Featured Publications
Consensuses, controversies, and future directions in treatment deintensification for human papillomavirus‐associated oropharyngeal cancer
Kang J, Yu Y, Chen L, Zakeri K, Gelblum D, McBride S, Riaz N, Tsai C, Kriplani A, Hung T, Fetten J, Dunn L, Ho A, Boyle J, Ganly I, Singh B, Sherman E, Pfister D, Wong R, Lee N. Consensuses, controversies, and future directions in treatment deintensification for human papillomavirus‐associated oropharyngeal cancer. CA A Cancer Journal For Clinicians 2022, 73: 164-197. PMID: 36305841, PMCID: PMC9992119, DOI: 10.3322/caac.21758.Peer-Reviewed Original ResearchConceptsTransoral robotic surgeryOropharyngeal cancerDeintensification strategiesHuman papillomavirus-associated oropharyngeal cancerSubstantial long-term morbidityHPV-positive oropharyngeal cancerNational database studyHuman papillomavirus infectionLong-term morbidityThird of patientsDe-escalation trialsLevel I evidenceStandard of careCurrent treatment standardsOptimal patient outcomesDeintensification trialsTreatment deintensificationAdjuvant therapyHPV statusPapillomavirus infectionFavorable prognosisI evidenceMedical oncologyTreatment indicationsCommon cancerOropharyngeal Carcinoma
Husain Z, Kang J, Lee N, Poon I. Oropharyngeal Carcinoma. Practical Guides In Radiation Oncology 2022, 15-25. DOI: 10.1007/978-3-030-99590-4_2.Peer-Reviewed Original ResearchLong-term treatment toxicityOropharyngeal squamous cell carcinomaCurative treatment optionSquamous cell carcinomaPatterns of failureElective coverageOropharyngeal carcinomaTreatment toxicityNeck malignanciesAccurate target delineationCell carcinomaDisease stageTreatment optionsCurative potentialPhysical examCommon headClinical scenariosRadiation oncologistsSurgical anatomyTarget volumeTarget delineationVolume coverageCarcinomaMultimodal imagingPrimary targetLarynx Cancer
Fan D, Kang J, Yu Y, Cahlon O, Riaz N, Lee N. Larynx Cancer. Practical Guides In Radiation Oncology 2022, 45-60. DOI: 10.1007/978-3-030-99590-4_4.Peer-Reviewed Original ResearchPostoperative radiotherapyLarynx cancerEarly stage squamous cell carcinomaOrgan preservation therapyEarly-stage diseaseLymph node metastasisAdvanced larynx cancerSquamous cell carcinomaStandard of careHigh-risk casesPre-treatment evaluationCommon clinical scenariosThin-cut CTPET/CTDefinitive chemoradiotherapyAdvanced diseaseLocoregional recurrencePreservation therapyGlottic larynxNode metastasisSubglottic extensionCell carcinomaLaryngeal cancerPhysical examOrgan preservationOropharyngeal Cancer Early Outcomes and Challenges During the COVID-19 Pandemic
Kang J, Wu Y, Rybkin A, Yu Y, Chen L, Zakeri K, McBride S, Riaz N, Tsai C, Gelblum D, Wong R, Sherman E, Pfister D, Lee N. Oropharyngeal Cancer Early Outcomes and Challenges During the COVID-19 Pandemic. International Journal Of Radiation Oncology • Biology • Physics 2021, 111: e412. PMCID: PMC8536212, DOI: 10.1016/j.ijrobp.2021.07.1185.Peer-Reviewed Original ResearchDefinitive radiation therapyCOVID cohortRadiation therapyMore patientsAdvanced diseaseMonth outcomesPC cohortNew patientsCurative-intent radiation therapyGrade 3 dysphagiaOropharyngeal cancer outcomesCancer-specific survivalSupportive care needsKaplan-Meier methodLong-term outcomesDiagnosis/treatmentCOVID-19 pandemicMATERIAL/METHODSPerson consultsRT startClinicopathologic factorsOPC patientsHistorical cohortMedian timeEarly outcomesDose and Volume De-Escalation for Elective Nodal Regions in Patients With Human Papillomavirus (HPV)-Positive Oropharyngeal Cancer (OPC) Undergoing Curative-Intent Concurrent Chemoradiation (CCRT)
