PIONEERING BIG DATA IN RADIATION ONCOLOGY

Size: px
Start display at page:

Download "PIONEERING BIG DATA IN RADIATION ONCOLOGY"

Transcription

1 TM PIONEERING BIG DATA IN RADIATION ONCOLOGY Todd McNutt PhD Associate Professor Radiation Oncology Johns Hopkins University Presented at the Target Insight Toronto, CAN May 8 th, 2015

2 Disclosures This work has been partially funded with collaborations from: Philips Radiation Oncology Systems Elekta Oncology Systems Toshiba Medical Systems as well as Commonwealth Foundation Maritz Foundation 2

3 Problem Ability to advance radiotherapy is limited by our knowledge of which patients are at risk of high grade toxicity or of limited ability to cure. Knowledge from clinical trials is quite coarse and fails to consider all of the aspects of the individual patient. Big Data offers an opportunity to better predict treatment outcome and provide improved clinical decisions for individual patients.

4 Personalized care using database of prior patients How to best to treat individual patient? Pathology Diagnosis Performance Status Comorbidities Patient History Radiotherapy Surgery Chemotherapy CONSULT TREATMENT Survival FOLLOW-UP Quality of Life Clinical assessments Lab Values Toxicities Disease Status Prediction of complications for early intervention? Predicted response and toxicity?

5 Precision Radiotherapy Treatment Planning

6 Mucositis data collected at JHU # patients Toxicity grade 6

7 Promote Culture of Data Collection Data collected over entire treatment Consult Demographics Diagnosis Staging Baseline Tox Baseline QoL History Weekly On Treatment Toxicity QoL Patient status Symptom Mgmt End of Treatment Acute toxicity QoL Patient status Symptom mgmt Disease response Follow Up Late toxicity QoL Patient status Disease response Simulation Targets OARs OVH Planning Rx Dose DVH Image Guidance Motion Disease Response At what time point do we have enough data to make decision based on future prediction? Auto Plan Risk Based Symptom Mgmt Therapy Mgmt Input Variables => Prediction?

8 MOSAIQ Browser Departmental Analytics Framework Multi-Disciplinary Clinics RadOnc Users Security Certificate Johns Hopkins Enterprise Login SiteMinder Access Management Mobile Solutions Mosaiq Browser -IIS -ASP.NET -C# -SQL Data Access Layer SQL SQL Query Log Clinical Analytics IDE - Visual Studio - SVN repository MOSAIQ Security Rights MOSAIQ DB

9 Data Collection in Clinic Clinical Assessment Quality of life Disease Status 5/27/2015 9

10 Head and Neck Oncospace Landscape Home-based Assessment (FitNinja) Head and Neck Tissue Bank (Chung) SNP Genotyping Pre-Treatment Imaging (Kiess/Hobbs/Shen) On-Treatment Imaging (Lee/Shekhar) (Toshiba) Oncospace - On-Treatment Evaluation - RT dosimetry Swallow Function (Starmer et al) Toxicity PROs Oncologic Outcome Neck Function (Sweet) Ocular Function (Subramanian) Post-Treatment Oncologic and Toxicity (Ding/Fakhry/Murano/Prince/ Wasserman Ecological Momentary Assessments (EMAs)

11 Extract, Transform, Load DICO M MOSAIQ - SQL Query - Lab, Toxicity, Assessments Oncospace Pinnacle TPS - Scripts, Python, DICOM - DVH, OVH, Shapes

12 Oncospace tables and schema Patient Private Health Info (access restricted) Family History Social History Medical History Medications (chemo) Surgical Procedures Test Results (Labs) Assessments (Toxicities) Clinical Events Tumors Radiation Summary Patient Representations (CT based geometries) (m:n) Image Transform Image Feature Pathology Feature Organ DVH Data Organ Dose Summaries 1 : N multiple instances 1 : 1 single instance m : n relates m to n Organ DVH Feature ROI DVH Data Radiotherapy Sessions ROI Dose Summary ROI DVH Features Shape Descriptor Regions of Interest Data (m:n) Shape Relationship Features

13 Data inventory Toxicities (24var/pt) Quality of Life (64var/pt) Measured data (6 var/pt) Disease response(8var/pt) w 2-4w 4-6w 6w-3m 3m-6m 6m-1y 1-2y 2-3y 3-4y 4-5y 5-6y >6y 5/27/

14 Organs at risk with full dose 5/27/

15 Learning health system can t exist without data Decision Point Facts Controls Outcomes time Knowledge Database Facts Decisions Controls Presentation of Predictions Predictive Modeling Predicted Outcomes Data Feedback (Facts, Outcomes) 15

16 Oncospace Consortium Repository (It s all about the data) Johns Hopkins U. Washington U. Toronto Sunnybrook U. Virginia Institution X Knowledge Base Registry $/pt Quality Reporting Decision Support Research N

17 Toxicity trends during and after treatment detect outliers During Treatment Follow up Dysphagia Swallowing Worsens after Tx for many patients then improves long term Mucositis Inflammation Heals after Tx for most patients Xerostomia Dry Mouth Tends to be permanent #pts Toxicity grade (0-5)

18 Toxicity trends during and after treatment detect outliers During Treatment Follow up Dysgeusia Taste disturbance Worsens through Tx then improves long term Voice Change Worsens through Tx #pts Toxicity grade (0-5)

19 DVH, Toxicities and Grade distributions Voice Change Larynx 50% Volume Dysphagia Larynx_edema 30% Volume Toxicity Grade 0,1,2,3,4,5 Mean and stddev of DX% at grade Number of patients by grade at D50%

20 OVH: serial vs parallel Target OAR1 OAR2 r 70,1 r 70,2 For parallel organs, OAR2 is more easily spared. For serial organs, OAR1 is more easily spared.

