Publications by authors named "Minsky B"
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.
Evaluating pre-consult patient education videos for patients with newly-diagnosed anal squamous cell carcinoma: Impact on patient comprehension, satisfaction and distress.
Tech Innov Patient Support Radiat Oncol
December 2024
We hypothesized that pre-consult patient education videos can improve patient understanding about their diagnosis, lead to high satisfaction and low distress. In this pilot study, we developed a patient education video curriculum for patients with newly-diagnosed anal cancer. Comprehension of key content was evaluated by comparing pre- and post-test scores.
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- The study investigates the effectiveness of radiation therapy (RT) for intrahepatic cholangiocarcinoma (iCCA) and explores a new approach to assess treatment response using quantitative measures rather than traditional size-based methods.
- By analyzing CT scans from 154 patients, researchers found that changes in viable tumor volume after RT are better indicators of overall survival (OS) compared to standard RECIST criteria, with a notable threshold of a 33% reduction in viable volume signaling optimal treatment response.
- The findings highlight the potential for personalized RT approaches based on individual tumor characteristics, suggesting that mathematical models derived from CT imaging can improve patient outcomes by identifying optimal treatment protocols.
Purpose: The purpose of this phase 1 trial was to evaluate the safety and toxicity of preoperative short-course chemoradiotherapy (CRT) as part of total neoadjuvant therapy (TNT) for patients with potentially resectable gastric or gastroesophageal adenocarcinoma.
Methods And Materials: Patients were enrolled between March 2021 and December 2022 and received CRT (30 Gy radiation in 10 fractions with concurrent capecitabine or 5-fluorouracil), then received systemic therapy for 2 months, and then underwent surgery. The primary endpoint was CRT safety; secondary endpoints were pathologic complete response, perioperative complications, and overall survival (OS).
Unlabelled: Secondary endpoints (SEP) provide crucial information in the interpretation of clinical trials, but their features are not yet well understood. Thus, we sought to empirically characterize the scope and publication rate of SEPs among late-phase oncology trials. We assessed SEPs for each randomized, published phase III oncology trial across all publications and ClinicalTrials.
View Article and Find Full Text PDFBackground: Perioperative chemotherapy has become the standard of care for locally advanced gastric cancer. Total neoadjuvant therapy (TNT), including both chemotherapy and chemoradiation, is utilized in other gastrointestinal malignancies. We determined survival in a contemporary cohort of gastric cancer patients treated with TNT.
View Article and Find Full Text PDFIntroduction: With locally advanced pancreatic cancer (LAPC), uncontrolled local tumor growth frequently leads to mortality. Advancements in radiotherapy (RT) techniques have enabled conformal delivery of escalated-dose RT (EDR), which may have potential local control and overall survival (OS) benefits based on retrospective and early prospective studies. With evidence for EDR emerging, we characterized the adoption of EDR across the United States and its associated outcomes.
View Article and Find Full Text PDFObjectives: This study investigates retreatment rates in single-fraction radiation therapy (SFRT) for painful bone metastasis in patients with limited life expectancy. We compared retreatment-free survival (RFS) in patients from a rapid access bone metastases clinic (RABC) and non-RABC patients, identifying factors associated with retreatment.
Methods: In this observational study, we analysed RABC patients who received SFRT between April 2018 and November 2019, using non-RABC SFRT patients as a comparison group.
Missing visual elements (MVE) in Kaplan-Meier (KM) curves can misrepresent data, preclude curve reconstruction, and hamper transparency. This study evaluated KM plots of phase III oncology trials. MVE were defined as an incomplete y-axis range or missing number at risk table in a KM curve.
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- Traditional guidelines recommend preserving 700 cc of liver during radiation treatment to minimize the risk of liver failure, but this study explores using SPECT imaging to better identify and protect functional liver tissue in patients with diminished liver volume from previous treatments.
- The phase I trial involved 12 patients with colorectal liver metastases, all having received prior chemotherapy, and assessed safety by monitoring for toxicities after high-dose liver-directed radiotherapy.
- Results showed that incorporating SPECT imaging allowed for safe administration of higher radiation doses without dose-limiting toxicities, achieving a 57% in-field control rate and a 73% overall survival rate after one year.
Importance: In 2018, the first online adaptive magnetic resonance (MR)-guided radiotherapy (MRgRT) system using a 1.5-T MR-equipped linear accelerator (1.5-T MR-Linac) was clinically introduced.
View Article and Find Full Text PDFPurpose: Chemoradiation therapy (CRT) is the standard treatment for squamous cell carcinoma of the anus (SCCA). This study aimed to investigate the relationship between vaginal dosimetry and long-term patient-reported dyspareunia after treatment. We further aimed to use the anterior vaginal wall (AVW) as an organ at risk to define an actionable dosimetric clinical goal to decrease the risk of patient-reported dyspareunia.
View Article and Find Full Text PDFImportance: Subgroup analyses are often performed in oncology to investigate differential treatment effects and may even constitute the basis for regulatory approvals. Current understanding of the features, results, and quality of subgroup analyses is limited.
Objective: To evaluate forest plot interpretability and credibility of differential treatment effect claims among oncology trials.