Tsai C, McBride S, Riaz N, Kang J, Spielsinger D, Waldenberg T, Yu Y, Chen L, Zakeri K, Wong R, Dunn L, Sherman E, Lee N. Dose and Volume De-Escalation for Elective Nodal Regions in Patients With Human Papillomavirus (HPV)-Positive Oropharyngeal Cancer (OPC) Undergoing Curative-Intent Concurrent Chemoradiation (CCRT). International Journal Of Radiation Oncology • Biology • Physics 2021, 111: s142-s143. DOI: 10.1016/j.ijrobp.2021.07.321.Peer-Reviewed Original ResearchConcurrent chemoradiationDe-escalation strategiesOropharyngeal cancerGross diseaseNodal recurrenceDisease recurrenceOPC patientsLevel IbHPV-positive OPC patientsLocoregional recurrence-free survivalElective nodal regionsFavorable locoregional controlFeeding tube dependenceHigh-dose cisplatinPositive oropharyngeal cancerPrimary concurrent chemoradiationRecurrence-free survivalNode-positive neckFeeding tube placementLong-term resultsNode-negative neckDe-escalation approachMATERIAL/METHODSHigh control ratesRadiation treatment plans
2023
Concurrent carboplatin and paclitaxel definitive radiation therapy for locally advanced head and neck cancer
Han J, Zakeri K, Raab G, Hesse J, Shamseddine A, Chen L, Yu Y, Kang J, McBride S, Riaz N, Tsai C, Gelblum D, Sherman E, Wong R, Michel L, Lee N. Concurrent carboplatin and paclitaxel definitive radiation therapy for locally advanced head and neck cancer. Head & Neck 2023, 45: 2207-2216. PMID: 37439286, PMCID: PMC10981461, DOI: 10.1002/hed.27456.Peer-Reviewed Original ResearchConceptsLocoregional recurrenceDistant metastasisOverall survivalHNSCC patientsConcurrent carboplatinDefinitive chemoradiationConsecutive HNSCC patientsDefinitive radiation therapyMedian radiation doseKaplan-Meier methodCumulative incidence functionFree survivalAdvanced headMedian ageMedian dosesNeck cancerAUC 1Radiation therapyCarboplatinPatientsChemoradiationPaclitaxelRadiation doseExcellent optionIncidence functionPost-operative PET/CT improves the detection of early recurrence of squamous cell carcinomas of the oral cavity
Yu Y, Schöder H, Zakeri K, Chen L, Kang J, McBride S, Tsai C, Gelblum D, Boyle J, Cracchiolo J, Cohen M, Singh B, Ganly I, Patel S, Michel L, Dunn L, Sherman E, Pfister D, Wong R, Riaz N, Lee N. Post-operative PET/CT improves the detection of early recurrence of squamous cell carcinomas of the oral cavity. Oral Oncology 2023, 141: 106400. PMID: 37099979, PMCID: PMC10631462, DOI: 10.1016/j.oraloncology.2023.106400.Peer-Reviewed Original ResearchConceptsOral squamous cell carcinomaIntermediate-risk featuresPET/CTHigh-risk featuresPost-operative radiationSquamous cell carcinomaEarly recurrenceRisk featuresSurgical marginsCell carcinomaPET/CT planningAddition of chemotherapyClose surgical marginsDisease-free survivalPositive surgical marginsRecords of patientsPositron emission tomographyTreatment intensificationBaseline characteristicsNode positivityLymphovascular invasionOverall survivalPT3-4Perineural invasionTumor thickness
2022
Peer Review of Head and Neck Cancer Planning Target Volumes in Radiation Oncology
Hesse J, Zakeri K, Chen L, Yu Y, Kang J, Riaz N, Tsai C, McBride S, Gelblum D, Lee N. Peer Review of Head and Neck Cancer Planning Target Volumes in Radiation Oncology. International Journal Of Radiation Oncology • Biology • Physics 2022, 114: e472-e473. DOI: 10.1016/j.ijrobp.2022.07.1729.Peer-Reviewed Original ResearchStart of RTTarget volumeFurther workupNeck cancerTreatment planPositive findingsNeck radiation oncologistMinority of patientsOverall treatment planTreatment planningPlanning target volumeProspective peer reviewTumor board discussionMATERIAL/METHODSNeck cancer casesRadiation treatment plansFurther surgeryUnderwent biopsyAdditional surgeryAdditional workupOncology servicesSignificant changesCancer casesPatientsRadiation oncologistsTreatment Outcomes for Radiation Therapy with Concurrent Carboplatin and Paclitaxel for Locally Advanced Head and Neck Cancer