21 Shape-dose relationship for radiation plan quality Shape relationship DB of prior patients Dose prediction parotids 0 PTV normalized volume Dose (Gy) Right parotid Left parotid For a selected Organ at Risk and %V, find the lowest dose achieved from all patients whose %V is closer to the selected target volume? Decisions: Plan quality assessment Automated planning IMRT objective selection Dosimetric trade-offs

22 Sample automated radiation planning result Original plan Automated plan 30% reduction in dose to parotids Auto plan Original Plan Dot: right No-dot: left Dose(Gy) brain (Gy) (max) Brainstem (Gy) (max) Cord4mm (Gy) (max) L inner ear (Gy)(mean) original re-plan R inner ear (Gy) (mean) mandible (Gy) (max) larynx for edema (V50) esophagus (Gy)(max) original % re-plan % 61

23 Toxicity and Dose Volume Histogram Scott Robertson PhD 23

24 Prevalence and prediction of treatment-related complications RISK STRUCTURES TOXICITIES / OUTCOMES 10%/Gy 5%/Gy MODELLED RISK May 27,

25 Voice Change

26 Bad DVH! DVH assumes that every sub-region of an OAR has the same radiosensitivity and functional importance to the related toxicity DVH assumes that each OAR is uniquely responsible for the overall human function related to the toxicity

27 Spatial dose analysis Method Voice dysfunction n=99, n + =8, n - =91 Xerostomia n=364, n + =275, n - =89 Bagged Naïve Bayes (1000 iterations) Bagged Linear Regression (1000 iterations) Naïve Bayes Linear Regression Random Forest (1000 trees) Hopkins NTCP inhealth LKB

28 Classification with correlated features: unreliability of feature ranking and solutions Simulation of 1, 10 and 20 variables with a correlation of 0.9 with variable 3 Genuer et al.

29 Weight loss prediction Endpoint: > 5kg loss at 3 months post RT Larynx salivary glands thyroid hypopharynx yes FALSE FALSE At planning Larynx D55 < 27.5Gy no Diagnostic ICD-9 Combo Parotid D50< 13.5Gy Distance: HD-PTV to Superior Constrictor Muscle >= 1.1cm Combo Masticatory Muscle D41 < 38.4Gy FALSE FALSE FALSE FALSE oropharynx tongue nasopharynx nasal cavities Larynx D80 < 23.0Gy TRUE Larynx salivary glands thyroid hypopharynx Nausea < 1 (CACAE) FALSE Skin Acute < 3 (CACAE) N stage < 2 Diagnostic ICD-9 At end of RT yes Combo Parotid D61< 7.5Gy Pain Intensity - Current < 5 Able to eat foods I like >= 3 (FACT) larynx D59 < 27.4Gy Distance: LD-PTV to Larynx >= -1.3cm Cricopharyngeal Muscle D100 < 38.1Gy oropharynx tongue nasopharynx nasal cavities Diagnostic ICD-9 tongue Esophagitis/ Pharyngitis < 3 (CACAE) Combo Parotid D96< 6.5Gy Larynx D10 < 42.3Gy FALSE TRUE TRUE FALSE FALSE TRUE FALSE TRUE FALSE TRUE FALSE TRUE FALSE TRUE no 5/27/

30 What can we do with the data? Shape based auto-planning Clinical (prostate, pancreas) Efficient high quality plan Weight loss prediction Improved symptom management Toxicity Risk DVH based Spatial dose based Disease response prediction Pancreas resectability Head and neck HPV dose de-escalation Shape relationship parotids PTV DB of prior patients normalized volume Dose prediction Right parotid Left parotid Dose (Gy) 30

31 Summary The Oncospace model can house RT data effectively and provides a model for sharing Data collection in the clinical environment has been demonstrated All patient on trial Data exploration and analysis across multiple institutions is possible Exploring models to stratify patients to improve the predictive power of the data Decision support to improve quality and safety has been demonstrated Personalized medicine has not been fully demonstrated, but remains a tenable goal

32 Acknowledgments JHU-RO Sierra Cheng MD Kim Evans MS Michael Bowers BS Joseph Moore PhD Scott Robertson PhD Wuyang Yang MS, MD John Wong PhD Theodore DeWeese MD GI Team Joseph Herman MD Amy Hacker-Prietz PA H&N Team Harry Quon MD Giuseppe Sanguineti MD Heather Starmer MD Ana Keiss MD Mysha Allen RN Sara Afonso RN JHU - CS Russ Taylor PhD Misha Kazhdan PhD Fumbeya Murango BS Philips PROS Karl Bzdusek BS Toshiba Minoru Nakatsugawa PhD Bobby Davey PhD Rachel-Louise Koktava John Haller Elekta

Automated Treatment Planning Using a Database of Prior Patient Treatment Plans

Automated Treatment Planning Using a Database of Prior Patient Treatment Plans Automated Treatment Planning Using a Database of Prior Patient Treatment Plans Todd McNutt PhD, Binbin Wu PhD, Joseph Moore PhD, Steven Petit PhD, Misha Kazhdan PhD, Russell Taylor PhD Shape DB work funded

More information

Evolution of Head and Neck Treatment Using Protons. Mayank Amin, M.Sc,CMD

Evolution of Head and Neck Treatment Using Protons. Mayank Amin, M.Sc,CMD Evolution of Head and Neck Treatment Using Protons Mayank Amin, M.Sc,CMD Facility Layout Gantry Room 3 Fixed Beams Room 4 HEBT Gantry Room 2 Gantry Room 1 Synchrotron Linac Treatment Planning Imaging Area

More information

THE DOSIMETRIC EFFECTS OF

THE DOSIMETRIC EFFECTS OF THE DOSIMETRIC EFFECTS OF OPTIMIZATION TECHNIQUES IN IMRT/IGRT PLANNING 1 Multiple PTV Head and Neck Treatment Planning, Contouring, Data, Tips, Optimization Techniques, and algorithms AAMD 2013, San Antonio,

More information

Proton Therapy Center Czech

Proton Therapy Center Czech Proton Therapy Center Czech The main goal of radiotherapy is to irreversibly damage tumor cells, whereas the cells of healthy tissue are damaged only reversibly or not at all. Proton therapy currently

More information

Our Facility. Advanced clinical center with the newest and highly exact technology for treatment of patients with cancer pencil beam

Our Facility. Advanced clinical center with the newest and highly exact technology for treatment of patients with cancer pencil beam PTC Czech The main goal of radiotherapy is to irreversibly damage tumor cells, whereas the cells of healthy tissue are damaged only reversibly or not at all. Proton therapy currently comes closest to this

