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Start Over Author "Kirkpatrick A" Journal international journal of radiation oncology, biology, physics
264 results on '"Kirkpatrick A"'

2. Long-Term Intracranial Outcomes With Combination Dual Immune-Checkpoint Blockade and Stereotactic Radiosurgery in Patients With Melanoma and Non-Small Cell Lung Cancer Brain Metastases

Author

Vaios, Eugene J., Shenker, Rachel F., Hendrickson, Peter G., Wan, Zihan, Niedzwiecki, Donna, Winter, Sebastian F., Shih, Helen A., Dietrich, Jorg, Wang, Chunhao, Salama, April K.S., Clarke, Jeffrey M., Allen, Karen, Sperduto, Paul, Mullikin, Trey, Kirkpatrick, John P., Floyd, Scott R., and Reitman, Zachary J.

Published
2024
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3. Beyond an Updated Graded Prognostic Assessment (Breast GPA): A Prognostic Index and Trends in Treatment and Survival in Breast Cancer Brain Metastases From 1985 to Today.

Author

Sperduto, Paul W, Mesko, Shane, Li, Jing, Cagney, Daniel, Aizer, Ayal, Lin, Nancy U, Nesbit, Eric, Kruser, Tim J, Chan, Jason, Braunstein, Steve, Lee, Jessica, Kirkpatrick, John P, Breen, Will, Brown, Paul D, Shi, Diana, Shih, Helen A, Soliman, Hany, Sahgal, Arjun, Shanley, Ryan, Sperduto, William, Lou, Emil, Everett, Ashlyn, Boggs, Drexell Hunter, Masucci, Laura, Roberge, David, Remick, Jill, Plichta, Kristin, Buatti, John M, Jain, Supriya, Gaspar, Laurie E, Wu, Cheng-Chia, Wang, Tony JC, Bryant, John, Chuong, Michael, Yu, James, Chiang, Veronica, Nakano, Toshimichi, Aoyama, Hidefumi, and Mehta, Minesh P

Subjects
Humans, Breast Neoplasms, Brain Neoplasms, BRCA1 Protein, Prognosis, Survival Analysis, Retrospective Studies, Aged, Aged, 80 and over, Middle Aged, Female, Rare Diseases, Clinical Research, Cancer, Breast Cancer, Other Physical Sciences, Clinical Sciences, Oncology and Carcinogenesis, Oncology & Carcinogenesis
Abstract

PurposeBrain metastases are a common sequelae of breast cancer. Survival varies widely based on diagnosis-specific prognostic factors (PF). We previously published a prognostic index (Graded Prognostic Assessment [GPA]) for patients with breast cancer with brain metastases (BCBM), based on cohort A (1985-2007, n = 642), then updated it, reporting the effect of tumor subtype in cohort B (1993-2010, n = 400). The purpose of this study is to update the Breast GPA with a larger contemporary cohort (C) and compare treatment and survival across the 3 cohorts.Methods and materialsA multi-institutional (19), multinational (3), retrospective database of 2473 patients with breast cancer with newly diagnosed brain metastases (BCBM) diagnosed from January 1, 2006, to December 31, 2017, was created and compared with prior cohorts. Associations of PF and treatment with survival were analyzed. Kaplan-Meier survival estimates were compared with log-rank tests. PF were weighted and the Breast GPA was updated such that a GPA of 0 and 4.0 correlate with the worst and best prognoses, respectively.ResultsMedian survival (MS) for cohorts A, B, and C improved over time (from 11, to 14 to 16 months, respectively; P < .01), despite the subtype distribution becoming less favorable. PF significant for survival were tumor subtype, Karnofsky Performance Status, age, number of BCBMs, and extracranial metastases (all P < .01). MS for GPA 0 to 1.0, 1.5-2.0, 2.5-3.0, and 3.5-4.0 was 6, 13, 24, and 36 months, respectively. Between cohorts B and C, the proportion of human epidermal receptor 2 + subtype decreased from 31% to 18% (P < .01) and MS in this subtype increased from 18 to 25 months (P < .01).ConclusionsMS has improved modestly but varies widely by diagnosis-specific PF. New PF are identified and incorporated into an updated Breast GPA (free online calculator available at brainmetgpa.com). The Breast GPA facilitates clinical decision-making and will be useful for stratification of future clinical trials. Furthermore, these data suggest human epidermal receptor 2-targeted therapies improve clinical outcomes in some patients with BCBM.

