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Article: A Rare Case of Unresectable Adenoid Cystic Carcinoma of the Nasopharynx Treated with Intensity Modulated Proton Therapy.

Phan, Jae / Ng, Sweet Ping / Pollard, Courtney / Phan, Jack

2017 Volume 9, Issue 9, Page(s) e1688

Abstract: Adenoid cystic carcinoma (ACC) is generally treated with surgical resection followed by postoperative radiotherapy. In cases where surgical management is precluded due to the location of the tumor and/or patient factors, radiation therapy can be offered ... ...

Abstract	Adenoid cystic carcinoma (ACC) is generally treated with surgical resection followed by postoperative radiotherapy. In cases where surgical management is precluded due to the location of the tumor and/or patient factors, radiation therapy can be offered to achieve local control. Here, we present a case of unresectable Stage T4N0 ACC of the nasopharynx with skull base and intracranial extension treated with intensity modulated proton therapy (IMPT), which achieved good local control with no significant late toxicity.
Language	English
Publishing date	2017-09-15
Publishing country	United States
Document type	Case Reports
ZDB-ID	2747273-5
ISSN	2168-8184
ISSN	2168-8184
DOI	10.7759/cureus.1688
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Article: Spontaneous seromuscular laceration of the sigmoid colon: a case report.

Pollard, Courtney / Fransman, Ryan B / Jessie, Timothy A / Gurfinchel, Gregory

Clinical case reports

2015 Volume 3, Issue 12, Page(s) 1007–1011

Abstract: Injury to bowel can result in high morbidity and death. Bowel injuries typically occur after external trauma to the abdomen. Bowel injury in the absence of external trauma is rare. Here, we report a 36-year-old male presenting with a sigmoid colon ... ...

Abstract	Injury to bowel can result in high morbidity and death. Bowel injuries typically occur after external trauma to the abdomen. Bowel injury in the absence of external trauma is rare. Here, we report a 36-year-old male presenting with a sigmoid colon laceration likely due to long-standing constipation.
Language	English
Publishing date	2015-11-02
Publishing country	England
Document type	Case Reports
ZDB-ID	2740234-4
ISSN	2050-0904
ISSN	2050-0904
DOI	10.1002/ccr3.396
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Article ; Online: Molecular genesis of non-muscle-invasive urothelial carcinoma (NMIUC).

Pollard, Courtney / Smith, Steven C / Theodorescu, Dan

Expert reviews in molecular medicine

2010 Volume 12, Page(s) e10

Abstract: Urothelial carcinoma (UC) is the most common type of bladder cancer in Western nations. Most patients present with the non-muscle-invasive (NMIUC) form of the disease, while up to a third harbour the invasive form (MIUC). Specifically, the aetiology of ... ...

Abstract	Urothelial carcinoma (UC) is the most common type of bladder cancer in Western nations. Most patients present with the non-muscle-invasive (NMIUC) form of the disease, while up to a third harbour the invasive form (MIUC). Specifically, the aetiology of NMIUC appears to be multifactorial and very different from that of MIUC. Loss of specific tumour suppressor genes as well as gain-of-function mutations in proteins within defined cellular signalling pathways have been implicated in NMIUC aetiology. The regions of chromosome 9 that harbour CDKN2A, CDKN2B, TSC1, PTCH1 and DBC1 are frequently mutated in NMIUC, resulting in functional loss; in addition, HRAS and FGFR3, which are both proto-oncogenes encoding components of the Ras-MAPK signalling pathway, have been found to harbour activating mutations in a large number of NMIUCs. Interestingly, some of these molecular events are mutually exclusive, suggesting functional equivalence. Since several of these driving changes are amenable to therapeutic targeting, understanding the signalling events in NMIUC may offer novel approaches to manage the recurrence and progression of this disease.
MeSH term(s)	Carcinoma, Transitional Cell/genetics ; Carcinoma, Transitional Cell/pathology ; Chromosomes, Human, Pair 9/genetics ; Humans ; Muscles ; Neoplasm Invasiveness ; Proto-Oncogene Proteins p21(ras)/metabolism ; Receptor, Fibroblast Growth Factor, Type 3/metabolism ; Urothelium/pathology
Chemical Substances	Receptor, Fibroblast Growth Factor, Type 3 (EC 2.7.10.1) ; HRAS protein, human (EC 3.6.5.2) ; Proto-Oncogene Proteins p21(ras) (EC 3.6.5.2)
Language	English
Publishing date	2010-03-25
Publishing country	England
Document type	Journal Article ; Research Support, N.I.H., Extramural ; Review
ISSN	1462-3994
ISSN (online)	1462-3994
DOI	10.1017/S1462399410001407
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Article: Nasopharyngeal carcinoma presenting as an inconspicuous primary lesion with extensive cavernous sinus involvement and temporal lobe extension: a case report and review of literature.

