2022
Practice Patterns Related to Mitigation of Neurocognitive Decline in Patients Receiving Whole Brain Radiation Therapy
Jairam V, Park HS, Yu JB, Bindra RS, Contessa JN, Jethwa KR. Practice Patterns Related to Mitigation of Neurocognitive Decline in Patients Receiving Whole Brain Radiation Therapy. Advances In Radiation Oncology 2022, 7: 100949. PMID: 35521071, PMCID: PMC9065721, DOI: 10.1016/j.adro.2022.100949.Peer-Reviewed Original ResearchWhole-brain radiation therapyBrain radiation therapyRadiation oncologistsPractice patternsRadiation therapyHA-WBRTNeurocognitive declineCommon reasonHippocampal avoidance whole brain radiation therapyNational practice patternsDeleterious cognitive effectsRoutine clinical practiceNeurocognitive preservationBrain metastasesTreatment delayProvider characteristicsEffective treatmentCurrent evidencePearson χMemantineClinical practicePatientsPrior authorizationMajority of respondentsTherapy
2021
Practice Patterns Related to Mitigation of Neurocognitive Decline in Patients Receiving Whole-Brain Radiation Therapy
Jairam V, Park H, Yu J, Bindra R, Contessa J, Jethwa K. Practice Patterns Related to Mitigation of Neurocognitive Decline in Patients Receiving Whole-Brain Radiation Therapy. International Journal Of Radiation Oncology • Biology • Physics 2021, 111: e569. DOI: 10.1016/j.ijrobp.2021.07.1536.Peer-Reviewed Original ResearchWhole-brain radiation therapyWhole brain radiotherapyRadiation oncologistsPractice patternsBrain radiotherapyWBRT patientsNeurocognitive declineRadiation therapyCommon reasonCurrent evidenceHippocampal-avoidance whole-brain radiotherapyN-methyl-D-aspartate receptor antagonistConventional whole brain radiotherapyBrain radiation therapyNational practice patternsDeleterious cognitive effectsRoutine clinical practiceT-testMATERIAL/METHODSStudent's t-testMost radiation oncologistsIntracranial controlNeurocognitive preservationBrain metastasesMedication costsLinear accelerator-based single-fraction stereotactic radiosurgery versus hypofractionated stereotactic radiotherapy for intact and resected brain metastases up to 3 cm: A multi-institutional retrospective analysis.
Diamond BH, Jairam V, Zuberi S, Li JY, Marquis TJ, Rutter CE, Park HS. Linear accelerator-based single-fraction stereotactic radiosurgery versus hypofractionated stereotactic radiotherapy for intact and resected brain metastases up to 3 cm: A multi-institutional retrospective analysis. Journal Of Radiosurgery And SBRT 2021, 7: 179-187. PMID: 33898081, PMCID: PMC8055233.Peer-Reviewed Original ResearchIntracranial progression-free survivalLocal progression-free survivalSingle-fraction stereotactic radiosurgeryProgression-free survivalBrain metastasesSF-SRSOverall survivalStereotactic radiotherapyStereotactic radiosurgeryMulti-institutional retrospective analysisSignificant differencesResected Brain MetastasesLarge brain metastasesTime of treatmentIntact metastasesRetrospective analysisLocal controlMetastasisSimilar outcomesSurvivalPatientsRadiotherapyRadiosurgery
2020
Nationwide Patterns of Hemorrhagic Stroke among Patients Hospitalized with Brain Metastases: Influence of Primary Cancer Diagnosis and Anticoagulation
Lee V, Jairam V, Yu J, Park H. Nationwide Patterns of Hemorrhagic Stroke among Patients Hospitalized with Brain Metastases: Influence of Primary Cancer Diagnosis and Anticoagulation. International Journal Of Radiation Oncology • Biology • Physics 2020, 108: e687-e688. DOI: 10.1016/j.ijrobp.2020.07.2045.Peer-Reviewed Original ResearchNationwide Patterns of Hemorrhagic Stroke among Patients Hospitalized with Brain Metastases: Influence of Primary Cancer Diagnosis and Anticoagulation
Park H, Lee V, Jairam V, Yu J. Nationwide Patterns of Hemorrhagic Stroke among Patients Hospitalized with Brain Metastases: Influence of Primary Cancer Diagnosis and Anticoagulation. International Journal Of Radiation Oncology • Biology • Physics 2020, 108: e52-e53. DOI: 10.1016/j.ijrobp.2020.02.593.Peer-Reviewed Original ResearchNationwide patterns of hemorrhagic stroke among patients hospitalized with brain metastases: influence of primary cancer diagnosis and anticoagulation
