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Article ; Online: Proton Therapy: Current Status and Controversies.

Press, Robert H / Mehta, Minesh P

2024 , Page(s) OP2400132

Abstract: Expert commentary on the evolving role of proton therapy, discussing the current status and controversies of proton therapy in the modern era. ...

Abstract	Expert commentary on the evolving role of proton therapy, discussing the current status and controversies of proton therapy in the modern era.
Language	English
Publishing date	2024-03-28
Publishing country	United States
Document type	Editorial
ZDB-ID	3028198-2
ISSN	2688-1535 ; 2688-1527
ISSN (online)	2688-1535
ISSN	2688-1527
DOI	10.1200/OP.24.00132
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Article ; Online: In Regard to Chopade et al.

Hasan, Shaakir / Choi, J Isabelle / Chhabra, Arpit / Press, Robert H / Simone, Charles B

International journal of radiation oncology, biology, physics

2023 Volume 115, Issue 2, Page(s) 540–541

MeSH term(s)	Humans ; Radiotherapy Dosage
Language	English
Publishing date	2023-01-09
Publishing country	United States
Document type	Letter ; Comment
ZDB-ID	197614-x
ISSN	1879-355X ; 0360-3016
ISSN (online)	1879-355X
ISSN	0360-3016
DOI	10.1016/j.ijrobp.2022.10.007
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Article ; Online: Prognostic implications of HER2NEU-low in metastatic breast cancer.

Neubauer, Zachary / Hasan, Shaakir / Press, Robert H / Chhabra, Arpit M / Fox, Jana / Bakst, Richard / Simone, Charles B / Choi, J Isabelle

Cancer medicine

2024 Volume 13, Issue 2, Page(s) e6979

Abstract: Introduction: We explored characteristics and clinical outcomes of HER2-negative and HER2-low metastatic breast cancers using real-world data.: Methods: We queried the National Cancer Database to identify MBC patients that were HER2-low or HER2- ... ...

Abstract	Introduction: We explored characteristics and clinical outcomes of HER2-negative and HER2-low metastatic breast cancers using real-world data. Methods: We queried the National Cancer Database to identify MBC patients that were HER2-low or HER2-negative per immunohistochemical staining. A binomial regression analysis identified demographic and clinical correlates of each subtype. A Cox multivariable regression analysis (MVA) and propensity-match analysis were performed to identify correlates of survival. Results: Excluding missing data, 24,636 MBC patients diagnosed between 2008 and 2015 were identified; 27.9% were HER2-negative and 72.1% were HER2-low. There were no relevant demographic differences between the groups. HER2-low tumors were half as likely to have concomitant hormone receptor-positive status (p < 0.01). The 3-year survival rate among hormone receptor-negative patients was 33.8% for HER2-low and 32.2% for HER2-negative (p < 0.05), and 60.9% and 55.6% in HER2-low and HER2-negative cases among hormone receptor-positive patients (p < 0.05), respectively. HER2-low cases were associated with better survival on MVA (HR =0.95, 95% CI 0.91-0.99) and remained superior with propensity-matching (HR = 0.92, 95% CI 0.89-0.96). In a subset analysis isolated to hormone receptor-positive cases, HER2-low remained correlated with improved survival (HR = 0.93, 95% CI 0.89-0.98) with propensity-matched MVA. Correlates of worse survival include older age as a continuous variable (HR = 1.02, 95% CI 1.02-1.02) and Black race (HR = 1.26, 95% CI 1.20-1.32) [all p < 0.01]. Conclusions: In the largest such analysis performed to date, our study demonstrates a small but statistically significant association with improved survival for HER2-low tumors compared to HER2-negative tumors in MBC.
MeSH term(s)	Humans ; Female ; Breast Neoplasms/pathology ; Prognosis ; Receptor, ErbB-2/analysis
Chemical Substances	Receptor, ErbB-2 (EC 2.7.10.1)
Language	English
Publishing date	2024-02-20
Publishing country	United States
Document type	Journal Article
ZDB-ID	2659751-2
ISSN	2045-7634 ; 2045-7634
ISSN (online)	2045-7634
ISSN	2045-7634
DOI	10.1002/cam4.6979
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Article ; Online: Heresy - Is there a role for ultrasound in management of the non-palpable testicle?