Han J, Zakeri K, Raab G, Chen L, Yu Y, Kang J, McBride S, Riaz N, Tsai C, Gelblum D, Sherman E, Wong R, Michel L, Lee N. Treatment Outcomes for Radiation Therapy with Concurrent Carboplatin and Paclitaxel for Locally Advanced Head and Neck Cancer. International Journal Of Radiation Oncology • Biology • Physics 2022, 114: e317. DOI: 10.1016/j.ijrobp.2022.07.1381.Peer-Reviewed Original ResearchProgression-free survivalCisplatin-ineligible patientsDefinitive radiation therapyUnknown primary cancerLocoregional controlRadiation therapyDistant controlConcurrent carboplatinWeekly carboplatinAdvanced headOverall survivalHNSCC patientsPrimary cancerNeck squamous cell carcinomaConclusions Radiation therapyConsecutive HNSCC patientsCycles of chemotherapySevere ulcerative colitisUpper gastrointestinal bleedMedian radiation doseSynchronous primary malignanciesKaplan-Meier methodSquamous cell carcinomaMATERIAL/METHODSCumulative incidence functionPhysician Graded Toxicity Profiles and Survival Outcomes among Patients with Non-Metastatic Oropharyngeal Carcinoma Treated with Proton Therapy vs. Intensity-Modulated Radiation Therapy
Youssef I, Yoon J, Zakeri K, Cohen M, Wong R, Yu Y, Kang J, Gelblum D, McBride S, Sherman E, Dunn L, Cracchiolo J, Chen L, Lee N. Physician Graded Toxicity Profiles and Survival Outcomes among Patients with Non-Metastatic Oropharyngeal Carcinoma Treated with Proton Therapy vs. Intensity-Modulated Radiation Therapy. International Journal Of Radiation Oncology • Biology • Physics 2022, 114: e325-e326. DOI: 10.1016/j.ijrobp.2022.07.1399.Peer-Reviewed Original ResearchProgression-free survivalIntensity-modulated radiation therapyOropharyngeal carcinomaAcute gradeIMRT groupLocoregional recurrenceOncologic outcomesAdverse eventsOverall survivalRadiation therapyPT groupSignificant differencesTreatment-related adverse eventsPatient/tumor characteristicsProton therapyCurative-intent radiationGrade 3 dysphagiaPresence of xerostomiaMedian RT doseRetrospective cohort studyProspective Randomized ComparisonPatient-reported outcomesSimilar oncologic outcomesMATERIAL/METHODSReduction of dosePrognosis of P16 and HPV Discordant Oropharyngeal Cancers: Natural Language Processing to Extract Data from Free-Text Pathology Reports
Shin E, Cartano O, Lee N, Kang J. Prognosis of P16 and HPV Discordant Oropharyngeal Cancers: Natural Language Processing to Extract Data from Free-Text Pathology Reports. International Journal Of Radiation Oncology • Biology • Physics 2022, 114: e322. DOI: 10.1016/j.ijrobp.2022.07.1391.Peer-Reviewed Original ResearchCancer-specific survivalHuman papillomavirus resultsOropharyngeal cancerHuman papillomavirusIn situ hybridizationP16 immunohistochemistryClinical trial eligibilityOverall survivalDiscordant tumorsPathology reportsTrial eligibilityFollow-upHuman papillomavirus in situ hybridizationEstimate cancer-specific survivalHuman papillomavirus testingTreatment de-escalationMedian follow-upDetect human papillomavirusKaplan-Meier methodSeries of patientsMinority of patientsExcellent prognosisClinical outcomesClinical managementDivergent prognosesNasal Cavity and Paranasal Sinus Tumors
Fan M, Yu Y, Kang J, Lee N. Nasal Cavity and Paranasal Sinus Tumors. Practical Guides In Radiation Oncology 2022, 87-98. DOI: 10.1007/978-3-030-99590-4_7.Peer-Reviewed Original ResearchParanasal sinusesNasal cavityTumor typesTarget delineationExperienced multidisciplinary teamSquamous cell carcinomaParanasal sinus tumorsDifferent natural historyCentral nervous systemMedical oncologistsSinus tumorAccurate target delineationCell carcinomaOptimal careNeck surgeonsCystic carcinomaNervous systemDiverse tumor typesMultidisciplinary teamRadiation oncologistsSkull baseNatural historyPatientsCarcinomaOncologistsOutcomes and Toxicities of Nonmedullary Thyroid Tumors Treated with Proton Beam Radiation Therapy