Lee V, Jairam V, Yu JB, Park HS. Nationwide patterns of hemorrhagic stroke among patients hospitalized with brain metastases: influence of primary cancer diagnosis and anticoagulation. Scientific Reports 2020, 10: 10084. PMID: 32572113, PMCID: PMC7308286, DOI: 10.1038/s41598-020-67316-8.Peer-Reviewed Original ResearchConceptsBrain metastasesLong-term anticoagulationIntracerebral hemorrhageKidney cancerHigh riskUtilization Project Nationwide Inpatient SampleDiagnosis of ICHHospital-related characteristicsRisks of anticoagulationPrimary cancer diagnosisMultivariable logistic regressionNationwide Inpatient SampleLonger lengthDiagnosis of melanomaMann-Whitney UHemorrhagic strokeNeurologic dysfunctionConcurrent diagnosisSignificant morbiditySecondary diagnosisInpatient SampleBaseline differencesDecreased qualityAnticoagulationHealthcare costsMulti-institutional retrospective review of stereotactic radiosurgery for brain metastasis in patients with small cell lung cancer without prior brain-directed radiotherapy.
Miccio JA, Barsky A, Gao S, Verma V, Noticewala SS, Jairam V, Johnson SB, Yu JB, Hansen JE, Aneja S, An Y, Decker RH, Bulent Omay S, Li J, Kurtz GA, Alonso-Basanta M, Lee JYK, Chiang VL, Park HS. Multi-institutional retrospective review of stereotactic radiosurgery for brain metastasis in patients with small cell lung cancer without prior brain-directed radiotherapy. Journal Of Radiosurgery And SBRT 2020, 7: 19-27. PMID: 32802575, PMCID: PMC7406345.Peer-Reviewed Original ResearchWhole brain radiotherapyBrain metastasesOverall survivalNeurologic deathSmall-cell lung cancer (SCLC) brain metastasesCell lung cancer brain metastasesLung cancer brain metastasesSalvage whole brain radiotherapyMulti-institutional retrospective reviewSmall cell lung cancerMost SCLC patientsSCLC brain metastasesTime of SRSMedian overall survivalCancer brain metastasesCell lung cancerIntracranial progressionSCLC patientsUpfront radiosurgeryBrain radiationBrain radiotherapySelect patientsRetrospective reviewLung cancerStereotactic radiosurgery
2019
Results of a pilot/phase II study of gamma knife radiosurgery for brain metastases and implications for future prospective clinical trials
Yu J, Singh C, Bindra R, Contessa J, Husain Z, Hansen J, Park H, Roberts K, Bond J, Tien C, Guo F, Colaco R, Housri N, Magnuson W, Mahajan A, Omay S, Chiang V. Results of a pilot/phase II study of gamma knife radiosurgery for brain metastases and implications for future prospective clinical trials. Journal Of Radiation Oncology 2019, 8: 39-46. DOI: 10.1007/s13566-018-0370-7.Peer-Reviewed Original ResearchYale-New Haven HospitalPhase II studyBrain metastasesClinical trialsII studyKnife radiosurgeryLocal controlPre-defined primary endpointWhole-brain radiation treatmentFuture prospective clinical trialsEvaluable brain metastasesSymptomatic radiation necrosisMedian patient ageLocal control ratePhase 2 studyGood local controlProspective clinical trialsNumber of metastasesLarge clinical trialsProportional hazards regressionFuture clinical trialsGamma knife radiosurgeryImportant clinical variablesStandard clinical practiceNew Haven Hospital
2018
A Pilot/Phase II Study of Stereotactic Radiosurgery for Brain Metastases Using Rational Dose Selection
Yu J, Singh C, Bindra R, Contessa J, Husain Z, Hansen J, Park H, Roberts K, Bond J, Tien C, Guo F, Colaco R, Housri N, Magnuson W, Omay B, Chiang V. A Pilot/Phase II Study of Stereotactic Radiosurgery for Brain Metastases Using Rational Dose Selection. International Journal Of Radiation Oncology • Biology • Physics 2018, 102: e372-e373. DOI: 10.1016/j.ijrobp.2018.07.1113.Peer-Reviewed Original Research
2017
Radiosurgery for Brain Metastases: Changing Practice Patterns and Disparities in the United States.
