Patrik Brodin

Albert Einstein College of Medicine | AECOM · Department of Radiation Oncology

Background and purpose: Hippocampus is a central component for neurocognitive function and memory. We investigated the predicted risk of neurocognitive impairment of craniospinal irradiation (CSI) and the deliverability and effects of hippocampal sparing. The risk estimates were derived from published NTCP models. Specifically, we leveraged the es...

Purpose/Objective(s) The use of stereotactic body radiation therapy (SBRT) for hepatocellular carcinoma (HCC) has been steadily increasing. Recently, it was reported that patients with HCC have a differential response to immune-checkpoint inhibitor based on the background liver disease etiology. Whether outcomes of SBRT are affected by underlying l...

Purpose/Objective(s) A PENTEC analysis of published investigations of central nervous system (CNS) subsequent neoplasms (CNS-SN) in childhood cancer survivors who received radiation therapy (RT) to the brain was performed to estimate the effect of RT dose and gender on the risk of CNS-SN following RT. Materials/Methods Through the PENTEC initiativ...

Purpose/Objective(s) Liver-directed therapy (LDT) following transarterial chemoembolization (TACE) can lead to improvement in survival for selected patients with unresectable hepatocellular carcinoma (HCC). However, there is uncertainty in the appropriate application and modality of therapy in current clinical practice guidelines. The aim of this s...

Purpose/Objective(s) To quantify imaging changes from pre- to post-treatment dynamic contrast enhanced (DCE) MRI following liver SBRT for hepatocellular carcinoma (HCC) and examine the association with changes in albumin-bilirubin (ALBI) score. Materials/Methods Patients from a single institution treated with liver SBRT for HCC with available DCE-...

Purpose/Objective(s) This study investigates the association between pre-treatment positron emission tomography (PET) metrics and clinical outcomes in anal squamous cell carcinoma (ASCC) patients treated with definitive radiation therapy (RT). We hypothesize that pre-treatment PET metrics may differentially predict clinical outcomes in ASCC patient...

Purpose/Objective(s) The frameless robotic radiosurgery system target tracking system was recently adapted to Tomotherapy. While a previous dosimetric study has demonstrated comparable prostate SBRT plans between the two systems, we report here our real-world dose delivery accuracy of synchronization technology motion compensation for prostate SBRT...

Since Schofield proposed the niche model in the ’70s, it has been assumed that hematopoietic stem cell (HSC) numbers are determined by their niche size. However, the number of niche cells is known to be greater than that of HSCs, and recent work has shown that nonconditioned transplantation of HSCs leads to an increase in their numbers in recipient...

Background To evaluate the change in parotid glands at mid-treatment during IMRT and the association between radiation dose to the parotid gland stem cell (PGSC) region and patient-reported xerostomia for patients with head and neck cancer (HNC). Material and Methods Patients who were treated from 2006–2012 at our institution with patient-reported...

Radionuclide irradiators (137Cs and 60Co) are commonly used in preclinical studies ranging from cancer therapy to stem cell biology. Amidst concerns of radiological terrorism, there are institutional initiatives to replace radionuclide sources with lower energy X-ray sources. As researchers transition, questions remain regarding whether the biologi...

Background Partial breast irradiation with Intra-operative radiotherapy (IORT) has become a popular management option as opposed to whole breast radiation using external beam radiotherapy for breast cancer patients. While previous studies have highlighted the use of IORT in breast cancer patients, there is a scarcity of literature on the use of IOR...

Purpose: Liver-directed therapy after transarterial chemoembolization (TACE) can lead to improvement in survival for selected patients with unresectable hepatocellular carcinoma (HCC). However, there is uncertainty in the appropriate application and modality of therapy in current clinical practice guidelines. The aim of this study was to develop a...

e16157 Background: BTCs are the second most common primary hepatobiliary malignancy with rising incidence and mortality worldwide. Individual characterization of BTCs at a genomic level is critical to tailor management strategies. Currently available data stem from studies in predominantly White populations. We conducted a retrospective study to de...

Purpose As life expectancy for HIV patients improve, hepatocellular carcinoma (HCC) has become a non-AIDS defining illness with a high impact on morbidity and mortality of HIV-infected individuals. We sought to compare outcomes in HIV- versus non-HIV-infected patients treated for HCC at a multiethnic academic medical health system. Methods A retro...