Pollard, Courtney / Mesko, Shane M / Ginsberg, Lawrence E / Kies, Merrill S / Raza, Shaan M / Su, Shirley Y / Tung, Sam / Phan, Jack

Clinical case reports

2017 Volume 5, Issue 10, Page(s) 1682–1688

Abstract: Detection of nodal metastasis in the neck or adjacent structures is common in nasopharyngeal carcinoma (NPC) when there is frank primary disease. Intracranial extension without obvious nasopharyngeal disease is not common. Here, we discuss a patient with ...

Abstract	Detection of nodal metastasis in the neck or adjacent structures is common in nasopharyngeal carcinoma (NPC) when there is frank primary disease. Intracranial extension without obvious nasopharyngeal disease is not common. Here, we discuss a patient with NPC that presented with extensive intracranial disease with subtle findings in the nasopharynx.
Language	English
Publishing date	2017-09-05
Publishing country	England
Document type	Case Reports
ZDB-ID	2740234-4
ISSN	2050-0904
ISSN	2050-0904
DOI	10.1002/ccr3.1166
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Article ; Online: Lymphopenia during radiotherapy in patients with oropharyngeal cancer.

Ng, Sweet Ping / Bahig, Houda / Jethanandani, Amit / Pollard, Courtney / Berends, Joel / Sturgis, Erich M / Johnson, Faye M / Elgohari, Baher / Elhalawani, Hesham / Rosenthal, David I / Skinner, Heath D / Gunn, G Brandon / Phan, Jack / Frank, Steven J / Mohamed, Abdallah S R / Fuller, Clifton D / Garden, Adam S

Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology

2020 Volume 145, Page(s) 95–100

Abstract: Purpose/objective: Radiation-induced lymphopenia has been associated with poor survival outcomes in certain solid tumors such as esophageal, lung, cervical and pancreatic cancers. We aim to determine the effect of treatment-related lymphopenia during ... ...

