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S u m m e r 2 0 0 0 Vo l u
m e 6
[More Bodine Bulletins]
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CLINICAL
TRIALS IN CANCER – PERSPECTIVES FROM THREE PATIENTS
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Advances in cancer treatment have been achieved
through the process of clinical trials. Many patients benefited
and will continue to benefit from the knowledge
gained through the study of pioneering patients enrolled
on various Phase I, II, and III protocols. Participation in
clinical trials can be physically and emotionally demanding
for patients, and the decision to enroll in a study can
often be a difficult one. Yet, participation can have its
own immediate rewards, as well. Here are some
thoughts from three Jefferson patients who were treated
with novel treatments in our department in recent years.
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Elena Sheehan: I didn’t choose to be a trailblazer. I was
chosen. I was asked in December of 1996 to be the first
patient on a Phase I clinical trial for the treatment of rectal
cancer. At that time my knowledge of clinical trials
was limited but after some discussion with my doctors I
made the decision to go ahead. The signing of the
acceptance form was just the beginning of a physical
and mental journey toward healing. In hindsight the
physical healing was the less formidable part of the pact
I made with myself, my doctors and Thomas Jefferson
University Hospital. My surgery would turn out to be a
complete success. The mental healing was another matter
altogether, (but) through the tremendous support of
family and friends and lots of prayers, I eventually
opened my eyes to the reality of a great prognosis.
Reaching the end of the clinical trial protocol also helped
me mentally. I had reached my destination point successfully.
Stan Wortman: How do I feel about being the first
person
in the brachytherapy program at Jefferson in
October 1996? Very fortunate to have this option available
to me locally. I did 6 months of research before
making my decision and feel it was the only option I was
comfortable with. I had complete confidence in the procedure
and my doctor...although I was "first" at
Jefferson...I have always felt that a teaching hospital has
the latest and most varied options for treatment in any
situation.
Alex Asselta: Advancement in medical treatment needs
people who are not afraid to take risks. When diagnosed
with cancer, I knew I had to fight in order to win.
That fight meant planning for the future...not only my
own, but for others. Protocol Program(s) are the future.
If there were a chance that a new procedure or method
of treatment could have a positive impact on the success
rate of future patients, I would willingly take that risk to
help other people. We need every advantage in our battle
against this disease that has no boundaries.
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If you are interested in participation in a clinical trial,
please see the list of current department protocols on
the inside panel. |
MEMORIAL DEDICATION
It is with great sorrow that we say farewell to two
wonderful friends of the Department of Radiation
Oncology and dedicate this edition of the Bodine
Bulletin to their loving memory. We shall all miss them.
Carol Kramer, MD at 48 years old lost her battle
against cancer. Carol was a physician at our Chestnut
Hill facility and moved on to the University of Kentucky.
Margaret Kramer was the wife of Simon Kramer,
MD, Jefferson’s Distinquished Professor Emeritus, an
international leader in the field of radiation oncology
and the first Chairman of the Department of Radiation
Oncology and Nuclear Medicine.
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FROM
THE CHAIRMAN
WALTER J. CURRAN,
JR.,
MD
Please note two important
physician transitions in our
practice. After a search conducted
by both Frankford
Hospital and Jefferson leadership,
Dr. Kelly Underhill has
accepted the medical directorship
of the Frankford Radiation
Oncology Center. Kelly joined
our practice in 1998 and will
work with Drs. Michael
Peterson and Eric Gressen at Frankford in meeting the
needs of patients and physicians at Frankford. In addition
we are very pleased to welcome Dr. David Suh back
to our department. David completed his training here at
Jefferson in 1997 and will serve as the medical director
of the Methodist Hospital Radiation Oncology Pavilion.
Please join me in welcoming David and Kelly to these
new opportunities.
