Min Yao

Shanghai Jiao Tong University

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Mitchell Machtay

University Hospitals Seidman Cancer Center

Pierre Lavertu

University Hospitals of Cleveland

Simon S. Lo

University of Washington

John M. Buatti

University of Iowa

Rod Rezaee

Case Western Reserve University

Sue S. Yom

University of California, San Francisco

Chad Zender

University of Cincinnati

Farzan Siddiqui

Henry Ford Health System

Shlomo A. Koyfman

Cleveland Clinic

Quynh‐Thu Le

Stanford University

Cooperative Institutions

Case Western Reserve University

145

University Hospitals of Cleveland

103

University Hospitals Seidman Cancer Center

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University Hospitals Case Medical Center

Cleveland Clinic

The University of Texas MD Anderson Cancer Center

Radiation Oncology Associates

University of Iowa

Huazhong University of Science and Technology

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NRG-HN003: Phase I and Expansion Cohort Study of Adjuvant Pembrolizumab, Cisplatin and Radiation Therapy in Pathologically High-Risk Head and Neck Cancer

Cancers (2021)

Julie E. Bauman Jonathan Harris Ravindra Uppaluri Min Yao Robert L. Ferris

The anti-PD1 monoclonal antibody pembrolizumab improves survival in recurrent/metastatic head and neck squamous cell carcinoma (HNSCC). Patients with locoregional, pathologically high-risk HNSCC recur frequently despite adjuvant cisplatin-radiation therapy (CRT). Targeting PD1 may reverse immunosuppression induced by HNSCC and CRT. We conducted a phase I trial with an expansion cohort (n = 20) to determine the recommended phase II schedule (RP2S) for adding fixed-dose pembrolizumab to standard adjuvant CRT. Eligible patients had resected HPV-negative, stage III-IV oral cavity, pharynx, or larynx HNSCC with extracapsular nodal extension or positive margin. RP2S was declared if three or fewer dose-limiting toxicities (DLT) occurred in a cohort of 12. DLT was defined as grade 3 or higher non-hematologic adverse event (AE) related to pembrolizumab, immune-related AE requiring over 2 weeks of systemic steroids, or unacceptable RT delay. A total of 34 patients enrolled at 23 NRG institutions. During the first cohort, only one DLT was observed (fever), thus RP2S was declared as pembrolizumab 200 mg every 3 weeks for eight doses, starting one week before CRT. During expansion, three additional DLTs were observed (wound infection, diverticulitis, nausea). Of the 34 patients, 28 (82%) received five or more doses of pembrolizumab. This regimen was safe and feasible in a cooperative group setting. Further development is warranted.

Regimen

10.3390/cancers13122882

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An Integrated Framework Based on Full Monte Carlo Simulations for Double-Scattering Proton Therapy

International Journal of Particle Therapy (2019)

Jiankui Yuan David B. Mansur Min Yao Tithi Biswas Yiran Zheng

We developed an integrated framework that employs a full Monte Carlo (MC) model for treatment-plan simulations of a passive double-scattering proton system.We have previously validated a virtual machine source model for full MC proton-dose calculations by comparing the percentage of depth-dose curves, spread-out Bragg peaks, and lateral profiles against measured commissioning data. This study further expanded our previous work by developing an integrate framework that facilitates its clinical use. Specifically, we have (1) constructed patient-specific applicator and compensator numerically from the plan data and incorporated them into the beamline, (2) created the patient anatomy from the computed tomography image and established the transformation between patient and machine coordinate systems, and (3) developed a graphical user interface to ease the whole process from importing the treatment plan in the Digital Imaging and Communications in Medicine format to parallelization of the MC calculations. End-to-end tests were performed to validate the functionality, and 3 clinical cases were used to demonstrate clinical utility of the framework.The end-to-end tests demonstrated that the framework functioned correctly for all tested functionality. Comparisons between the treatment planning system calculations and MC results in 3 clinical cases revealed large dose difference up to 17%, especially in the beam penumbra and near the end of beam range. The discrepancy likely originates from a variety of sources, such as the dose algorithms, modeling of the beamline, and the dose metric. The agreement for other regions was acceptable.An integrated framework was developed for full MC simulations of double-scattering proton therapy. It can be a valuable tool for dose verification and plan evaluation.

10.14338/ijpt-19-00063.1

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Citations (1)

FDG PET Accuracy in Assessment of Treatment Response in Head and Neck Cancer After Intensity Modulated Radiotherapy–Long-Term Outcome Report

International Journal of Radiation Oncology*Biology*Physics (2007)

Min Yao Heming Lu Michael M. Graham Yusuf Menda Minggen Lu

Tomotherapy

10.1016/j.ijrobp.2007.07.026

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Is Lack of Dosimetric Coverage Responsible for Post-SBRT Tumor Recurrence?

International Journal of Radiation Oncology*Biology*Physics (2014)

Tarun K. Podder Tithi Biswas Min Yao Simon S. Lo Y. Zhang

10.1016/j.ijrobp.2014.08.275

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Hospital-Based Registry Analysis of Staging Efficacy and Proposed Substaging for HPV Positive Oropharynx Cancers

International Journal of Radiation Oncology*Biology*Physics (2021)

Michael Kharouta K.V. Chaung Mohit Patel Nicole Fowler Rod Rezaee

AJCC staging system

Cancer staging

10.1016/j.ijrobp.2021.07.1177

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SU‐E‐T‐404: Evaluation of the Effect of Spine Hardware for CyberKnife Spinal Stereotactic Radiosurgery

Medical Physics (2015)

Jiankui Yuan Y Zhang Yiran Zheng B. W. Wessels Mitchell Machtay

Purpose: Spine hardware made of high‐Z materials such as titanium has the potential to affect the dose distribution around the metal rods in CyberKnife spinal stereotactic radiosurgery (SRS) treatments. The purpose of this work was to evaluate the magnitude of such effect retrospectively for clinical CyberKnife plans. Methods: The dose calculation was performed within the MultiPlan treatment planning system using the ray tracing (RT) and Monte Carlo (MC) method. A custom density model was created by extending the CT‐to‐Density table to titanium density of 4.5 g/cm3 with the CT number of 4095. To understand the dose perturbation caused by the titanium rod, a simple beam setup (7.5 mm IRIS collimator) was used to irradiate a mimic rod (5 mm) with overridden high density. Five patient spinal SRS cases were found chronologically from 2010 to 2015 in our institution. For each case, the hardware was contoured manually. The original plan was re‐calculated using both RT and MC methods with and without rod density override without changing clinical beam parameters. Results: The simple beam irradiation shows that there is 10% dose increase at the interface because of electron backscattering and 7% decrease behind the rod because of photon attenuation. For actual clinical plans, the iso‐dose lines and DVHs are almost identical (<2%) for calculations with and without density override for both RT and MC methods. However, there is a difference of more than 10% for D90 between RT and MC method. Conclusion: Although the dose perturbation around the metal rods can be as large as 10% for a single beam irradiation, for clinical treatments with complex beam composition the effect of spinal hardware to the PTV and spinal dose is minimal. As such, the MC dose algorithm without rod density override for CyberKnife spinal SRS is acceptable.

Cyberknife

Truebeam

10.1118/1.4924765

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Non-Skull Base Head and Neck Cancer

Medical radiology (2011)

Farzan Siddiqui David Raben Sue S. Yom Jiade J. Lu Min Yao

10.1007/174_2011_448

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Citations (1)

Value of FDG PET in assessment of treatment response and surveillance in head-and-neck cancer patients after intensity modulated radiation treatment: A preliminary report