Abstract	Purpose/objective: Radiation-induced lymphopenia has been associated with poor survival outcomes in certain solid tumors such as esophageal, lung, cervical and pancreatic cancers. We aim to determine the effect of treatment-related lymphopenia during radiotherapy on outcomes of patients with oropharyngeal cancer. Materials/methods: A retrospective analysis of all patients who completed definitive radiotherapy for oropharyngeal cancer at The University of Texas MD Anderson Cancer Center and had blood counts taken during radiotherapy from 2002 to 2013 were included. Patient, tumor and treatment characteristics, clinical outcomes and lymphocyte counts during radiotherapy were recorded. Lymphopenia was graded according to the CTCAE v4.0. Survival rates were estimated using the Kaplan-Meier method and compared with log-rank tests. Results: 850 patients were evaluated. The median age was 57 years. The majority of the cohort had p16/HPV-positive disease (71%), 8% had HPV-negative disease and 21% were unknown. The median radiation total dose was 70 Gy. 45% of patients had induction chemotherapy, and 87% had concurrent chemotherapy. 703 (83%) patients developed ≥grade 3 (G3) lymphopenia and 209 (25%) had grade 4 (G4) lymphopenia during radiotherapy. The median follow-up was 59 months; the 5-year overall survival rate was 81%. There were no significant differences in overall survival rates nor in disease control rates, in those who developed G3/G4 lymphopenia compared with those who did not. No significant effect of lymphopenia on survival was observed when analyzed according to p16/HPV status. Conclusion: In this large cohort of patients with oropharyngeal cancer, the development of lymphopenia during radiotherapy did not impact outcomes.
MeSH term(s)	Humans ; Lymphocytes ; Lymphopenia/etiology ; Middle Aged ; Oropharyngeal Neoplasms/radiotherapy ; Retrospective Studies ; Survival Rate
Language	English
Publishing date	2020-01-10
Publishing country	Ireland
Document type	Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't ; Research Support, U.S. Gov't, Non-P.H.S.
ZDB-ID	605646-5
ISSN	1879-0887 ; 0167-8140
ISSN (online)	1879-0887
ISSN	0167-8140
DOI	10.1016/j.radonc.2019.12.023
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Article: Dosimetric advantages of stereotactic radiosurgery as a boost to adjuvant conventional radiotherapy in the setting of adenoid cystic carcinoma of the parotid with skull base invasion.

Phan, Jae L / Pollard, Courtney / Wang, He / Ng, Sweet Ping / Sheu, Tommy / Ginsberg, Lawrence E / Hessel, Amy C / Gidley, Paul W / Rosenthal, David I / Phan, Jack

Clinical case reports

2018 Volume 6, Issue 11, Page(s) 2126–2130

Abstract: This study highlights gamma knife stereotactic radiosurgery (GK-SRS) as boost therapy in a patient with adenoid cystic carcinoma of the parotid involving the skull base and invasion of the facial nerve. Using GK-SRS, dose to the brainstem and temporal ... ...

Abstract	This study highlights gamma knife stereotactic radiosurgery (GK-SRS) as boost therapy in a patient with adenoid cystic carcinoma of the parotid involving the skull base and invasion of the facial nerve. Using GK-SRS, dose to the brainstem and temporal lobe were reduced when compared to less conformal radiotherapy techniques.
Language	English
Publishing date	2018-09-23
Publishing country	England
Document type	Case Reports
ZDB-ID	2740234-4
ISSN	2050-0904
ISSN	2050-0904
DOI	10.1002/ccr3.1788
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Article ; Online: Optimizing laryngeal sparing with intensity modulated radiotherapy or volumetric modulated arc therapy for unilateral tonsil cancer.

Moreno, Amy C / Wilke, Christopher / Wang, He / Tung, Shi-Ming Samuel / Pollard, Courtney / Garden, Adam S / Morrison, William H / Rosenthal, David I / Fuller, Clifton D / Gunn, Gary B / Reddy, Jay P / Shah, Shalin J / Frank, Steven J / Takiar, Vinita / Phan, Jack

Physics and imaging in radiation oncology

2019 Volume 10, Page(s) 29–34

Abstract: Background and purpose: Minimizing radiation dose exposure to nearby organs is key to limiting clinical toxicities associated with radiotherapy. Several treatment modalities such as split- or whole-field intensity-modulated radiotherapy (SF-IMRT, WF- ... ...