Youssef I, Yoon J, Mohamed N, Zakeri K, Press R, Yu Y, Kang J, Wong R, Tuttle R, Shaha A, Sherman E, Lee N. Outcomes and Toxicities of Nonmedullary Thyroid Tumors Treated with Proton Beam Radiation Therapy. International Journal Of Particle Therapy 2022, 9: 20-30. PMID: 36060412, PMCID: PMC9415751, DOI: 10.14338/ijpt-22-00005.1.Peer-Reviewed Original ResearchPercent of patientsLocal-regional recurrenceThyroid cancerRadiation therapyGross diseaseOverall survivalPercutaneous endoscopic gastrostomy tubeProton therapyProton beam radiation therapyAcute grade 3Central neck compartmentFavorable therapeutic ratioIntensity-modulated radiation therapyBeam radiation therapyProton beam therapyConcurrent chemotherapyPalliative radiationUnresectable diseaseAdjuvant radiationDefinitive radiationT4 diseaseMetastatic diseaseNeck compartmentRegional recurrenceUpper mediastinumOutcomes for Organ Preservation with Chemoradiation Therapy for T4 Larynx and Hypopharynx Cancer
Eita A, Mohamed N, Rybkin A, Kang J, Fiasconaro M, Zhigang Z, Zakeri K, Yu Y, Sadaka E, Sherman E, Dunn L, Cracchiolo J, Wong R, Cohen M, Lee N. Outcomes for Organ Preservation with Chemoradiation Therapy for T4 Larynx and Hypopharynx Cancer. The Laryngoscope 2022, 133: 1138-1145. PMID: 35801573, PMCID: PMC10547133, DOI: 10.1002/lary.30279.Peer-Reviewed Original ResearchConceptsUnivariate analysisLocoregional failureT4 laryngealNonoperative managementHypopharyngeal cancerRadiation therapyPercutaneous endoscopic gastrostomy tubeHypopharynx cancer patientsYear OS ratesDisease-free survivalNon-surgical managementHypopharynx groupsInoperable diseaseLast followUnresectable diseaseChemoradiation therapyNodal statusGastrostomy tubeHypopharynx cancerOS ratesStage T4Cancer patientsFunctional outcomeTracheostomy tubeOrgan preservationEvaluation of Substantial Reduction in Elective Radiotherapy Dose and Field in Patients With Human Papillomavirus–Associated Oropharyngeal Carcinoma Treated With Definitive Chemoradiotherapy
Tsai CJ, McBride SM, Riaz N, Kang JJ, Spielsinger DJ, Waldenberg T, Gelblum D, Yu Y, Chen LC, Zakeri K, Wong RJ, Dunn L, Pfister DG, Sherman EJ, Lee NY. Evaluation of Substantial Reduction in Elective Radiotherapy Dose and Field in Patients With Human Papillomavirus–Associated Oropharyngeal Carcinoma Treated With Definitive Chemoradiotherapy. JAMA Oncology 2022, 8: 364-372. PMID: 35050342, PMCID: PMC8778604, DOI: 10.1001/jamaoncol.2021.6416.Peer-Reviewed Original ResearchConceptsDistant metastasis-free survivalProgression-free survivalMetastasis-free survivalOropharyngeal carcinomaConcurrent chemoradiotherapyDe-escalation strategiesRadiotherapy doseTotal doseSubclinical regionsLocoregional controlGross diseaseCohort studyOverall survivalClinical outcomesHuman Papillomavirus–Associated Oropharyngeal CarcinomaHigh-dose cisplatin therapyHPV-positive oropharyngeal carcinomaTarget volumeBilateral level IBGy of radiotherapyPrimary concurrent chemoradiotherapyRetrospective cohort studyFavorable clinical outcomeAmerican Joint CommitteeLong-term followPeer Review of Head and Neck Cancer Planning Target Volumes in Radiation Oncology
Hesse J, Chen L, Yu Y, Kang J, Riaz N, Tsai C, McBride S, Gelblum D, Zakeri K, Lee N. Peer Review of Head and Neck Cancer Planning Target Volumes in Radiation Oncology. Advances In Radiation Oncology 2022, 7: 100917. PMID: 35647395, PMCID: PMC9133360, DOI: 10.1016/j.adro.2022.100917.Peer-Reviewed Original ResearchStart of RTAdditional workupTarget volumeAdditional surgeryNeck cancerTreatment planPositive findingsNeck radiation oncologistMinority of patientsOverall treatment planTreatment planningPlanning target volumeProspective peer reviewTumor board discussionNeck cancer casesRadiation treatment plansUnderwent biopsyMedical oncologistsSignificant changesCancer casesAdditional consultationPatientsRadiation oncologistsRadiation therapy planningTreatment volume
2021
Long-term Therapeutic and Functional Outcomes With Organ Preservation for T4 Larynx and Hypopharynx Cancers
