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6. Performance of a Prostate-Specific Membrane Antigen Positron Emission Tomography/Computed Tomography–Derived Risk-Stratification Tool for High-risk and Very High-risk Prostate Cancer

Author

Xiang, Michael, Martin, Ting, Savjani, Ricky, Pollom, Erqi L, Karnes, R Jeffrey, Grogan, Tristan, Wong, Jessica K, Motterle, Giovanni, Tosoian, Jeffrey J, Trock, Bruce J, Klein, Eric A, Stish, Bradley J, Dess, Robert T, Spratt, Daniel E, Pilar, Avinash, Reddy, Chandana, Levin-Epstein, Rebecca, Wedde, Trude B, Lilleby, Wolfgang A, Fiano, Ryan, Merrick, Gregory S, Stock, Richard G, Demanes, D Jeffrey, Moran, Brian J, Huland, Hartwig, Tran, Phuoc T, Martin, Santiago, Martinez-Monge, Rafael, Krauss, Daniel J, Abu-Isa, Eyad I, Alam, Ridwan, Schwen, Zeyad, Pisansky, Thomas M, Choo, C Richard, Song, Daniel Y, Greco, Stephen, Deville, Curtiland, McNutt, Todd, DeWeese, Theodore L, Ross, Ashley E, Ciezki, Jay P, Boutros, Paul C, Nickols, Nicholas G, Bhat, Prashant, Shabsovich, David, Juarez, Jesus E, Chong, Natalie, Kupelian, Patrick A, Rettig, Matthew B, Zaorsky, Nicholas G, Berlin, Alejandro, Tward, Jonathan D, Davis, Brian J, Reiter, Robert E, Steinberg, Michael L, Elashoff, David, Horwitz, Eric M, Tendulkar, Rahul D, Tilki, Derya, Czernin, Johannes, Gafita, Andrei, Romero, Tahmineh, Calais, Jeremie, and Kishan, Amar U

Subjects
Biomedical and Clinical Sciences, Clinical Sciences, Oncology and Carcinogenesis, Biomedical Imaging, Prostate Cancer, Cancer, Clinical Research, Urologic Diseases, Aging, Prevention, Detection, screening and diagnosis, 4.2 Evaluation of markers and technologies, Good Health and Well Being, Adult, Aged, Aged, 80 and over, Antigens, Surface, Biomarkers, Tumor, Clinical Decision Rules, Follow-Up Studies, Glutamate Carboxypeptidase II, Humans, Male, Middle Aged, Neoplasm Staging, Nomograms, Positron Emission Tomography Computed Tomography, Prognosis, Prostatic Neoplasms, Retrospective Studies, Risk Assessment, SEER Program, Survival Analysis, Biomedical and clinical sciences, Health sciences
Abstract

ImportanceProstate-specific membrane antigen (PSMA) positron emission tomography/computed tomography (PET/CT) can detect low-volume, nonlocalized (ie, regional or metastatic) prostate cancer that was occult on conventional imaging. However, the long-term clinical implications of PSMA PET/CT upstaging remain unclear.ObjectivesTo evaluate the prognostic significance of a nomogram that models an individual's risk of nonlocalized upstaging on PSMA PET/CT and to compare its performance with existing risk-stratification tools.Design, setting, and participantsThis cohort study included patients diagnosed with high-risk or very high-risk prostate cancer (ie, prostate-specific antigen [PSA] level >20 ng/mL, Gleason score 8-10, and/or clinical stage T3-T4, without evidence of nodal or metastatic disease by conventional workup) from April 1995 to August 2018. This multinational study was conducted at 15 centers. Data were analyzed from December 2020 to March 2021.ExposuresCurative-intent radical prostatectomy (RP), external beam radiotherapy (EBRT), or EBRT plus brachytherapy (BT), with or without androgen deprivation therapy.Main outcomes and measuresPSMA upstage probability was calculated from a nomogram using the biopsy Gleason score, percentage positive systematic biopsy cores, clinical T category, and PSA level. Biochemical recurrence (BCR), distant metastasis (DM), prostate cancer-specific mortality (PCSM), and overall survival (OS) were analyzed using Fine-Gray and Cox regressions. Model performance was quantified with the concordance (C) index.ResultsOf 5275 patients, the median (IQR) age was 66 (60-72) years; 2883 (55%) were treated with RP, 1669 (32%) with EBRT, and 723 (14%) with EBRT plus BT; median (IQR) PSA level was 10.5 (5.9-23.2) ng/mL; 3987 (76%) had Gleason grade 8 to 10 disease; and 750 (14%) had stage T3 to T4 disease. Median (IQR) follow-up was 5.1 (3.1-7.9) years; 1221 (23%) were followed up for at least 8 years. Overall, 1895 (36%) had BCR, 851 (16%) developed DM, and 242 (5%) died of prostate cancer. PSMA upstage probability was significantly prognostic of all clinical end points, with 8-year C indices of 0.63 (95% CI, 0.61-0.65) for BCR, 0.69 (95% CI, 0.66-0.71) for DM, 0.71 (95% CI, 0.67-0.75) for PCSM, and 0.60 (95% CI, 0.57-0.62) for PCSM (P

