2024
Opioid prescribing trends and pain scores among adult patients with cancer in a large health system.
Baum L, Soulos P, KC M, Jeffery M, Ruddy K, Lerro C, Lee H, Graham D, Liberatore M, Rivera D, Leapman M, Jairam V, Dinan M, Gross C, Park H. Opioid prescribing trends and pain scores among adult patients with cancer in a large health system. Journal Of Clinical Oncology 2024, 42: 11059-11059. DOI: 10.1200/jco.2024.42.16_suppl.11059.Peer-Reviewed Original ResearchDocumented painHealth systemOpioid prescribingOpioid prescriptionsOpioid prescribing trendsYale New Haven Health SystemPrescribing trendsMetastatic cancerDocumented pain scoresUS health systemOpioid usePain scoresAdult patientsCalculated predicted probabilitiesFlowsheet dataRetrospective cohort studyRelated harmSolid tumor malignanciesCohort studyCancer painPrescribingContext of cancer treatmentStudy criteriaPainSurgery cohortReal world outcomes of patients with small cell lung cancer (SCLC) presenting with brain metastasis at diagnosis in a single institution health system.
Joseph J, Matera R, Park H, Chiang V, Chiang A. Real world outcomes of patients with small cell lung cancer (SCLC) presenting with brain metastasis at diagnosis in a single institution health system. Journal Of Clinical Oncology 2024, 42: e20136-e20136. DOI: 10.1200/jco.2024.42.16_suppl.e20136.Peer-Reviewed Original ResearchExtensive-stage small cell lung cancerMedian progression free survivalSmall cell lung cancerGamma knife radiosurgeryMedian overall survivalBrain metsCell lung cancerBrain metastasesFree survivalBrain radiationExtensive-stage small cell lung cancer patientsPatients treated with Gamma Knife radiosurgeryLung cancerSmall cell lung cancer patientsAggressive lung cancer subtypePatients treated with chemoimmunotherapyUpfront gamma knife radiosurgerySingle-institution retrospective studyAdvanced radiation techniquesTreated with chemoimmunotherapyProgression free survivalOutcomes of patientsLung cancer subtypesFrontline chemoimmunotherapyPlatinum doubletsRadioresistant Pulmonary Oligometastatic and Oligoprogressive Lesions From Nonlung Primaries: Impact of Histology and Dose-Fractionation on Local Control After Radiation Therapy
Verma N, Laird J, Moore N, Hayman T, Housri N, Peters G, Knowlton C, Jairam V, Campbell A, Park H. Radioresistant Pulmonary Oligometastatic and Oligoprogressive Lesions From Nonlung Primaries: Impact of Histology and Dose-Fractionation on Local Control After Radiation Therapy. Advances In Radiation Oncology 2024, 9: 101500. PMID: 38699671, PMCID: PMC11063223, DOI: 10.1016/j.adro.2024.101500.Peer-Reviewed Original ResearchLocal recurrence-free survivalNon-lung primaryAssociated with higher local recurrence-free survivalProgression-free survivalBiologically effective doseLocal controlRadioresistant metastasesOverall survivalPulmonary metastasesPrimary cancerColorectal carcinomaAssociated with superior local controlMultivariate analysisPatients treated with radiotherapyRisk of local recurrenceMedian follow-up timeMultivariable Cox proportional hazards regressionInferior local controlMedian total doseSuperior local controlAssociated with decreased riskImpact of histologyMetastasis-free survivalRecurrence-free survivalLocal failureStereotactic Body Radiotherapy in Locally Advanced Non–Small Cell Lung Cancer—Is This the Future?
