID: 16587641 PMCID: PMC1076070 DOI: 10.1073/pnas.17.6.389] [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: 11/18/2022] Open
Affiliation(s)
- A A Albert
- Department of Mathematics, Columbia University
| |
Collapse
|
26
|
Albert AA. ON DIRECT PRODUCTS, CYCLIC DIVISION ALGEBRAS, AND PURE RIEMANN MATRICES. Proc Natl Acad Sci U S A 1930; 16:313-5. [PMID: 16587574 PMCID: PMC526638 DOI: 10.1073/pnas.16.4.313] [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: 11/18/2022] Open
Affiliation(s)
- A A Albert
- Department of Mathematics, Columbia University
| |
Collapse
|
27
|
Albert AA. ON THE STRUCTURE OF PURE RIEMANN MATRICES WITH NON-COMMUTATIVE MULTIPLICATION ALGEBRAS. Proc Natl Acad Sci U S A 1930; 16:308-12. [PMID: 16587573 PMCID: PMC526637 DOI: 10.1073/pnas.16.4.308] [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: 11/18/2022] Open
Affiliation(s)
- A A Albert
- Department of Mathematics, Columbia University
| |
Collapse
|
28
|
Affiliation(s)
- A A Albert
- Department of Mathematics, Princeton University
| |
Collapse
|
29
|
Albert AA. The Group of the Rank Equation of Any Normal Division Algebra. Proc Natl Acad Sci U S A 1928; 14:906-7. [PMID: 16587420 PMCID: PMC1085796 DOI: 10.1073/pnas.14.12.906] [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: 11/18/2022] Open
Affiliation(s)
- A A Albert
- Department of Mathematics, Princeton University
| |
Collapse
|
30
|
Albert AA. Normal Division Algebras Satisfying Mild Assumptions. Proc Natl Acad Sci U S A 1928; 14:904-6. [PMID: 16587419 PMCID: PMC1085795 DOI: 10.1073/pnas.14.12.904] [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: 11/18/2022] Open
Affiliation(s)
- A A Albert
- Department of Mathematics, Princeton University
| |
Collapse
|