The First International Conference on Intensity
Modulated Radiotherapy (IMRT) was hosted by our
department on March 17-19 2000. Dr. Jim Galvin and
his staff did an outstanding job coordinating the symposium
and the workshop in which there were over 200
European and American participants. IMRT is an exciting
new therapeutic approach for cancer patients. Under the
leadership of Drs. Rich Valicenti, Rani Anne, Maria
Werner-Wasik, and several faculty physicists, our department
is evaluating several methods of optimizing IMRT.
We have delivered IMRT at the Bodine Center for selected
patients with brain or head and neck tumors with our
NOMOS Peacock system and for selected men with
prostate cancer using our multileaf collimator system.
The exciting future of this technology was beautifully
summarized by Dr. Clifton Ling of Memorial Sloan
Kettering Cancer Center during the Third Annual
Suntharalingam Lecture on April 17, 2000.
Finally, two clinical trials testing the anti-angiogenesis
agent angiostatin were initiated this spring with
Jefferson as the sole clinical site. These trials mark the
first testing of this promising agent against human cancer.
The first trial, led by Dr. Robert Capizzi, is a phase I
trial of the agent alone and the second trial, led by Dr.
Adam Dicker and myself, will study the delivery of
angiostatin in conjunction with radiotherapy. This trial is
just one of several trials in which novel systemic agents
are being tested with ionizing radiation at our facilities.
Please don’t hesitate to contact me at 215-955-6701 or
Roseann Bonanni at 215-955-8683, if you have questions
regarding these or other studies for your patients.
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Walter J. Curran, Jr., MD
Chairman
Department of Radiation Oncology
Kimmel Cancer Center
Thomas Jefferson University
Phone: (215) 955-6700
Fax: (215) 955-0412
E-mail: walter.curran@mail.tju.edu |
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Shari Rudoler, MD
Editor, Bodine Bulletin
Jefferson/Lower Bucks
Radiation Oncology Center
Phone: (215) 785-9910, Fax (215) 785-9911
E-mail: shari.rudoler@mail.tju.edu |
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Joy Soleiman, MPA
Administrator, Clinical Science Division
Kimmel Cancer Center
Thomas Jefferson University
Phone: (215) 955-5948
Fax: (215) 955-0412
E-mail: joy.soleiman@mail.tju.edu |
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WELCOME
TO NEW DEPARTMENT MEMBERS
At the
Bodine Center
Physicians:
David Suh, 8/00 |
Administrative:
John Penner, 7/00
Jared Hume, 6/00 |
New
Residents:
Heather Lee, 7/00
Ming Wang, 7/00 |
Physics Postdoctoral Fellows:
Haijun Song, Ph.D., 3/00
Darek Michalski, Ph.D.,3/00 |
Radiation Therapists:
Barbara Amato, 5/00
Heather Warner, 5/00
Beth Ruppert, 7/00 |
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At Methodist
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Dosimetrist:
Rochelle Wise-Payne, 4/00 |
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At Riddle
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Clerical:
Judith Yorke, 12/99 |
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FOND FAREWELL
TO DEPARTMENT MEMBERS
Dwight Heron, MD has accepted a
faculty position for July 2000 at the University of
Pittsburgh Medical Center.
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INTERNATIONAL SYMPOSIUM
ON IMRT
The introduction of Intensity
Modulated Radiation Therapy (IMRT) provides a means of conforming dose
to targets while fully protecting surrounding critical structures. This
capability of Three-dimensional Conformal Radiation Therapy (3DCRT) has
excited the Radiation Oncology community because of the improved
potential for critical normal tissue sparing and the possibility for
tumor dose escalation. However, the technology that surrounds IMRT is
extremely complex. It involves, to mention just a few important
considerations, devices like the multileaf collimator, inverse treatment
planning systems and linear accelerators with special capabilities for
rapid and reliable delivery of large numbers of field segments.
In March 2000 Thomas Jefferson
University hosted an international symposium on IMRT. This event was a
great success with 200 physicists, physicians, and dosimetrists
attending the lectures on the first day. The morning of the second day
was devoted to demonstrations in which well over 100 people
participated.
