A5040332558- Management of metastatic bone disease
- Palliative Care and End-of-Life Issues
- Cancer Diagnosis and Treatment
- Advanced Radiotherapy Techniques
- Brain Metastases and Treatment
- Cancer survivorship and care
- Spine and Intervertebral Disc Pathology
- Economic and Financial Impacts of Cancer
- Endometrial and Cervical Cancer Treatments
- Ethics in medical practice
- Ovarian cancer diagnosis and treatment
- Childhood Cancer Survivors' Quality of Life
- Spinal Fractures and Fixation Techniques
- Patient Dignity and Privacy
- Boron Compounds in Chemistry
- Glioma Diagnosis and Treatment
- Radiation Therapy and Dosimetry
- COVID-19 and healthcare impacts
- Endometriosis Research and Treatment
- Advances in Oncology and Radiotherapy
- Cervical Cancer and HPV Research
- Empathy and Medical Education
- Meningioma and schwannoma management
- Diversity and Career in Medicine
- Autopsy Techniques and Outcomes
Memorial Sloan Kettering Cancer Center
2020-2024
Dana-Farber Brigham Cancer Center
2017-2019
Massachusetts General Hospital
2017-2019
Brigham and Women's Hospital
2018
Dana-Farber Cancer Institute
2018
Harvard Affiliated Emergency Medicine Residency
2018
Radiation Oncology Associates
2018
University of Pennsylvania
2013-2014
External-beam radiation therapy (RT) is standard of care (SOC) for pain relief symptomatic bone metastases. We aimed to evaluate the efficacy asymptomatic metastases in preventing skeletal-related events (SRE).In a multicenter randomized controlled trial, adult patients with widely metastatic solid tumor malignancies were stratified by histology and planned SOC (systemic or observation) randomly assigned 1:1 ratio receive RT high-risk alone. The primary outcome trial was SRE. Secondary...
Palliation of metastatic disease compromises a significant portion radiation treatments in the United States. These patients present unique challenge resource-limited settings, as expeditious treatment is often required to prevent serious morbidity. In order reduce risk infection with severe acute respiratory syndrome coronavirus-2 and maximize benefit patients, we evidence-based recommendations for oncologic emergencies. Radiation oncologists expertise at high-volume comprehensive cancer...
Importance Despite federal initiatives encouraging the enrollment of individuals from racial and ethnic minority groups in US clinical trials, no studies to date have specifically examined demographic disparities among participants phase 1 drug development trials for patients with metastatic cancer. Objective To assess trends therapeutic cancer 2000 2018. Design, Setting, Participants In this cross-sectional study, ClinicalTrials.gov was queried July 2021 identify completed January 1, 2000,...
PURPOSE Randomized controlled trials have demonstrated that palliative care (PC) can improve quality of life and survival for outpatients with advanced cancer, but there are limited population-based data on the value inpatient PC. We assessed PC as a component high-value among nationally representative sample inpatients metastatic cancer identified hospitalization characteristics significantly associated high costs. METHODS Hospitalizations patients 18 years older primary diagnosis from...
Abstract Background Hospice and end‐of‐life health care utilization among patients with esophageal cancer are understudied. We used the Surveillance, Epidemiology, End Results (SEER)‐Medicare linked database to analyze hospice use treatment patterns. Methods included diagnosed adenocarcinoma or squamous cell carcinoma between 2000 2011 who had died by December 31, 2013. evaluated patterns of enrollment, chemotherapy receipt, radiation acute hospitalizations, intensive unit (ICU) admissions...
Many patients with metastatic cancer receive high-cost, low-value care near the end of life. Identifying a high likelihood receiving is an important step to improve appropriate end-of-life care.To analyze patterns and interventions during terminal hospitalizations examine whether management associated sociodemographic status among adult at life.This retrospective, population-based cross-sectional study used data from Healthcare Cost Utilization Project all-payer, encounter-level information...
BACKGROUND AND PURPOSE: A retrospective single-center analysis of the safety and efficacy reirradiation to 40 Gy in 5 fractions (reSBRT) patients previously treated with stereotactic body radiotherapy spine was performed. METHODS: We identified 102 consecutive reSBRT for 105 lesions between 3/2013 8/2021. Sixty-three (61.8%) were same vertebral level, 39 (38.2%) overlapping immediately adjacent levels. Local control defined as absence progression within target volume. The probability local...
"Shut the door," chief resident said to me. While I was green enough at beginning of my clinical clerkships believe that most medical education would happen bedside, moment, learning another important fact: a large part ethical going behind closed doors call room. The health care team polluted by pervasive atmosphere frustration, as silent but tangible thick layer fog, obscured patient's ability evaluate consequences choice lay before her. attending did not permit, let alone create, an...
Bone metastases cause significant morbidity in patients with cancer, and radiation therapy (RT) is an effective treatment approach. Indications for more complex ablative techniques are emerging. We sought to evaluate RT trends at a large multi-site tertiary cancer center.Patients who received bone single institution (including regional outpatient clinics) from 2016 2018 were identified. Patients grouped by regimen: single-fraction conventional (8 Gy × 1), 30 10 fractions, SBRT, "other"....
This cross-sectional study uses data from the Centers for Medicare & Medicaid Services to assess use of professional society guideline-nonconcordant radiotherapy in patients at end life.
Local treatment for bone metastases is becoming increasingly complex. National guidelines traditionally focus only on radiation therapy (RT), leaving a gap in clinical decision support resources available to clinicians. The objective of this study was reach expert consensus regarding multidisciplinary management non-spine metastases, which would facilitate standardizing within an academic-community partnership.A panel physicians treating metastatic disease across the Memorial Sloan Kettering...
Palliative care and radiation therapy have played an expanding role in the management of patients with advanced cancers. Recent advances our understanding oligometastatic disease led to increasing demand for familiarity ablative techniques. Recognizing demands hospitalized rapid access care, we created inpatient oncology consult service (IROC) consolidated expertise palliative In this quality improvement cohort study, analyzed consults placed before after IROC implementation found that...
Given its sharp dose fall off and ability to spare healthy surrounding tissue, proton beam therapy (PBT) has traditionally been used treat various types of malignancies in the definitive setting, with strong, empirical data supporting utility safety. In palliative however, photon generally remained standard care radiation treatment delivery due lower cost, greater availability. However, recent suggest that use PBT may provide benefit terms symptom management disease control patients locally...
5042 Background: Limited data exist regarding disease-related complications (DRCs), such as bone fractures and urinary obstruction (UO), near end of life men who die with prostate cancer. We aimed to describe the burden DRCs in these patients. Methods: As part Cancer Research-UK funded Clustered randomised trial PSA testing for cancer, we examined a cohort 2603 died within 10 years diagnosis. collected clinical factors DRCs. used univariate analysis examine association between diagnostic...