Publications by authors named "Adam Mueller"

Article Synopsis
  • Local treatment options for recurrence of pancreatic adenocarcinoma are limited, with median survival times of 9-13 months, but MRI-guided stereotactic body radiation therapy (MRgSBRT) may improve outcomes by allowing higher radiation doses while protecting normal tissue.
  • In a study involving 15 patients treated with MRgSBRT, the median overall survival after recurrence was 14.1 months, with local control rates of 92.3% and 83.9% at 6 and 12 months, respectively.
  • The treatment showed manageable side effects, with 47% experiencing mild acute gastrointestinal toxicity and 31% facing chronic gastrointestinal issues, but no severe
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Purpose: Limited structured educational programs are available for the continued professional development of radiation oncology nurses. In this study, we evaluated a pilot curriculum focusing on clinical workflow and toxicity management for radiation oncology nurses at a single university-affiliated medical center network.

Methods And Materials: Based on a previous multi-institutional needs assessment, a targeted curriculum on clinical workflow and toxicity management was developed, including didactic lectures, written disease-specific toxicity management guidelines, and standardized medication/laboratory order preference lists in the electronic health record.

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Background And Purpose: Radiation dose escalation may improve local control (LC) and overall survival (OS) in select pancreatic ductal adenocarcinoma (PDAC) patients. We prospectively evaluated the safety and efficacy of ablative stereotactic magnetic resonance (MR)-guided adaptive radiation therapy (SMART) for borderline resectable (BRPC) and locally advanced pancreas cancer (LAPC). The primary endpoint of acute grade ≥ 3 gastrointestinal (GI) toxicity definitely related to SMART was previously published with median follow-up (FU) 8.

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Fiducial markers are utilized for image guided radiotherapy (IGRT) alignment during the delivery of liver stereotactic body radiosurgery (SBRT). There are limited data demonstrating the impact of matching fiducials on the accuracy of liver SBRT. This study quantifies the benefit of fiducial-based alignment and improvements in inter-observer reliability.

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Purpose: Magnetic resonance (MR) image guidance may facilitate safe ultrahypofractionated radiation dose escalation for inoperable pancreatic ductal adenocarcinoma. We conducted a prospective study evaluating the safety of 5-fraction Stereotactic MR-guided on-table Adaptive Radiation Therapy (SMART) for locally advanced (LAPC) and borderline resectable pancreatic cancer (BRPC).

Methods And Materials: Patients with LAPC or BRPC were eligible for this multi-institutional, single-arm, phase 2 trial after ≥3 months of systemic therapy without evidence of distant progression.

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Pancreatic cancer is one of the most lethal cancers, due to its uniquely aggressive behavior and resistance to therapy. The tumor microenvironment of pancreatic cancer is immunosuppressive, and attempts at utilizing immunotherapies have been unsuccessful. Radiation therapy (RT) results in immune activation and antigen presentation in other cancers, but in pancreatic cancer has had limited success in stimulating immune responses.

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Purpose: Metastasis remains a major hurdle in treating aggressive malignancies such as pancreatic ductal adenocarcinoma (PDAC). Improving response to treatment, therefore, requires a more detailed characterization of the cellular populations involved in controlling metastatic burden.

Experimental Design: PDAC patient tissue samples were subjected to RNA sequencing analysis to identify changes in immune infiltration following radiotherapy.

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Article Synopsis
  • Research is focused on overcoming resistance to radiation therapy (RT) combined with immunotherapy in head and neck squamous cell carcinoma (HNSCC) using mouse models to understand the tumor microenvironment's response to treatment.
  • Findings reveal that targeting traditional immunosuppressive myeloids is ineffective; instead, a combination of RT, Treg depletion, and anti-CD137 agonism enhances dendritic cell activation and reprograms Tregs, leading to a strong CD8 T cell response.
  • Successfully increasing RT dosage and combining it with specific treatments results in tumor eradication, while high Treg levels in human oral squamous cell carcinoma are linked to quicker tumor recurrence, emphasizing the need to manipulate
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Introduction: Radiation therapy (XRT) has been investigated as a possible treatment for high-risk non-muscle invasive bladder cancer (NMIBC) with the goal of bladder preservation, especially with the ongoing Bacillus Calmette-Guerin (BCG) shortage. Yet, little is known about the clinical efficacy and the quality of evidence supporting XRT for NMIBC. Herein, we performed a systematic review and meta-analysis to evaluate XRT in the treatment of patients with high-risk NMIBC.

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Mass medication to manage population health can be achieved by providing therapeutics in the drinking water. Young nursery pigs are highly sensitive to the flavor and smell of water. Medications that reduce water palatability often lead to an interruption in water and feed intake.

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Article Synopsis
  • Stromal fibrosis in pancreatic ductal adenocarcinoma (PDAC) activates pathways that promote survival and epithelial-to-mesenchymal transition (EMT), contributing to resistance to therapy and tumor invasion after radiation treatment.
  • Research shows that after neoadjuvant stereotactic body radiation therapy (SBRT), there is an increase in fibrosis and specific gene signatures associated with EMT, implicating two proteins—ADAM10 and ephrinB2—as key players in tumor progression.
  • Targeting ADAM10 can reduce RT-induced fibrosis and enhance tumor cell sensitivity to radiation, leading to increased survival in mouse models, suggesting new strategies to overcome radiation resistance in PDAC patients.
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Background: The role of neoadjuvant stereotactic body radiation therapy (SBRT) in patients with borderline resectable pancreas cancer (BRPC) and locally advanced pancreas cancer (LAPC) remains controversial.

