2021
Does Prophylactic Paraortic Lymph Node Irradiation Improve Outcomes in Women With Stage IIIC1 Endometrial Carcinoma?
Yoon J, Fitzgerald H, Wang Y, Wang Q, Vergalasova I, Elshaikh MA, Dimitrova I, Damast S, Li JY, Fields EC, Beriwal S, Keller A, Kidd EA, Usoz M, Jolly S, Jaworski E, Leung EW, Donovan E, Taunk NK, Chino J, Natesan D, Russo AL, Lea JS, Albuquerque KV, Lee LJ, Hathout L. Does Prophylactic Paraortic Lymph Node Irradiation Improve Outcomes in Women With Stage IIIC1 Endometrial Carcinoma? Practical Radiation Oncology 2021, 12: e123-e134. PMID: 34822999, DOI: 10.1016/j.prro.2021.10.002.Peer-Reviewed Original ResearchMeSH KeywordsEndometrial NeoplasmsFemaleHumansLymph NodesNeoplasm Recurrence, LocalNeoplasm StagingRadiotherapy, AdjuvantRetrospective StudiesConceptsStage IIIC1 endometrial cancerPelvic radiation therapyOverall survivalEndometrial cancerRadiation therapySurvival outcomesFirst recurrenceHazard ratioRFS ratesCommon siteRecurrence-free survival ratesMulti-institutional retrospective studyPropensity scoreCox proportional hazards modelImproved survival outcomesKaplan-Meier methodProportional hazards modelInternational FederationNew therapeutic approachesAdjuvant chemotherapyDistant recurrenceSystemic chemotherapyImprove OutcomesClinical outcomesDistant metastasisA Multi-Institutional Analysis of Adjuvant Chemotherapy and Radiation Sequence in Women With Stage IIIC Endometrial Cancer
Hathout L, Wang Y, Wang Q, Vergalasova I, Elshaikh MA, Dimitrova I, Damast S, Li JY, Fields EC, Beriwal S, Keller A, Kidd EA, Usoz M, Jolly S, Jaworski E, Leung EW, Donovan E, Taunk NK, Chino J, Natesan D, Russo AL, Lea JS, Albuquerque KV, Lee LJ. A Multi-Institutional Analysis of Adjuvant Chemotherapy and Radiation Sequence in Women With Stage IIIC Endometrial Cancer. International Journal Of Radiation Oncology • Biology • Physics 2021, 110: 1423-1431. PMID: 33677053, DOI: 10.1016/j.ijrobp.2021.02.055.Peer-Reviewed Original ResearchConceptsStage IIIC endometrial carcinomaOverall survivalEndometrial carcinomaRadiation therapyAdjuvant chemotherapyAdjuvant therapyPALN recurrenceSystemic chemotherapyRFS ratesMulti-institutional retrospective cohort studyStage IIIC endometrial cancerRecurrence-free survival ratesLymph node recurrenceSequential radiation therapyAdjuvant radiation therapyRetrospective cohort studyGrade 3 tumorsAdjuvant treatment regimensKaplan-Meier methodVaginal cuff brachytherapyHigh rateSequence of treatmentChemotherapy concurrentNodal radiationNode recurrence
2020
Stage III uterine serous carcinoma: modern trends in multimodality treatment
Li JY, Young MR, Huang G, Litkouhi B, Santin A, Schwartz PE, Damast S. Stage III uterine serous carcinoma: modern trends in multimodality treatment. Journal Of Gynecologic Oncology 2020, 31: e53. PMID: 32266802, PMCID: PMC7286763, DOI: 10.3802/jgo.2020.31.e53.Peer-Reviewed Original ResearchMeSH KeywordsAdultAgedAged, 80 and overBrachytherapyEndometrial NeoplasmsFemaleHumansHysterectomyMiddle AgedNeoplasm StagingRadiotherapy, AdjuvantRetrospective StudiesConceptsUterine serous carcinomaExternal beam RTVaginal brachytherapyOverall survivalHuman epidermal growth factor receptorModern treatment eraSentinel node samplingRegional nodal recurrenceKaplan-Meier estimatesLog-rank testCox proportional hazardsExternal beam radiotherapyEpidermal growth factor receptorERA treatmentGrowth factor receptorUSC patientsFree survivalNodal recurrenceTreatment eraMultimodality treatmentPatient characteristicsPerioperative periodRegional nodalSerous carcinomaNode sampling
2019
Outcomes and relapse patterns of stage IB grade 2 or 3 endometrial cancer treated with adjuvant vaginal brachytherapy
Hochreiter A, Kelly JR, Young MR, Litkouhi B, Black JD, Stromberger C, Higgins S, Schwartz PE, Damast S. Outcomes and relapse patterns of stage IB grade 2 or 3 endometrial cancer treated with adjuvant vaginal brachytherapy. International Journal Of Gynecological Cancer 2019, 30: 48. PMID: 31722964, DOI: 10.1136/ijgc-2019-000675.Peer-Reviewed Original ResearchConceptsDisease-free survivalLower uterine segment involvementPelvic recurrence-free survivalStage IB grade 2Uterine segment involvementLymph node dissectionRecurrence-free survivalEndometrial cancerRisk factorsVaginal brachytherapyOverall survivalGrade 2Endometrioid histologyNode dissectionPelvic recurrenceSegment involvementLymph nodesMyometrial invasionMultivariable Cox proportional hazards regressionEarly-stage endometrial cancerUnderwent lymph node dissectionCox proportional hazards regressionReduced disease-free survivalAdjuvant vaginal brachytherapySole adjuvant therapy
