Publications by authors named "Rimner A"
Article Synopsis
- The study evaluates the effectiveness of stereotactic body radiotherapy (SBRT) in improving survival outcomes for patients with oligometastatic head-and-neck squamous cell carcinoma (HNSCC) and pulmonary metastases across 16 international centers.
- Out of 178 patients treated, the median overall survival was 33 months, while progression-free survival was 9 months, with low rates of local failure and minimal severe toxicity reported.
- Factors influencing survival included age and sex, with older patients and females having worse outcomes, while a longer time between HNSCC diagnosis and SBRT treatment was linked to better survival rates.
Background And Purpose: We investigate discrepancies in the assessment of treatment-related symptoms in lung cancer between healthcare professionals and patients, and factors contributing to these discrepancies.
Materials And Methods: Data from 515 participants in the REQUITE study were analysed. Five symptoms (cough, dyspnoea, bronchopulmonary haemorrhage, chest wall pain, dysphagia) were evaluated both before and after radiotherapy.
Background: CALGB 30610 trial demonstrated that once daily thoracic radiotherapy (TRT) was not superior compared to standard twice daily TRT, in patients with limited stage small cell lung cancer. Quality of life outcomes may help oncologists decide the best treatment approach.
Methods: A total of 417 patients on CALGB 30610 participated in the quality-of-life substudy (CALGB 70702), which included the FACT Trial Outcome Index-Lung Cancer (FACT-L TOI), FACT-Esophageal Cancer (FACT-E) Eating and Swallowing Indices, ECOG Acute Esophagitis Scale, Hospital Anxiety and Depression Scale (HADS), difficulty swallowing, EQ-5D, and treatment convenience assessment at baseline, 3, 5, 7, 12, 26, and 52 weeks after starting TRT.
Introduction: Reirradiation has gained increasing interest, as advances in systemic therapy increase the survival of patients with cancer, and modern radiation techniques allow more precise treatments. However, high-quality prospective evidence on the safety and efficacy of reirradiation to guide clinical practice remains scarce. This systematic review evaluates ongoing prospective studies on reirradiation to identify research gaps and priorities.
View Article and Find Full Text PDFBackground: Respiratory motion irregularities in lung cancer patients are common and can be severe during multi-fractional (∼20 mins/fraction) radiotherapy. However, the current clinical standard of motion management is to use a single-breath respiratory-correlated four-dimension computed tomography (RC-4DCT or 4DCT) to estimate tumor motion to delineate the internal tumor volume (ITV), covering the trajectory of tumor motion, as a treatment target.
Purpose: To develop a novel multi-breath time-resolved (TR) 4DCT using the super-resolution reconstruction framework with TR 4D magnetic resonance imaging (TR-4DMRI) as guidance for patient-specific breathing irregularity assessment, overcoming the shortcomings of RC-4DCT, including binning artifacts and single-breath limitations.
Article Synopsis
- The study aimed to create a prediction model to help decide between stereotactic body radiotherapy (SBRT) and minimally invasive surgery (MIS) for treating early-stage non-small cell lung cancer (NSCLC).
- Researchers analyzed data from 1,291 patients to develop the model using logistic regression, which produced three risk categories for patient treatment based on several health factors.
- The model showed strong predictive power and suggested that the decision on treatment modality does not significantly impact overall survival, highlighting the importance of assessing intermediate-risk patients through a multidisciplinary approach.
Introduction: The multidisciplinary American Radium Society Thoracic Committee was assigned to create appropriate use criteria on cardiac toxicity prevention and management for patients undergoing radiotherapy.
Methods: A systematic review of the current literature was conducted. Case variants of patients with thoracic malignancies undergoing radiation were created based on presence or absence of cardiovascular risk factors and treatment-related risks assessed by dose exposure to the heart and cardiac substructures.
Article Synopsis
- Definitive radiation therapy is the standard for early-stage NSCLC that can't be surgically removed, but there’s debate on the best approach for tumors near critical structures like the trachea and heart.
- The American Radium Society’s Thoracic AUC panel reviewed extensive literature to establish consensus guidelines on managing these complex cases, employing modified Delphi methods for agreement.
- The guidelines advocate for radiotherapy as a primary option, recommend hypofractionated radiotherapy for certain ultracentral tumors, and consider stereotactic body radiation therapy appropriate for specific central lesions, while highlighting the suitability of intensity-modulated radiotherapy over three-dimensional conformal techniques.
Purpose: The aim of this secondary analysis of the prospective randomized phase 2 PET-Plan trial (ARO-2009-09; NCT00697333) was to evaluate the impact of mediastinal tumor burden and lymphatic spread in patients with locally advanced non-small-cell lung cancer (NSCLC).
Methods: All patients treated per protocol (n = 172) were included. Patients received isotoxically dose-escalated chemoradiotherapy up to a total dose of 60-74 Gy in 30-37 fractions, aiming as high as possible while adhering to normal tissue constraints.
Purpose: Small cell lung cancer (SCLC) is characterized by rapid progression after platinum resistance. Circulating tumor (ctDNA) dynamics early in treatment may help determine platinum sensitivity.
Materials And Methods: Serial plasma samples were collected from patients receiving platinum-based chemotherapy for SCLC on the first 3 days of cycle one and on the first days of subsequent cycles with paired samples collected both before and again after infusions.
