2022
Brachytherapy impacts on sexual function: An integrative review of the literature focusing on cervical cancer
Chin C, Damast S. Brachytherapy impacts on sexual function: An integrative review of the literature focusing on cervical cancer. Brachytherapy 2022, 22: 30-46. PMID: 36567175, DOI: 10.1016/j.brachy.2022.10.012.Peer-Reviewed Original ResearchConceptsSexual morbidityCervical cancerSexual sequelaeImage-guided adaptive brachytherapyQuality of lifeSecondary preventionCurative treatmentDosimetric factorsCommon symptomsVaginal doseCancer patientsClose surveillanceSexual functionIndirect sequelaeSexual symptomsVaginal morbidityVaginal toxicitySexual dysfunctionAdaptive brachytherapySexual healthClinical interventionsMorbidityCritical organsSequelaeEffect relationshipImplementing a simulation-based curriculum for hybrid intracavitary/interstitial brachytherapy using a new, commercially available, US/MR/CT-compatible gynecologic phantom
Li J, Tien C, Kassick M, Peters G, Damast S. Implementing a simulation-based curriculum for hybrid intracavitary/interstitial brachytherapy using a new, commercially available, US/MR/CT-compatible gynecologic phantom. Brachytherapy 2022, 22: 157-165. PMID: 36528476, DOI: 10.1016/j.brachy.2022.11.006.Peer-Reviewed Original ResearchRadiation therapy in the definitive management of medically inoperable endometrial cancer
Chin C, Damast S. Radiation therapy in the definitive management of medically inoperable endometrial cancer. International Journal Of Gynecological Cancer 2022, 32: 323-331. PMID: 35256419, DOI: 10.1136/ijgc-2021-002532.Peer-Reviewed Original ResearchConceptsMultiparametric magnetic resonance imagingInoperable patientsEndometrial cancerImage-guided brachytherapyRadiation therapySystemic anti-tumor immune responseAnti-tumor immune responseThree-dimensional image-guided brachytherapyInoperable endometrial cancerDefinitive radiation therapyPoor surgical candidatesNovel systemic agentsRecent consensus guidelinesHigh-volume centersExtent of tumorRates of obesityMagnetic resonance imagingMedical inoperabilityLate morbiditySurgical candidatesSystemic agentsClinical stagingDefinitive managementOngoing trialsUterine sizeDosimetric study of Varian Universal Multi-Channel Cylinder System for High-Dose-Rate 192Ir Brachytherapy
Tien CJ, Damast S, Chen ZJ. Dosimetric study of Varian Universal Multi-Channel Cylinder System for High-Dose-Rate 192Ir Brachytherapy. Brachytherapy 2022, 21: 244-254. PMID: 34996715, DOI: 10.1016/j.brachy.2021.11.001.Peer-Reviewed Original Research
2021
Prognostic impact of mismatch repair deficiency in high- and low-intermediate-risk, early-stage endometrial cancer following vaginal brachytherapy
Li JY, Park HS, Huang GS, Young MR, Ratner E, Santin A, Damast S. Prognostic impact of mismatch repair deficiency in high- and low-intermediate-risk, early-stage endometrial cancer following vaginal brachytherapy. Gynecologic Oncology 2021, 163: 557-562. PMID: 34602287, DOI: 10.1016/j.ygyno.2021.09.018.Peer-Reviewed Original ResearchConceptsRecurrence-free survivalEndometrioid endometrial cancerVaginal brachytherapyPMMR patientsOverall survivalEEC patientsEndometrial cancerExact testThree-year recurrence-free survivalEarly-stage endometrial cancerCox proportional hazards regressionPoor recurrence-free survivalAdjuvant vaginal brachytherapyThree-year OSMultivariable Cox regressionLympho-vascular invasionSignificant prognostic variablesProportional hazards regressionLog-rank testKaplan-Meier estimatesDeficient mismatch repairMismatch repair statusFisher's exact testMismatch repair deficiencyDMMR statusA Multi-Institutional Analysis of Adjuvant Chemotherapy and Radiation Sequence in Women With Stage IIIC Endometrial Cancer
Hathout L, Wang Y, Wang Q, Vergalasova I, Elshaikh MA, Dimitrova I, Damast S, Li JY, Fields EC, Beriwal S, Keller A, Kidd EA, Usoz M, Jolly S, Jaworski E, Leung EW, Donovan E, Taunk NK, Chino J, Natesan D, Russo AL, Lea JS, Albuquerque KV, Lee LJ. A Multi-Institutional Analysis of Adjuvant Chemotherapy and Radiation Sequence in Women With Stage IIIC Endometrial Cancer. International Journal Of Radiation Oncology • Biology • Physics 2021, 110: 1423-1431. PMID: 33677053, DOI: 10.1016/j.ijrobp.2021.02.055.Peer-Reviewed Original ResearchConceptsStage IIIC endometrial carcinomaOverall survivalEndometrial carcinomaRadiation therapyAdjuvant chemotherapyAdjuvant therapyPALN recurrenceSystemic chemotherapyRFS ratesMulti-institutional retrospective cohort studyStage IIIC endometrial cancerRecurrence-free survival ratesLymph node recurrenceSequential radiation therapyAdjuvant radiation therapyRetrospective cohort studyGrade 3 tumorsAdjuvant treatment regimensKaplan-Meier methodVaginal cuff brachytherapyHigh rateSequence of treatmentChemotherapy concurrentNodal radiationNode recurrenceBenefits of a Multidisciplinary Women’s Sexual Health Clinic in the Management of Sexual and Menopausal Symptoms After Pelvic Radiotherapy