Published
2021

7. Impact of mental illness on end‐of‐life emergency department use in elderly patients with gastrointestinal malignancies

Author

Kashyap, Mehr, Harris, Jeremy P, Chang, Daniel T, and Pollom, Erqi L

Subjects
Health Services, Cancer, Clinical Research, Serious Mental Illness, Behavioral and Social Science, Aging, Mental Health, Brain Disorders, 4.1 Discovery and preclinical testing of markers and technologies, Detection, screening and diagnosis, Management of diseases and conditions, 7.1 Individual care needs, Mental health, Good Health and Well Being, Aged, Aged, 80 and over, Anxiety, Bipolar Disorder, Dementia, Depression, Emergency Service, Hospital, Female, Gastrointestinal Neoplasms, Health Services Needs and Demand, Humans, Logistic Models, Male, Medicare, Mental Disorders, Multimorbidity, Psychotic Disorders, Quality of Health Care, SEER Program, Socioeconomic Factors, Substance-Related Disorders, Terminal Care, Time Factors, United States, cancer management, digestive cancer, quality of life, SEER&#8208, SEER-Medicare, Biochemistry and Cell Biology, Oncology and Carcinogenesis
Abstract

BackgroundElderly patients with gastrointestinal cancer and mental illness have significant comorbidities that can impact the quality of their care. We investigated the relationship between mental illness and frequent emergency department (ED) use in the last month of life, an indicator for poor end-of-life care quality, among elderly patients with gastrointestinal cancers.MethodsWe used SEER-Medicare data to identify decedents with gastrointestinal cancers who were diagnosed between 2004 and 2013 and were at least 66 years old at time of diagnosis (median age: 80 years, range: 66-117 years). We evaluated the association between having a diagnosis of depression, bipolar disorders, psychotic disorders, anxiety, dementia, and/or substance use disorders and ED use in the last 30 days of life using logistic regression models.ResultsOf 160,367 patients included, 54,661 (34.1%) had a mental illness diagnosis between one year prior to cancer diagnosis and death. Patients with mental illness were more likely to have > 1 ED visit in the last 30 days of life (15.6% vs. 13.3%, p

Published
2021

8. The clinical and financial cost of mental disorders among elderly patients with gastrointestinal malignancies

Author

Harris, Jeremy P, Kashyap, Mehr, Humphreys, Jessica N, Pollom, Erqi L, and Chang, Daniel T

Subjects
Biomedical and Clinical Sciences, Clinical Sciences, Oncology and Carcinogenesis, Digestive Diseases, Mental Health, Clinical Research, Cancer, Health Services, Behavioral and Social Science, Colo-Rectal Cancer, Brain Disorders, Mental health, Good Health and Well Being, Age Factors, Aged, Aged, 80 and over, Comorbidity, Databases, Factual, Female, Financial Stress, Gastrointestinal Neoplasms, Health Care Costs, Health Expenditures, Humans, Male, Medicare, Mental Disorders, Prognosis, Retrospective Studies, Risk Assessment, Risk Factors, SEER Program, Time Factors, United States, colon cancer, financial toxicity, gastrointestinal cancer, mental disorder, SEER-Medicare, Biochemistry and Cell Biology, Oncology and carcinogenesis
Abstract

The clinical and financial effects of mental disorders are largely unknown among gastrointestinal (GI) cancer patients. Using the Surveillance, Epidemiology, and End Results (SEER)-Medicare linked database, we identified patients whose first cancer was a primary colorectal, pancreatic, gastric, hepatic/biliary, esophageal, or anal cancer as well as those with coexisting depression, anxiety, psychotic, or bipolar disorder. Survival, chemotherapy use, total healthcare expenditures, and patient out-of-pocket expenditures were estimated and compared based on the presence of a mental disorder. We identified 112,283 patients, 23,726 (21%) of whom had a coexisting mental disorder. Median survival for patients without a mental disorder was 52 months (95% CI 50-53 months) and for patients with a mental disorder was 43 months (95% CI 42-44 months) (p