More information

Corporate Medical Policy

Corporate Medical Policy Corporate Medical Policy Intensity Modulated Radiation Therapy (IMRT) of Head and Neck File Name: Origination: Last CAP Review: Next CAP Review: Last Review: intensity_modulated_radiation_therapy_imrt_of_head_and_neck

More information

Evaluation of an automated knowledge based treatment planning system for head and neck

Evaluation of an automated knowledge based treatment planning system for head and neck Krayenbuehl et al. Radiation Oncology (2015) 10:226 DOI 10.1186/s13014-015-0533-2 RESEARCH Open Access Evaluation of an automated knowledge based treatment planning system for head and neck Jerome Krayenbuehl

More information

Learning about Mouth Cancer

Learning about Mouth Cancer Learning about Mouth Cancer Creation of this material was made possible in part by a pioneering grant from CBCC-USA. Distributed by India Cancer Initiative What is mouth cancer? Our bodies are made up

More information

Chapter 7. Accepted for publication in Acta Oncologica

Chapter 7. Accepted for publication in Acta Oncologica Chapter 7 The potential of intensity-modulated proton radiotherapy to reduce swallowing dysfunction in the treatment of head and neck cancer: a planning comparative study Hans Paul van der Laan, Tara A.

More information

Head and Neck Treatment Planning: A Comparative Review of Static Field IMRT Rapid Arc Tomotherapy HD

Head and Neck Treatment Planning: A Comparative Review of Static Field IMRT Rapid Arc Tomotherapy HD Good Morning Head and Neck Treatment Planning: A Comparative Review of Static Field IMRT Rapid Arc Tomotherapy HD Barbara Agrimson, BS RT(T)(R), CMD Steve Rhodes, BS RT(T), CMD Disclaimer This presentation

More information

THE SECRETS OF OUR SUCCESS

THE SECRETS OF OUR SUCCESS THE SECRETS OF OUR SUCCESS QUALITY OF LIFE STUDIES OF THE NCIC Andrea Bezjak, MDCM, MSc,, FRCPC Chair, NCIC CTG QOL Committee Outline of the Presentation Can we consider NCIC CTG QOL activities a success?

More information

Clinical Education A comprehensive and specific training program. carry out effective treatments from day one

Clinical Education A comprehensive and specific training program. carry out effective treatments from day one Proton Therapy Clinical Education A comprehensive and specific training program carry out effective treatments from day one Forewarned is forearmed Although over 100,000 patients have been treated in proton

More information

Medical Marijuana Use in Patients with History of SCCHN Treated with Radiotherapy

Medical Marijuana Use in Patients with History of SCCHN Treated with Radiotherapy HEALTH SERVICES RESEARCH Assessment the Impact of Real-time Tumor Tracking & Reduced Planning Target Volume Margins on Quality-of-Life in Prostate Cancer Patients Treatment with Intensity Modulated Radiotherapy

More information

C a nc e r C e nter. Annual Registry Report

C a nc e r C e nter. Annual Registry Report C a nc e r C e nter Annual Registry Report 214 214 Cancer Registry Report Larraine A. Tooker, CTR Please note that the 214 Cancer Registry Annual Report is created in 214, but it reflects data on cases

More information

PATIENT INFORMATION ABOUT ADJUVANT THERAPY AFTER THE WHIPPLE OPERATION FOR ADENOCARCINOMA ( CANCER ) OF THE PANCREAS AND RELATED SITES.

PATIENT INFORMATION ABOUT ADJUVANT THERAPY AFTER THE WHIPPLE OPERATION FOR ADENOCARCINOMA ( CANCER ) OF THE PANCREAS AND RELATED SITES. PATIENT INFORMATION ABOUT ADJUVANT THERAPY AFTER THE WHIPPLE OPERATION FOR ADENOCARCINOMA ( CANCER ) OF THE PANCREAS AND RELATED SITES. Radiation Oncology Sidney Kimmel Cancer Center at Johns Hopkins Last

More information

Radiation Therapy for Prostate Cancer: Treatment options and future directions

Radiation Therapy for Prostate Cancer: Treatment options and future directions Radiation Therapy for Prostate Cancer: Treatment options and future directions David Weksberg, M.D., Ph.D. PinnacleHealth Cancer Institute September 12, 2015 Radiation Therapy for Prostate Cancer: Treatment

More information

Dosimetric impact of the 160 MLC on head and neck IMRT treatments

Dosimetric impact of the 160 MLC on head and neck IMRT treatments JOURNAL OF APPLIED CLINICAL MEDICAL PHYSICS, VOLUME 15, NUMBER 6, 2014 Dosimetric impact of the 160 MLC on head and neck IMRT treatments Prema Rassiah-Szegedi, a Martin Szegedi, Vikren Sarkar, Seth Streitmatter,

More information

How To Know If You Have Cancer At Mercy Regional Medical Center

How To Know If You Have Cancer At Mercy Regional Medical Center MERCY REGIONAL CANCER CENTER 2012 CANCER PROGRAM ANNUAL REPORT Using 2011 Data Mercy Regional Cancer Center When you have cancer, you might think first of treatments chemotherapy and radiation. You want

More information

Diagnosis and Treatment of Common Oral Lesions Causing Pain

Diagnosis and Treatment of Common Oral Lesions Causing Pain Diagnosis and Treatment of Common Oral Lesions Causing Pain John D. McDowell, DDS, MS University of Colorado School of Dentistry Chair, Oral Diagnosis, Medicine and Radiology Director, Oral Medicine and

More information

Veterinary Oncology: The Lumps We Hate To Treat

Veterinary Oncology: The Lumps We Hate To Treat Veterinary Oncology: The Lumps We Hate To Treat Michelle Turek, DVM, DACVIM (Oncology), DACVR (Radiation Oncology) College of Veterinary Medicine University of Georgia Athens, GA Veterinary Oncology Veterinary

More information

Concurrent Chemotherapy and Radiotherapy for Head and Neck Cancer

Concurrent Chemotherapy and Radiotherapy for Head and Neck Cancer Concurrent Chemotherapy and Radiotherapy for Head and Neck Cancer Ryan J. Burri; Nancy Y. Lee Published: 03/23/2009 Abstract and Introduction Abstract Head and neck cancer is best managed in a multidisciplinary

