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206. In Reply to Cheung

Author

Turaka, Aruna, primary, Buyyounouski, Mark K., additional, Horwitz, Eric M., additional, and Movsas, Benjamin, additional

Published
2013
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208. Intermittent Androgen Suppression for Rising PSA Level After Radiotherapy

Author

Crook, Juanita M., primary, O’Callaghan, Christopher J., additional, Duncan, Graeme, additional, Dearnaley, David P., additional, Higano, Celestia S., additional, Horwitz, Eric M., additional, Frymire, Eliot, additional, Malone, Shawn, additional, Chin, Joseph, additional, Nabid, Abdenour, additional, Warde, Padraig, additional, Corbett, Thomas, additional, Angyalfi, Steve, additional, Goldenberg, S. Larry, additional, Gospodarowicz, Mary K, additional, Saad, Fred, additional, Logue, John P., additional, Hall, Emma, additional, Schellhammer, Paul F., additional, Ding, Keyue, additional, and Klotz, Laurence, additional

Published
2013
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209. Biochemical and clinical significance of the posttreatment prostate-specific antigen bounce for prostate cancer patients treated with external beam radiation therapy alone Presented at the 46th Annual Meeting of the American Society for Therapeutic Radiology and Oncology, Atlanta, GA, October 3???7, 2004.

Author

Department of Radiation Oncology, University of Michigan, Ann Arbor, Michigan, Department of Radiation Oncology, Fox Chase Cancer Center, Philadelphia, Pennsylvania ; Fax: (215) 214-1629 ; Department of Radiation Oncology, Fox Chase Cancer Center, 333 Cottman Ave., Philadelphia, PA 19111-2497, Department of Biomathematics, University of Texas M. D. Anderson Cancer Center, Houston, Texas, Department of Radiation Oncology, Cleveland Clinic Foundation, Cleveland, Ohio, Department of Radiation Oncology, William Beaumont Hospital, Royal Oak, Michigan, Department of Radiation Oncology, Mallinckrodt Institute of Radiology, St. Louis, Missouri, Department of Radiation Oncology, Mayo Clinic, Rochester, Minnesota, Department of Radiation Oncology, Massachusetts General Hospital, Boston, Massachusetts, Department of Radiation Oncology, Memorial Sloan-Kettering Cancer Center, New York, New York, Division of Radiation Oncology, University of Texas M. D. Anderson Cancer Center, Houston, Texas, Horwitz, Eric M., Levy, Lawrence B., Thames, Howard D., Kupelian, Patrick A., Martinez, Alvaro A., Michalski, Jeffrey M., Pisansky, Thomas M., Sandler, Howard M., Shipley, William U., Zelefsky, Michael J., Zietman, Anthony L., Kuban, Deborah A., Department of Radiation Oncology, University of Michigan, Ann Arbor, Michigan, Department of Radiation Oncology, Fox Chase Cancer Center, Philadelphia, Pennsylvania ; Fax: (215) 214-1629 ; Department of Radiation Oncology, Fox Chase Cancer Center, 333 Cottman Ave., Philadelphia, PA 19111-2497, Department of Biomathematics, University of Texas M. D. Anderson Cancer Center, Houston, Texas, Department of Radiation Oncology, Cleveland Clinic Foundation, Cleveland, Ohio, Department of Radiation Oncology, William Beaumont Hospital, Royal Oak, Michigan, Department of Radiation Oncology, Mallinckrodt Institute of Radiology, St. Louis, Missouri, Department of Radiation Oncology, Mayo Clinic, Rochester, Minnesota, Department of Radiation Oncology, Massachusetts General Hospital, Boston, Massachusetts, Department of Radiation Oncology, Memorial Sloan-Kettering Cancer Center, New York, New York, Division of Radiation Oncology, University of Texas M. D. Anderson Cancer Center, Houston, Texas, Horwitz, Eric M., Levy, Lawrence B., Thames, Howard D., Kupelian, Patrick A., Martinez, Alvaro A., Michalski, Jeffrey M., Pisansky, Thomas M., Sandler, Howard M., Shipley, William U., Zelefsky, Michael J., Zietman, Anthony L., and Kuban, Deborah A.