Press, Benjamin H / Olawoyin, Olamide / Arlen, Angela M / Silva, Cicero T / Weiss, Robert M

Journal of pediatric urology

2023 Volume 20, Issue 1, Page(s) 106–111

Abstract: Introduction: AUA Guidelines do not support the routine use of ultrasound (US) in evaluation of boys with an undescended testicle (UDT) prior to urology referral. Multiple studies have demonstrated that real time US is inferior to a physical examination ...

Abstract	Introduction: AUA Guidelines do not support the routine use of ultrasound (US) in evaluation of boys with an undescended testicle (UDT) prior to urology referral. Multiple studies have demonstrated that real time US is inferior to a physical examination by a pediatric urologist in detecting an UDT. However, improved US technology, which now permits detection of the non-palpable testis located just proximal to the internal ring, may aid in guiding the surgical approach to the non-palpable testis. We evaluated US findings of boys deemed to have a non-palpable UDT and compared them to surgical findings. Objective: To assess the role of pre-operative ultrasonography in guiding surgical management in boys deemed to have a non-palpable testis by a pediatric urologist. Study design: US of boys with a non-palpable UDT, as reported by a pediatric urologist on physical exam, during a 3-year period, were reviewed. All US were performed jointly by a technician and pediatric radiologist. Patient demographics, laterality, and intra-operative findings were assessed. Results: Thirty-one boys with a non-palpable testicle on physical exam underwent scrotal/inguinal/pelvis US at a median age of 7.5 months (IQR 2.5-12.3 months). Two patients had bilateral non-palpable testicles, 21 had a non-palpable left sided testicle and 8 had a non-palpable right sided testicle. Of the 33 non-palpable testes, 5 (15.2%) were identified in the inguinal canal. Sixteen (48.5%) were visualized in the lower pelvis just proximal to the internal ring and graded as intra-abdominal. Four (12.1%) nubbins or very atrophic testes were identified in the inguinal region or scrotum and 5 (15.2%) testes were not identified on US. Three (9.1%) testes were observed to be mobile between the lower pelvis just proximal to the internal ring and the inguinal canal. Of the 8 patients with testes that were identified in the inguinal canal, or mobile between the lower pelvis and inguinal canal, 7 avoided a diagnostic laparoscopy and underwent an inguinal orchiopexy. Of the 16 testicles located in the lower pelvis proximal to the internal ring, only 2 underwent laparoscopy/laparoscopic orchiopexy. Discussion: In cases of a non-palpable testicle following a physical examination by a urologist, an ultrasound can impact the operative plan, and allow for patients to avoid laparoscopy. In our cohort, 87.5% of non-palpable testes avoided laparoscopic surgery after ultrasound identification of a viable testis. Conclusions: US in the evaluation of cryptorchidism can guide surgical management in select cases in which a testis is non-palpable following careful examination by a urologist.
MeSH term(s)	Male ; Humans ; Child ; Infant ; Cryptorchidism/diagnostic imaging ; Cryptorchidism/surgery ; Laparoscopy ; Ultrasonography ; Orchiopexy
Language	English
Publishing date	2023-09-09
Publishing country	England
Document type	Journal Article
ZDB-ID	2237683-5
ISSN	1873-4898 ; 1477-5131
ISSN (online)	1873-4898
ISSN	1477-5131
DOI	10.1016/j.jpurol.2023.08.032
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Article: A National Survey of Radiation Oncology Experiences Completing Tele-Consultations During the Coronavirus Disease (COVID-19) Pandemic.

Chhabra, Arpit M / Chowdhary, Mudit / Choi, J Isabelle / Hasan, Shaakir / Press, Robert H / Simone, Charles B

Advances in radiation oncology

2021 Volume 6, Issue 1, Page(s) 100611

Abstract: Purpose: The emergence of the coronavirus disease (COVID-19) global pandemic has led to a significant shift in the delivery of health care, including an explosive growth of telemedicine services. This reverberated in the field of radiation oncology, ... ...