Lester-Coll N, Park H. Stereotactic Body Radiotherapy in Locally Advanced Non–Small Cell Lung Cancer—Is This the Future? JAMA Oncology 2024, 10: 360-361. PMID: 38206616, DOI: 10.1001/jamaoncol.2023.5856.Peer-Reviewed Original Research
2023
Differential Effect of Consolidative Thoracic Radiation Therapy in Extensive-Stage Small Cell Lung Cancer Based on Sex
Jairam V, Soulos P, Madhav K, Gross C, Slotman B, Chiang A, Park H. Differential Effect of Consolidative Thoracic Radiation Therapy in Extensive-Stage Small Cell Lung Cancer Based on Sex. Advances In Radiation Oncology 2023, 9: 101413. PMID: 38778819, PMCID: PMC11110031, DOI: 10.1016/j.adro.2023.101413.Peer-Reviewed Original ResearchExtensive-stage small-cell lung cancerConsolidative thoracic radiotherapyProgression-free survivalSmall cell lung cancerCell lung cancerCREST trialThoracic radiotherapyLung cancerElectronic health record-derived databaseFirst-line systemic therapyStandard first-line treatmentCox proportional hazards regressionFirst-line treatmentNational practice patternsProportional hazards regressionSuperior OSInitial chemotherapyBaseline characteristicsSystemic therapyMale patientsFemale patientsPatient sexHazards regressionSurvival outcomesPractice patternsDose-Volume Predictors of Radiation Pneumonitis After Thoracic Hypofractionated Radiation Therapy
Sasse A, Oh P, Saeed N, Yang D, Hayman T, Knowlton C, Peters G, Campbell A, Laird J, Housri N, Park H. Dose-Volume Predictors of Radiation Pneumonitis After Thoracic Hypofractionated Radiation Therapy. Practical Radiation Oncology 2023, 14: e97-e104. PMID: 37984711, DOI: 10.1016/j.prro.2023.11.006.Peer-Reviewed Original ResearchMean lung doseHypofractionated radiation therapyRisk of gradeRadiation pneumonitisLung V20Lung V5Dose-volume predictorsDosimetric risk factorsLogistic regression analysisGrade 5 casesSingle healthcare systemPrimary endpointDose regimensMultivariable analysisLung doseThoracic tumorsDosimetric variablesRisk factorsPneumonitisRadiation therapyCommon treatmentClinical practicePatientsSignificant associationPotential predictorsTrends in new and persistent opioid use in older adults with and without cancer
Baum L, KC M, Soulos P, Jeffery M, Ruddy K, Lerro C, Lee H, Graham D, Rivera D, Leapman M, Jairam V, Dinan M, Gross C, Park H. Trends in new and persistent opioid use in older adults with and without cancer. Journal Of The National Cancer Institute 2023, 116: 316-323. PMID: 37802882, DOI: 10.1093/jnci/djad206.Peer-Reviewed Original ResearchAdditional opioid useNew opioid useOpioid useNon-metastatic cancerPersistent opioid useRetrospective cohort studySolid tumor malignanciesClinical strataEligible patientsNaïve patientsOpioid prescribingMetastatic patientsSurgery patientsCohort studySEER-MedicareMetastatic cancerPatientsTumor malignancyCancerOlder adultsSurgeryRandom sampleAdditional useChemotherapyPrescribingPre-operative chemoradiotherapy with or without induction chemotherapy for operable locally-advanced esophageal cancer
Peters G, Talcott W, Peters N, Dhanasopan A, Lacy J, Cecchini M, Kortmansky J, Stein S, Lattanzi S, Park H, Boffa D, Johung K, Jethwa K. Pre-operative chemoradiotherapy with or without induction chemotherapy for operable locally-advanced esophageal cancer. Journal Of Gastrointestinal Oncology 2023, 14: 1181-1192. PMID: 37435226, PMCID: PMC10331751, DOI: 10.21037/jgo-22-1005.Peer-Reviewed Original ResearchProgression-free survivalMedian progression-free survivalOverall survivalIC-CRTInduction chemotherapySingle-institution retrospective cohort studyPre-operative chemoradiotherapyAdvanced esophageal cancerAdvanced esophageal carcinomaPathologic complete responseRetrospective cohort studyKaplan-Meier methodSubset of patientsProportional hazards regressionCycles of inductionAdenocarcinoma histologyCRT cohortCohort studyComplete responsePathologic responseTreatment cohortsDistant metastasisHazards regressionEsophageal cancerEsophageal carcinoma
2022
