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Low Body Mass Index As a Risk Factor for Long-Term Proctitis after Prostate SBRT: Assessing the Dosimetric and Clinical Implications [Meeting Abstract]

Blacksburg, S. R.; Sheu, R.; Carpenter, T. J.; Demircioglu, G.; Witten, M. R.; Mendez, C.; Ilyas, A.; Dodin, F.; Chieng, T.; Garbus, J.; Pappas, D.; Haas, J. A.
ISSN: 0360-3016
CID: 4686382

Prostate Fiducial Marker Placement in Patients on Anticoagulation: Feasibility Prior to Prostate SBRT

Iocolano, Michelle; Blacksburg, Seth; Carpenter, Todd; Repka, Michael; Carbone, Susan; Demircioglu, Gizem; Miccio, Maryann; Katz, Aaron; Haas, Jonathan
Background and Purpose: Fiducial marker placement is required in patients undergoing robotic-based Stereotactic Body Radiotherapy (SBRT) or image-guided radiation therapy (IGRT) for prostate cancer. Many patients take antiplatelet or anticoagulant medication due to other medical comorbidities. They are often required to temporarily discontinue these medications prior to invasive medical procedures as they are prone to bleed. Some patients are unable to discontinue therapy due to an elevated risk of thromboembolic events. The purpose of this study is to report this institution's experience placing fiducial markers in prostate cancer patients who are on chronic antiplatelet or anticoagulant medication. Materials and Methods: From August 2015-March 2019 57 patients on chronic antiplatelet or anticoagulation therapy who were not cleared to stop these medications underwent transrectal ultrasound guided (TRUS) fiducial marker placement for SBRT/IGRT. All patients were monitored by a registered nurse during the procedure for prolonged bleeding that required staff to hold pressure to the area with a 4 × 4 gauze until it resolved. All patients were also called the following day to assess for ongoing bleeding events. Treatment planning CT scan confirmed the ideal geometry of the marker placement. Results: All 57 patients on antiplatelet or anticoagulant medication who underwent fiducial marker placement were discharged home the same day of the procedure. Four patients experienced persistent bleeding that required a nurse to hold prolonged pressure to the area. No patient experienced significant bleeding the following day or any untoward cardiovascular event. Conclusions: This series suggests the use of antiplatelet or anticoagulant medication is not an absolute contraindication to fiducial marker placement in patients undergoing SBRT or IGRT for prostate cancer. These patients should be closely monitored after the procedure for bleeding complications. Practitioners may consider the patient's medical comorbidities, risk factors for thromboembolism, and overall functional status as there is no standardized protocol for discontinuing anticoagulant or antiplatelet therapy for fiducial marker placement.
PMID: 32175274
ISSN: 2234-943x
CID: 4371092

Omission of MRI For Treatment Planning Does Not Affect Long-Term Outcomes after Prostate SBRT. [Meeting Abstract]

Blacksburg, S. R.; Sheu, R.; Carpenter, T. J.; Demircioglu, G.; Witten, M. R.; Mendez, C.; Auto, H.; Zheng, B.; Katz, A. E.; Haas, J. A.
ISSN: 0360-3016
CID: 4686372

Assessing Clinical and Dosimetric Predictors For Low PSA Nadir after Stereotactic Body Radiation Monotherapy with Intraprostatic Dose Escalation [Meeting Abstract]

Blacksburg, S. R.; Sheu, R.; Carpenter, T. J.; Demircioglu, G.; Repka, M. C.; Witten, M. R.; Mendez, C.; Shin, W.; Chieng, T.; Katz, A. E.; Haas, J. A.
ISSN: 0360-3016
CID: 4686362

The Prognostic Impact of Delayed Time From Biopsy in Men with Low Risk Prostate Cancer Treated with Definitive SBRT [Meeting Abstract]

Blacksburg, S. R.; Carpenter, T. J.; Demircioglu, G.; Witten, M. R.; Mendez, C.; Dodin, F.; Katz, A. E.; Haas, J. A.
ISSN: 0360-3016
CID: 4686392

Obstructive Uropathy after Prostate SBRT is Rare: Characterizing Clinical and Dosimetric Predictors From a Large Patient Cohort [Meeting Abstract]