Li JY, D’Addario J, Tymon-Rosario J, Menderes G, Young MR, Johung K, Ratner E, Minkin MJ, Damast S. Benefits of a Multidisciplinary Women’s Sexual Health Clinic in the Management of Sexual and Menopausal Symptoms After Pelvic Radiotherapy. American Journal Of Clinical Oncology 2021, 44: 143-149. PMID: 33755031, DOI: 10.1097/coc.0000000000000800.Peer-Reviewed Original ResearchMeSH KeywordsAdultBrachytherapyCombined Modality TherapyDyspareuniaFemaleGenital Neoplasms, FemaleHumansInterdisciplinary CommunicationMenopauseMiddle AgedPatient SatisfactionPelvisRadiation InjuriesRadiotherapyRectal NeoplasmsRetrospective StudiesSexual Dysfunction, PhysiologicalSexual HealthTreatment OutcomeVaginal DiseasesWomen's Health ServicesConceptsPelvic radiotherapySexual health clinicsMenopausal symptomsPersistent menopausal symptomsSystemic hormone therapyFemale cancer patientsPatterns of careDilator therapyVaginal estrogenGastrointestinal malignanciesHormone therapyVaginal drynessMedian ageMultidisciplinary careRetrospective reviewFemale patientsTreatment patternsCancer patientsPatient satisfactionSexual symptomsTestosterone creamVaginal lubricantsHealth clinicsSTATA 13.1Patients
2020
Feasibility of deploying a U.S. simulation-based gynecological brachytherapy educational workshop to an international setting
Damast S, Felder S, Fields E, Singer L. Feasibility of deploying a U.S. simulation-based gynecological brachytherapy educational workshop to an international setting. Brachytherapy 2020, 19: 777-782. PMID: 33221261, DOI: 10.1016/j.brachy.2020.09.015.Peer-Reviewed Original ResearchStage III uterine serous carcinoma: modern trends in multimodality treatment
Li JY, Young MR, Huang G, Litkouhi B, Santin A, Schwartz PE, Damast S. Stage III uterine serous carcinoma: modern trends in multimodality treatment. Journal Of Gynecologic Oncology 2020, 31: e53. PMID: 32266802, PMCID: PMC7286763, DOI: 10.3802/jgo.2020.31.e53.Peer-Reviewed Original ResearchConceptsUterine serous carcinomaExternal beam RTVaginal brachytherapyOverall survivalHuman epidermal growth factor receptorModern treatment eraSentinel node samplingRegional nodal recurrenceKaplan-Meier estimatesLog-rank testCox proportional hazardsExternal beam radiotherapyEpidermal growth factor receptorERA treatmentGrowth factor receptorUSC patientsFree survivalNodal recurrenceTreatment eraMultimodality treatmentPatient characteristicsPerioperative periodRegional nodalSerous carcinomaNode sampling
2019
Outcomes and relapse patterns of stage IB grade 2 or 3 endometrial cancer treated with adjuvant vaginal brachytherapy
Hochreiter A, Kelly JR, Young MR, Litkouhi B, Black JD, Stromberger C, Higgins S, Schwartz PE, Damast S. Outcomes and relapse patterns of stage IB grade 2 or 3 endometrial cancer treated with adjuvant vaginal brachytherapy. International Journal Of Gynecological Cancer 2019, 30: 48. PMID: 31722964, DOI: 10.1136/ijgc-2019-000675.Peer-Reviewed Original ResearchConceptsDisease-free survivalLower uterine segment involvementPelvic recurrence-free survivalStage IB grade 2Uterine segment involvementLymph node dissectionRecurrence-free survivalEndometrial cancerRisk factorsVaginal brachytherapyOverall survivalGrade 2Endometrioid histologyNode dissectionPelvic recurrenceSegment involvementLymph nodesMyometrial invasionMultivariable Cox proportional hazards regressionEarly-stage endometrial cancerUnderwent lymph node dissectionCox proportional hazards regressionReduced disease-free survivalAdjuvant vaginal brachytherapySole adjuvant therapyDevelopment of a Multi-Institutional Simulation-Based Gynecologic Brachytherapy Curriculum
Singer L, Damast S, Lin L, Taunk N, Lee LJ, Albuquerque K, Chino J, Petereit D, Joyner M, Fields E. Development of a Multi-Institutional Simulation-Based Gynecologic Brachytherapy Curriculum. International Journal Of Radiation Oncology • Biology • Physics 2019, 104: 1175-1176. PMID: 31327414, DOI: 10.1016/j.ijrobp.2019.05.023.Peer-Reviewed Original ResearchCervical Cancer, Version 3.2019, NCCN Clinical Practice Guidelines in Oncology.