Published
2020

5. Graded Prognostic Assessment (GPA) for Patients With Lung Cancer and Brain Metastases: Initial Report of the Small Cell Lung Cancer GPA and Update of the Non-Small Cell Lung Cancer GPA Including the Effect of Programmed Death Ligand 1 and Other Prognostic Factors

Author

Sperduto, Paul W., De, Brian, Li, Jing, Carpenter, David, Kirkpatrick, John, Milligan, Michael, Shih, Helen A., Kutuk, Tugce, Kotecha, Rupesh, Higaki, Hajime, Otsuka, Manami, Aoyama, Hidefumi, Bourgoin, Malie, Roberge, David, Dajani, Salah, Sachdev, Sean, Gainey, Jordan, Buatti, John M., Breen, William, Brown, Paul D., Ni, Lisa, Braunstein, Steve, Gallitto, Matthew, Wang, Tony J.C., Shanley, Ryan, Lou, Emil, Shiao, Jay, Gaspar, Laurie E., Tanabe, Satoshi, Nakano, Toshimichi, An, Yi, Chiang, Veronica, Zeng, Liang, Soliman, Hany, Elhalawani, Hesham, Cagney, Daniel, Thomas, Evan, Boggs, Drexell H., Ahluwalia, Manmeet S., and Mehta, Minesh P.

Published
2022
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6. Estimating Survival in Melanoma Patients With Brain Metastases: An Update of the Graded Prognostic Assessment for Melanoma Using Molecular Markers (Melanoma-molGPA).

Author

Sperduto, Paul W, Jiang, Wen, Brown, Paul D, Braunstein, Steve, Sneed, Penny, Wattson, Daniel A, Shih, Helen A, Bangdiwala, Ananta, Shanley, Ryan, Lockney, Natalie A, Beal, Kathryn, Lou, Emil, Amatruda, Thomas, Sperduto, William A, Kirkpatrick, John P, Yeh, Norman, Gaspar, Laurie E, Molitoris, Jason K, Masucci, Laura, Roberge, David, Yu, James, Chiang, Veronica, and Mehta, Minesh

Subjects
Humans, Melanoma, Brain Neoplasms, Proto-Oncogene Proteins B-raf, Genetic Markers, Prognosis, Karnofsky Performance Status, Regression Analysis, Age Factors, Aged, Aged, 80 and over, Middle Aged, Clinical Decision-Making, Brain Cancer, Neurosciences, Clinical Research, Rare Diseases, Patient Safety, Cancer, Brain Disorders, Detection, screening and diagnosis, 4.2 Evaluation of markers and technologies, Other Physical Sciences, Clinical Sciences, Oncology and Carcinogenesis, Oncology & Carcinogenesis
Abstract

PurposeTo update the Diagnosis-Specific Graded Prognostic Assessment (DS-GPA) for a markedly heterogeneous patient population, patients with melanoma and brain metastases, using a larger, more current cohort, including molecular markers.MethodsThe original Melanoma-GPA is based on data from 483 patients whose conditions were diagnosed between 1985 and 2005. This is a multi-institutional retrospective database analysis of 823 melanoma patients with newly diagnosed brain metastases from January 1, 2006, to December 31, 2015. Multivariable analyses identified significant prognostic factors, which were weighted and included in the updated index (Melanoma-molGPA). Multiple Cox regression was used to select and weight prognostic factors in proportion to their hazard ratios to design the updated Melanoma-molGPA in which scores of 4.0 and 0.0 are associated with the best and worst prognoses, as with all of the diagnosis-specific GPA indices. Log-rank tests were used to compare adjacent classes.ResultsThere were 5 significant prognostic factors for survival (age, Karnofsky performance status [KPS], extracranial metastases [ECM], number of brain metastases, and BRAF status), whereas only KPS and the number of brain metastases were significant in the original Melanoma-GPA. Median survival improved from 6.7 to 9.8 months between the 2 treatment eras, and the median survival times for patients with Melanoma-molGPA of 0 to 1.0, 1.5 to 2.0, 2.5 to 3.0, and 3.5 to 4.0 were 4.9, 8.3, 15.8, and 34.1 months (P

