Publications by authors named "A C Koong"
Multiple randomized trials have suggested that the addition of comprehensive metastasis-directed therapy to best systemic therapy improves disease control and survival among patients with oligometastatic disease, even for histologies with a high propensity for rapid spread. Here, we review the growing literature supporting the oligometastatic paradigm in pancreatic ductal adenocarcinoma. We summarize key details from nascent institutional series and reflect on the recently reported phase II randomized EXTEND trial.
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- SBRT for abdominal tumors faces challenges like respiratory motion and low tumor contrast, making accurate treatment difficult.
- Breath-hold treatments using CT-on-rails (CTOR) improve visualization of both tumors and surrounding tissues, helping to better align radiation targets and protect normal tissues.
- Case studies show that using diagnostic-quality CT guidance allows for precise adjustments in treatment alignment, effectively reducing radiation doses to sensitive organs like the stomach.
Article Synopsis
- Current radiation oncology (RO) trainees lack formal mentorship and training on clinical trial design and implementation, relying mostly on informal education within residency programs.
- The "Fletcher-Cox Pathway," initiated at MD Anderson Cancer Center in 2018, has successfully established a structured clinical trial training program for RO residents, receiving positive feedback and participation.
- The program enables trainees to design and submit clinical trials, fostering mentorship relationships and aiming to create a national platform to enhance access to clinical trial education and resources in RO.
Background And Purpose: FLASH or ultra-high dose rate (UHDR) radiation therapy (RT) has gained attention in recent years for its ability to spare normal tissues relative to conventional dose rate (CDR) RT in various preclinical trials. However, clinical implementation of this promising treatment option has been limited because of the lack of availability of accelerators capable of delivering UHDR RT. Commercial options are finally reaching the market that produce electron beams with average dose rates of up to 1000 Gy/s.
View Article and Find Full Text PDFRedefining FLASH Radiation Therapy: The Impact of Mean Dose Rate and Dose Per Pulse in the Gastrointestinal Tract.
Int J Radiat Oncol Biol Phys
October 2024
Purpose: The understanding of how varying radiation beam parameter settings affect the induction and magnitude of the FLASH effect remains limited. We sought to systematically evaluate how the magnitude of radiation-induced gastrointestinal toxicity depends on the interplay between mean dose rate (MDR) and dose per pulse (DPP).
Methods And Materials: C57BL/6J mice received total abdominal irradiation (TAI, 11-14 Gy single fraction) through either conventional (CONV) irradiation (low-DPP and low MDR, CONV) or through various combinations of DPP and MDR up to ultra-high-dose-rate beam conditions.