Koh WJ, Abu-Rustum NR, Bean S, Bradley K, Campos SM, Cho KR, Chon HS, Chu C, Clark R, Cohn D, Crispens MA, Damast S, Dorigo O, Eifel PJ, Fisher CM, Frederick P, Gaffney DK, Han E, Huh WK, Lurain JR, Mariani A, Mutch D, Nagel C, Nekhlyudov L, Fader AN, Remmenga SW, Reynolds RK, Tillmanns T, Ueda S, Wyse E, Yashar CM, McMillian NR, Scavone JL. Cervical Cancer, Version 3.2019, NCCN Clinical Practice Guidelines in Oncology. Journal Of The National Comprehensive Cancer Network 2019, 17: 64-84. PMID: 30659131, DOI: 10.6004/jnccn.2019.0001.Peer-Reviewed Original ResearchMeSH KeywordsAntineoplastic Combined Chemotherapy ProtocolsBrachytherapyCervix UteriChemoradiotherapy, AdjuvantFemaleFertility PreservationHumansHysterectomyMass ScreeningMedical OncologyNeoplasm StagingOrgan Sparing TreatmentsPapanicolaou TestPapillomaviridaePapillomavirus InfectionsSocieties, MedicalUnited StatesUterine Cervical NeoplasmsConceptsCervical cancerHuman papilloma virus vaccinationNCCN Clinical Practice GuidelinesTreatment of recurrentAdvanced cervical cancerClinical practice guidelinesMalignant epithelial tumorsNCCN guidelinesMetastatic diseaseVirus vaccinationUterine cervixCommon cancerPrecancerous lesionsFull guidelinePractice guidelinesEpithelial tumorsRoutine screeningCancerScreening protocolTreatmentGuidelinesMost casesEarly stagesCervixVaccination
2018
Extended duration of dilator use beyond 1 year may reduce vaginal stenosis after intravaginal high-dose-rate brachytherapy
Stahl JM, Qian JM, Tien CJ, Carlson DJ, Chen Z, Ratner ES, Park HS, Damast S. Extended duration of dilator use beyond 1 year may reduce vaginal stenosis after intravaginal high-dose-rate brachytherapy. Supportive Care In Cancer 2018, 27: 1425-1433. PMID: 30187220, DOI: 10.1007/s00520-018-4441-5.Peer-Reviewed Original ResearchConceptsVaginal stenosisEndometrial carcinomaMultivariable Cox proportional hazardsMultivariable Cox regression analysisVD useAcademic tertiary referral centerTertiary referral centerCox regression analysisLog-rank testCox proportional hazardsDevelopment of gradeDilator usePelvic radiotherapyReferral centerNoncompliant patientsPrimary outcomeAdjuvant brachytherapyEC patientsConclusionsThe riskRate brachytherapyProportional hazardsOptimal durationPatientsBrachytherapyStudy period
2017
Cost-effectiveness of adjuvant intravaginal brachytherapy in high-intermediate risk endometrial carcinoma
Stahl JM, Damast S, Bledsoe TJ, An Y, Verma V, Yu JB, Young MR, Lester-Coll NH. Cost-effectiveness of adjuvant intravaginal brachytherapy in high-intermediate risk endometrial carcinoma. Brachytherapy 2017, 17: 399-406. PMID: 29275078, DOI: 10.1016/j.brachy.2017.11.012.Peer-Reviewed Original ResearchConceptsQuality-adjusted life yearsIncremental cost-effectiveness ratioPay thresholdsAdjuvant intravaginal brachytherapyOne-way sensitivity analysesProbabilistic sensitivity analysesCost-effectiveness ratioBase-case analysisAverage cumulative costSocietal willingnessSensitivity analysisLife yearsTime horizonPORTEC-2 trialCumulative costsWillingnessPORTEC-1Medicare reimbursementCostHIR patientsMean costPreferred management optionMarkov modelCase analysisNet increaseImpact of vaginal cylinder diameter on outcomes following brachytherapy for early stage endometrial cancer