Published
2017

9. The Prognostic Value of BRAF, C-KIT, and NRAS Mutations in Melanoma Patients With Brain Metastases.

Author

Sperduto, Paul W, Jiang, Wen, Brown, Paul D, Braunstein, Steve, Sneed, Penny, Wattson, Daniel A, Shih, Helen A, Bangdiwala, Ananta, Shanley, Ryan, Lockney, Natalie A, Beal, Kathryn, Lou, Emil, Amatruda, Thomas, Sperduto, William A, Kirkpatrick, John P, Yeh, Norman, Gaspar, Laurie E, Molitoris, Jason K, Masucci, Laura, Roberge, David, Yu, James, Chiang, Veronica, and Mehta, Minesh

Subjects
Humans, Melanoma, Brain Neoplasms, Proto-Oncogene Proteins B-raf, Antineoplastic Agents, Prognosis, Immunotherapy, Linear Models, Proportional Hazards Models, Statistics, Nonparametric, Retrospective Studies, Mutation, Genes, ras, Time Factors, Adult, Aged, Aged, 80 and over, Middle Aged, Female, Male, Proto-Oncogene Proteins c-kit, Molecular Targeted Therapy, Brain Cancer, Cancer, Brain Disorders, Clinical Research, Neurosciences, Rare Diseases, Other Physical Sciences, Clinical Sciences, Oncology and Carcinogenesis, Oncology & Carcinogenesis
Abstract

PurposeBrain metastases are a common problem in patients with melanoma, but little is known about the effect of gene mutations on survival in these patients.Methods and materialsWe created a retrospective multi-institutional database of 823 patients with melanoma and brain metastases diagnosed between 2006 and 2015. Clinical parameters, gene mutation status (BRAF, C-KIT, NRAS), and treatment were correlated with survival. Treatment patterns and outcomes were compared with a prior era (1985-2005).ResultsBRAF status was known in 584 of 823 patients (71%). BRAF, NRAS, and C-KIT mutations were present in 51%, 22%, and 11% of tested patients, respectively. The median time from primary diagnosis to brain metastasis was 32 months, and overall median survival (MS) from the time of initial treatment of brain metastases was 10 months. MS for BRAF-positive and BRAF-negative patients was 13 months and 9 months, respectively (P=.02). There was no significant difference in MS in patients with or without NRAS or C-KIT mutations. The time from primary diagnosis to brain metastasis did not vary by mutation and was not associated with survival after the diagnosis of brain metastases. MS for the 1985 to 2005 and 2006 to 2015 cohorts was 6.7 months and 10.0 months, respectively (P

Published
2017

11. Effect of Targeted Therapies on Prognostic Factors, Patterns of Care, and Survival in Patients With Renal Cell Carcinoma and Brain Metastases

Author

Sperduto, Paul W., Deegan, Brian J., Li, Jing, Jethwa, Krishan R., Brown, Paul D., Lockney, Natalie, Beal, Kathryn, Rana, Nitesh G., Attia, Albert, Tseng, Chia-Lin, Sahgal, Arjun, Shanley, Ryan, Sperduto, William A., Lou, Emil, Zahra, Amir, Buatti, John M., Yu, James B., Chiang, Veronica, Molitoris, Jason K., Masucci, Laura, Roberge, David, Shi, Diana D., Shih, Helen A., Olson, Adam, Kirkpatrick, John P., Braunstein, Steve, Sneed, Penny, and Mehta, Minesh P.