Rybkin A, Eita A, Kang J, Fiasconaro M, Zhang Z, Zakeri K, Yu Y, Chen L, Gelblum D, Tsai C, Riaz N, McBride S, Sherman E, Dunn L, Ho A, Cohen M, Cracchiolo J, Pfister D, Wong R, Lee N. Long-term Therapeutic and Functional Outcomes With Organ Preservation for T4 Larynx and Hypopharynx Cancers. International Journal Of Radiation Oncology • Biology • Physics 2021, 111: e365-e366. DOI: 10.1016/j.ijrobp.2021.07.1084.Peer-Reviewed Original ResearchPercutaneous endoscopic gastrostomyDisease-free survivalHypopharynx cancerLocoregional failureOverall survivalUnivariate analysisChemoradiation therapyRadiation therapySurgical candidatesDistant metastasisStage T4Functional outcomeMedian disease-free intervalAdequate supportive careOrgan preservation trialsYear OS ratesDefinitive radiation therapyDisease-free intervalKaplan-Meier methodLarynx groupSupportive careEndoscopic gastrostomyMethods PatientsNodal statusNonoperative managementThe effect of short radiation treatment breaks on chemo‐radiotherapy for oropharyngeal cancers
Rybkin A, Kang JJ, Lee A, Kitpanit S, Fan M, Mohamed N, Cartano O, Zakeri K, Gelblum D, Sherman E, Dunn L, Boyle J, Wong R, Chen L, Yu Y, McBride SM, Tsai CJ, Riaz N, Lee NY. The effect of short radiation treatment breaks on chemo‐radiotherapy for oropharyngeal cancers. Head & Neck 2021, 43: 3796-3809. PMID: 34585792, PMCID: PMC9414892, DOI: 10.1002/hed.26879.Peer-Reviewed Original ResearchConceptsRadiation treatment breaksOropharyngeal squamous cell carcinomaOverall treatment timeTreatment breaksClinical outcomesDefinitive concurrent chemoradiotherapySquamous cell carcinomaConcurrent chemoradiotherapyOPSCC patientsOropharyngeal cancerDisease failureCell carcinomaNeck cancerCancer recurrenceConsecutive cohortMultivariate analysisSignificant associationPatientsCancerFurther investigationProlongationDaysOutcomesNumerous studiesChemoradiotherapyTERT Promoter Mutations Are Enriched in Oral Cavity Cancers and Associated With Locoregional Recurrence
Yu Y, Fan D, Song X, Zakeri K, Chen L, Kang J, McBride S, Tsai CJ, Dunn L, Sherman E, Katabi N, Dogan S, Cracchiolo J, Cohen M, Boyle JO, Lee M, Valero C, Wang J, Wong R, Morris L, Riaz N, Lee N. TERT Promoter Mutations Are Enriched in Oral Cavity Cancers and Associated With Locoregional Recurrence. JCO Precision Oncology 2021, 5: 1259-1269. PMID: 34381934, PMCID: PMC8345918, DOI: 10.1200/po.20.00515.Peer-Reviewed Original ResearchConceptsSquamous cell carcinomaLocoregional failurePatterns of failureCumulative incidenceCell carcinomaPromoter mutationsHPV-positive oropharyngeal squamous cell carcinomaMemorial Sloan-Kettering Cancer CenterRisk of LRFOropharyngeal squamous cell carcinomaNeck squamous cell carcinomaHPV-negative HNSCCsReverse transcriptase (TERT) promoter mutationsOral cavity cancerNext-generation sequencingTERT promoter mutationsDisease subsiteLocoregional recurrenceOverall cohortOverall survivalProspective cohortCancer CenterHuman papillomavirusLaryngopharyngeal cancerUnique pathogenesisProton radiotherapy for recurrent or metastatic sarcoma with palliative quad shot
Lee A, Kang J, Bernstein H, Marqueen K, Neal B, Kelly C, Dickson M, Tsai C, Tap W, Singer S, Alektiar K, Lee N. Proton radiotherapy for recurrent or metastatic sarcoma with palliative quad shot. Cancer Medicine 2021, 10: 4221-4227. PMID: 34085781, PMCID: PMC8267151, DOI: 10.1002/cam4.3646.Peer-Reviewed Original ResearchConceptsLocal progression-free survivalMetastatic sarcomaSystemic therapyQUAD ShotOverall survivalUnivariate analysisPalliative responseMedian local progression-free survivalGrade 3 acute toxicityFurther systemic therapyProgression-free survivalConcurrent systemic therapyProton therapyCommon histologyMedian followProton RTTreatment optionsRadiation therapyPatientsLocal controlSarcomaTherapyRegimenProton radiotherapyAcute toxicity