More information

Particle Therapy for Lung Cancer. Bradford Hoppe MD, MPH Assistant Professor University of Florida bhoppe@floridaproton.org

Particle Therapy for Lung Cancer. Bradford Hoppe MD, MPH Assistant Professor University of Florida bhoppe@floridaproton.org Particle Therapy for Lung Cancer Bradford Hoppe MD, MPH Assistant Professor University of Florida bhoppe@floridaproton.org Content Rationale for Particle Therapy in Lung Cancer Proof of Principle Treatment

More information

Advanced Radiation Therapy of Cancer by Proton Beam

Advanced Radiation Therapy of Cancer by Proton Beam March 20th, 2014 Advanced Radiation Therapy of Cancer by Proton Beam Fukui Prefectural Hospital Proton Therapy Center Yamamoto, Kazutaka Wave (electromagnetic wave) IR (Ionizing) Radiation 700 400 350~100

More information

Goals and Objectives: Breast Cancer Service Department of Radiation Oncology

Goals and Objectives: Breast Cancer Service Department of Radiation Oncology Goals and Objectives: Breast Cancer Service Department of Radiation Oncology The breast cancer service provides training in the diagnosis, management, treatment, and follow-up of breast malignancies, including

More information

Principles of Radiation Therapy A Bapsi Chakravarthy, MD Associate e P rofessor Professor Radiation Oncology

Principles of Radiation Therapy A Bapsi Chakravarthy, MD Associate e P rofessor Professor Radiation Oncology Principles of Radiation Therapy A Bapsi Chakravarthy, MD Associate Professor Radiation Oncology Disclosure Information I have no financial relationships to disclose relevant to the conten of this presentation.

More information

Radiation Protection in Radiotherapy

Radiation Protection in Radiotherapy Radiation Protection in Radiotherapy Albert Lisbona Medical Physics Department CLCC Nantes Atlantique 44805 Saint-Herblain France a-lisbona@nantes.fnclcc.fr Radiation therapy The lecture is oriented to

More information

Management of Postmenopausal Women with T1 ER+ Tumors: Options and Tradeoffs. Case Study. Surgery. Lumpectomy and Radiation

Management of Postmenopausal Women with T1 ER+ Tumors: Options and Tradeoffs. Case Study. Surgery. Lumpectomy and Radiation Management of Postmenopausal Women with T1 ER+ Tumors: Options and Tradeoffs Michael Alvarado, MD Associate Professor of Surgery University of California San Francisco Case Study 59 yo woman with new palpable

More information

Radiotherapy in locally advanced & metastatic NSC lung cancer

Radiotherapy in locally advanced & metastatic NSC lung cancer Radiotherapy in locally advanced & metastatic NSC lung cancer Dr Raj Hegde. MD. FRANZCR Consultant Radiation Oncologist. William Buckland Radiotherapy Centre. Latrobe Regional Hospital. Locally advanced

More information

Chapter 8. General discussion and conclusions - 153 -

Chapter 8. General discussion and conclusions - 153 - Chapter 8 General discussion and conclusions - 153 - Chapter 8 General discussion and conclusions The aim of this thesis was (1) to investigate if irradiation with scanned intensity-modulated proton therapy

More information

Current Status and Perspectives of Radiation Therapy for Breast Cancer

Current Status and Perspectives of Radiation Therapy for Breast Cancer Breast Cancer Current Status and Perspectives of Radiation Therapy for Breast Cancer JMAJ 45(10): 434 439, 2002 Masahiro HIRAOKA, Masaki KOKUBO, Chikako YAMAMOTO and Michihide MITSUMORI Department of Therapeutic

More information

The Science behind Proton Beam Therapy

The Science behind Proton Beam Therapy The Science behind Proton Beam Therapy Anthony Zietman MD Shipley Professor of Radiation Oncology Massachusetts General Hospital Harvard Medical School Principles underlying Radiotherapy Radiation related

More information

Esophageal Cancer Treatment

Esophageal Cancer Treatment Scan for mobile link. Esophageal Cancer Treatment What is Esophageal Cancer? Esophageal cancer occurs when cancer cells develop in the esophagus, a long, tube-like structure that connects the throat and

More information

Prostatectomy, pelvic lymphadenect. Med age 63 years Mean followup 53 months No other cancer related therapy before recurrence. Negative.

Prostatectomy, pelvic lymphadenect. Med age 63 years Mean followup 53 months No other cancer related therapy before recurrence. Negative. Adjuvante und Salvage Radiotherapie Ludwig Plasswilm Klinik für Radio-Onkologie, KSSG CANCER CONTROL WITH RADICAL PROSTATECTOMY ALONE IN 1,000 CONSECUTIVE PATIENTS 1983 1998 Clinical stage T1 and T2 Mean

More information

Current Status and Future Direction of Proton Beam Therapy

Current Status and Future Direction of Proton Beam Therapy Current Status and Future Direction of Proton Beam Therapy National Cancer Center Hospital East Division of Radiation Oncology and Particle Therapy Tetsuo Akimoto Comparison of status of particle therapy

More information

Non-Small Cell Lung Cancer Treatment Comparison to NCCN Guidelines

Non-Small Cell Lung Cancer Treatment Comparison to NCCN Guidelines Non-Small Cell Lung Cancer Treatment Comparison to NCCN Guidelines April 2008 (presented at 6/12/08 cancer committee meeting) By Shelly Smits, RHIT, CCS, CTR Conclusions by Dr. Ian Thompson, MD Dr. James

More information

Department of Radiation Oncology

Department of Radiation Oncology Department of Radiation Oncology Welcome to Radiation Oncology at Emory Clinic Every member of Emory Clinic Department of Radiation Oncology strives to provide the highest quality of care for you as our

More information

Evaluation of complexity and deliverability of IMRT- treatment plans. Author: Elin Svensson Supervisors: Anna Bäck and Anna Karlsson Hauer