Utilization and Survival Impact of Hypofractionated Radiotherapy in Stage I Non-small Cell Lung Cancer
Saeed N, Jin L, Amini A, Verma V, Lester-Coll N, Chen P, Decker R, Park H. Utilization and Survival Impact of Hypofractionated Radiotherapy in Stage I Non-small Cell Lung Cancer. American Journal Of Clinical Oncology 2022, 46: 66-72. PMID: 36662872, DOI: 10.1097/coc.0000000000000974.Peer-Reviewed Original ResearchConceptsNon-small cell lung cancerStage I non-small cell lung cancerOverall survivalCell lung cancerLung cancerStereotactic body radiation therapyNational Cancer DatabaseLog-rank testBody radiation therapyOptimal fractionation scheduleMultivariable modeling techniquesOS benefitHypofractionated radiotherapySurvival impactMultivariable analysisCox regressionCancer DatabaseRetrospective analysisFractionation schedulesRadiation therapyHFRTPatientsCFRTRadiotherapyKaplan-Meier estimatorOutcomes Stratification of Head and Neck Cancer Using Pre- and Post-treatment DNA Methylation From Peripheral Blood
Qian D, Ulrich B, Peng G, Zhao H, Conneely K, Miller A, Bruner D, Eldridge R, Wommack E, Higgins K, Shin D, Saba N, Smith A, Burtness B, Park H, Stokes W, Beitler J, Xiao C. Outcomes Stratification of Head and Neck Cancer Using Pre- and Post-treatment DNA Methylation From Peripheral Blood. International Journal Of Radiation Oncology • Biology • Physics 2022, 115: 1217-1228. PMID: 36410685, DOI: 10.1016/j.ijrobp.2022.11.009.Peer-Reviewed Original ResearchConceptsRecurrence-free survivalWorse recurrence-free survivalOverall survivalMethylation risk scoreRadiation therapyValidation cohortPeripheral bloodDiscovery cohortOutcome stratificationShorter recurrence-free survivalNeck squamous cell carcinomaGastrostomy tube insertionHigher neutrophil countOral cavity cancerAforementioned risk factorsSquamous cell carcinomaPeripheral blood samplesNonmetastatic HNSCCNeutrophil countPrognostic factorsCox regressionPrognostic valueCell carcinomaTube insertionImmune modulationFactors Associated With In-Hospital Mortality in Mycosis Fungoides Patients: A Multivariable Analysis
King ALO, Lee V, Mirza FN, Jairam V, Yang DX, Yu JB, Park HS, Girardi M, Wilson LD, An Y, Wilson L. Factors Associated With In-Hospital Mortality in Mycosis Fungoides Patients: A Multivariable Analysis. Cureus 2022, 14: e28043. PMID: 36120198, PMCID: PMC9474264, DOI: 10.7759/cureus.28043.Peer-Reviewed Original ResearchCutaneous T-cell lymphomaNationwide Emergency Department SampleHospital mortalityMycosis fungoides patientsMycosis fungoidesMF patientsBackground Mycosis fungoidesIn-Hospital MortalitySpecific clinical factorsMultivariable logistic regressionEmergency Department SampleT-cell lymphomaUnderstanding of patientsSézary syndromeClinical factorsIndolent courseMultivariable analysisSurvival outcomesFemale sexHospital characteristicsAdvanced ageEmpirical managementPatientsMF casesGreater riskImmunotherapy After Chemotherapy and Radiation for Clinical Stage III Lung Cancer
Pichert MD, Canavan ME, Maduka RC, Li AX, Ermer T, Zhan PL, Kaminski M, Udelsman BV, Blasberg JD, Park HS, Goldberg SB, Boffa DJ. Immunotherapy After Chemotherapy and Radiation for Clinical Stage III Lung Cancer. JAMA Network Open 2022, 5: e2224478. PMID: 35925606, PMCID: PMC9353596, DOI: 10.1001/jamanetworkopen.2022.24478.Peer-Reviewed Original ResearchConceptsStage III non-small cell lung cancerNon-small cell lung cancerClinical stage III non-small cell lung cancerUnresectable stage III non-small cell lung cancerPropensity-matched sampleGeneral US populationSurvival advantageCohort studyLung cancerMultivariable Cox proportional hazards modelsUS populationStage III lung cancerMedian age 66 yearsCox proportional hazards modelNational Cancer DatabaseEfficacy of immunotherapyAge 66 yearsProtocol rangesCell lung cancerClinical trial populationsProportional hazards modelTerms of ageImmunotherapy initiationImmunotherapy recipientsImmunotherapy useImpact of radiotherapy delay following biopsy for patients with unresected glioblastoma.