Abstract	Background and purpose: Minimizing radiation dose exposure to nearby organs is key to limiting clinical toxicities associated with radiotherapy. Several treatment modalities such as split- or whole-field intensity-modulated radiotherapy (SF-IMRT, WF-IMRT) and volumetric modulated arc therapy (VMAT) are being used to treat tonsillar cancer patients with unilateral neck radiotherapy. Herein, we provide a modern dosimetric comparison of all three techniques. Materials and methods: Forty patients with tonsillar cancer treated with definitive, ipsilateral neck SF-IMRT were evaluated. Each patient was re-planned with WF-IMRT and VMAT techniques, and doses to selected organs-at-risk (OARs) including the larynx, esophagus, and brainstem were compared. Results: No significant differences in target coverage existed between plans; however, the heterogeneity index improved using WF-IMRT and VMAT relative to SF-IMRT. Compared to SF-IMRT, WF-IMRT and VMAT plans had significantly lower mean doses to the supraglottic larynx (31 Gy, 18.5 Gy, 17 Gy; p < 0.01), the MDACC-defined larynx (13.4 Gy, 10.5 Gy, 9.8 Gy; p < 0.01), and RTOG-defined larynx (15.8 Gy, 12.1 Gy, 11.1 Gy; p < 0.01), respectively. Mean esophageal dose was lowest with SF-IMRT over WF-IMRT and VMAT (5.9 Gy, 12.2 Gy, 11.1 Gy; p < 0.01) but only in the absence of lower neck disease. On average, VMAT plans had shorter treatment times and required less monitor units than both SF-IMRT and WF-IMRT. Conclusion: In the setting of unilateral neck radiotherapy, WF-IMRT and VMAT plans can be optimized to significantly improve dose sparing of critical structures compared to SF-IMRT. VMAT offers additional advantages of shorter treatment times and fewer required monitor units.
Language	English
Publishing date	2019-05-01
Publishing country	Netherlands
Document type	Journal Article
ISSN	2405-6316
ISSN (online)	2405-6316
DOI	10.1016/j.phro.2019.04.002
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Article ; Online: Surveillance imaging for patients with head and neck cancer treated with definitive radiotherapy: A partially observed Markov decision process model.

Ng, Sweet Ping / Ajayi, Temitayo / Schaefer, Andrew J / Pollard, Courtney / Bahig, Houda / Garden, Adam S / Rosenthal, David I / Gunn, G Brandon / Frank, Steven J / Phan, Jack / Morrison, William H / Johnson, Jason M / Mohamed, Abdallah S R / Sturgis, Erich M / Fuller, Clifton D

Cancer

2019 Volume 126, Issue 4, Page(s) 749–756

Abstract: Background: A possible surveillance model for patients with head and neck cancer (HNC) who received definitive radiotherapy was created using a partially observed Markov decision process. The goal of this model is to guide surveillance imaging policies ... ...

Abstract	Background: A possible surveillance model for patients with head and neck cancer (HNC) who received definitive radiotherapy was created using a partially observed Markov decision process. The goal of this model is to guide surveillance imaging policies after definitive radiotherapy. Methods: The partially observed Markov decision process model was formulated to determine the optimal times to scan patients. Transition probabilities were computed using a data set of 1508 patients with HNC who received definitive radiotherapy between the years 2000 and 2010. Kernel density estimation was used to smooth the sample distributions. The reward function was derived using cost estimates from the literature. Additional model parameters were estimated using either data from the literature or clinical expertise. Results: When considering all forms of relapse, the model showed that the optimal time between scans was longer than the time intervals used in the institutional guidelines. The optimal policy dictates that there should be less time between surveillance scans immediately after treatment compared with years after treatment. Comparable results also held when only locoregional relapses were considered as relapse events in the model. Simulation results for the inclusive relapse cases showed that <15% of patients experienced a relapse over a simulated 36-month surveillance program. Conclusions: This model suggests that less frequent surveillance scan policies can maintain adequate information on relapse status for patients with HNC treated with radiotherapy. This model could potentially translate into a more cost-effective surveillance program for this group of patients.
MeSH term(s)	Algorithms ; Carcinoma, Squamous Cell/diagnostic imaging ; Carcinoma, Squamous Cell/radiotherapy ; Cohort Studies ; Female ; Head and Neck Neoplasms/diagnostic imaging ; Head and Neck Neoplasms/radiotherapy ; Humans ; Magnetic Resonance Imaging/methods ; Male ; Markov Chains ; Middle Aged ; Models, Biological ; Monitoring, Physiologic/methods ; Neoplasm Recurrence, Local ; Tomography, X-Ray Computed/methods
Language	English
Publishing date	2019-11-14
Publishing country	United States
Document type	Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't ; Research Support, U.S. Gov't, Non-P.H.S.
ZDB-ID	1429-1
ISSN	1097-0142 ; 0008-543X ; 1934-662X
ISSN (online)	1097-0142
ISSN	0008-543X ; 1934-662X
DOI	10.1002/cncr.32597
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Article ; Online: A prospective evaluation of health-related quality of life after skull base re-irradiation.