Methods: We retrospectively evaluated BRPC and LAPC patients treated at our institution who underwent 2-3 months of chemotherapy followed by SBRT to a dose of 30-33 Gy. Overall survival (OS) and recurrence-free survival (RFS) were estimated and compared by Kaplan-Meier and log-rank methods.

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Background: Persistent controversy exists with regard to how and when patients with head and neck cancer should undergo imaging after definitive therapy. The current study was conducted to evaluate whether the type of imaging modality used in posttreatment imaging impacts cancer-specific survival for patients with advanced head and neck squamous cell carcinoma.

Methods: A retrospective study of National Cancer Institute Surveillance, Epidemiology, and End Results (SEER) program-Medicare-linked data in patients with an advanced stage of the 3 most common head and neck malignancies (oral cavity, oropharynx, and larynx) was conducted.

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Article Synopsis
  • Pancreatic ductal adenocarcinoma (PDAC) has a complex environment filled with different types of immune cells that can either help or hinder cancer treatment.
  • Researchers studied how these immune cells change after radiotherapy (a cancer treatment) to better understand how they respond.
  • They found that targeting a specific molecule called STAT3 can help make radiotherapy more effective by reducing harmful cells and improving the body's immune response against the tumor.
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The aggressive nature of glioblastoma multiforme (GBM) may be attributed to the dysregulation of pathways driving both proliferation and invasion. EphrinB2, a membrane-bound ligand for some of the Eph receptors, has emerged as a critical target regulating these pathways. In this study, we investigated the role of ephrinB2 in regulating proliferation and invasion in GBM using intracranial and subcutaneous xenograft models.

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Article Synopsis
  • Fibroblasts play a crucial role in the tumor microenvironment (TME) by transforming into cancer-associated fibroblasts (CAFs), which support tumor growth and resistance through their interactions with cancer and immune cells.
  • When activated, CAFs contribute to tumorigenesis and metastasis by altering the immune response, changing the tumor's metabolism, remodeling the extracellular matrix, and fostering resistance to treatments like radiation therapy.
  • This review highlights the complex relationship between CAFs and immune cells during radiation therapy, suggesting that targeting CAF formation pathways could help reduce organ fibrosis and slow tumor progression.
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Astroviruses cause disease in a variety of species. Yet, little is known about the epidemiology of a majority of astroviruses including porcine astrovirus type 3 (PoAstV3), which is a putative cause of polioencephalomyelitis in swine. Accordingly, a cross-sectional study was conducted on sow farms with or without reported PoAstV3-associated neurologic disease in growing pigs weaned from those farms.

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Background: The optimal imaging for the staging of oropharyngeal cancer is not well defined.

Methods: The linked Surveillance, Epidemiology, and End Results (SEER)-Medicare database for 2006 through 2011 was used to compare patient characteristics and hospital region by the initial imaging modality used for patients with oropharyngeal cancer. The primary outcome was 3-year cancer-specific survival (CSS).

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Purpose: A driving factor in pancreatic ductal adenocarcinoma (PDAC) treatment resistance is the tumor microenvironment, which is highly immunosuppressive. One potent immunologic adjuvant is radiotherapy. Radiation, however, has also been shown to induce immunosuppressive factors, which can contribute to tumor progression and formation of fibrotic tumor stroma.

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Identifying targets present in the tumor microenvironment that contribute to immune evasion has become an important area of research. In this study, we identified EphB4-ephrin-B2 signaling as a regulator of both innate and adaptive components of the immune system. EphB4 belongs to receptor tyrosine kinase family that interacts with ephrin-B2 ligand at sites of cell-cell contact, resulting in bidirectional signaling.

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Article Synopsis
  • Radioresistance is a significant challenge in treating head and neck cancer, with regulatory T cells (Tregs) contributing to an immune-inhibitory environment that hampers radiation effectiveness.* -
  • In experiments using a mouse model, combining Treg depletion with radiation improved tumor eradication rates, increased T-cell activity, and fostered tumor-specific memory responses compared to radiation alone.* -
  • STAT3 inhibition, when combined with radiation, showed potential in reducing Tregs and enhancing anti-tumor immune response, marking it as a promising therapeutic strategy against radiation resistance in head and neck cancer.*
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Objectives: Studies have shown the utility of lipid-lowering agents in improving outcomes in various cancers. We aim to explore how statins affect overall survival and cancer specific survival in head and neck cancer patients using population-based datasets.

Patients And Methods: Using the Surveillance, Epidemiology, and End Results (SEER)-Medicare linked dataset, we separated HNC patients into three groups: those with no hyperlipidemia (nH), those with hyperlipidemia and not taking a statin (HnS), and those with hyperlipidemia and taking a statin (H + S).

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causes porcine proliferative enteropathy. This is an enteric disease characterized by thickening of the wall of the ileum that leads to decreased growth of animals and diarrhea. In this study, we investigated the host response to infection by performing transcriptomic and pathway analysis of intestinal tissue samples from groups of infected and noninfected animals at 14, 21, and 28 days postchallenge.

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