Abstract

BACKGROUND. The posttreatment prostate-specific antigen (PSA) bounce phenomenon has been recognized in at least 20% of all patients treated with radiation. The purpose of the current report was to determine if there was a difference in biochemical and clinical control between the bounce and nonbounce (NB) patients using pooled data on 4839 patients with T1-2 prostate cancer treated with external beam radiation therapy (RT) alone at 9 institutions between 1986 and 1995. METHODS. The median follow-up was 6.3 years. A posttreatment PSA bounce was defined by a minimal rise of 0.4 ng/mL over a 6-month follow-up period, followed by a drop in PSA level of any magnitude. Endpoints included no biochemical evidence of disease (bNED) failure (BF) (ASTRO definition), distant failure (DF), cause-specific failure (CSF), and overall survival (OS). Patients were stratified by pretreatment PSA, Gleason score, T stage, age, dose, and risk group. RESULTS. In all, 978 (20%) patients experienced at least 1 posttreatment PSA bounce. Within 3 subgroups (risk group, pretreatment PSA, and age), statistically significant differences of remaining bounce-free were observed on univariate analysis. Patients < 70 years had a 72% chance of remaining bounce-free at 5 years compared with 75% for older patients ( P = .04). The NB patients had 72% bNED control at 10 years compared with 58% for the bounce patients. The effect of a bounce remained statistically significant on multivariate analysis ( P < .0001). No statistically significant difference in DF, CSF, or OS was observed. CONCLUSIONS. Patients treated with external beam radiation therapy alone who experience a posttreatment PSA bounce have increased risk of BF. However, this did not translate into a difference in clinical failure with the available follow-up in the current study. Cancer 2006. ?? 2006 American Cancer Society.

Published
2007

210. ASTRO APEx® and RO-ILS™ are applicable to medical malpractice in radiation oncology.

Author

Zaorsky, Nicholas G, Ricco, Anthony G, Churilla, Thomas M, Horwitz, Eric M, and Den, Robert B

Abstract

Aim: To analyze malpractice trials in radiation oncology and assess how ASTRO APEx® and RO-ILS™ apply to such cases.Methods: The Westlaw database was reviewed using PICOS/PRISMA methods. Fisher's exact and Mann-Whitney U tests were used to find factors associated with outcomes.Results: Of 34 cases identified, external beam was used in 26 (77%). The most common factors behind malpractice were excessive toxicity (80%) and lack of informed consent (66%). ASTRO APEx pillars and ROI-LS had applicability to all but one case. Factors favoring the defendant included statute of limitations (odds ratio: 8.1; 95% CI: 1.3-50); those favoring the plaintiff included patient death (odds ratio: 0.7; 95% CI: 0.54-0.94).Conclusion: APEx and RO-ILS are applicable to malpractice trials in radiation oncology. [ABSTRACT FROM AUTHOR]

Published
2016
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211. A comparison of robotic arm versus gantry linear accelerator stereotactic body radiation therapy for prostate cancer.

Author

Avkshtol, Vladimir, Yanqun Dong, Hayes, Shelly B., Hallman, Mark A., Price, Robert A., Sobczak, Mark L., Horwitz, Eric M., and Zaorsky, Nicholas G.