Qian JM, Stahl JM, Young MR, Ratner E, Damast S. Impact of vaginal cylinder diameter on outcomes following brachytherapy for early stage endometrial cancer. Journal Of Gynecologic Oncology 2017, 28: 0. PMID: 29027402, PMCID: PMC5641534, DOI: 10.3802/jgo.2017.28.e84.Peer-Reviewed Original ResearchMeSH KeywordsAdenocarcinomaAdultAgedAged, 80 and overBody Mass IndexBrachytherapyConstriction, PathologicDatabases, FactualEndometrial NeoplasmsFemaleGastrointestinal DiseasesGravidityHumansHysterectomyLymph Node ExcisionMiddle AgedNeoplasm StagingOvariectomyRadiation InjuriesRadiotherapy, AdjuvantSalpingectomyTreatment OutcomeVaginaVaginal DiseasesConceptsVaginal brachytherapyVaginal symptomsLate grade 3 toxicityEarly-stage endometrial cancerNormal body mass indexAdjuvant vaginal brachytherapyGrade 3 toxicityShorter vaginal lengthStage endometrial cancerEndometrial cancer patientsBody mass indexRate of recurrenceAcute gastrointestinalTreatment tolerabilityVaginal stenosisEndometrial cancerVaginal lengthMass indexRecurrence rateCancer patientsVaginal toxicityTreatment characteristicsHigh riskSide effectsPatients
2016
Influence of robotic-assisted laparoscopic hysterectomy on vaginal cuff healing and brachytherapy initiation in endometrial carcinoma patients
Stahl JM, Park HS, Silasi DA, Azodi M, Damast S. Influence of robotic-assisted laparoscopic hysterectomy on vaginal cuff healing and brachytherapy initiation in endometrial carcinoma patients. Practical Radiation Oncology 2016, 6: 226-232. PMID: 27364883, DOI: 10.1016/j.prro.2015.09.015.Peer-Reviewed Original ResearchMeSH KeywordsAgedBrachytherapyEndometrial NeoplasmsFemaleHumansHysterectomyMiddle AgedRoboticsVaginaConceptsRobotic-assisted laparoscopic hysterectomyVaginal cuff healingEndometrial carcinoma patientsIntravaginal brachytherapyAdjuvant intravaginal brachytherapyCuff healingLaparoscopic hysterectomyCarcinoma patientsEndometrial carcinomaTAH patientsHealing statusHealing timeEarly-stage endometrial carcinomaExternal beam radiation therapyVaginal cuff recurrenceTotal abdominal hysterectomyBeam radiation therapyAbdominal hysterectomySecondary outcomesConsecutive patientsLocal recurrencePrimary outcomeOncology evaluationMean intervalHysterectomy
2015
Predictors of vaginal stenosis after intravaginal high-dose-rate brachytherapy for endometrial carcinoma
Park HS, Ratner ES, Lucarelli L, Polizzi S, Higgins SA, Damast S. Predictors of vaginal stenosis after intravaginal high-dose-rate brachytherapy for endometrial carcinoma. Brachytherapy 2015, 14: 464-470. PMID: 25887343, DOI: 10.1016/j.brachy.2015.03.001.Peer-Reviewed Original ResearchConceptsVaginal stenosisDilator useIndependent predictorsEndometrial carcinomaTotal doseRate brachytherapyMultivariable logistic regression analysisExternal beam radiation therapyCommon Terminology CriteriaEffective adjuvant treatmentMonths of followupPost-treatment factorsBeam radiation therapyHigher total doseLogistic regression analysisTerminology CriteriaAdjuvant treatmentFollowup visitMean followupAdverse eventsLast followupMultivariable analysisRisk factorsRadiation therapyPatients
2014
Adjuvant Carboplatin, Paclitaxel, and Vaginal Cuff Brachytherapy for Stage III Endometrial Cancer: Analysis of Outcomes and Patterns of Recurrence Based on Pathologic Characteristics