A truly international faculty
contributed to the lectures. In addition to the US faculty members,
there was representation from the Netherlands Cancer Institute in
Amsterdam, Holland, the University of Gent in Belgium, the Christie
Hospital in Manchester, England and the Royal Marsden Hospital in
London, England. Along with the contributing faculty from Thomas
Jefferson University Hospital, the US was represented on the program by
William Beaumont Hospital in Detroit, Michigan, the University of
Maryland in Baltimore, and the University of Washington in Seattle.
Elekta Oncology Sysems co-sponsored the symposium. Each of the
institutions listed above is part of the Elekta consortium, and the
symposium gave this group the opportunity to show the results of many
years of effort in making intensity modulated dose delivery possible on
Elekta equipment.
The
second day consisted of demonstrations. Groups of ten to twelve
individuals rotated through the eight different demos. Two
inverse planing systems (NOMOS and Nucletron) were available,
and
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| DEPARTMENT
LOCATIONS
Bodine Center for Cancer
Treatment
Thomas Jefferson
University Hospital
111 South 11th Street
Philadelphia, PA
19107-5097
215-955-6702
Jefferson–Chestnut Hill
Radiation
Oncology Center
Chestnut Hill Hospital
8835 Germantown Avenue
Philadelphia, PA 19118
215-248-8712
Radiation Oncology Center
Frankford Hospital–Torresdale
Division
Red Lion & Knights
Roads
Philadelphia, PA 19114
215-612-4300
Jefferson–Lower Bucks
Radiation
Oncology Center
Lower Bucks Hospital
501 Bath Road
Bristol, PA 19007
215-785-9910
Radiation Oncology
Pavillion at
Methodist Hospital
Division
Thomas Jefferson
University Hospital
2301 South Broad Street
Philadelphia, PA 19148
215-952-1444
Jefferson Radiation
Oncology Center at Riddle
Health Care Center I,
Suite 2
1078 West Baltimore Pike
Media, PA 19063
610-627-4350
Will’s Eye Hospital
Stereotactic Radiosurgery
9th & Walnut Streets |
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consortium members were on hand to share their experience
using these devices. Researchers at Thomas Jefferson
demonstrated a "forward" planning technique they have
devised for handling targets with invaginations. Relative to
"inverse" planning, these researchers feel that their
approach has distinct advantages in terms of ease of dose
delivery, quality assurance and treatment verification. Two
accelerators were used to demonstrate both dynamic and static
IMRT. Additionally, the research group at the University of
Maryland demonstrated Intensity Modulated Arc Therapy or IMAT.
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BUDDY
PROGRAM
The Kimmel
Cancer Center has a unique support program available to newly diagnosed
patients. The Buddy Program allows patients with newly diagnosed cancer to be
matched with cancer survivors, "buddies", who provide short-term
support and guidance. The buddies in the program are individuals who were
treated for cancer at Jefferson, and who were recommended by their physician
or nurse as someone who would be a good support to a newly diagnosed patient.
The buddies participate in a three-hour volunteer training program. They then
can be matched with patients based on diagnosis, treatment, age and gender to
provide short-term support over the telephone. Buddies can assist patients in
coping with diagnosis, treatment and symptom management, communicating with
family, friends and the medical team, and accessing other information and
support resources.
Often when people are newly diagnosed
with cancer they describe a feeling of isolation, a feeling that no one can
really understand what they are going through. This is true even for those
individuals who have the very best existing social support networks. Support
from someone who knows first hand what these individuals are experiencing can
be invaluable in helping them to cope with their cancer diagnosis and all of
the changes that can go along with it. The Buddy Program offers a unique
alternative to those individuals who are either not able or not interested in
attending a support group. If you know of someone who would be interested in
talking with a buddy, please call 215-955-8370.