Subjects
MEDICAL robotics, RADIOTHERAPY, PROSTATE cancer treatment
Abstract

Prostate cancer is the most prevalent cancer diagnosed in men in the United States besides skin cancer. Stereotactic body radiation therapy (SBRT; 6–15 Gy per fraction, up to 45 minutes per fraction, delivered in five fractions or less, over the course of approximately 2 weeks) is emerging as a popular treatment option for prostate cancer. The American Society for Radiation Oncology now recognizes SBRT for select low- and intermediate-risk prostate cancer patients. SBRT grew from the notion that high doses of radiation typical of brachytherapy could be delivered noninvasively using modern external-beam radiation therapy planning and delivery methods. SBRT is most commonly delivered using either a traditional gantry-mounted linear accelerator or a robotic arm-mounted linear accelerator. In this systematic review article, we compare and contrast the current clinical evidence supporting a gantry vs robotic arm SBRT for prostate cancer. The data for SBRT show encouraging and comparable results in terms of freedom from biochemical failure (>90% for low and intermediate risk at 5–7 years) and acute and late toxicity (<6% grade 3–4 late toxicities). Other outcomes (eg, overall and cancer-specific mortality) cannot be compared, given the indolent course of low-risk prostate cancer. At this time, neither SBRT device is recommended over the other for all patients; however, gantry-based SBRT machines have the abilities of treating larger volumes with conventional fractionation, shorter treatment time per fraction (~15 minutes for gantry vs ~45 minutes for robotic arm), and the ability to achieve better plans among obese patients (since they are able to use energies >6 MV). Finally, SBRT (particularly on a gantry) may also be more cost-effective than conventionally fractionated external-beam radiation therapy. Randomized controlled trials of SBRT using both technologies are underway. [ABSTRACT FROM AUTHOR]

Published
2016
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212. Advanced small cell carcinoma of the bladder: clinical characteristics, treatment patterns and outcomes in 960 patients and comparison with urothelial carcinoma.

Author

Geynisman, Daniel M., Handorf, Elizabeth, Wong, Yu‐Ning, Doyle, Jamie, Plimack, Elizabeth R., Horwitz, Eric M., Canter, Daniel J., Uzzo, Robert G., Kutikov, Alexander, and Smaldone, Marc C.

Subjects
SMALL cell carcinoma, CARCINOMA, TRANSITIONAL cell carcinoma, URINARY organ cancer, BLADDER cancer
Abstract

To describe the clinical characteristics, treatment patterns and outcomes in advanced small cell bladder cancer ( aSCBC) patients and compare to those with urothelial carcinoma ( UC). Individuals in the National Cancer Data Base with a diagnosis of either nodal (TxN+M0) or distant metastatic (TxNxM1) disease were identified from 1998 to 2010. We assessed the relationships between stage, treatment modalities and survival in the aSCBC cohort and compared these to UC patients. In the 960 patient aSCBC cohort (62% M1), 50% received palliative therapy alone, 68% in M1 versus 21% in M0 groups ( P < 0.0001). Single modality local therapy (15%) and surgical (21%) or radiation-based (14%) multimodal therapy ( MMT) were used in the other 50%. Cystectomy-based MMT was utilized in 45% of N+M0 versus 6.4% of NxM1 patients ( P < 0.0001). Median overall survival ( OS) for aSCBC patients was 8.6 months; 13.0 months in N+M0 versus 5.3 months in NxM1 patients ( P < 0.0001). Survival was similar between TxN1M0 and TxN2-3M0 patients (14.8 months vs. 12.1 months, P = 0.15). Urothelial carcinoma patients ( n = 27,796, 45% M1) lived longer compared to aSCBC patients in the N+M0 group (17.3 months vs. 13.0 months, P = 0.0007). There were not clinically significant differences in OS between UC and aSCBC patients in the M1 group. Advanced SCBC is a rare disease with a poor survival and palliative therapy is common, especially in M1 patients. In comparison to UC, the outcomes for aSCBC patients are worse in those with lymph node only involvement but similar in those with distant disease. [ABSTRACT FROM AUTHOR]

Published
2016
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215. American Brachytherapy Society consensus guidelines for transrectal ultrasound-guided permanent prostate brachytherapy

Author

Davis, Brian J., primary, Horwitz, Eric M., additional, Lee, W. Robert, additional, Crook, Juanita M., additional, Stock, Richard G., additional, Merrick, Gregory S., additional, Butler, Wayne M., additional, Grimm, Peter D., additional, Stone, Nelson N., additional, Potters, Louis, additional, Zietman, Anthony L., additional, and Zelefsky, Michael J., additional

Published
2012
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217. Optimal Use of Combined Modality Therapy in the Treatment of Esophageal Cancer

Author

Shaikh, Talha, Meyer, Joshua E., and Horwitz, Eric M.