Young MR, Higgins SA, Ratner E, Yu JB, Mani S, Silasi DA, Azodi M, Rutherford T, Schwartz PE, Damast S. Adjuvant Carboplatin, Paclitaxel, and Vaginal Cuff Brachytherapy for Stage III Endometrial Cancer: Analysis of Outcomes and Patterns of Recurrence Based on Pathologic Characteristics. International Journal Of Gynecological Cancer 2014, 25: 431. PMID: 25621409, PMCID: PMC5603450, DOI: 10.1097/igc.0000000000000376.Peer-Reviewed Original ResearchMeSH KeywordsAdenocarcinomaAgedAntineoplastic Combined Chemotherapy ProtocolsBrachytherapyCarboplatinChemoradiotherapy, AdjuvantDisease-Free SurvivalEndometrial NeoplasmsFemaleHumansHysterectomyLymph NodesLymphatic MetastasisMiddle AgedNeoplasm Recurrence, LocalNeoplasm StagingPaclitaxelRetrospective StudiesSurvival RateTreatment FailureConceptsDisease-free survivalVaginal cuff brachytherapyStage III endometrial adenocarcinomaStage III endometrial cancerNode-negative diseaseOverall survivalAdjuvant chemotherapyEndometrial cancerEndometrial adenocarcinomaType IComprehensive surgical stagingLow-risk histologyNode-positive diseaseOutcomes of patientsHigh-risk histologyNode-positive ratePatterns of recurrenceAnalysis of outcomesType II diseaseAdjuvant carboplatinVaginal failuresSurgical stagingAdjuvant therapyNode negativeNode positiveComparative Patient-Centered Outcomes (Health State and Adverse Sexual Symptoms) Between Adjuvant Brachytherapy Versus No Adjuvant Brachytherapy in Early Stage Endometrial Cancer
Damast S, Alektiar K, Eaton A, Gerber NK, Goldfarb S, Patil S, Jia R, Leitao M, Carter J, Basch E. Comparative Patient-Centered Outcomes (Health State and Adverse Sexual Symptoms) Between Adjuvant Brachytherapy Versus No Adjuvant Brachytherapy in Early Stage Endometrial Cancer. Annals Of Surgical Oncology 2014, 21: 2740-2754. PMID: 24619493, DOI: 10.1245/s10434-014-3562-4.Peer-Reviewed Original ResearchConceptsFemale Sexual Function IndexPoor health statesSexual functioningEndometrial cancerSexual functionEarly-stage endometrial cancerHealth statesStage I endometrial cancerBaseline sexual activityStage endometrial cancerEndometrial cancer survivorsSexual Function IndexSignificant risk factorsSurgery groupUnderwent surgeryEQ5D scoresFSFI scoreSurgery typeAdjuvant brachytherapyCancer survivorsMore frequent useRisk factorsFunction IndexSexual dysfunctionMultivariable regression
2012
Five-year outcomes of adjuvant carboplatin/paclitaxel chemotherapy and intravaginal radiation for stage I–II papillary serous endometrial cancer
Kiess AP, Damast S, Makker V, Kollmeier MA, Gardner GJ, Aghajanian C, Abu-Rustum NR, Barakat RR, Alektiar KM. Five-year outcomes of adjuvant carboplatin/paclitaxel chemotherapy and intravaginal radiation for stage I–II papillary serous endometrial cancer. Gynecologic Oncology 2012, 127: 321-325. PMID: 22850412, DOI: 10.1016/j.ygyno.2012.07.112.Peer-Reviewed Original ResearchMeSH KeywordsAgedAged, 80 and overAntineoplastic AgentsAntineoplastic Combined Chemotherapy ProtocolsBrachytherapyCarboplatinChemoradiotherapy, AdjuvantCystadenocarcinoma, PapillaryCystadenocarcinoma, SerousDrug Administration ScheduleEndometrial NeoplasmsFemaleFollow-Up StudiesHumansHysterectomyMiddle AgedNeoplasm StagingOvariectomyPaclitaxelRetrospective StudiesSalpingectomySurvival AnalysisTreatment OutcomeConceptsCarboplatin/paclitaxel chemotherapyUterine papillary serous carcinomaPaclitaxel chemotherapyStage IEarly-stage uterine papillary serous carcinomaPapillary serous endometrial cancerParaaortic lymph node samplingDistant recurrence ratesMedian patient ageStage II diseaseFive-year outcomesLymph node samplingKaplan-Meier methodOverall survival ratePapillary serous carcinomaSingle institution experienceLog-rank testSerous endometrial cancerConcurrent carboplatinMedian followPelvic radiationOmental biopsyPara-aorticPelvic recurrenceUnderwent surgery