Evaluation of complexity and deliverability of IMRT- treatment plans. Author: Elin Svensson Supervisors: Anna Bäck and Anna Karlsson Hauer Evaluation of complexity and deliverability of IMRT- treatment plans Author: Elin Svensson Supervisors: Anna Bäck and Anna Karlsson Hauer June 11 Abstract Background: Intensity modulated beams are used

More information

Stomach (Gastric) Cancer. Prof. M K Mahajan ACDT & RC Bathinda

Stomach (Gastric) Cancer. Prof. M K Mahajan ACDT & RC Bathinda Stomach (Gastric) Cancer Prof. M K Mahajan ACDT & RC Bathinda Gastric Cancer Role of Radiation Layers of the Stomach Mucosa Submucosa Muscularis Serosa Stomach and Regional Lymph Nodes Stomach and Regional

More information

Proton Therapy for Pediatric Cancers

Proton Therapy for Pediatric Cancers Proton Therapy for Pediatric Cancers Christine Hill- Kayser, MD Editor- in- Chief, OncoLink Assistant Professor of Radiation Oncology, Pediatrics Service, University of Pennsylvania Melanie Eisenhower,

More information

The Canadian National System for Incident Reporting in Radiation Treatment (NSIR-RT) Taxonomy March 2, 2015 V2

The Canadian National System for Incident Reporting in Radiation Treatment (NSIR-RT) Taxonomy March 2, 2015 V2 The Canadian National System for Incident Reporting in Radiation Treatment (NSIR-RT) Taxonomy March 2, 2015 V2 Taxonomy Data Category Number Description Data Fields and Menu Choices 1. Impact 1.1 Incident

More information

Basic Radiation Therapy Terms

Basic Radiation Therapy Terms Basic Radiation Therapy Terms accelerated radiation: radiation schedule in which the total dose is given over a shorter period of time. (Compare to hyperfractionated radiation.) adjuvant therapy (add-joo-vunt):

More information

Pediatric Oncology for Otolaryngologists

Pediatric Oncology for Otolaryngologists Pediatric Oncology for Otolaryngologists Frederick S. Huang, M.D. Division of Hematology/Oncology Department of Pediatrics The University of Texas Medical Branch Grand Rounds Presentation to Department

More information

Brain Tumor Treatment

Brain Tumor Treatment Scan for mobile link. Brain Tumor Treatment Brain Tumors Overview A brain tumor is a group of abnormal cells that grows in or around the brain. Tumors can directly destroy healthy brain cells. They can

More information

Andre Konski, MD, MBA, MA, FACR Professor & Chair Department of Radiation Oncology Wayne State University School of Medicine Barbara Ann Karmanos

Andre Konski, MD, MBA, MA, FACR Professor & Chair Department of Radiation Oncology Wayne State University School of Medicine Barbara Ann Karmanos Andre Konski, MD, MBA, MA, FACR Professor & Chair Department of Radiation Oncology Wayne State University School of Medicine Barbara Ann Karmanos Cancer Center Financial None The views that I will be going

More information

SCD Case Study. Most malignant lesions of the tonsil are either lymphosarcoma or carcinoma.

SCD Case Study. Most malignant lesions of the tonsil are either lymphosarcoma or carcinoma. SCD Case Study Dry Mouth This case study details a patient who has experienced xerostomia as a result of treatment for squamous cell carcinoma of the left tonsil involving surgery followed by deep x-ray

More information

Radiation therapy involves using many terms you may have never heard before. Below is a list of words you could hear during your treatment.

Radiation therapy involves using many terms you may have never heard before. Below is a list of words you could hear during your treatment. Dictionary Radiation therapy involves using many terms you may have never heard before. Below is a list of words you could hear during your treatment. Applicator A device used to hold a radioactive source

More information

Dental health following cancer treatment

Dental health following cancer treatment Dental health following cancer treatment Treatment for cancer often increases the risk for dental problems. As a cancer survivor, it is important for you to understand the reasons why dental care is especially

More information

M D Anderson Cancer Center Orlando TomoTherapy s Implementation of Image-guided Adaptive Radiation Therapy

M D Anderson Cancer Center Orlando TomoTherapy s Implementation of Image-guided Adaptive Radiation Therapy M D Anderson Cancer Center Orlando TomoTherapy s Implementation of Image-guided Adaptive Radiation Therapy Katja Langen, PhD Research supported by TomoTherapy Inc. Today s Lecture Introduction to helical

More information

Principal Investigator: Valerie W. Rusch, MD, FACS, Chief, Thoracic Surgery Memorial Sloan-Kettering Cancer Center

Principal Investigator: Valerie W. Rusch, MD, FACS, Chief, Thoracic Surgery Memorial Sloan-Kettering Cancer Center Protocol 1101-1088 Phase I study of intra-pleural administration of GL-ONC1 in patients with malignant pleural effusion: primary, metastases and mesothelioma Principal Investigator: Valerie W. Rusch, MD,

More information

Clinical Trials and Radiation Treatment. Gerard Morton Odette Cancer Centre Sunnybrook Research Institute University of Toronto

Clinical Trials and Radiation Treatment. Gerard Morton Odette Cancer Centre Sunnybrook Research Institute University of Toronto Clinical Trials and Radiation Treatment Gerard Morton Odette Cancer Centre Sunnybrook Research Institute University of Toronto What I will cover.. A little about radiation treatment The clinical trials

More information

New strategies in anticancer therapy

New strategies in anticancer therapy 癌 症 診 療 指 引 簡 介 及 臨 床 應 用 New strategies in anticancer therapy 中 山 醫 學 大 學 附 設 醫 院 腫 瘤 內 科 蔡 明 宏 醫 師 2014/3/29 Anti-Cancer Therapy Surgical Treatment Radiotherapy Chemotherapy Target Therapy Supportive

More information

Prostate Cancer Guide. A resource to help answer your questions about prostate cancer

Prostate Cancer Guide. A resource to help answer your questions about prostate cancer Prostate Cancer Guide A resource to help answer your questions about prostate cancer Thank you for downloading this guide to prostate cancer treatment. We know that all the information provided online

More information

Oropharyngeal carcinoma State of the Art

Oropharyngeal carcinoma State of the Art Oropharyngeal carcinoma State of the Art Pr. Jean Bourhis Institute Gustave Roussy Ville juif, France - Among HNSCC what are the specificities of the oropharyngeal sub site? - Frequent among HNSCC - More

More information

Protons vs. CyberKnife. Protons vs. CyberKnife. Page 1 UC SF. What are. Alexander R. Gottschalk, M.D., Ph.D.