Kann BH, Park HS, Johnson SB, Chiang VL, Yu JB. Radiosurgery for Brain Metastases: Changing Practice Patterns and Disparities in the United States. Journal Of The National Comprehensive Cancer Network 2017, 15: 1494-1502. PMID: 29223987, DOI: 10.6004/jnccn.2017.7003.Peer-Reviewed Original ResearchConceptsNational Cancer Data BaseStereotactic radiosurgeryBrain metastasesPractice patternsBrain radiotherapyMetastatic diseaseMetastatic non-small cell lung cancerNon-small cell lung cancerNon-SR patientsUpfront brain radiotherapyNational practice patternsProportion of patientsKaplan-Meier methodCell lung cancerProportion of facilitiesQuality of lifeChi-square testActuarial survivalIntracranial controlNeurocognitive toxicityNonprivate insuranceSRS useNCDB analysisDiagnosis yearMultivariable analysisAngiotensin receptor blockade: a novel approach for symptomatic radiation necrosis after stereotactic radiosurgery
Chowdhary M, Okwan-Duodu D, Switchenko JM, Press RH, Jhaveri J, Buchwald ZS, Zhong J, Chapman BV, Bindra RS, Contessa JN, Park HS, Yu JB, Decker RH, Olson JJ, Oyesiku NM, Abrams RA, Shu HG, Curran WJ, Crocker IR, Patel KR. Angiotensin receptor blockade: a novel approach for symptomatic radiation necrosis after stereotactic radiosurgery. Journal Of Neuro-Oncology 2017, 136: 289-298. PMID: 29124649, PMCID: PMC5784434, DOI: 10.1007/s11060-017-2652-0.Peer-Reviewed Original ResearchConceptsSymptomatic radiation necrosisOverall survivalStereotactic radiosurgeryIntracranial efficacyRadiation necrosisKaplan-Meier methodLate radiation toxicitySignificant predictive factorsArteriovenous malformation patientsCumulative incidence modelsIntracranial outcomesBaseline characteristicsBlockade therapyBrain metastasesProspective trialABT groupConsecutive patientsMedian ageMeier methodPreclinical evidencePredictive factorsAVM cohortsRadiation toxicityPrognostic analysisMultivariate analysis
2016
Spine Stereotactic Body Radiotherapy Outcomes in Patients with Concurrent Brain Metastases
Colaco RJ, Park HS, Laurans MS, Chiang VS, Yu JB, Husain ZA. Spine Stereotactic Body Radiotherapy Outcomes in Patients with Concurrent Brain Metastases. Cureus 2016, 8: e679. PMID: 27563505, PMCID: PMC4985044, DOI: 10.7759/cureus.679.Peer-Reviewed Original ResearchSpine stereotactic body radiotherapyConcurrent brain metastasisStereotactic body radiotherapyOverall survivalSpine metastasesLocal controlBrain metastasesMultivariable analysisOne-year local controlOne-year overall survivalCox proportional hazards regressionMedian patient ageProportional hazards regressionLog-rank testMann-Whitney testCBM patientsSurvival prognosticatorPain controlComplete stagingPatient ageSpinal metastasesClinical outcomesHazards regressionRadioresistant histologiesBody radiotherapy
2015
Adjuvant hypofractionated partial-brain radiation therapy for pediatric Ewing sarcoma brain metastases: case report.
van Dams R, Park HS, Alomari AK, Ricciardi AS, Rao H, McNamara J, DiLuna ML, Bindra RS. Adjuvant hypofractionated partial-brain radiation therapy for pediatric Ewing sarcoma brain metastases: case report. Journal Of Neurosurgery Pediatrics 2015, 17: 434-8. PMID: 26636250, DOI: 10.3171/2015.8.peds15313.Peer-Reviewed Original ResearchConceptsPartial brain radiation therapyRadiation therapyCase reportSarcoma brain metastasesEvidence of diseaseGross tumor resectionGross total resectionBrain metastasesInflammatory changesIntracranial metastasesSarcoma metastasisTumor resectionMetastasisTherapyResectionPatientsLimited marginReasonable approachReportDexamethasoneDiseaseGyBrainMonthsChanging practice patterns of Gamma Knife versus linear accelerator-based stereotactic radiosurgery for brain metastases in the US.