Background And Purpose: Radiation pneumonitis (RP) is a common side effect of thoracic radiotherapy and often has a long course characterized by acute exacerbations and progression to permanent lung fibrosis. There are no validated biomarkers of prognosis in patients diagnosed with RP.
Materials And Methods: We analyzed a time course of serum chemokines, cytokines, and other proteins from patients with grade 2+ RP in a randomized clinical trial of a steroid taper plus nintedanib, a multiple tyrosine kinase inhibitor, versus placebo plus a steroid taper for the treatment of RP.
Purpose: Small cell lung cancer (SCLC) often metastasizes to the brain and has poor prognosis. SCLC subtypes distinguished by expressing transcriptional factors ASCL1 or NEUROD1 have been identified. This study investigates the impact of transcription factor-defined SCLC subtype on incidence and outcomes of brain metastases (BMs).
View Article and Find Full Text PDFBackground: Electromagnetic transponders bronchoscopically implanted near the tumor can be used to monitor deep inspiration breath hold (DIBH) for thoracic radiation therapy (RT). The feasibility and safety of this approach require further study.
Methods: We enrolled patients with primary lung cancer or lung metastases.
Importance: The treatment of locally advanced non-small cell lung cancer (LA-NSCLC) has been informed by more than 5 decades of clinical trials and other relevant literature. However, controversies remain regarding the application of various radiation and systemic therapies in commonly encountered clinical scenarios.
Objective: To develop case-referenced consensus and evidence-based guidelines to inform clinical practice in unresectable LA-NSCLC.
Superior vena cava (SVC) syndrome occurs due to obstructed blood flow through the SVC. It can present clinically on a spectrum, between asymptomatic and life-threatening emergency. Patients commonly report a feeling of fullness in the head, facial, neck and upper extremity edema, and dyspnea.
View Article and Find Full Text PDFIntroduction: The primary tumor (T) component in the eighth edition of pleural mesothelioma (PM) staging system is based on pleural involvement and extent of invasion. Quantitative assessment of pleural tumor has been found to be prognostic. We explored quantitative and qualitative metrics to develop recommendations for T descriptors in the upcoming ninth edition of the PM staging system.
View Article and Find Full Text PDFBackground: In radiotherapy, real-time tumor tracking can verify tumor position during beam delivery, guide the radiation beam to target the tumor, and reduce the chance of a geometric miss. Markerless kV x-ray image-based tumor tracking is challenging due to the low tumor visibility caused by tumor-obscuring structures. Developing a new method to enhance tumor visibility for real-time tumor tracking is essential.
View Article and Find Full Text PDFArticle Synopsis
- Early radiation pneumonitis (RP) after chemoradiation can lead to treatment discontinuation and worse survival in stage III non-small cell lung cancer patients, with 13% of a study cohort experiencing RP.
- This study explored various RP prediction models, including mean lung dose (MLD) and F-FDG PET/CT features, finding that a combined MLD and SUV model improved predictive accuracy compared to the MLD-alone model.
- The final model showed better performance (AUC 0.77) and could help identify patients at high risk for RP, potentially allowing for preventative interventions to enhance treatment outcomes.
Background And Purpose: Objective assessment of delivered radiotherapy (RT) to thoracic organs requires fast and accurate deformable dose mapping. The aim of this study was to implement and evaluate an artificial intelligence (AI) deformable image registration (DIR) and organ segmentation-based AI dose mapping (AIDA) applied to the esophagus and the heart.
Materials And Methods: AIDA metrics were calculated for 72 locally advanced non-small cell lung cancer patients treated with concurrent chemo-RT to 60 Gy in 2 Gy fractions in an automated pipeline.
Purpose: Data are limited on radiation-induced lung toxicities (RILT) after multiple courses of lung stereotactic body radiation therapy (SBRT). We herein analyze a large cohort of patients to explore the clinical and dosimetric risk factors associated with RILT in such settings.
Methods And Materials: A single institutional database of patients treated with multiple courses of lung SBRT between January 2014 and December 2019 was analyzed.
Purpose: Hispanic and Latinx people in the United States are the fastest-growing ethnic group. However, previous studies in non-small-cell lung cancer (NSCLC) often analyze these diverse communities in aggregate. We aimed to identify differences in NSCLC stage at diagnosis in the US population, focusing on disaggregated Hispanic/Latinx individuals.
View Article and Find Full Text PDFPurpose: Larger tumors are underrepresented in most prospective trials on stereotactic body radiation therapy (SBRT) for inoperable non-small cell lung cancer (NSCLC). We performed this phase 1 trial to specifically study the maximum tolerated dose (MTD) of SBRT for NSCLC >3 cm.
Methods And Materials: A 3 + 3 dose-escalation design (cohort A) with an expansion cohort at the MTD (cohort B) was used.
Background: The objective of this study is to determine the outcomes and toxicities of patients with malignant pleural mesothelioma (MPM) treated with stereotactic body radiotherapy (SBRT).
Materials And Methods: Data were extracted from an institutional tumor registry for patients diagnosed with mesothelioma and treated with SBRT. Kaplan-Meier and Cox regression analyses were employed to determine local control (LC) and overall survival (OS).