Abstract	Purpose: The emergence of the coronavirus disease (COVID-19) global pandemic has led to a significant shift in the delivery of health care, including an explosive growth of telemedicine services. This reverberated in the field of radiation oncology, with a recent American Society for Radiation Oncology (ASTRO) nationwide survey reporting 89% of surveyed clinics began to offer telemedicine programs to patients because of the pandemic. However, this survey did not study the perceptions and experiences of those clinicians delivering telemedicine services. Methods and materials: We investigated through a national physician survey the merits and limitations of radiation oncology tele-consultations. An anonymous web-based survey was distributed using SurveyMonkey (www.surveymonkey.com) via email. Results: Seventy six respondents (16.1% overall response rate) completed the survey, with broad representation from both academic and community-based practices. Many respondents agreed that transitioning to tele-consultations was a needed step given the emergence of the pandemic, despite most having never previously offered this service. Despite many radiation oncologists having little prior experience with tele-consultations, a majority were satisfied in being able to explain the details of a medical diagnosis, provide results of imaging and bloodwork, and discuss recommendations around radiation treatments through this format. Nearly half of the respondents agreed that tele-consultations felt impersonal, with the inability to complete physical examinations noted as a contributor to the impersonality. Nevertheless, respondents still agreed that telemedicine will play an important role going forward, and almost 90% agreed that they would offer tele-consultations even after the pandemic has resolved.
Language	English
Publishing date	2021-01-13
Publishing country	United States
Document type	Journal Article
ISSN	2452-1094
ISSN	2452-1094
DOI	10.1016/j.adro.2020.10.024
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Article: Reirradiation With Proton Therapy for Recurrent Malignancies of the Esophagus and Gastroesophageal Junction: Results of the Proton Collaborative Group Multi-Institutional Prospective Registry Trial.

Hotca, Alexandra / Sindhu, Kunal K / Lehrer, Eric J / Hartsell, William F / Vargas, Carlos / Tsai, Henry K / Chang, John H / Apisarnthanarax, Smith / Nichols, Romaine C / Chhabra, Arpit M / Hasan, Shaakir / Press, Robert H / Lazarev, Stanislav / Hajj, Carla / Kabarriti, Rafi / Rule, William G / Simone, Charles B / Choi, J Isabelle

Advances in radiation oncology

2024 Volume 9, Issue 5, Page(s) 101459

Abstract: Purpose: Treatment options for recurrent esophageal cancer (EC) previously treated with radiation therapy (RT) are limited. Reirradiation (reRT) with proton beam therapy (PBT) can offer lower toxicities by limiting doses to surrounding tissues. In this ... ...

Abstract	Purpose: Treatment options for recurrent esophageal cancer (EC) previously treated with radiation therapy (RT) are limited. Reirradiation (reRT) with proton beam therapy (PBT) can offer lower toxicities by limiting doses to surrounding tissues. In this study, we present the first multi-institutional series reporting on toxicities and outcomes after reRT for locoregionally recurrent EC with PBT. Methods and materials: Analysis of the prospective, multicenter, Proton Collaborative Group registry of patients with recurrent EC who had previously received photon-based RT and underwent PBT reRT was performed. Patient/tumor characteristics, treatment details, outcomes, and toxicities were collected. Local control (LC), distant metastasis-free survival (DMFS), and overall survival (OS) were estimated using the Kaplan-Meier method. Event time was determined from reRT start. Results: Between 2012 and 2020, 31 patients received reRT via uniform scanning/passive scattering (61.3%) or pencil beam scanning (38.7%) PBT at 7 institutions. Median prior RT, PBT reRT, and cumulative doses were 50.4 Gy (range, 37.5-110.4), 48.6 Gy (relative biological effectiveness) (25.2-72.1), and 99.9 Gy (79.1-182.5), respectively. Of these patients, 12.9% had 2 prior RT courses, and 67.7% received PBT with concurrent chemotherapy. Median follow-up was 7.2 months (0.9-64.7). Post-PBT, there were 16.7% locoregional only, 11.1% distant only, and 16.7% locoregional and distant recurrences. Six-month LC, DMFS, and OS were 80.5%, 83.4%, and 69.1%, respectively. One-year LC, DMFS, and OS were 67.1%, 83.4%, and 27%, respectively. Acute grade ≥3 toxicities occurred in 23% of patients, with 1 acute grade 5 toxicity secondary to esophageal hemorrhage, unclear if related to reRT or disease progression. No grade ≥3 late toxicities were reported. Conclusions: In the largest report to date of PBT for reRT in patients with recurrent EC, we observed acceptable acute toxicities and encouraging rates of disease control. However, these findings are limited by the poor prognoses of these patients, who are at high risk of mortality. Further research is needed to better assess the long-term benefits and toxicities of PBT in this specific patient population.
Language	English
Publishing date	2024-02-06
Publishing country	United States
Document type	Journal Article
ISSN	2452-1094
ISSN	2452-1094
DOI	10.1016/j.adro.2024.101459
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Article ; Online: In Regard to Razavian et al.