Background: The standard treatment for recurrent or persistent anal squamous cell carcinoma is surgical salvage, but disease control and survival are suboptimal.
Patients/methods: Patients treated for recurrent or persistent anal squamous cell carcinoma at our institution from 2002 to 2022 were included. Patients were classified by type of salvage treatment received: surgery alone vs.
Background: Despite the increasing utilization of sphincter and/or organ-preservation treatment strategies, many patients with low-lying rectal cancers require abdominoperineal resection (APR), leading to permanent ostomy. Here, we aimed to characterize overall, sexual-, and bladder-related patient-reported quality of life (QOL) for individuals with low rectal cancers. We additionally aimed to explore potential differences in patient-reported outcomes between patients with and without a permanent ostomy.
View Article and Find Full Text PDFPurpose: With expansion of academic cancer center networks across geographically-dispersed sites, ensuring high-quality delivery of care across all network affiliates is essential. We report on the characteristics and efficacy of a radiation oncology peer-review quality assurance (QA) system implemented across a large-scale multinational cancer network.
Methods And Materials: Since 2014, weekly case-based peer-review QA meetings have been standard for network radiation oncologists with radiation oncology faculty at a major academic center.
In gastroesophageal junction (GEJ) adenocarcinoma cases, a prognosis based on ypTNM staging could be affected by preoperative therapy. Patients with esophageal adenocarcinoma and gastric adenocarcinoma who underwent preoperative therapy followed by surgical resection from 2006 through 2017 were identified in the National Cancer Database. To enable stage-by-stage OS comparisons, tumors were classified into four gross ypTNM groups: ypT1/2, N-negative; ypT1/2, N-positive; ypT3/4, N-negative; and ypT3/4, N-positive.
View Article and Find Full Text PDFPurpose: At our institution, we treat patients with a daily vaginal dilator (VD) during chemoradiation (CRT) for squamous cell carcinoma of the anus (SCCA). We evaluated compliance with daily VD use, radiation dose to the vaginal wall (VW), and anterior vaginal wall (AVW), and patient-reported long-term sexual function.
Methods And Materials: We included women with SCCA who received definitive, intensity-modulated radiation therapy-based CRT.
Article Synopsis
- The 'Table 1 Fallacy' is when researchers misuse significance testing to incorrectly assess balance in baseline variables between randomized groups in clinical trials, leading to potential misinterpretations.
- In a study of 765 phase III oncology trials with over half a million patients, the fallacy was found in 25% of trials, with only 3% of comparisons deemed statistically significant, which is close to the expected type I error rate of 5%.
- Factors that reduced the likelihood of encountering the fallacy included industry sponsorship, larger trial sizes, and publication in European journals, indicating a need for improved practices in reporting and analyzing trial data to avoid misleading conclusions.
Article Synopsis
- * The research analyzed 61 M1 ICC patients receiving L-RT versus 220 undergoing chemotherapy alone, revealing a notable difference in overall survival (OS): 21 months for L-RT compared to 9 months for chemotherapy.
- * Results indicate that L-RT is linked to a reduced risk of death from TRLF and longer OS, suggesting its potential benefit over chemotherapy alone for M1 ICC patients.
Background: Although most patients with cancer are treated with local therapy (LT), the proportion of late-phase clinical trials investigating local therapeutic interventions is unknown. The purpose of this study was to determine the proportion, characteristics, and trends of phase 3 cancer clinical trials assessing the therapeutic value of LT over time.
Methods: This was a cross-sectional analysis of interventional randomized controlled trials in oncology published from 2002 through 2020 and registered on ClinicalTrials.
Article Synopsis
- The study investigates how often primary endpoint (PEP) changes occur in oncology randomized clinical trials (RCTs) and whether these changes influence the trial's success in meeting its predefined success criteria.
- Out of 755 trials analyzed, about 19.2% had changes to their primary endpoints, but 70.3% of those changes were not disclosed in the published articles.
- The research showed that PEP changes were more easily detected when multiple protocol versions were available, and there was a significant correlation between these changes and a positive trial outcome.
Background: Microscopically positive (R1) surgical margins after gastrectomy increase gastric cancer recurrence risk, but optimal management after R1 gastrectomy is controversial. We sought to identify the impact of R1 margins on recurrence patterns and survival in the era of preoperative therapy for gastric cancer.
Methods: Patients who underwent gastrectomy for adenocarcinoma during 1998-2017 at a major cancer center were enrolled.
Importance: For many types of epithelial malignant neoplasms that are treated with definitive radiotherapy (RT), treatment prolongation and interruptions have an adverse effect on outcomes.
Objective: To analyze the association between RT duration and outcomes in patients with esophageal cancer who were treated with definitive chemoradiotherapy (CRT).
Design, Setting, And Participants: This study was an unplanned, post hoc secondary analysis of 3 prospective, multi-institutional phase 3 randomized clinical trials (Radiation Therapy Oncology Group [RTOG] 8501, RTOG 9405, and RTOG 0436) of the National Cancer Institute-sponsored NRG Oncology (formerly the National Surgical Adjuvant Breast and Bowel Project, RTOG, and Gynecologic Oncology Group).