Abstract

Esophageal cancer is associated with a poor prognosis with 5-year survival rates of approximately 15% to 20%. Although patients with early stage disease may adequately be treated with a single modality, combined therapy typically consisting of neoadjuvant chemoradiation followed by esophagectomy is being adopted increasingly in patients with locally advanced disease. In patients who are not surgical candidates, definitive chemoradiation is the preferred treatment approach. All patients with newly diagnosed esophageal cancer should be evaluated in the multidisciplinary setting by a surgeon, radiation oncologist, and medical oncologist owing to the importance of each specialty in the management of these patients.

Published
2017
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218. Small-Cell Carcinoma of the Bladder: 20-Year Single-Institution Retrospective Review

Author

Jung, Kyungsuk, Ghatalia, Pooja, Litwin, Samuel, Horwitz, Eric M., Uzzo, Robert G., Greenberg, Richard E., Viterbo, Rosalia, Geynisman, Daniel M., Kutikov, Alexander, Plimack, Elizabeth R., Smaldone, Marc C., Wong, Yu-Ning, and Bilusic, Marijo

Abstract

We performed a retrospective survival analysis of 38 patients with small-cell carcinoma of the bladder treated at our institution. In multivariable adjusted analysis, we could not find any significant survival advantage associated with neoadjuvant chemotherapy, surgery, or radiation. Most of the long-term survivors received platinum-based neoadjuvant chemotherapy followed by radical cystectomy.

Published
2017
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220. Prostate-specific antigen doubling time predicts the development of distant metastases for patients who fail 3-dimensional conformal radiotherapy or intensity modulated radiation therapy using the Phoenix definition

Author

Klayton, Tracy L., primary, Ruth, Karen, additional, Buyyounouski, Mark K., additional, Uzzo, Robert G., additional, Wong, Yu-Ning, additional, Chen, David Y.T., additional, Sobczak, Mark, additional, Peter, Ruth, additional, and Horwitz, Eric M., additional

Published
2011
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222. American Society for Radiation Oncology (ASTRO) and American College of Radiology (ACR) Practice Guideline for the Transperineal Permanent Brachytherapy of Prostate Cancer

Author

Rosenthal, Seth A., primary, Bittner, Nathan H.J., additional, Beyer, David C., additional, Demanes, D. Jeffrey, additional, Goldsmith, Brian J., additional, Horwitz, Eric M., additional, Ibbott, Geoffrey S., additional, Lee, W. Robert, additional, Nag, Subir, additional, Suh, W. Warren, additional, and Potters, Louis, additional

Published
2011
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226. The role of overall treatment time in the outcome of radiotherapy of prostate cancer: An analysis of biochemical failure in 4839 men treated between 1987 and 1995

Author

Thames, Howard D., primary, Kuban, Deborah, additional, Levy, Larry B., additional, Horwitz, Eric M., additional, Kupelian, Patrick, additional, Martinez, Alvaro, additional, Michalski, Jeffrey, additional, Pisansky, Thomas, additional, Sandler, Howard, additional, Shipley, William, additional, Zelefsky, Michael, additional, and Zietman, Anthony, additional

Published
2010
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237. Ten-Year Follow-Up of Radiation Therapy Oncology Group Protocol 92-02: A Phase III Trial of the Duration of Elective Androgen Deprivation in Locally Advanced Prostate Cancer

Author

Horwitz, Eric M., primary, Bae, Kyounghwa, additional, Hanks, Gerald E., additional, Porter, Arthur, additional, Grignon, David J., additional, Brereton, Harmar D., additional, Venkatesan, Varagur, additional, Lawton, Colleen A., additional, Rosenthal, Seth A., additional, Sandler, Howard M., additional, and Shipley, William U., additional