Hasan, Shaakir / Press, Robert H / Choi, J Isabelle / Chhabra, Arpit M / Simone, Charles B

International journal of radiation oncology, biology, physics

2020 Volume 108, Issue 5, Page(s) 1390–1391

MeSH term(s)	Female ; Fractures, Stress ; Genital Neoplasms, Female ; Humans ; Pelvis ; Radiotherapy Dosage
Language	English
Publishing date	2020-11-18
Publishing country	United States
Document type	Letter ; Comment
ZDB-ID	197614-x
ISSN	1879-355X ; 0360-3016
ISSN (online)	1879-355X
ISSN	0360-3016
DOI	10.1016/j.ijrobp.2020.06.033
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Article ; Online: Optimal surgical timing and radiotherapy dose for trimodality therapy in locally advanced non-small cell lung cancer.

Han, James E / Hasan, Shaakir / Choi, J Isabelle / Press, Robert H / Simone, Charles B

Cancer medicine

2021 Volume 10, Issue 17, Page(s) 5794–5808

Abstract: Purpose/objectives: Data are conflicting on the effects of time interval from neoadjuvant chemoradiation (NCRT) to surgery for locally advanced non-small-cell lung cancer (LA-NSCLC). This study investigated the impact of surgical timing after NCRT and ... ...

Abstract	Purpose/objectives: Data are conflicting on the effects of time interval from neoadjuvant chemoradiation (NCRT) to surgery for locally advanced non-small-cell lung cancer (LA-NSCLC). This study investigated the impact of surgical timing after NCRT and radiation dose on postoperative mortality and overall survival (OS). Materials and methods: Using the National Cancer Database, we identified 3489 LA-NSCLC patients treated with NCRT and surgery. Multivariate Cox proportional hazards analysis (MVA) was used to examine the effects of surgery >7 weeks from NCRT completion on OS. Propensity score (PS)-matched survival analysis for surgery ≤7 and >7 weeks was performed. Postoperative mortality was assessed. Results: Median OS for surgery ≤7 weeks and >7 weeks after NCRT were 56.9 versus 45.6 months (hazard ratio, HR 1.18 [1.07-1.30]; p < 0.001). Surgery >7 weeks correlated with decreased OS on MVA (HR 1.15 [1.04-1.27]; p = 0.009) and PS matching (HR 1.16 [1.049-1.29]; p = 0.004). Time as a continuous variable correlated with OS on MVA (HR 1.003 [1.001-1.006]; p = 0.0056) and PS matching (HR 1.004 [1.001-1.006]; p = 0.004). Among 2902 lobectomy patients, the mortality rate for surgery ≤66 days was 5.2% versus 8.1% for >66 days (MVA HR 1.59 [1.02-2.49]; p = 0.04). Higher neoadjuvant radiotherapy dose correlated with surgery >7 weeks and lobectomy >66 days on MVA. Conclusions: Increased interval >7 weeks from NCRT to surgery for LA-NSCLC is correlated with worse OS and lobectomy ≤66 days correlated with improved OS. Surgery ≤7weeks may improve tumor control, whereas higher mortality for surgery >66 days may relate to late NCRT manifestations. Neoadjuvant doses of 44-50.4 Gy may minimize risks of radiation-induced lung injury and surgical complications and facilitate surgery within the optimal 7-week interval.
MeSH term(s)	Adult ; Aged ; Aged, 80 and over ; Carcinoma, Non-Small-Cell Lung/mortality ; Carcinoma, Non-Small-Cell Lung/pathology ; Carcinoma, Non-Small-Cell Lung/radiotherapy ; Carcinoma, Non-Small-Cell Lung/surgery ; Combined Modality Therapy/methods ; Female ; Humans ; Lung Neoplasms/mortality ; Lung Neoplasms/pathology ; Lung Neoplasms/radiotherapy ; Lung Neoplasms/surgery ; Male ; Middle Aged ; Prospective Studies ; Survival Analysis ; Time Factors ; Young Adult
Language	English
Publishing date	2021-08-05
Publishing country	United States
Document type	Journal Article
ZDB-ID	2659751-2
ISSN	2045-7634 ; 2045-7634
ISSN (online)	2045-7634
ISSN	2045-7634
DOI	10.1002/cam4.4123
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Article ; Online: Racial inequity and other social disparities in the diagnosis and management of bladder cancer.