Gao S, Jin L, Moliterno J, Corbin ZA, Bindra RS, Contessa JN, Yu JB, Park HS. Impact of radiotherapy delay following biopsy for patients with unresected glioblastoma. Journal Of Neurosurgery 2022, 138: 610-620. PMID: 35907197, DOI: 10.3171/2022.5.jns212761.Peer-Reviewed Original ResearchConceptsWeeks of biopsyOverall survivalCox proportional hazards regression modelingProportional hazards regression modelingNational Cancer DatabaseInitiation of radiotherapyKaplan-Meier methodWorse overall survivalWilcoxon rank sum testEffects of confoundersRank sum testUnresected diseaseAdjuvant radiotherapyConcurrent chemotherapyMedian intervalMultivariable analysisRadiotherapy delayCancer DatabaseClinical dataBiopsyPatientsLate initiationAggressive natureRadiotherapyPotential associationA guide for managing patients with stage I NSCLC: deciding between lobectomy, segmentectomy, wedge, SBRT and ablation— part 1: a guide to decision-making
Detterbeck FC, Blasberg JD, Woodard GA, Decker RH, Kumbasar U, Park HS, Mase VJ, Bade BC, Li AX, Brandt WS, Madoff DC. A guide for managing patients with stage I NSCLC: deciding between lobectomy, segmentectomy, wedge, SBRT and ablation— part 1: a guide to decision-making. Journal Of Thoracic Disease 2022, 0: 0-0. PMID: 35813719, PMCID: PMC9264102, DOI: 10.21037/jtd-21-1823.Peer-Reviewed Original ResearchLong-term outcomesIndividual patientsHealthy patientsLung cancerFavorable tumorsStage I lung cancerBetter long-term outcomesI lung cancerStage I NSCLCOlder patientsPatient selectionPoint of careSurgical approachClinical careEffect modifiersTreatment selectionPatientsTreatment approachesPatient valuesClinical judgmentSystematic reviewRelevant outcomesLong-term differencesAvailable evidenceShort-term differencesA guide for managing patients with stage I NSCLC: deciding between lobectomy, segmentectomy, wedge, SBRT and ablation—part 2: systematic review of evidence regarding resection extent in generally healthy patients
Detterbeck FC, Mase VJ, Li AX, Kumbasar U, Bade BC, Park HS, Decker RH, Madoff DC, Woodard GA, Brandt WS, Blasberg JD. A guide for managing patients with stage I NSCLC: deciding between lobectomy, segmentectomy, wedge, SBRT and ablation—part 2: systematic review of evidence regarding resection extent in generally healthy patients. Journal Of Thoracic Disease 2022, 0: 0-0. PMID: 35813747, PMCID: PMC9264068, DOI: 10.21037/jtd-21-1824.Peer-Reviewed Original ResearchNon-randomized comparisonHealthy patientsResection extentIndividual patientsSystematic reviewStage I lung cancerI lung cancerStage I NSCLCCharacteristics of patientsPulmonary function testsLong-term outcomesRisk of recurrenceVideo-assisted approachSublobar resectionWedge resectionRandomized trialsFunction testsLung cancerResidual confoundingEffect modifiersShort-term benefitsLobectomyPatientsPubMed systematic reviewMargin distanceA guide for managing patients with stage I NSCLC: deciding between lobectomy, segmentectomy, wedge, SBRT and ablation—part 4: systematic review of evidence involving SBRT and ablation