Park HS, Wang EH, Rutter CE, Corso CD, Chiang VL, Yu JB. Changing practice patterns of Gamma Knife versus linear accelerator-based stereotactic radiosurgery for brain metastases in the US. Journal Of Neurosurgery 2015, 124: 1018-24. PMID: 26473783, DOI: 10.3171/2015.4.jns1573.Peer-Reviewed Original ResearchConceptsSingle-fraction stereotactic radiosurgeryNon-small cell lung cancerBrain metastasesStereotactic radiosurgeryNational Cancer Data BaseMultivariable logistic regression analysisSingle-fraction SRSLinear accelerator-based stereotactic radiosurgeryAcademic facility typesLimited brain metastasesNSCLC brain metastasesProportion of patientsYear of diagnosisToxicity of treatmentCell lung cancerLogistic regression analysisSRS useWide geographic variationChi-square testComparative effectiveness researchProspective trialIndependent predictorsMultivariable analysisNonclinical factorsRadiosurgery system
2014
Prophylactic Cranial Irradiation for Patients With Locally Advanced Non–Small-Cell Lung Cancer at High Risk for Brain Metastases
Park HS, Decker RH, Wilson LD, Yu JB. Prophylactic Cranial Irradiation for Patients With Locally Advanced Non–Small-Cell Lung Cancer at High Risk for Brain Metastases. Clinical Lung Cancer 2014, 16: 292-297. PMID: 25499149, DOI: 10.1016/j.cllc.2014.11.005.Peer-Reviewed Original ResearchConceptsProphylactic cranial irradiationLA-NSCLC patientsSequential landmark analysesCell lung cancerBrain metastasesHigh riskCranial irradiationSurvival benefitLung cancerLandmark analysisEffect of PCICox proportional hazards regressionNon-PCI patientsOverall survival benefitEnd Results (SEER) databaseHigh-risk patientsStage III NSCLCGroup of patientsProportional hazards regressionLog-rank testSignificant survival differenceImmortal time biasPopulation-based analysisAdult patientsOnly patients
2011
Stereotactic radiosurgery with or without whole-brain radiotherapy for brain metastases: an update
Park HS, Chiang VL, Knisely JP, Raldow AC, Yu JB. Stereotactic radiosurgery with or without whole-brain radiotherapy for brain metastases: an update. Expert Review Of Anticancer Therapy 2011, 11: 1731-1738. PMID: 22050022, DOI: 10.1586/era.11.165.Peer-Reviewed Original ResearchConceptsWhole-brain radiation therapyStereotactic radiosurgeryBrain metastasesAddition of SRSUse of SRSMD Anderson Cancer CenterWhole brain radiotherapyLocal tumor controlStandard of careAnderson Cancer CenterNormal brain tissueNonrandomized evidenceLimited metastasesOligometastatic diseaseCancer CenterTumor controlRelative sparingRadiation therapyBrain tissueMetastasisSingle fractionNormal tissuesPatientsRadiosurgeryTrialsDelayed Radiation-Induced Vasculitic Leukoencephalopathy
Rauch PJ, Park HS, Knisely JP, Chiang VL, Vortmeyer AO. Delayed Radiation-Induced Vasculitic Leukoencephalopathy. International Journal Of Radiation Oncology • Biology • Physics 2011, 83: 369-375. PMID: 22024206, DOI: 10.1016/j.ijrobp.2011.06.1982.Peer-Reviewed Original ResearchConceptsGamma knife radiosurgeryKnife radiosurgeryRadiation therapyYale-New Haven HospitalRadiation-induced leukoencephalopathyHigh-dose radiation fieldT cell infiltrationMetastatic brain cancerFocused radiation therapyMedium-sized vesselsNew Haven HospitalActive vasculitisLeukoencephalopathic changesVasculitic componentBrain metastasesVascular sclerosisNeuropathologic examinationSignificant morbiditySurgical managementTumor recurrencePathological evidenceHistopathologic observationsLeukoencephalopathyPathological differencesBrain cancer