Bahig, Houda / Ng, Sweet P / Pollard, Courtney / Nguyen, Theresa P / Gunn, Gary B / Rosenthal, David I / Fuller, Clifton D / Frank, Steven J / Garden, Adam S / Reddy, Jay P / Morrison, William H / Ferrarotto, Renata / Hanna, Ehab Y / DeMonte, Franco / Su, Shirley Y / Phan, Jack

Head & neck

2019 Volume 42, Issue 3, Page(s) 485–497

Abstract: Purpose: To report cancer control outcomes and health-related quality of life (HRQoL) outcomes after highly conformal skull-based re-irradiation (re-RT).: Methods: Patients planned for curative intent re-RT to a recurrent or new skull base tumor were ...

Abstract	Purpose: To report cancer control outcomes and health-related quality of life (HRQoL) outcomes after highly conformal skull-based re-irradiation (re-RT). Methods: Patients planned for curative intent re-RT to a recurrent or new skull base tumor were enrolled. HRQoL were assessed using the MD Anderson Symptom Inventory Brain Tumor (MDASI-BT) and the anterior skull base surgery quality of life (ASBQ) questionnaires. Results: Thirty-nine patients were treated with stereotactic body RT or intensity modulated RT. Median follow-up was 14 months. Progression free survival was 71% at 1-year. There was mild clinically significant worsening of fatigue, lack of appetite and drowsiness (MDASI-BT), and physical function (ASBQ) at the end of RT, followed by recovery to baseline on subsequent follow-ups. Subjective emotions were clinically improved at 12 months, with patients reporting feeling less tense/nervous. Conclusion: Conformal skull base re-RT is associated with mild immediate deterioration in physical function followed by rapid and sustained recovery.
MeSH term(s)	Humans ; Prospective Studies ; Quality of Life ; Re-Irradiation ; Skull Base ; Treatment Outcome
Language	English
Publishing date	2019-12-23
Publishing country	United States
Document type	Journal Article
ZDB-ID	645165-2
ISSN	1097-0347 ; 0148-6403 ; 1043-3074
ISSN (online)	1097-0347
ISSN	0148-6403 ; 1043-3074
DOI	10.1002/hed.26037
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Article ; Online: Comparison of tumor delineation using dual energy computed tomography versus magnetic resonance imaging in head and neck cancer re-irradiation cases.

Physics and imaging in radiation oncology

2020 Volume 14, Page(s) 1–5

Abstract: In treatment planning, multiple imaging modalities can be employed to improve the accuracy of tumor delineation but this can be costly. This study aimed to compare the interobserver consistency of using dual energy computed tomography (DECT) versus ... ...

Abstract	In treatment planning, multiple imaging modalities can be employed to improve the accuracy of tumor delineation but this can be costly. This study aimed to compare the interobserver consistency of using dual energy computed tomography (DECT) versus magnetic resonance imaging (MRI) for delineating tumors in the head and neck cancer (HNC) re-irradiation scenario. Twenty-three patients with recurrent HNC and had planning DECT and MRI were identified. Contoured tumor volumes by seven radiation oncologists were compared. Overall, T1c MRI performed the best with median DSC of 0.58 (0-0.91) for T1c. T1c MRI provided higher interobserver agreement for skull base sites and 60 kV DECT provided higher interobserver agreement for non-skull base sites.
Language	English
Publishing date	2020-04-29
Publishing country	Netherlands
Document type	Journal Article
ISSN	2405-6316
ISSN (online)	2405-6316
DOI	10.1016/j.phro.2020.04.001
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