Published
2020

10. Patterns of Progression in Patients With Newly Diagnosed Glioblastoma Treated With 5-mm Margins in a Phase 1/2 Trial of 5-Fraction Stereotactic Radiosurgery With Concurrent and Adjuvant Temozolomide

Author

Mendoza, Maria G., Azoulay, Melissa, Chang, Steven D., Gibbs, Iris C., Hancock, Steven L., Pollom, Erqi L., Adler, John R., Harraher, Ciara, Li, Gordon, Gephart, Melanie Hayden, Nagpal, Seema, Thomas, Reena P., Recht, Lawrence D., Jacobs, Lisa R., Modlin, Leslie A., Wynne, Jacob, Seiger, Kira, Fujimoto, Dylann, Usoz, Melissa, von Eyben, Rie, Choi, Clara Y.H., and Soltys, Scott G.

Published
2023
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11. A Phase I/II Trial of 5-Fraction Stereotactic Radiosurgery with 5-mm Margins with Concurrent Temozolomide in Newly Diagnosed Glioblastoma: Primary Outcomes

Author

Azoulay, Melissa, Chang, Steven D, Gibbs, Iris C, Hancock, Steven L, Pollom, Erqi L, Harsh, Griffith R, Adler, John R, Harrahar, Ciara, Li, Gordon, Gephart, Melanie Hayden, Nagpal, Seema, Thomas, Reena P, Recht, Lawrence D, Jacobs, Lisa R, Modlin, Leslie A, Wynne, Jacob, Seiger, Kira, Fujimoto, Dylann, Usoz, Melissa, von Eyben, Rie, Choi, Clara YH, and Soltys, Scott G

Subjects
Biomedical and Clinical Sciences, Clinical Sciences, Oncology and Carcinogenesis, Rare Diseases, Neurosciences, Brain Disorders, Brain Cancer, Cancer, Evaluation of treatments and therapeutic interventions, 6.1 Pharmaceuticals, Aged, Aged, 80 and over, Antineoplastic Agents, Alkylating, Brain Neoplasms, Chemoradiotherapy, Female, Glioblastoma, Humans, Male, Middle Aged, Radiosurgery, Temozolomide, glioblastoma, hypofractionated, newly diagnosed, prospective, radiosurgery, Oncology & Carcinogenesis, Oncology and carcinogenesis
Abstract

BackgroundWe sought to determine the maximum tolerated dose (MTD) of 5-fraction stereotactic radiosurgery (SRS) with 5-mm margins delivered with concurrent temozolomide in newly diagnosed glioblastoma (GBM).MethodsWe enrolled adult patients with newly diagnosed glioblastoma to 5 days of SRS in a 3 + 3 design on 4 escalating dose levels: 25, 30, 35, and 40 Gy. Dose limiting toxicity (DLT) was defined as Common Terminology Criteria for Adverse Events grades 3-5 acute or late CNS toxicity, including adverse radiation effect (ARE), the imaging correlate of radiation necrosis.ResultsFrom 2010 to 2015, thirty patients were enrolled. The median age was 66 years (range, 51-86 y). The median target volume was 60 cm3 (range, 14.7-137.3 cm3). DLT occurred in 2 patients: one for posttreatment cerebral edema and progressive disease at 3 weeks (grade 4, dose 40 Gy); another patient died 1.5 weeks following SRS from postoperative complications (grade 5, dose 40 Gy). Late grades 1-2 ARE occurred in 8 patients at a median of 7.6 months (range 3.2-12.6 mo). No grades 3-5 ARE occurred. With a median follow-up of 13.8 months (range 1.7-64.4 mo), the median survival times were: progression-free survival, 8.2 months (95% CI: 4.6-10.5); overall survival, 14.8 months (95% CI: 10.9-19.9); O6-methylguanine-DNA methyltransferase hypermethylated, 19.9 months (95% CI: 10.5-33.5) versus 11.3 months (95% CI: 8.9-17.6) for no/unknown hypermethylation (P = 0.03), and 27.2 months (95% CI: 11.2-48.3) if late ARE occurred versus 11.7 months (95% CI: 8.9-17.6) for no ARE (P = 0.08).ConclusionsThe per-protocol MTD of 5-fraction SRS with 5-mm margins with concurrent temozolomide was 40 Gy in 5 fractions. ARE was limited to grades 1-2 and did not statistically impact survival.