Published
2008
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242. Phase II Study of Low-Dose Paclitaxel and Cisplatin in Combination With Split-Course Concomitant Twice-Daily Reirradiation in Recurrent Squamous Cell Carcinoma of the Head and Neck: Results of Radiation Therapy Oncology Group Protocol 9911

Author

Langer, Corey J., primary, Harris, Jonathan, additional, Horwitz, Eric M., additional, Nicolaou, Nicos, additional, Kies, Merrill, additional, Curran, Walter, additional, Wong, Stuart, additional, and Ang, Kian, additional

Published
2007
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247. Multi-institutional analysis of long-term outcome for stages T1–T2 prostate cancer treated with permanent seed implantation

Author

Zelefsky, Michael J., primary, Kuban, Deborah A., additional, Levy, Larry B., additional, Potters, Louis, additional, Beyer, David C., additional, Blasko, John C., additional, Moran, Brian J., additional, Ciezki, Jay P., additional, Zietman, Anthony L., additional, Pisansky, Thomas M., additional, Elshaikh, Mohamed, additional, and Horwitz, Eric M., additional

Published
2007
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250. Impact of obesity on outcomes after definitive dose-escalated intensity-modulated radiotherapy for localized prostate cancer.

Author

Wang, Lora S., Murphy, Colin T., Ruth, Karen, Zaorsky, Nicholas G., Smaldone, Marc C., Sobczak, Mark L., Kutikov, Alexander, Viterbo, Rosalia, and Horwitz, Eric M.

Subjects
PROSTATE cancer treatment, INTENSITY modulated radiotherapy, OBESITY, HEALTH outcome assessment, BODY mass index
Abstract

BACKGROUND Previous publications have demonstrated conflicting results regarding body mass index (BMI) and prostate cancer (CaP) outcomes after definitive radiotherapy (RT) before the dose escalation era. The goal of the current study was to determine whether increasing BMI was associated with outcomes in men with localized CaP who were treated with dose-escalated RT. METHODS The authors identified patients with localized (T1b-T4N0M0) CaP who were treated with definitive intensity-modulated RT and image-guided RT from 2001 through 2010. BMI was analyzed as a continuous variable. Adjusting for confounders, multivariable competing risk and Cox proportional hazards regression models were used to assess the association between BMI and the risk of biochemical failure (BF), distant metastases (DM), cause-specific mortality (CSM), and overall mortality. RESULTS Of the 1442 patients identified, approximately 20% had a BMI <25 kg/m2, 48% had a BMI of 25 to 29.9 kg/m2, 23% had a BMI of 30 to 34.9 kg/m2, 6% had a BMI of 35 to 39.9 kg/m2, and 4% had a BMI of ≥40 kg/m2. The median follow-up was 47.6 months (range, 1-145 months), with a median age of 68 years (range, 36-89 years). The median dose was 78 grays (range, 76-80 grays) and 30% of patients received androgen deprivation therapy. Increasing BMI was found to be inversely associated with age ( P<.001) and pretreatment prostate-specific antigen level ( P = .018). On multivariable analysis, increasing BMI was associated with an increased risk of BF (hazard ratio [HR], 1.03; 95% confidence interval [95% CI], 1.00-1.07 [ P = .042]), DM (HR, 1.07; 95% CI, 1.02-1.11 [ P = .004]), CSM (HR, 1.15; 95% CI, 1.07-1.23 [ P<.001]), and overall mortality (HR, 1.05; 95% CI, 1.02-1.08 [ P = .004]). CONCLUSIONS For patients with CaP receiving dose-escalated intensity-modulated RT with daily image-guidance, increasing BMI appears to be associated with an increased risk of BF, DM, CSM, and overall mortality. Cancer 2015;121:3010-3017. © 2015 American Cancer Society. [ABSTRACT FROM AUTHOR]

Published
2015
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