Published
2018
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13. The Effect of Gene Alterations and Tyrosine Kinase Inhibition on Survival and Cause of Death in Patients With Adenocarcinoma of the Lung and Brain Metastases

Author

Sperduto, Paul W., Yang, T. Jonathan, Beal, Kathryn, Pan, Hubert, Brown, Paul D., Bangdiwala, Ananta, Shanley, Ryan, Yeh, Norman, Gaspar, Laurie E., Braunstein, Steve, Sneed, Penny, Boyle, John, Kirkpatrick, John P., Mak, Kimberley S., Shih, Helen A., Engelman, Alex, Roberge, David, Arvold, Nils D., Alexander, Brian, Awad, Mark M., Contessa, Joseph, Chiang, Veronica, Hardie, John, Ma, Daniel, Lou, Emil, Sperduto, William, and Mehta, Minesh P.

Published
2016
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17. Effect of Tumor Subtype on Survival and the Graded Prognostic Assessment for Patients With Breast Cancer and Brain Metastases

Author

Sperduto, Paul W., Kased, Norbert, Roberge, David, Xu, Zhiyuan, Shanley, Ryan, Luo, Xianghua, Sneed, Penny K., Chao, Samuel T., Weil, Robert J., Suh, John, Bhatt, Amit, Jensen, Ashley W., Brown, Paul D., Shih, Helen A., Kirkpatrick, John, Gaspar, Laurie E., Fiveash, John B., Chiang, Veronica, Knisely, Jonathan P.S., Sperduto, Christina Maria, Lin, Nancy, and Mehta, Minesh

Published
2012
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20. Graded Prognostic Assessment (GPA) for Patients With Lung Cancer and Brain Metastases: Initial Report of the Small Cell Lung Cancer GPA and Update of the Non-Small Cell Lung Cancer GPA Including the Effect of Programmed Death Ligand 1 and Other Prognostic Factors

Author

Paul W. Sperduto, Brian De, Jing Li, David Carpenter, John Kirkpatrick, Michael Milligan, Helen A. Shih, Tugce Kutuk, Rupesh Kotecha, Hajime Higaki, Manami Otsuka, Hidefumi Aoyama, Malie Bourgoin, David Roberge, Salah Dajani, Sean Sachdev, Jordan Gainey, John M. Buatti, William Breen, Paul D. Brown, Lisa Ni, Steve Braunstein, Matthew Gallitto, Tony J.C. Wang, Ryan Shanley, Emil Lou, Jay Shiao, Laurie E. Gaspar, Satoshi Tanabe, Toshimichi Nakano, Yi An, Veronica Chiang, Liang Zeng, Hany Soliman, Hesham Elhalawani, Daniel Cagney, Evan Thomas, Drexell H. Boggs, Manmeet S. Ahluwalia, and Minesh P. Mehta

Subjects
Cancer Research, Radiation, Lung Neoplasms, Brain Neoplasms, Adenocarcinoma of Lung, Adenocarcinoma, Prognosis, Small Cell Lung Carcinoma, B7-H1 Antigen, ErbB Receptors, Oncology, Carcinoma, Non-Small-Cell Lung, Humans, Radiology, Nuclear Medicine and imaging, Anaplastic Lymphoma Kinase, Retrospective Studies
Abstract