Published
2020

12. Anal Cancer

Author

Miller, Jacob A., Bazan, Jose G., Pollom, Erqi L., Koong, Albert C., Chang, Daniel T., Lee, Nancy Y., Series Editor, Lu, Jiade J., Series Editor, and Yu, Yao, editor

Published
2022
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13. Rectal Cancer

Author

Miller, Jacob A., Bazan, Jose G., Pollom, Erqi L., Koong, Albert C., Chang, Daniel T., Lee, Nancy Y., Series Editor, Lu, Jiade J., Series Editor, and Yu, Yao, editor

Published
2022
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21. List of contributors

Author

Akiyoshi, Takashi, primary, Beets-Tan, Regina, additional, Benson, Sean, additional, Bodalal, Zuhir, additional, Brouwer, Nelleke Pietronella Maria, additional, Burggraaf, Jacobus, additional, Cai, Lishan, additional, Ceelen, Wim P., additional, Chang, Daniel T., additional, De Clercq, Alexander, additional, Debbaut, Charlotte, additional, Delgado, Carlos Alejandro Silvera, additional, Elias, Alexandra, additional, Francke, Kai, additional, Frick, Melissa A., additional, Galema, Hidde A., additional, Hans, Dedecker, additional, Hans, Prenen, additional, Hardiman, Karin, additional, Hazen, Sanne-Marije J.A., additional, Hilling, Denise E., additional, Hoorens, Anne, additional, Hutteman, Merlijn, additional, Ikeda, Masataka, additional, Ito, Masaaki, additional, Jan, Albert, additional, Kanemitsu, Yukihide, additional, Kataoka, Kozo, additional, Keereweer, Stijn, additional, Koudehi, Ghazal Adeli, additional, Kusters, Miranda, additional, Laura, Wuyts, additional, Laure-Anne, Teuwen, additional, Lauwerends, Lorraine J., additional, Loo, Phoebe, additional, Maas, Monique, additional, Marc, Peeters, additional, Meijer, Ruben P.J., additional, Monson, John R.T., additional, Nagtegaal, Iris D., additional, Pollom, Erqi L., additional, Rey, Sergio, additional, Salavati, Hooman, additional, Schito, Luana, additional, Segers, Patrick, additional, Shiozawa, Manabu, additional, Sluckin, Tania C., additional, Smithson, Mary, additional, Struys, Mathieu J.R., additional, Tiernan, Jim P., additional, Tije, ten, additional, Timon, Vandamme, additional, Trebeschi, Stefano, additional, Tsukada, Yuichiro, additional, Vahrmeijer, Alexander L., additional, van Ramshorst, Gabrielle H., additional, Verhoef, Cornelis, additional, Vitzthum, Lucas K., additional, Waktola, Selam, additional, West, Nicholas P., additional, Westwood, Alice C., additional, Willaert, Wouter, additional, and Wright, Jesse P., additional

Published
2022
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26. Phase 1/2 Trial of 5-Fraction Stereotactic Radiosurgery With 5-mm Margins With Concurrent and Adjuvant Temozolomide in Newly Diagnosed Supratentorial Glioblastoma: Health-Related Quality of Life Results.

Author

Pollom, Erqi L, Fujimoto, Dylann, Wynne, Jacob, Seiger, Kira, Modlin, Leslie A, Jacobs, Lisa R, Azoulay, Melissa, von Eyben, Rie, Tupper, Laurie, Gibbs, Iris C, Hancock, Steven L, Li, Gordon, Chang, Steven D, Adler, John R, Harsh, Griffith R, Harraher, Ciara, Nagpal, Seema, Thomas, Reena P, Recht, Lawrence D, Choi, Clara YH, and Soltys, Scott G

Subjects
Humans, Glioblastoma, Brain Neoplasms, Neoplasm Recurrence, Local, Disease Progression, Dacarbazine, Antineoplastic Agents, Alkylating, Treatment Outcome, Chemotherapy, Adjuvant, Radiosurgery, Prospective Studies, Communication, Quality of Life, Aged, Aged, 80 and over, Middle Aged, Survivors, Female, Male, Kaplan-Meier Estimate, Chemoradiotherapy, Surveys and Questionnaires, Radiation Dose Hypofractionation, Temozolomide, Clinical Trials and Supportive Activities, Brain Disorders, Rare Diseases, Clinical Research, Cancer, Neurosciences, Brain Cancer, Evaluation of treatments and therapeutic interventions, 6.1 Pharmaceuticals, Other Physical Sciences, Clinical Sciences, Oncology and Carcinogenesis, Oncology & Carcinogenesis
Abstract