Blacksburg, S. R.; Sheu, R.; Carpenter, T. J.; Repka, M. C.; Demircioglu, G.; Witten, M. R.; Mendez, C.; Auto, H.; Shin, W.; Zafar, S.; Ilyas, A.; Haas, J. A.
ISSN: 0360-3016
CID: 4686352

Comparisons Between Patients at Suburban and Inner-City Facilities Treated With Prostate SBRT: Long-Term Parity in Outcomes Despite Measurable Differences in Demographic and Disease Profiles [Meeting Abstract]

Blacksburg, S. R.; Carpenter, T. J.; Marans, H.; Demircioglu, G.; Witten, M. R.; Repka, M. C.; Mendez, C.; Katz, A. E.; Haas, J. A.
ISSN: 0360-3016
CID: 4686232

Analysis of Local Control and Pain Control After Spine Stereotactic Radiosurgery Reveals Inferior Outcomes for Hepatocellular Carcinoma Compared With Other Radioresistant Histologies

McGee, Heather M; Carpenter, Todd J; Ozbek, Umut; Kirkwood, Katherine A; Tseng, Tzu-Chi; Blacksburg, Seth; Germano, Isabelle M; Green, Sheryl; Buckstein, Michael
PURPOSE/OBJECTIVE:This study aimed to evaluate the efficacy of stereotactic radiosurgery (SRS) for spinal metastases from hepatocellular carcinoma (HCC) compared with other radioresistant histologies (renal cell carcinoma [RCC], melanoma, and sarcoma) in terms of local control (LC) and pain control. METHODS AND MATERIALS/METHODS:We performed a retrospective review of patients treated with SRS to the spine for metastatic HCC, RCC, melanoma, and sarcoma between January 2007 and May 2014. Radiographic assessments of LC, overall survival, and patient-reported pain control were analyzed as univariable analyses and with various patient- and treatment-related parameters as multivariable analyses (MVA). RESULTS:Of the 96 patients treated with SRS, 41 patients had radioresistant histologies, including 18 HCC, 1 mixed HCC and cholangiocarcinoma, 15 RCC, 6 melanoma, and 1 leiomyosarcoma. Extraosseous disease was present in 63% of patients (74% in HCC; 55% in non-HCC; P = not significant). Spinal cord compression was present in 29% of patients (32% in HCC; 27% in non-HCC; P = not significant), and 24% of patients had decompressive surgery before SRS (26% in HCC; 23% in non-HCC; P = not significant). With a median follow-up time of 8.7 months, the actuarial 3-, 6-, and 12-month LC rates were 71%, 61%, 41%, respectively, for HCC, and 94%, 94%, and 85%, respectively, for non-HCC. The median time to local failure was 3 months for HCC and 11 months for non-HCC. On MVA, there was a strong trend toward inferior LC with HCC (P = .059). Of the 28 patients with pretreatment pain, pain relief was achieved in 93% of patients, but the 2 patients who did not experience pain relief both had HCC. The actuarial 3-, 6-, and 12-month pain control rates were 68%, 51%, 17%, respectively, for HCC, and 100%, 89%, and 89%, respectively, for non-HCC (P = .023), and remained significant on MVA (P = .034). CONCLUSIONS:Compared with other radioresistant histologies, HCC has inferior LC and pain relief after SRS. Whether HCC may benefit from further dose escalation or combined treatment with new therapies is an area of future research.
PMID: 30543868
ISSN: 1879-8519
CID: 3733682

Demographic and Pharmaceutical Predictors of Unfavorable Prostate Cancer [Meeting Abstract]

Blacksburg, S. R.; Demircioglu, G.; Carpenter, T. J.; Mirza, A.; Witten, M. R.; Mendez, C.; Katz, A. E.; Haas, J. A.
ISSN: 0360-3016
CID: 4111982

Evidence of Stage Migration to Higher Risk Prostate Cancer and its Financial Implications in a Single Institution [Meeting Abstract]

Haas, J. A.; Mendez, C.; Sanchez, A.; Mirza, A.; Carpenter, T. J.; Witten, M. R.; Demircioglu, G.; Katz, A. E.; Repka, M. C.; Blacksburg, S. R.
ISSN: 0360-3016
CID: 4111992