Patients with lung cancer and brain metastases represent a markedly heterogeneous population. Accurate prognosis is essential to optimally individualize care. In prior publications, we described the graded prognostic assessment (GPA), but a GPA for patients with small cell lung cancer (SCLC) has never been reported, and in non-small cell lung cancer (NSCLC), the effect of programmed death ligand 1 (PD-L1) was unknown. The 3-fold purpose of this work is to provide the initial report of an SCLC GPA, to evaluate the effect of PD-L1 on survival in patients with NSCLC, and to update the Lung GPA accordingly.A multivariable analysis of prognostic factors and treatments associated with survival was performed on 4183 patients with lung cancer (3002 adenocarcinoma, 611 nonadenocarcinoma, 570 SCLC) with newly diagnosed brain metastases between January 1, 2015, and December 31, 2020, using a multi-institutional retrospective database. Significant variables were used to update the Lung GPA.Overall median survival for lung adenocarcinoma, SCLC, and nonadenocarcinoma was 17, 10, and 8 months, respectively, but varied widely by GPA from 2 to 52 months. In SCLC, the significant prognostic factors were age, performance status, extracranial metastases, and number of brain metastases. In NSCLC, the distribution of molecular markers among patients with lung adenocarcinoma and known primary tumor molecular status revealed alterations/expression in PD-L1 50% to 100%, PD-L1 1% to 49%, epidermal growth factor receptor, and anaplastic lymphoma kinase in 32%, 31%, 30%, and 7%, respectively. Median survival of patients with lung adenocarcinoma and brain metastases with 0, 1% to 49%, and ≥50% PD-L1 expression was 17, 19, and 24 months, respectively (P.01), confirming PD-L1 is a prognostic factor. Previously identified prognostic factors for NSCLC (epidermal growth factor receptor and anaplastic lymphoma kinase status, performance status, age, number of brain metastases, and extracranial metastases) were reaffirmed. These factors were incorporated into the updated Lung GPA with robust separation between subgroups for all histologies.Survival for patients with lung cancer and brain metastases has improved but varies widely. The initial report of a GPA for SCLC is presented. For patients with NSCLC-adenocarcinoma and brain metastases, PD-L1 is a newly identified significant prognostic factor, and the previously identified factors were reaffirmed. The updated indices establish unique criteria for SCLC, NSCLC-nonadenocarcinoma, and NSCLC-adenocarcinoma (incorporating PD-L1). The updated Lung GPA, available for free at brainmetgpa.com, provides an accurate tool to estimate survival, individualize treatment, and stratify clinical trials.

Published
2021

21. Diagnosis-Specific Prognostic Factors, Indexes, and Treatment Outcomes for Patients With Newly Diagnosed Brain Metastases: A Multi-Institutional Analysis of 4,259 Patients

Author

Sperduto, Paul W., Chao, Samuel T., Sneed, Penny K., Luo, Xianghua, Suh, John, Roberge, David, Bhatt, Amit, Jensen, Ashley W., Brown, Paul D., Shih, Helen, Kirkpatrick, John, Schwer, Amanda, Gaspar, Laurie E., Fiveash, John B., Chiang, Veronica, Knisely, Jonathan, Sperduto, Christina Maria, and Mehta, Minesh

Published
2010
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34. Management of Unruptured AVMs: The Pendulum Swings

Author

Nadia N. Laack, Giuseppe Minniti, John P. Kirkpatrick, Lia M. Halasz, Michael D. Chan, and Scott G. Soltys

Subjects
Intracranial Arteriovenous Malformations, Cancer Research, Radiation, adverse outcome, business.industry, clinical outcome, Brain, morbidity, mortality rate, Data science, Oncology, incidence, Medicine, mortality risk, Humans, Radiology, Nuclear Medicine and imaging, human, business, brain arteriovenous malformation, gamma knife radiosurgery
Published
2019

41. Consensus Contouring Guidelines for Postoperative Completely Resected Cavity Stereotactic Radiosurgery for Brain Metastases

Author

Lilyana Angelov, Arjun Sahgal, Paul D. Brown, Mark Ruschin, Anita Mahajan, Kevin S. Oh, Hany Soliman, Scott G. Soltys, Veronica Chiang, Jason P. Sheehan, John P. Kirkpatrick, and Simon S. Lo

Subjects
Surgical resection, Cancer Research, medicine.medical_specialty, Consensus, genetic structures, medicine.medical_treatment, Planning target volume, Radiosurgery, 03 medical and health sciences, 0302 clinical medicine, Cohen's kappa, medicine, Humans, Radiology, Nuclear Medicine and imaging, Contouring, Radiation, medicine.diagnostic_test, business.industry, Brain Neoplasms, Treatment options, Magnetic resonance imaging, Combined Modality Therapy, Magnetic Resonance Imaging, Surgery, Clinical Practice, Oncology, 030220 oncology & carcinogenesis, Practice Guidelines as Topic, Radiology, business, 030217 neurology & neurosurgery
Abstract