Protons vs. CyberKnife. Protons vs. CyberKnife. Page 1 UC SF. What are. Alexander R. Gottschalk, M.D., Ph.D. Protons vs. CyberKnife UC SF Protons vs. CyberKnife UC SF Alexander R. Gottschalk, M.D., Ph.D. Associate Professor and Director of the CyberKnife Radiosurgery Program Department of Radiation Oncology University

More information

Radioterapia panencefalica. Umberto Ricardi

Radioterapia panencefalica. Umberto Ricardi Radioterapia panencefalica Umberto Ricardi Background Systemic disease to the brain is unfortunately a quite common event Radiotherapy, especially with the great technical development during the past decades,

More information

KINGS COUNTY HOSPITAL CENTER EXECUTIVE SUMMARY. Always Here When You Need Us

KINGS COUNTY HOSPITAL CENTER EXECUTIVE SUMMARY. Always Here When You Need Us KINGS COUNTY HOSPITAL CENTER EXECUTIVE SUMMARY Always Here When You Need Us Kings County Hospital Center Cancer Care Program ANNUAL REPORT 2013: EXECUTIVE SUMMARY The Kings County Hospital Center Cancer

More information

Transition from 2D to 3D Brachytherapy in Cervical Cancers: The Vienna Experience. Richard Pötter MD. BrachyNext, Miami, 2014.

Transition from 2D to 3D Brachytherapy in Cervical Cancers: The Vienna Experience. Richard Pötter MD. BrachyNext, Miami, 2014. Transition from 2D to 3D Brachytherapy in Cervical Cancers: The Vienna Experience Richard Pötter MD BrachyNext, Miami, 2014 Disclosures Richard Pötter, MD, does not have any financial relationships or

More information

Tricia Cox on 7/18/2012 at Oncology Center. Sarah Randolf. Female

Tricia Cox on 7/18/2012 at Oncology Center. Sarah Randolf. Female SAMPLE This Survivorship Care Plan will facilitate cancer care following active treatment. It may include important contact information, a treatment summary, recommendations for follow-up care testing,

More information

Enhancing the Child s Voice in Clinical Care and Research

Enhancing the Child s Voice in Clinical Care and Research Enhancing the Child s Voice in Clinical Care and Research Bryce B. Reeve, Ph.D. Associate Professor, Health Policy and Management Member, Lineberger Comprehensive Cancer Center bbreeve@email.unc.edu Standardized,

More information

Radiation Oncology Nursing Care. Helen Lusby Radiation Oncology Nurse BAROC 2012

Radiation Oncology Nursing Care. Helen Lusby Radiation Oncology Nurse BAROC 2012 Radiation Oncology Nursing Care Helen Lusby Radiation Oncology Nurse BAROC 2012 Definitions Radiation Therapy: Treatment of cancer using x- ray particles that cause ionisation within the cells. External

More information

Analysis of Population Cancer Risk Factors in National Information System SVOD

Analysis of Population Cancer Risk Factors in National Information System SVOD Analysis of Population Cancer Risk Factors in National Information System SVOD Mužík J. 1, Dušek L. 1,2, Pavliš P. 1, Koptíková J. 1, Žaloudík J. 3, Vyzula R. 3 Abstract Human risk assessment requires

More information

Post Treatment Log File Based QA Varian. Krishni Wijesooriya, PhD University of Virginia. D e p a r t m e n t of R a d i a t i o n O n c o l o g y

Post Treatment Log File Based QA Varian. Krishni Wijesooriya, PhD University of Virginia. D e p a r t m e n t of R a d i a t i o n O n c o l o g y Post Treatment Log File Based QA Varian Krishni Wijesooriya, PhD University of Virginia Learning Objectives What information could be accessed via log files Scenarios where Log files could be used. How

More information

The evolution of rectal cancer therapy. Objectives

The evolution of rectal cancer therapy. Objectives The evolution of rectal cancer therapy Hagen Kennecke MD MHA FRCPC Western Canada Consensus Conference September 5, 2014 Objectives Identify standard therapy: stage II/III rectal cancer Update recent adjuvant

More information

2011 ANNUAL REPORT C.H. Chub O Reilly Cancer Center. The cancer journey

2011 ANNUAL REPORT C.H. Chub O Reilly Cancer Center. The cancer journey 2011 ANNUAL REPORT C.H. Chub O Reilly Cancer Center The cancer journey The C.H. Chub O Reilly Cancer Center is home to the latest technology and treatments, including davinci surgery, the region s only

More information

Technology Assisting Cancer Outcomes: Automated Biomarker Abstraction Overcoming Textual Data-Silos

Technology Assisting Cancer Outcomes: Automated Biomarker Abstraction Overcoming Textual Data-Silos Technology Assisting Cancer Outcomes: Automated Biomarker Abstraction Overcoming Textual Data-Silos Patrick Mergler, MBA PMP CPHIMS DISCLAIMER: The views and opinions expressed in this presentation are

More information

Proton Therapy for Head & Neck Cancers

Proton Therapy for Head & Neck Cancers Proton Therapy for Head & Neck Cancers Robert S Malyapa, MD, PhD and William M Mendenhall, MD University of Florida Proton Therapy Institute, Jacksonville, USA Carmen Ares, MD and Ralf Schneider, MD Paul

More information

2014Cancer Annual Report

2014Cancer Annual Report 2014Cancer Annual Report Cancer doesn, t care but we do. Letter from Cancer Committee Chair and Cancer Liaison Accredited by the American College of Surgeons Commission on Cancer, CHRISTUS St. Patrick

More information

ALCHEMIST (Adjuvant Lung Cancer Enrichment Marker Identification and Sequencing Trials)

ALCHEMIST (Adjuvant Lung Cancer Enrichment Marker Identification and Sequencing Trials) ALCHEMIST (Adjuvant Lung Cancer Enrichment Marker Identification and Sequencing Trials) 3 Integrated Trials Testing Targeted Therapy in Early Stage Lung Cancer Part of NCI s Precision Medicine Effort in

More information

Prostate cancer is the most common cause of death from cancer in men over age 75. Prostate cancer is rarely found in men younger than 40.

