Publications by authors named "Monica S Krishnan"
Article Synopsis
- Stereotactic body radiation therapy (SBRT) is being studied as a treatment for patients with oligometastatic bone disease, which involves having three or fewer active tumor sites, due to its ability to target tumors effectively while minimizing damage to surrounding tissues.
- The study involved 98 patients treated with SBRT at two hospitals between December 2016 and May 2019, assessing outcomes like overall survival and treatment-related toxicity over a median follow-up of 26.7 months.
- Results showed a 2-year local progression-free survival rate of 84.8%, an overall survival rate of 87.3%, but also indicated that 26.5% of patients experienced treatment-related toxicity.
Context: There is a paucity of data describing patients' expectations of goals of palliative radiotherapy (RT) and overall prognosis.
Objectives: To explore patients' perceptions of and preferences for communication surrounding goals of palliative RT and cancer prognosis.
Methods: We conducted a qualitative study utilizing semi-structured interviews with seventeen patients with either bone or lung metastases receiving their first course of palliative RT at a comprehensive cancer center.
Background: Early specialty palliative care (PC) integration improves oncologic outcomes. We aimed to examine longitudinal relationships between specialty PC and palliative radiotherapy (RT), temporal distribution of symptoms, and predictors of earlier specialty PC.
Methods: We retrospectively reviewed 135 patients with metastatic cancer who received palliative RT at our institution (7/2017-2/2018) and who had died by final study follow-up (6/2021).
Purpose: Although local control is an important issue for longer-term survivors of spinal metastases treated with conventional external beam radiation therapy (EBRT), the literature on radiographic local failure (LF) in these patients is sparse. To inform clinical decision-making, we evaluated rates, consequences, and predictors of radiographic LF in patients with spinal metastases managed with palliative conventional EBRT alone.
Methods And Materials: We retrospectively reviewed 296 patients with spinal metastases who received palliative EBRT at a single institution (2006-2013).
Article Synopsis
- The study focuses on assessing the safety and maximum tolerated dose (MTD) of cisplatin in combination with radiation therapy for women with early-stage triple-negative breast cancer (TNBC), which has higher recurrence rates than other types of breast cancer.
- The trial involved 55 patients divided into two groups (breast-conserving therapy and mastectomy), with dose levels of cisplatin starting from 10 mg/m and escalating up to 40 mg/m; various side effects were monitored to determine the MTD.
- Results showed that the recommended MTD for the mastectomy cohort was 30 mg/m and for the breast-conserving therapy cohort
Context: Patient-provider communication impacts how patients with cancer make decisions about treatment.
Objectives: To examine patient perceptions of discussions, decision-making, and psychosocial burdens related to receiving palliative radiotherapy (RT), in order to inform best practices for communication about palliative RT.
Methods: We conducted an exploratory qualitative study using oral questionnaires and semi-structured interviews.
Context: Palliative radiation therapy (RT) is frequently used to ameliorate cancer-associated symptoms and improve quality of life.
Objectives: To examine how palliative care (PC) as a specialty is integrated at the time of RT consultation for patients with advanced cancer.
Methods: We retrospectively reviewed 162 patients with metastatic cancer who received palliative RT at our institution (7/2017-2/2018).
Purpose: While the 0-10 pain scale is often used to assess treatment response, it may not accurately reflect change in pain over time. The purpose of this study is to correlate pain improvement using the 0-10 pain scale to patients' perceived improvement in pain following palliative radiation therapy (RT), and to qualitatively characterize themes of pain assessment.
Methods: Patients age ≥ 20 receiving RT for spinal metastases were enrolled.
Purpose: Clinical pathways increase compliance with treatment guidelines, improve outcomes, and reduce costs. Guidelines recommend single fraction radiation therapy (SFRT) for palliation of uncomplicated bone metastases, but implementation is variable. We examined the effects of a pathway tool on SFRT rates in an academic radiation oncology practice.
View Article and Find Full Text PDFPurpose: The American Society of Clinical Oncology has recommended tailoring palliative cancer care (PCC) to the distinct and complex needs of advanced cancer patients. The Supportive and Palliative Radiation Oncology (SPRO) service was initiated July 2011 to provide dedicated palliative radiation oncology (RO) care to cancer patients. We used care providers' ratings to assess SPRO's impact on the quality of PCC and compared perceptions of PCC delivery among physicians practicing with and without a dedicated palliative RO service.
View Article and Find Full Text PDFPurpose: To develop and evaluate a structured didactic curriculum to complement clinical experiences during radiation oncology clerkships at 2 academic medical centers.
Methods And Materials: A structured didactic curriculum was developed to teach fundamentals of radiation oncology and improve confidence in clinical competence. Curriculum lectures included: (1) an overview of radiation oncology (history, types of treatments, and basic clinic flow); (2) fundamentals of radiation biology and physics; and (3) practical aspects of radiation treatment simulation and planning.
Background: Predicting life expectancy (LE) in patients with metastatic cancer who are receiving palliative therapies is a difficult task. The purpose of the current study was to develop a LE prediction model among patients receiving palliative radiotherapy (RT) that identifies those patients with short (< 3 months) and long (> 1 year) LEs.
Methods: The records of 862 patients with metastatic cancer receiving palliative RT at the Dana-Farber/Brigham and Women's Cancer Center between June 2008 and July 2011 were retrospectively reviewed.
Purpose: We surveyed how radiation oncologists think about and incorporate a palliative cancer patient's life expectancy (LE) into their treatment recommendations.
Methods And Materials: A 41-item survey was e-mailed to 113 radiation oncology attending physicians and residents at radiation oncology centers within the Boston area. Physicians estimated how frequently they assessed the LE of their palliative cancer patients and rated the importance of 18 factors in formulating LE estimates.
Recent data suggest that axillary lymph node dissection (ALND) may be unnecessary for patients with positive sentinel lymph node biopsy (SLNB) receiving whole-breast irradiation (ACOSOG Z0011). The purpose of this study was to use decision analysis with simulated patients to determine subgroups with positive SLNB who may still benefit from ALND. We performed a decision analysis simulating axillary recurrence (ALR) risk, lymphedema, and quality of life following breast-conserving surgery (BCS) with positive SLNB and either completion ALND and whole-breast radiation (ALND + BRT) or breast radiation (BRT) alone.
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