Hasan, Shaakir / Lazarev, Stanislav / Garg, Madhur / Mehta, Keyur / Press, Robert H / Chhabra, Arpit / Choi, J Isabelle / Simone, Charles B / Gorovets, Daniel

Cancer medicine

2022 Volume 12, Issue 1, Page(s) 640–650

Abstract: Background: We investigate the impact of gender, race, and socioeconomic status on the diagnosis and management of bladder cancer in the United States.: Methods: We utilized the National Cancer Database to stratify cases of urothelial cell carcinoma ... ...

Abstract	Background: We investigate the impact of gender, race, and socioeconomic status on the diagnosis and management of bladder cancer in the United States. Methods: We utilized the National Cancer Database to stratify cases of urothelial cell carcinoma of the bladder as early (Tis, Ta, T1), muscle invasive (T2-T3, N0), locally advanced (T4, N1-3), and metastatic. Multivariate binomial and multinomial logistic regression analyses identified demographic characteristics associated with stage at diagnosis and receipt of cancer-directed therapies. Odds ratios (OR) are reported with 95% confidence intervals. Results: After exclusions, we identified 331,714 early, 72,154 muscle invasive, 15,579 locally advanced, and 15,161 metastatic cases from 2004-2016. Relative to diagnosis at early stage, the strongest independent predictors of diagnosis at muscle invasive, locally advanced, and metastatic disease included Black race (OR = 1.19 [1.15-1.23], OR = 1.49 [1.40-1.59], OR = 1.66 [1.56-1.76], respectively), female gender (OR = 1.21 [1.18-1.21], OR = 1.16 [1.12-1.20], and OR = 1.34 [1.29-1.38], respectively), and uninsured status (OR = 1.22 [1.15-1.29], OR = 2.09 [1.94-2.25], OR = 2.57 [2.39-2.75], respectively). Additional demographic factors associated with delayed diagnosis included older age, treatment at an academic center, Medicaid insurance and patients from lower income/less educated/more rural areas (all p < 0.01). Treatment at a non-academic center, older age, women, Hispanic and Black patients, lower income and rural areas were all less likely to receive cancer-directed therapies in early stage disease (all p < 0.01). Women, older patients, and Black patients remained less likely to receive treatment in muscle invasive, locally advanced, and metastatic disease (all p < 0.01). Conclusion: Black race was the strongest independent predictor of delayed diagnosis and substandard treatment of bladder cancer.
MeSH term(s)	Humans ; Female ; United States/epidemiology ; Urinary Bladder Neoplasms/diagnosis ; Urinary Bladder Neoplasms/therapy ; Urinary Bladder Neoplasms/pathology ; Medicaid ; Carcinoma, Transitional Cell ; Hispanic or Latino ; Black People ; Healthcare Disparities
Language	English
Publishing date	2022-06-08
Publishing country	United States
Document type	Journal Article
ZDB-ID	2659751-2
ISSN	2045-7634 ; 2045-7634
ISSN (online)	2045-7634
ISSN	2045-7634
DOI	10.1002/cam4.4917
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Article ; Online: Towards answering the optimal palliative fractionation conundrum: single- versus multi-fraction radiation therapy for spinal cord compression.

Han, James E / Press, Robert H / Hasan, Shaakir / Choi, J Isabelle / Simone, Charles B

Annals of palliative medicine

2020 Volume 9, Issue 4, Page(s) 1370–1374

MeSH term(s)	Dose Fractionation, Radiation ; Humans ; Palliative Care ; Spinal Cord Compression/radiotherapy ; Spinal Neoplasms/radiotherapy
Language	English
Publishing date	2020-05-12
Publishing country	China
Document type	Journal Article
ZDB-ID	2828544-X
ISSN	2224-5839 ; 2224-5839
ISSN (online)	2224-5839
ISSN	2224-5839
DOI	10.21037/apm-20-990
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