Objective: To quantify the clinical performance of a machine learning (ML) algorithm for organ-at-risk (OAR) dose prediction for lung stereotactic body radiation therapy (SBRT) and estimate the treatment planning benefit from having upfront access to these dose predictions. Methods: ML models were trained using multi-center data consisting of 20...

Purpose: Although fatigue is a known side effect in head and neck cancer (HNC) patients receiving radiotherapy, knowledge regarding long-term fatigue and dose-response relationships to organs at risk (OAR) is scarce. The aim of this prospective study was to analyze patient-reported fatigue in HNC patients receiving radiotherapy and to explore any p...

Background and purpose Disease recurrence and distant metastases (DM) are major concerns for oropharyngeal cancer (OPC) patients receiving definitive chemo-radiotherapy. Here, we investigated whether pre-treatment primary tumor positron emission tomography (PET) features could predict progression-free survival (PFS) or DM. Methods and materials Pr...

Purpose Radionuclide irradiators ( ¹³⁷ Cs and ⁶⁰ Co) are commonly used in preclinical studies ranging from cancer therapy to stem cell biology. There are institutional initiatives to replace radionuclide sources with lower-energy X-ray sources amidst concerns of radiological terrorism. As researchers transition, there are questions whether the biol...

Purpose/Objective(s) To assess outcomes after definitive chemo-irradiation in HIV patients with anal cancer, and evaluate hemato-immunologic (HI) toxicity by dynamics of CD4+ cell counts and lymphocytes and their association with the dose received by active bone marrow (ABM). Materials/Methods Patients treated for anal cancer with HIV infection at...

Purpose/Objective(s) Prior work has demonstrated that transcriptional signatures and immune cell infiltrates associated with phosphatidylinositol 3-kinase (PI3K) downregulation are able to distinguish glioblastoma patients who respond to immune checkpoint blockade. PI3K/Akt pathway is involved in tumorigenesis, immune microenvironment regulation, a...

Purpose/Objective(s) To report outcomes in patients with inoperable endometrial cancer (ECa) treated with definitive radiotherapy and perform a dosimetric comparison of organs at risk (OARs) for HDR brachytherapy (BT) vs SBRT boost in those who received combined external beam RT (EBRT)+BT treatment. Materials/Methods An institutional retrospective...

Objectives This study aimed to evaluate quantitative and qualitative screening measures for anomalous computed tomography (CT) scans in cancer patients with potential coronavirus disease 2019 (COVID-19) as an automated detection tool in a radiation oncology treatment setting. Methods We identified a non-COVID-19 cohort and patients with suspected C...

Purpose Adolescent young adults (AYA) with Hodgkin lymphoma (HL) are treated according to either pediatric or adult protocols, however, the best strategy has yet to be established. We describe the AYA patients referred for radiotherapy and quantify the risk of radiation-induced late effects and the corresponding life years lost (LYL) following pedi...

Purpose: Immunotherapy is now a first-line treatment for metastatic non-small cell lung cancer (NSCLC) and melanomaQuery. It is important to understand the relationship between immunotherapy and radiation to the brain. The aim of this study was to assess the role of stereotactic radiosurgery (SRS) or WBRT in addition to immunotherapy in patients w...

e24094 Background: Up to 95% of patients receiving radiation therapy (RT) develop radiation dermatitis (RD), which can be therapy-limiting and detrimental to quality of life. Despite its ubiquity, no evidence-based gold standard for the management of RD exists, which highlights the inadequate understanding of its pathogenesis. Prior studies have su...

Purpose To determine the appropriateness of implementing Mobius3D/FX (Varian Medical Systems, Inc., Palo Alto, CA, USA) as not only a pretreatment secondary check but as an alternative to measurement-based patient-specific intensity-modulated radiation therapy (IMRT) quality assurance (QA). Methods Mobius3D/FX was commissioned and stock beam models...

The prostate is a hormone-responsive organ where testicular androgens drive the proliferation and survival of prostatic cells, ensuring the development and functioning of this gland throughout life. Androgen deprivation therapy leads to apoptosis of prostatic cells and organ regression, and is a cornerstone of prostate cancer and benign prostatic h...