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NEWSMAKERS
Dr. Greg Bednarz will give
an oral presentation entitled "Deconvolution of detector size
effect for output factor measurement for narrow Gamma Knife radiosurgery
beams", at the World Congress on Medical Physics.
Christopher Chen, MD
presented an abstract entitled "Does isotope selection affect
urinary symptoms after combined conformal radiotherapy and permanent
prostate implant? An evaluation of patients treated with either PD-103
or I-124 for implant boost" at the Annual Meeting of American
Brachytherapy Society in Alexandria, VA in April 2000.
Walter J. Curran, Jr., MD
presented results of RTOG 94-10, a Phase III non-small cell lung cancer
trial at an oral session of the American Society of Clinical Oncology
Meeting, May 2000 in New Orleans.
James M. Galvin, PhD gave a
lecture entitled "Treatment Planning for Intensity Modulated
Radiation Therapy" in New Brunswick, New Jersey, April 2000 at the
invitation of the New Jersey Academy of Medicine. Dr. Galvin also spoke
at the XIII International Conference on the "Use of Computers in
Radiation Therapy", in Heidelberg, Germany May 2000. Dr. Galvin
will be doing an oral presentation entitled "Using segmented fields
to treat the breast" and a poster presentation entitled "A
sequential optimization technique for forward treatment planning for
IMRT" at the World Congress on Medical Physics and Biomedical
Engineering July 2000 in Chicago. Dr. Galvin will also be chairing the
session on IMRT delivery and the organizational meeting of radio-therapy
accelerators maintenance personnel.
Eric Gressen, MD, a faculty
member practising at Frankford Torresdale Hospital, has been promoted to
Assistant Professor.
Murshed Hossain, PhD will
give two oral presentations: Time dependent effects in the
linear-quadratic model and evolutionary time factor" and
"Calculating combined dose distributions and dose-volume histograms
for sequential and concurrent boosts when inverse planning is used for
IMRT".
Leslie Hughes, MD has been
elected to the Executive Committee of the Association of Residents in
Radiation Oncology (ARRO).
Samuel Hughes, MD has been
appointed Chief Resident for the academic year 2000-2001. This
responsibility will begin April 3, 2000.
M. Saiful Huq, PhD was
invited to speak about "AAPM’s TG-51 protocol for clinical
reference dosimetry of high-energy photon and electron beams" at
the Ohio River Valley Chapter of the AAPM
October 1999, the New Jersey Chapter of the AAPM October 1999 and the
Delaware River Valley Chapter of the AAPM December 1999. He also
lectured on "Photon beam calibration using
the IAEA Code of Practice TRS-277". "Beam calibration using
the IAEA coP based on standards of absorbed dose to water," and
"Immobilization and setup verification" at an international
workshop on medical physics in radiotherapy and nuclear medicine
organized by the Bangladesh Medical Physicists Association held in
Dhaka, Bangladesh December 1999. Dr. Huq spoke on similar topics at the
Second Beijing International Congress on Medical Radiation Physics,
Beijing, May 2000. Dr. M. Saiful Huq will be doing an oral presentation
entitled "Clinical reference dosimetry for electron beams:
comparison between AAPM TG-51 and TG-21 protocols" at the World
Congress on Medical Physics and Biomedical Engineering in Chicago,
Illinois, July 2000.
Dennis B. Leeper, PhD
lectured at the Fourth Turkish National Congress of Radiation Oncology
(UROK 2000), March 2000 in Bursa, Turkey. Dr. Leeper gave four talks,
one was entitled "Tumor pH Oxygenation and other Microenvironmental
Factors Affecting Therapeutic Response", the other three talks were
refresher courses in Radiobiology. Dr. Leeper also attended the 8th
International Congress of Hyperthermic Oncology held in Kyong-Ju, Korea
April 2000. He gave two talks entitled, "pH Manipulation for Heat
Sensitization" and "Acidification of Human Melanoma Xenografts
during Exposure to MIBG and Hyperglycemia". He was elected as the
representative from the North America Hyperthermia Society to the
International Association of Hyperthermic Oncology and was elected as
Secretary-Treasurer of the ICHO.
