2017 Research Grant: NF1 and KEAP1 mutations are correlated to increased rates of local failure after radiation therapy for spine metastases from non-small cell lung cancer

The spine is a common site of metastasis from non-small cell lung cancer (NSCLC), a disease hallmarked by heterogeneity in molecular alterations. Traditional spine radiation treatment (RT) with conventionally fractionated external beam radiation therapy (cEBRT) is associated with high local failure (LF) rates in patients surviving more than 12 months. Treatment with advanced techniques including stereotactic body radiation therapy (SBRT) significantly reduces LF. We hypothesized that specific genomic mutations in NSCLC metastases impart increased risk of LF, and that treatment with SBRT would prevent LF in metastases harboring such alterations.
Source: The Spine Journal - Category: Orthopaedics Authors: Source Type: research

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Conclusions: Percutaneous CT fluoroscopy-guided permanent seed brachytherapy is a safe, efficacious, and cost effective primary and salvage treatment for lung cancer. CT-fluoroscopy resources are readily available in the community and are an effective alternative to stereotactic body radiation therapy (SBRT), intensity-modulated radiation therapy (IMRT)/proton beam, radiofrequency ablation (RFA), and cryoablation (CA). Percutaneous CT fluoroscopy-guided permanent seed brachytherapy has an equivalent or better local control rate, a lower resource cost, and a far lower integral radiation dose than other therapies. We believe...
Source: Journal of Contemporary Brachytherapy - Category: Cancer & Oncology Tags: J Contemp Brachytherapy Source Type: research
Conclusions The recent, first randomized clinical trial demonstrated overall and progression free survival benefits after SBRT to oligometastatic disease which supports prior retrospective case series (6). The spine is a common site of metastatic bone disease, and as high quality data continue to mature, along with completion of additional randomized clinical trials, it is expected that utility of SBRT to the spine will increase in the future. Spine SBRT is unique due to the requirement of sharp dose falloff to prevent serious neurologic morbidity. With recent advances in radiotherapy planning, robotic patient positionin...
Source: Frontiers in Oncology - Category: Cancer & Oncology Source Type: research
ConclusionsGenerally, superior vena cava syndrome is the result of extrinsic compression of the superior vena cava by tumor. Our patient ’s case represents the development of superior vena cava syndrome after an excellent response of tumor with near-complete tumor response. We suspect chemoradiation therapy as a potential etiology for the precipitation of the superior vena cava syndrome, which is currently not well reported in the medical literature.
Source: Journal of Medical Case Reports - Category: General Medicine Source Type: research
Publication date: May–June 2018Source: Practical Radiation Oncology, Volume 8, Issue 3Author(s): Zachary D. Horne, Michael J. Dohopolski, David A. Clump, Steven A. Burton, Dwight E. HeronAbstractPurposeLocal failure following concurrent chemoradiation and in-lobe failures following stereotactic body radiation therapy (SBRT) are common. We evaluated our institutional experience using SBRT as salvage in this setting.Methods and materialsSeventy-two patients were reirradiated with SBRT for residual, locally recurrent, or new primary non-small cell lung cancer within or adjacent to a high-dose external beam radiation the...
Source: Practical Radiation Oncology - Category: Cancer & Oncology Source Type: research
ConclusionsOptimal palliation of patients with incurable NSCLC requires coordinated interdisciplinary care. Recent data establish a rationale for CC with palliative thoracic EBRT for a well-defined subset of patients with incurable stage III NSCLC. For all other patients with incurable NSCLC, data remain insufficient to support this treatment approach.
Source: Practical Radiation Oncology - Category: Cancer & Oncology Source Type: research
Publication date: May–June 2018Source: Practical Radiation Oncology, Volume 8, Issue 3Author(s): Zachary D. Horne, Michael J. Dohopolski, David A. Clump, Steven A. Burton, Dwight E. HeronAbstractPurposeLocal failure following concurrent chemoradiation and in-lobe failures following stereotactic body radiation therapy (SBRT) are common. We evaluated our institutional experience using SBRT as salvage in this setting.Methods and materialsSeventy-two patients were reirradiated with SBRT for residual, locally recurrent, or new primary non-small cell lung cancer within or adjacent to a high-dose external beam radiation the...
Source: Practical Radiation Oncology - Category: Cancer & Oncology Source Type: research
Conclusions Optimal palliation of patients with incurable NSCLC requires coordinated interdisciplinary care. Recent data establish a rationale for CC with palliative thoracic EBRT for a well-defined subset of patients with incurable stage III NSCLC. For all other patients with incurable NSCLC, data remain insufficient to support this treatment approach.
Source: Practical Radiation Oncology - Category: Cancer & Oncology Source Type: research
Abstract Distant failure is the main cause for human cancer-related mortalities. To develop a model for predicting distant failure in non-small cell lung cancer (NSCLC) and cervix caner (CC) patients, a shell feature, consisting of outer voxels around the tumor boundary, was constructed using pre-treatment positron emission tomography (PET) images from 48 NSCLC patients received stereotactic body radiation therapy (SBRT) and 52 CC patients underwent external beam radiation therapy and concurrent chemotherapy followed with high-dose-rate intracavitary brachytherapy. The hypothesis behind this feature is that non-in...
Source: Physics in Medicine and Biology - Category: Physics Authors: Tags: Phys Med Biol Source Type: research
Local treatment options for patients with in-field non-small cell lung cancer (NSCLC) recurrence following conventionally fractionated external beam radiation therapy (CF-EBRT) are limited. Stereotactic body r...
Source: Radiation Oncology - Category: Cancer & Oncology Authors: Tags: Research Source Type: research
This study compares the quality of treatment plans of peripheral non –small cell lung cancer (NSCLC) stereotactic body radiation therapy (SBRT) using 2 calculation algorithms, namely, Eclipse Anisotropic Analytical Algorithm (AAA) and Acuros External Beam (AXB), for 3-dimensional conformal radiation therapy (3DCRT) and volumetric-modulated arc therapy (VMAT). Four- dimensional computed tomography (4DCT) data from 20 anonymized patients were studied using Varian Eclipse planning system, AXB, and AAA version 10.0.28.
Source: Medical Dosimetry - Category: Radiology Authors: Tags: Medical Physics Contribution: Source Type: research
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