Prostate cancer is the most common cause of death from cancer in men over age 75. Prostate cancer is rarely found in men younger than 40. A.D.A.M. Medical Encyclopedia. Prostate cancer Cancer - prostate; Biopsy - prostate; Prostate biopsy; Gleason score Last reviewed: October 2, 2013. Prostate cancer is cancer that starts in the prostate

More information

Radiotherapy in Plasmacytoma and Myeloma. David Cutter Multiple Myeloma NSSG Annual Meeting 14 th September 2015

Radiotherapy in Plasmacytoma and Myeloma. David Cutter Multiple Myeloma NSSG Annual Meeting 14 th September 2015 Radiotherapy in Plasmacytoma and Myeloma David Cutter Multiple Myeloma NSSG Annual Meeting 14 th September 2015 Contents Indications for radiotherapy: Palliation in Multiple Myeloma Solitary Bone Plasmacytoma

More information

Radiation Fibrosis Fact Sheet

Radiation Fibrosis Fact Sheet Radiation Fibrosis Fact Sheet What is Radiation Fibrosis Syndrome (RFS), and when can it occur? Radiation Fibrosis Syndrome (RFS) is a term used to describe the multiple clinical symptoms associated with

More information

Your Certified Professional Cancer Coach. An Integrative Answer to Cancer Exclusive Professional Program for Patients with Cancer

Your Certified Professional Cancer Coach. An Integrative Answer to Cancer Exclusive Professional Program for Patients with Cancer Your Certified Professional Cancer Coach An Integrative Answer to Cancer Exclusive Professional Program for Patients with Cancer The CPCC Patient Program Nutrition & Lifestyle Oncology A Cancer Diagnosis

More information

Radiation Therapy in Prostate Cancer Current Status and New Advances

Radiation Therapy in Prostate Cancer Current Status and New Advances Radiation Therapy in Prostate Cancer Current Status and New Advances Arno J. Mundt MD Professor and Chairman Dept Radiation Oncology Moores Cancer Center UCSD Presentation Welcome Overview of UCSD, Moores

More information

Contemporary Orthopedic Care: The O.R. Through Rehabilitation

Contemporary Orthopedic Care: The O.R. Through Rehabilitation Session Descriptions and Objectives: The Impact of Orthopaedic Care, Michael West, CPA, MBA, CEO, Rothman Institute This session will provide an overview of the Health Care Reform. Conference participants

More information

Intensity-Modulated Radiation Therapy (IMRT)

Intensity-Modulated Radiation Therapy (IMRT) Scan for mobile link. Intensity-Modulated Radiation Therapy (IMRT) Intensity-modulated radiotherapy (IMRT) uses linear accelerators to safely and painlessly deliver precise radiation doses to a tumor while

More information

Oral Complications of Cancer Treatment: What the Oncology Team Can Do

Oral Complications of Cancer Treatment: What the Oncology Team Can Do Oral Complications of Cancer Treatment: What the Oncology Team Can Do Radiation to the head and neck and chemotherapy for any malignancy can cause oral side effects so debilitating that patients may tolerate

More information

Chapter I Overview Chapter Contents

Chapter I Overview Chapter Contents Chapter I Overview Chapter Contents Table Number Contents I-1 Estimated New Cancer Cases and Deaths for 2005 I-2 53-Year Trends in US Cancer Death Rates I-3 Summary of Changes in Cancer Incidence and Mortality

More information

Centralizing image and data management in radiation oncology with MOSAIQ Data Director

Centralizing image and data management in radiation oncology with MOSAIQ Data Director White Paper Centralizing image and data management in radiation oncology with MOSAIQ Data Director Authors: Laura Francis, Global Product Marketing, Elekta Software, UK and Erdal Sipahi, Information Technology,

More information

Our Department: structure and organization

Our Department: structure and organization EORTC meeting for Radiation Therapy Technologists: RTT s role in the modernization of radiotherapy 10th October 2014, Villejuif (Grand Paris), France Elekta Stereotactic Body Frame: transmission modelled

More information

Pancreatic Cancer: FDA Approved Treatments and Clinical Trials

Pancreatic Cancer: FDA Approved Treatments and Clinical Trials Pancreatic Cancer: FDA Approved Treatments and Clinical Trials Vincent J Picozzi MD MMM Virginia Mason Medical Center Seattle WA 1 Pancreatic cancer is the hardest cancer of all to treat 2 Pancreatic cancer:

More information

Seton Medical Center Hepatocellular Carcinoma Patterns of Care Study Rate of Treatment with Chemoembolization 2007 2012 N = 50

Seton Medical Center Hepatocellular Carcinoma Patterns of Care Study Rate of Treatment with Chemoembolization 2007 2012 N = 50 General Data Seton Medical Center Hepatocellular Carcinoma Patterns of Care Study Rate of Treatment with Chemoembolization 2007 2012 N = 50 The vast majority of the patients in this study were diagnosed

More information

Intensity Modulated Radiation Therapy (IMRT) for Thyroid Cancer

Intensity Modulated Radiation Therapy (IMRT) for Thyroid Cancer Thyroid Science 5(1):CLS1-8, 2010 www.thyroidscience.com Clinical and Laboratory Studies Intensity Modulated Radiation Therapy (IMRT) for Thyroid Cancer 1 2 5 Aruna Turaka, MD, Tianyu Li, MS, Jian Q. Yu,

More information

Case Number: RT2009-124(M) Potential Audiences: Intent Doctor, Oncology Special Nurse, Resident Doctor

Case Number: RT2009-124(M) Potential Audiences: Intent Doctor, Oncology Special Nurse, Resident Doctor Renal Cell Carcinoma of the Left Kidney Post Radical Surgery with pt4 Classification with Multiple Lung and Single Brain Metastases: the Role and Treatment Consideration of Radiotherapy Case Number: RT2009-124(M)