Park HS, Detterbeck FC, Madoff DC, Bade BC, Kumbasar U, Mase VJ, Li AX, Blasberg JD, Woodard GA, Brandt WS, Decker RH. A guide for managing patients with stage I NSCLC: deciding between lobectomy, segmentectomy, wedge, SBRT and ablation—part 4: systematic review of evidence involving SBRT and ablation. Journal Of Thoracic Disease 2022, 0: 0-0. PMID: 35813762, PMCID: PMC9264060, DOI: 10.21037/jtd-21-1826.Peer-Reviewed Original ResearchLong-term outcomesNon-randomized comparisonIndividual patientsSystematic reviewStage I lung cancerI lung cancerCharacteristics of patientsStage I NSCLCPulmonary function testsMinority of patientsShort-term outcomesStereotactic body radiotherapyThermal ablationLate toxicityPulmonary functionRandomized trialsFunction testsAdjusted comparisonsBody radiotherapyLung cancerResidual confoundingEffect modifiersShort-term benefitsPatientsPubMed systematic reviewA guide for managing patients with stage I NSCLC: deciding between lobectomy, segmentectomy, wedge, SBRT and ablation—part 3: systematic review of evidence regarding surgery in compromised patients or specific tumors
Bade BC, Blasberg JD, Mase VJ, Kumbasar U, Li AX, Park HS, Decker RH, Madoff DC, Brandt WS, Woodard GA, Detterbeck FC. A guide for managing patients with stage I NSCLC: deciding between lobectomy, segmentectomy, wedge, SBRT and ablation—part 3: systematic review of evidence regarding surgery in compromised patients or specific tumors. Journal Of Thoracic Disease 2022, 0: 0-0. PMID: 35813753, PMCID: PMC9264070, DOI: 10.21037/jtd-21-1825.Peer-Reviewed Original ResearchLimited pulmonary reserveLong-term outcomesResection extentNon-randomized comparisonPulmonary reserveOlder patientsIndividual patientsFavorable tumorsSystematic reviewStage I lung cancerFavorable long-term outcomeI lung cancerScreen-detected tumorsStage I NSCLCCharacteristics of patientsShort-term outcomesLesser resectionsPerioperative mortalityPulmonary functionSublobar resectionWedge resectionPatient selectionRandomized trialsLung cancerResidual confoundingQuantifying the rate and predictors of occult lymph node involvement in patients with clinically node-negative non-small cell lung cancer.
Haque W, Singh A, Park HS, Teh BS, Butler EB, Zeng M, Lin SH, Welsh JW, Chang JY, Verma V. Quantifying the rate and predictors of occult lymph node involvement in patients with clinically node-negative non-small cell lung cancer. Acta Oncologica (Stockholm, Sweden) 2022, 61: 403-408. PMID: 34913815, DOI: 10.1080/0284186X.2021.2012253.Peer-Reviewed Original ResearchPractice 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 respondentsTherapyNonadherence to Multimodality Cancer Treatment Guidelines in the United States
Tchelebi LT, Shen B, Wang M, Potters L, Herman J, Boffa D, Segel JE, Park HS, Zaorsky NG. Nonadherence to Multimodality Cancer Treatment Guidelines in the United States. Advances In Radiation Oncology 2022, 7: 100938. PMID: 35469182, PMCID: PMC9034283, DOI: 10.1016/j.adro.2022.100938.Peer-Reviewed Original ResearchGuideline-concordant treatmentAnal cancerMultimodality treatmentRectal cancerCervical cancerLung cancerAdvanced non-small cell lung cancerNasopharynx cancerNon-small cell lung cancerNonmetastatic anal cancerNational Cancer DatabasePercent of patientsAdvanced cervical cancerCancer treatment guidelinesCell lung cancerMultivariable logistic regressionPrimary tumor siteLow-volume facilitiesTreatment guidelinesComorbid conditionsCancer DatabaseOdds ratioNational guidelinesPatientsConfounding variables