PurposeWe report a longitudinal assessment of health-related quality of life (HRQOL) in patients with glioblastoma (GBM) treated on a prospective dose escalation trial of 5-fraction stereotactic radiosurgery (25-40 Gy in 5 fractions) with concurrent and adjuvant temozolomide.MethodsHRQOL was assessed using the European Organization for Research and Treatment of Cancer (EORTC) quality of life questionnaire core-30 (QLQ-C30) general, the EORTC quality of life questionnaire-brain cancer specific module (QLQ-BN20), and the M.D. Anderson Symptom Inventory-Brain Tumor (MDASI-BT). Questionnaires were completed at baseline and at every follow-up visit after completion of radiosurgery. Changes from baseline for 9 predefined HRQOL measures (global quality of life, physical functioning, social functioning, emotional functioning, motor dysfunction, communication deficit, fatigue, insomnia, and future uncertainty) were calculated at every time point.ResultsWith a median follow-up time of 10.4 months (range, 0.4-52 months), 139 total HRQOL questionnaires were completed by the 30 patients on trial. Compliance with HRQOL assessment was 76% at 12 months. Communication deficit significantly worsened over time, with a decline of 1.7 points per month (P=.008). No significant changes over time were detected in the other 8 scales of our primary analysis, including global quality of life. Although 8 patients (27%) experienced adverse radiation effects (ARE) on this dose escalation trial, it was not associated with a statistically significant decline in any of the primary HRQOL scales. Disease progression was associated with communication deficit, with patients experiencing an average worsening of 13.9 points per month after progression compared with 0.7 points per month before progression (P=.01).ConclusionOn this 5-fraction dose escalation protocol for newly diagnosed GBM, overall HRQOL remained stable and appears similar to historical controls of 30 fractions of radiation therapy. Tumor recurrence was associated with worsening communication deficit, and ARE did not correlate with a decline in HRQOL.

Published
2017

36. Nodular Leptomeningeal Disease—A Distinct Pattern of Recurrence After Postresection Stereotactic Radiosurgery for Brain Metastases: A Multi-institutional Study of Interobserver Reliability

Author

Turner, Brandon E., Prabhu, Roshan S., Burri, Stuart H., Brown, Paul D., Pollom, Erqi L., Milano, Michael T., Weiss, Stephanie E., Iv, Michael, Fischbein, Nancy, Soliman, Hany, Lo, Simon S., Chao, Samuel T., Cox, Brett W., Murphy, James D., Li, Gordon, Gephart, Melanie Hayden, Nagpal, Seema, Atalar, Banu, Azoulay, Melissa, Thomas, Reena, Tillman, Gayle, Durkee, Ben Y., Shah, Jennifer L., and Soltys, Scott G.

Published
2020
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47. 18F-EF5 PET-based Imageable Hypoxia Predicts Local Recurrence in Tumors Treated With Highly Conformal Radiation Therapy

Author

Qian, Yushen, Von Eyben, Rie, Liu, Yufei, Chin, Frederick T., Miao, Zheng, Apte, Sandeep, Carter, Justin N., Binkley, Michael S., Pollom, Erqi L., Harris, Jeremy P., Prionas, Nicolas D., Kissel, Madelyn, Simmons, Amanda, Diehn, Maximilian, Shultz, David B., Brown, J. Martin, Maxim, Peter G., Koong, Albert C., Graves, Edward E., and Loo, Billy W., Jr.

Published
2018
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49. Society for Women in Radiation Oncology Consensus Statement on Family and Medical Leave

Author

Baniel, Claire Christine, primary, Ponce, Sara Beltrán, additional, Lichter, Katie E., additional, Peters, Gabrielle W., additional, Small, Christina, additional, Seldon, Crystal, additional, Nguyen, Katarina T., additional, Khan, Amanda Farah, additional, Thomas, Charles R., additional, Small, William, additional, Kahn, Jenna M., additional, Olivier, Kenneth R., additional, Masters, Adrianna Henson, additional, Barry, Parul N., additional, Pollom, Erqi L., additional, and Jagsi, Reshma, additional

Published
2023
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