More information

Management of low grade glioma s: update on recent trials

Management of low grade glioma s: update on recent trials Management of low grade glioma s: update on recent trials M.J. van den Bent The Brain Tumor Center at Erasmus MC Cancer Center Rotterdam, the Netherlands Low grades Female, born 1976 1 st seizure 2005,

More information

Radiation Therapy for Cancer Treatment

Radiation Therapy for Cancer Treatment Radiation Therapy for Cancer Treatment Guest Expert: Kenneth, MD Associate Professor of Therapeutic Radiology www.wnpr.org www.yalecancercenter.org Welcome to Yale Cancer Center Answers with Dr. Ed and

More information

The Cancer Center of Chester County Annual Report 2006 With statistical data from 2005

The Cancer Center of Chester County Annual Report 2006 With statistical data from 2005 06 The Cancer Center of Chester County Annual Report 2006 With statistical data from 2005 2005 Statistical Report Community Screenings Screening Participants Normal Results Referred for Follow-up Colon

More information

In 1946 Harvard physicist Robert Wilson (1914-2000) suggested:

In 1946 Harvard physicist Robert Wilson (1914-2000) suggested: In 1946 Harvard physicist Robert Wilson (1914-2000) suggested: Protons can be used clinically Accelerators are available Maximum radiation dose can be placed into the tumor Proton therapy provides sparing

More information

There must be an appropriate administrative structure for each residency program.

There must be an appropriate administrative structure for each residency program. Specific Standards of Accreditation for Residency Programs in Radiation Oncology 2015 VERSION 3.0 INTRODUCTION The purpose of this document is to provide program directors and surveyors with an interpretation

More information

Health Information. Technology and Cancer Information Management. Health Information Technology & Cancer Information Management 363

Health Information. Technology and Cancer Information Management. Health Information Technology & Cancer Information Management 363 Health Information Technology & 363 Health Information Technology and Cancer Information Management Opportunities in the health information field have expanded with changes in health care delivery, utilization

More information

GUIDELINES FOR THE MANAGEMENT OF LUNG CANCER

GUIDELINES FOR THE MANAGEMENT OF LUNG CANCER GUIDELINES FOR THE MANAGEMENT OF LUNG CANCER BY Ali Shamseddine, MD (Coordinator); as04@aub.edu.lb Fady Geara, MD Bassem Shabb, MD Ghassan Jamaleddine, MD CLINICAL PRACTICE GUIDELINES FOR THE TREATMENT

More information

Foundations of Oncology Nursing Practice

Foundations of Oncology Nursing Practice Foundations of Oncology Nursing Practice Course Syllabus Course Lead:, RN, MN, BScN, CON(C) Associate Faculty:, RN, CON(C) Last updated January 27, 2011 Course Description: This online course will introduce

More information

Thomas A. Kollmorgen, M.D. Oregon Urology Institute

Thomas A. Kollmorgen, M.D. Oregon Urology Institute Thomas A. Kollmorgen, M.D. Oregon Urology Institute None 240,000 new diagnosis per year, and an estimated 28,100 deaths (2012) 2 nd leading cause of death from cancer in U.S.A. Approximately 1 in 6 men

More information

Big Data and Oncology Care Quality Improvement in the United States

Big Data and Oncology Care Quality Improvement in the United States Big Data and Oncology Care Quality Improvement in the United States Peter P. Yu, MD, FACP, FASCO President, American Society of Clinical Oncology Director of Cancer Research, Palo Alto Medical Foundation

More information

Multidisciplinary Head and Neck Cancer Clinic and Adherence with Speech Pathology

Multidisciplinary Head and Neck Cancer Clinic and Adherence with Speech Pathology The Laryngoscope VC 2011 The American Laryngological, Rhinological and Otological Society, Inc. Multidisciplinary Head and Neck Cancer Clinic and Adherence with Speech Pathology Heather Starmer, MA, CCC-SLP;

More information

IBA Proton Therapy. Biomed days 2015. Vincent Bossier. System Architect Vincent.bossier@iba-group.com. Protect, Enhance and Save Lives

IBA Proton Therapy. Biomed days 2015. Vincent Bossier. System Architect Vincent.bossier@iba-group.com. Protect, Enhance and Save Lives Vincent Bossier System Architect Vincent.bossier@iba-group.com IBA Proton Therapy Biomed days 2015 Protect, Enhance and Save Lives 1 Agenda AN INTRODUCTION TO IBA WHY PROTON THERAPY CLINICAL WORKFLOW TREATMENT

More information

How TARGIT Intra-operative Radiotherapy can help Older Patients with Breast cancer

How TARGIT Intra-operative Radiotherapy can help Older Patients with Breast cancer How TARGIT Intra-operative Radiotherapy can help Older Patients with Breast cancer Jeffrey S Tobias, Jayant S Vaidya, Frederik Wenz and Michael Baum, University College Hospital, London, UK - on behalf

More information

Clinical Trial Design. Sponsored by Center for Cancer Research National Cancer Institute

Clinical Trial Design. Sponsored by Center for Cancer Research National Cancer Institute Clinical Trial Design Sponsored by Center for Cancer Research National Cancer Institute Overview Clinical research is research conducted on human beings (or on material of human origin such as tissues,

More information

Breast Health Program

Breast Health Program Breast Health Program Working together, for your health. Breast Health Program The Breast Health Program at The University of Arizona Cancer Center offers patients a personalized approach to breast cancer,

More information

R E X C A N C E R C E N T E R. Annual Report 2012. Rex Cancer Care Committee 2012 On behalf of the Rex Cancer Center & Rex Health Care

R E X C A N C E R C E N T E R. Annual Report 2012. Rex Cancer Care Committee 2012 On behalf of the Rex Cancer Center & Rex Health Care R E X C A N C E R C E N T E R Annual Report 2012 Rex Cancer Care Committee 2012 On behalf of the Rex Cancer Center & Rex Health Care An American College of Surgeons Commission on Cancer Accredited Comprehensive

More information

Dental Health Following Childhood Cancer Treatment

Dental Health Following Childhood Cancer Treatment Following Childhood Cancer Treatment Treatment for cancer during childhood often increases the risk for dental problems. As a childhood cancer survivor, it is important for you to understand the reasons

More information