Purpose /Objective(s) Stereotactic radiosurgery (SRS) for metastatic disease to the brain is associated with higher in-brain failures compared to whole brain radiation therapy (WBRT). Here we investigated the relationship between low-dose fall off during SRS and location of new brain lesions. Materials and Methods One hundred sixty-seven patients...

BACKGROUND Intracranial arteriovenous malformation (AVM) is a congenital lesion that can potentially lead to devastating consequences if not treated. Many institutional cohort studies have reported on the outcomes after radiosurgery and factors associated with successful obliteration in the last few decades. OBJECTIVE To quantitatively assess the...

Background Proton therapy is a promising advancement in radiation oncology especially in terms of reducing normal tissue toxicity, although it is currently expensive and of limited availability. Here we estimated the individual quality of life benefit and cost-effectiveness of proton therapy in patients with oropharyngeal cancer treated with defini...

Importance: Hepatocellular carcinoma (HCC) is a heterogeneous disease with many available treatment modalities. Transarterial chemoembolization (TACE) is a valuable treatment modality for HCC lesions. This article seeks to evaluate the utility of additional ablative therapy in the management of patients with HCC who received an initial TACE proced...

Purpose Analyses from the ACRIN6668/RTOG0235 trial data identified the SumMean textural feature, calculated from 18-fluorodeoxyglucose positron emission tomography for tumors with a metabolic tumor volume >93 cm³, as a predictor of overall survival (OS) for patients with locally advanced non-small cell lung cancer (LA-NSCLC) receiving concurrent ch...

Importance: As of May 11, 2020, there have been more than 290 000 deaths worldwide from severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which causes coronavirus disease 2019 (COVID-19). Risk-adjusted differences in outcomes among patients of differing ethnicity and race categories are not well characterized. Objectives: To investig...

Background: Optimal alignment is of utmost importance when treating pediatric patients with craniospinal irradiation (CSI), especially with regards to field junctions and multiple isocenters and techniques applying high dose gradients. Here, we investigated the setup errors and uncertainties for pediatric CSI using different setup verification pro...

Aim: To describe the incidental detection of COVID-19 disease on positron-emission tomography/computed tomography (PET/CT) in a patient with cancer despite initial negative swab by polymerase chain reaction (PCR). Case report: Clinical and radiographic data were obtained from the electronic medical record. Nasopharyngeal swabs were obtained and...

Bone marrow (BM) mesenchymal stem and progenitor cells (MSPCs) are a critical constituent of the hematopoietic stem cell (HSC) niche. Previous studies have suggested that the zinc-finger epithelial-mesenchymal transition transcription factor Snai2 (also known as Slug) regulated HSCs autonomously. Here, we show that Snai2 expression in the BM is res...

Purpose There have been nearly 200,000 deaths from SARS-CoV-2 (COVID-19) worldwide so far. Cancer history appears to be a poor prognostic factor for COVID-19 patients, though the reasons for this are unclear. In this report, we assess if extent of prior lung irradiation is a risk factor for death due to COVID-19 infection. Methods Patients who tes...

PET using 18-fluorodeoxyglucose (FDG) has become an important part of the work-up for non-small cell lung cancer (NSCLC). This article summarizes advancements in using FDG-PET for patients with locally advanced NSCLC treated with definitive radiation therapy (RT). This article discusses prognostication of outcome based on pretreatment or midtreatme...

Radiation therapy (RT) has traditionally not been widely used in the management of hepatic malignancies for fear of toxicity in the form of radiation-induced liver disease (RILD). Pre-clinical hepatic irradiation models can provide clinicians with better understanding of the radiation tolerance of the liver, which in turn may lead to the developmen...

Background: There is recent interest in treating locally advanced rectal cancer (LARC) patients with total neoadjuvant therapy (TNT). However, whether TNT is associated with improved overall survival (OS) remains unknown. This study compares outcomes following TNT and following neoadjuvant chemoradiation therapy (nCRT) in patients with LARC, clini...

PURPOSE: The results of the RTOG 0933 and NRG CC001 clinical trials have shown that physical sparing of the hippocampus during cranial irradiation (CI) is associated with preservation of memory functions at 4- and 6-months following therapy. Whereas the putative roles of protection of neural stem cells (NSCs) residing within the subgranular zone (S...