2017
Cost-effectiveness of adjuvant intravaginal brachytherapy in high-intermediate risk endometrial carcinoma
Stahl JM, Damast S, Bledsoe TJ, An Y, Verma V, Yu JB, Young MR, Lester-Coll NH. Cost-effectiveness of adjuvant intravaginal brachytherapy in high-intermediate risk endometrial carcinoma. Brachytherapy 2017, 17: 399-406. PMID: 29275078, DOI: 10.1016/j.brachy.2017.11.012.Peer-Reviewed Original ResearchConceptsQuality-adjusted life yearsIncremental cost-effectiveness ratioPay thresholdsAdjuvant intravaginal brachytherapyOne-way sensitivity analysesProbabilistic sensitivity analysesCost-effectiveness ratioBase-case analysisAverage cumulative costSocietal willingnessSensitivity analysisLife yearsTime horizonPORTEC-2 trialCumulative costsWillingnessPORTEC-1Medicare reimbursementCostHIR patientsMean costPreferred management optionMarkov modelCase analysisNet increaseAdjuvant Therapy Use and Survival in Stage II Endometrial Cancer
Lester-Coll NH, Young MR, Park HS, Ratner ES, Litkouhi B, Damast S. Adjuvant Therapy Use and Survival in Stage II Endometrial Cancer. International Journal Of Gynecological Cancer 2017, 27: 1904-1911. PMID: 28763364, DOI: 10.1097/igc.0000000000001095.Peer-Reviewed Original ResearchConceptsReceipt of chemotherapyEndometrioid endometrial carcinomaNational Cancer Data BaseImproved overall survivalRole of chemotherapyOverall survivalAdjuvant chemotherapyAdjuvant treatmentStage II endometrial cancerCox proportional hazards regressionPropensity scoreAdjuvant therapy useGrade 3 diseaseStage II patientsProportional hazards regressionWorse overall survivalMultivariable logistic regressionKaplan-Meier estimatesLog-rank testAdjuvant radiotherapyExcellent prognosisLymphovascular invasionObservational cohortEEC patientsEndometrial cancerImpact of vaginal cylinder diameter on outcomes following brachytherapy for early stage endometrial cancer
Qian JM, Stahl JM, Young MR, Ratner E, Damast S. Impact of vaginal cylinder diameter on outcomes following brachytherapy for early stage endometrial cancer. Journal Of Gynecologic Oncology 2017, 28: 0. PMID: 29027402, PMCID: PMC5641534, DOI: 10.3802/jgo.2017.28.e84.Peer-Reviewed Original ResearchMeSH KeywordsAdenocarcinomaAdultAgedAged, 80 and overBody Mass IndexBrachytherapyConstriction, PathologicDatabases, FactualEndometrial NeoplasmsFemaleGastrointestinal DiseasesGravidityHumansHysterectomyLymph Node ExcisionMiddle AgedNeoplasm StagingOvariectomyRadiation InjuriesRadiotherapy, AdjuvantSalpingectomyTreatment OutcomeVaginaVaginal DiseasesConceptsVaginal brachytherapyVaginal symptomsLate grade 3 toxicityEarly-stage endometrial cancerNormal body mass indexAdjuvant vaginal brachytherapyGrade 3 toxicityShorter vaginal lengthStage endometrial cancerEndometrial cancer patientsBody mass indexRate of recurrenceAcute gastrointestinalTreatment tolerabilityVaginal stenosisEndometrial cancerVaginal lengthMass indexRecurrence rateCancer patientsVaginal toxicityTreatment characteristicsHigh riskSide effectsPatients
2015
Predictors of vaginal stenosis after intravaginal high-dose-rate brachytherapy for endometrial carcinoma
Park HS, Ratner ES, Lucarelli L, Polizzi S, Higgins SA, Damast S. Predictors of vaginal stenosis after intravaginal high-dose-rate brachytherapy for endometrial carcinoma. Brachytherapy 2015, 14: 464-470. PMID: 25887343, DOI: 10.1016/j.brachy.2015.03.001.Peer-Reviewed Original ResearchConceptsVaginal stenosisDilator useIndependent predictorsEndometrial carcinomaTotal doseRate brachytherapyMultivariable logistic regression analysisExternal beam radiation therapyCommon Terminology CriteriaEffective adjuvant treatmentMonths of followupPost-treatment factorsBeam radiation therapyHigher total doseLogistic regression analysisTerminology CriteriaAdjuvant treatmentFollowup visitMean followupAdverse eventsLast followupMultivariable analysisRisk factorsRadiation therapyPatients