Jay E. Reiff, PhD will
present "Interfraction variations in the location of the anatomic
isocenter with respect to an external coordinate system" at the
Chicago 2000 World Congress on Medical Physics and Biomedical
Engineering that will take place July 2000 in Chicago, Illinois.
Bruce Turner, MD, PhD,
presented an abstract entitled "Inhibitor of Apoptosis (IAPs) are
up regulated in Early Stage Prostate Cancer and Predicts Metastatic
Relapse" at the Annual Meeting of the American Society of Clinical
Oncology, May 2000.
Dr. Frank Waterman will be
giving an invited talk on "Post-Implant Dosimetry for Prostrate
Implants, Impact of Post-Implant Edema" at the 5th International
Symposium on 3D Conformal Radiation Therapy and Brachytherapy to be held
at the Memorial Sloan-Kettering Cancer Center, New York, June 2000.
Ying Xiao, PhD will present
"A Centralized Dose Calculation System for Radiation Therapy"
at the Symposium for Computer Applications in Radiology (SCAR), June
2000, in Philadelphia. Dr. Xiao will also have a poster presentation
entitled, "A Sequential Optimizaton Technique for Forward Treatment
Planning for IMRT" at the World Congress on Medical Physics and
Biomedical Engineering in Chicago, Illinois, July 2000. |
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SPECIAL EVENTS
The Third Annual Nagalingan Suntharalingam Lecture took place on
Monday , April 17, 2000 in Philadelphia. Clifton C. Ling, Ph.D.,
Enid Haupt Chairman of the
Department of Medical Physics at
Memorial Sloan-Kettering Cancer Center in New York
City , deliver ed the lectur e entitled, “Evidence – Based
Multidimensional Radiotherapy .”
Many r epr esentatives of the Radiation Oncology community attended, including physicians, physicists,
dosimetrists and radiobiologists.
chemotherapy .
PROSTATE
RTOG#9902-A Phase III pr otocol of androgen suppression (AS) and radiation therapy
(R T) vs. AS and RT followed by chemotherapy with paclitaxel, estramustine and etoposide (TEE) for localized, high-risk, pr ostate cancer .
RTOG #9910-A Phase III trial to evaluate the duration of neoadjuvant total androgen suppression (TAS) and radiation therapy (RT) in ntermediate-risk prostate cancer.
HEAD & NECK
A Phase I Intensive pharmacokinetic study of porfir omycin in head and neck cancer and other cancer patients with solid tumors r eceiving radiation therapy.
LUNG
NON SMALL CELL LUNG
RTOG #9801-A phase III study of amifostine mucosal protection for patients with favorable
prognosis inoperable stage II-IIIA/B non-small cell lung cancer (NSCLC) receiving sequential induction and concurr ent hyperfractionated radiotherapy with paclitaxel and carboplatin.
BRAIN METASTASES
Phase III randomized trial of gadolinium texaphyrin (PCI-0120) injection as a radiation sensitizer in patients r eceiving whole brain radiation therapy for the treatment of brain metastases (Pharmacyclics). (Can be treated at JOG institutes if randomized to WBRT only and the patient
agrees to have all MRIs done here).
BREAST
BREAST/DCIS
RTOG#9804-Phase III trial of tamoxifen alone vs. tamoxifen plus R T for good risk duct carcinoma in situ (DCIS) of the female breast.
BREAST
A Phase I T axoter e dose escalation trial of concurr ent adjuvant taxotere and radiation therapy in the treatment of breast cancer (JOG #010).
GI
STOMACH
RTOG #9904-A Phase II trial of pr eoperative chemotherapy and chemoradiotherapy for potentially resectable adenocar cinoma of the stomach.
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Revised: July 10, 2000. URL:
http://www.kcc.tju.edu/RadOnc/Bod_Bulletin/sum_2000.htm
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