To propose contouring guidelines based on consensus contours generated by 10 international experts for cavity stereotactic radiosurgery (SRS), an emerging treatment option after surgical resection of brain metastases. No guidelines for contouring the surgical cavity volume have been previously reported.Ten postoperative completely resected cases with varying clinical scenarios and locations within the brain were selected. For each case, 10 experts independently contoured the surgical cavity clinical target volume (CTV). All the contours were analyzed, and agreement was calculated using the simultaneous truth and performance level estimation (STAPLE) with the kappa statistic. A follow-up survey was also completed by each investigator to summarize their contouring rationale for a number of different clinical scenarios. The results from the survey and the consensus STAPLE contours were both summarized to establish contouring guidelines.A high level of agreement was found between the expert CTV contours (mean sensitivity 0.75, mean specificity 0.98), and the mean kappa was 0.65. The agreement was statistically significant at P.001 for all cases. From these results and analyses of the survey answers, the recommendations for CTV include fusion of the preoperative magnetic resonance imaging scan to aid in volume delineation; contouring the entire surgical tract regardless of the preoperative location of the tumor; extension of the CTV 5 to 10 mm along the dura overlying the bone flap to account for microscopic disease extension in cases with preoperative dural contact; and a margin of ≤5 mm into the adjacent sinus when preoperative venous sinus contact was present.Consensus contouring guidelines for postoperative completely resected cavity SRS treatment were established using expert contours and clinical practice. However, in the absence of clinical data supporting these recommendations, these guidelines serve as a baseline for further study and refinement.

Published
2017

45. Brain Metastases From Melanoma: Therapy at the Crossroads

Author

Helen A. Shih, Lia M. Halasz, John C. Breneman, Nadia N. Laack, John P. Kirkpatrick, and Scott G. Soltys

Subjects
Oncology, Cancer Research, medicine.medical_specialty, Radiation, Skin Neoplasms, business.industry, Brain Neoplasms, Melanoma, Brain, medicine.disease, 03 medical and health sciences, 0302 clinical medicine, Text mining, 030220 oncology & carcinogenesis, Internal medicine, Medicine, Humans, Radiology, Nuclear Medicine and imaging, 030212 general & internal medicine, business
Published
2016

46. Radiation dose-volume effects in the spinal cord

Author

Albert J. van der Kogel, John P. Kirkpatrick, and Timothy E. Schultheiss

Subjects
Cancer Research, medicine.medical_specialty, Cord, medicine.medical_treatment, Central nervous system, Radiosurgery, Radiation Tolerance, Myelopathy, Translational research [ONCOL 3], medicine, Animals, Humans, Radiology, Nuclear Medicine and imaging, Radiation Injuries, Radiation, Radiotherapy, business.industry, Age Factors, Dose-Response Relationship, Radiation, Spinal cord, medicine.disease, Rats, Radiation therapy, Regimen, Dose–response relationship, medicine.anatomical_structure, Spinal Cord, Oncology, Retreatment, Radiology, Nuclear medicine, business
Abstract

Item does not contain fulltext Dose-volume data for myelopathy in humans treated with radiotherapy (RT) to the spine is reviewed, along with pertinent preclinical data. Using conventional fractionation of 1.8-2 Gy/fraction to the full-thickness cord, the estimated risk of myelopathy is

Published
2010

50. First in Human Clinical Trial of a Metalloporphyrin Dual Radioprotectant and Radiosensitizer, BMX-001, in Newly Diagnosed High-Grade Glioma Undergoing Concurrent Chemoradiation

Author

Peters, K.B., Kirkpatrick, J.P., Batinic-Haberle, I., Affronti, M.L., Woodring, S., Iden, D., Lipp, E.S., Boyd, K., Healy, P., Herndon, J., Spasojevic, I., Penchev, S., Gad, S., Silberstein, D., Johnson, M.O., Randazzo, D., Desjardins, A., Friedman, H.S., Ashley, D.M., and Crapo, J.

Published
2019
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