2014
Comparative Patient-Centered Outcomes (Health State and Adverse Sexual Symptoms) Between Adjuvant Brachytherapy Versus No Adjuvant Brachytherapy in Early Stage Endometrial Cancer
Damast S, Alektiar K, Eaton A, Gerber NK, Goldfarb S, Patil S, Jia R, Leitao M, Carter J, Basch E. Comparative Patient-Centered Outcomes (Health State and Adverse Sexual Symptoms) Between Adjuvant Brachytherapy Versus No Adjuvant Brachytherapy in Early Stage Endometrial Cancer. Annals Of Surgical Oncology 2014, 21: 2740-2754. PMID: 24619493, DOI: 10.1245/s10434-014-3562-4.Peer-Reviewed Original ResearchConceptsFemale Sexual Function IndexPoor health statesSexual functioningEndometrial cancerSexual functionEarly-stage endometrial cancerHealth statesStage I endometrial cancerBaseline sexual activityStage endometrial cancerEndometrial cancer survivorsSexual Function IndexSignificant risk factorsSurgery groupUnderwent surgeryEQ5D scoresFSFI scoreSurgery typeAdjuvant brachytherapyCancer survivorsMore frequent useRisk factorsFunction IndexSexual dysfunctionMultivariable regression
2012
Sexual Functioning Among Endometrial Cancer Patients Treated With Adjuvant High-Dose-Rate Intra-Vaginal Radiation Therapy
Damast S, Alektiar KM, Goldfarb S, Eaton A, Patil S, Mosenkis J, Bennett A, Atkinson T, Jewell E, Leitao M, Barakat R, Carter J, Basch E. Sexual Functioning Among Endometrial Cancer Patients Treated With Adjuvant High-Dose-Rate Intra-Vaginal Radiation Therapy. International Journal Of Radiation Oncology • Biology • Physics 2012, 84: e187-e193. PMID: 22572074, PMCID: PMC5538259, DOI: 10.1016/j.ijrobp.2012.03.030.Peer-Reviewed Original ResearchMeSH KeywordsAdministration, IntravaginalAdolescentAdultAgedAged, 80 and overBrachytherapyCross-Sectional StudiesDehydrationDilatationEndometrial NeoplasmsFemaleHumansHysterectomyLaparotomyLibidoMiddle AgedOrgasmPainPersonal SatisfactionRadiotherapy DosageRadiotherapy, AdjuvantReference ValuesRegression AnalysisRisk FactorsSexual Dysfunction, PhysiologicalSurveys and QuestionnairesVaginal Creams, Foams, and JelliesVaginal DiseasesYoung AdultConceptsFemale Sexual Function IndexEndometrial cancer patientsSexual dysfunctionFSFI scoreSexual functioningCancer patientsEarly stage endometrial cancer patientsQuestionnaire completionRates of SDLubricant useLower FSFI scoresSexual Function IndexPoor sexual functioningRadiation oncology clinicPostmenopausal statusSimple hysterectomyPostmenopausal populationOncology clinicAdjuvant brachytherapyEC patientsRisk factorsFunction IndexRadiation therapyHigh doseMultivariate analysis
2009
Locoregional Outcomes of Inflammatory Breast Cancer Patients Treated With Standard Fractionation Radiation and Daily Skin Bolus in the Taxane Era
Damast S, Ho AY, Montgomery L, Fornier MN, Ishill N, Elkin E, Beal K, McCormick B. Locoregional Outcomes of Inflammatory Breast Cancer Patients Treated With Standard Fractionation Radiation and Daily Skin Bolus in the Taxane Era. International Journal Of Radiation Oncology • Biology • Physics 2009, 77: 1105-1112. PMID: 19879068, DOI: 10.1016/j.ijrobp.2009.06.042.Peer-Reviewed Original ResearchMeSH KeywordsAdenocarcinomaAdultAgedAged, 80 and overAntineoplastic Combined Chemotherapy ProtocolsBreast NeoplasmsCapecitabineCarboplatinCyclophosphamideDeoxycytidineDisease-Free SurvivalDose Fractionation, RadiationDoxorubicinDrug Administration ScheduleEpirubicinFemaleFluorouracilHumansMastectomy, Modified RadicalMiddle AgedNeoadjuvant TherapyPaclitaxelRadiodermatitisRadiotherapy, AdjuvantRetrospective StudiesConceptsDistant metastasis-free survivalStandard fractionation radiationCombined-modality therapyInflammatory breast cancer patientsMetastasis-free survivalBreast cancer patientsLocoregional controlRadiation therapyLocoregional outcomeSkin bolusCancer patientsChest wallAdjuvant radiation therapyExcellent locoregional controlMajority of patientsSignificant therapeutic challengeScar boostTaxane eraIBC patientsRadical mastectomyRegional lymphaticsTherapeutic challengeDaily fractionsStandard fractionationPrescribed treatment