Background Patients with lower socioeconomic status (SES), ethnic minorities and elevated neutrophil–lymphocyte ratio (NLR) have been suggested to have worse outcomes in hepatocellular carcinoma (HCC). However, how changes in NLR after intervention relate to survival has not been elucidated. Objectives We evaluated the association of NLR with over...

Purpose: To determine if anal cancer patients with HPV positive disease have different overall survival (OS) compared to those with HPV negative disease, and to elucidate differences in the association between radiation dose and OS. Patients and methods: We utilized the National Cancer Database (NCDB) registry to identify a cohort of non-metastatic...

Purpose: Using in vivo measurements from optically stimulated luminescence dosimeters (OSLDs) to develop and validate a prediction model for estimating the skin dose received by patients undergoing breast intraoperative radiation therapy (IORT). Methods and materials: IORT was performed using INTRABEAM-600 with spherical applicators placed in th...

e15071 Background: To determine if anal cancer patients with HPV positive disease have different overall survival (OS) compared to those with HPV negative disease, and to elucidate differences in the association between radiation dose and OS. Methods: We utilized the National Cancer Database (NCDB) registry to identify a cohort of non-metastatic an...

In the prostate, stem and progenitor cell regenerative capacities have been ascribed to both basal and luminal epithelial cells. Here, we show that a rare subset of mesenchymal cells in the prostate are epithelial-primed Nestin-expressing cells (EPNECs) that can generate self-renewing prostate organoids with bipotential capacity. Upon transplantati...

Purpose: The aim of our study was to report on patterns of failure using detailed information from follow-up positron emission tomography-computed tomography (PET/CT) scans for patients with laryngeal squamous cell carcinoma (SCCA) treated with definitive radiation therapy using intensity-modulated radiation therapy (IMRT). Methods: One hundred...

Surgical cavity sizing applicators were developed for utilization prior to intraoperative radiation therapy (IORT) of the breast lumpectomy cavity with the Zeiss INTRABEAM (Carl Zeiss Meditec AG, Jena, Germany) device. The use of these applicators minimizes the number of sterilizations of the treatment applicator, which is currently limited to 100...

Head and neck cancer poses a particular challenge in radiation therapy, whilst being an effective treatment modality it requires very high doses of radiation to provide effective therapy. This is further complicated by the fact that the head and neck region contains a large number of radiosensitive tissues, often resulting in patients experiencing...

Purpose: Developing a quantitative decision-support strategy estimating the impact of normal tissue complications from definitive radiation therapy (RT) for head and neck cancer (HNC). We developed this strategy to identify patients with oropharyngeal HNC who may benefit most from receiving proton RT. Methods and materials: Recent normal tissue...

Background and purpose: The purpose of this study was to investigate whether treatment information from medical records can be used to estimate radiation doses to heart and lungs retrospectively in pediatric patients receiving spinal irradiation with conventional posterior fields. Material and methods: An algorithm for retrospective dosimetry in...

Purpose/Objective(s) To evaluate if response assessment based on mid-treatment computed tomography (CT) scans during definitive radiation therapy (RT) for oropharyngeal head and neck cancer (HNC) can predict for loco-regional recurrence (LRR). Materials/Methods HNC patients treated at our institution with RT undergo CT rescans at 15th fraction and...

Objective: To investigate whether photon or proton based SBRT is the preferred modality for high dose hypofractionation prostate cancer treatment. Achievable dose distributions were compared when uncertainties in target positioning and range uncertainties were appropriately accounted for. Methods: Ten patients with prostate cancer previously tre...

Currently, interactions between voxels are neglected in the tumor control probability (TCP) models used in biologically-driven intensity-modulated radiotherapy treatment planning. However, experimental data suggests that this may not always be justified when bystander effects are important. We propose a model inspired by the Ising model, a short-ra...

There has recently been an increasing interest in model-based evaluation and comparison of different treatment options in radiation oncology studies. This is partly driven by the considerable technical advancements in radiation therapy of the last decade, leaving radiation oncologists with a multitude of options to consider. In lieu of randomized t...

Background and purpose: Due to the long life expectancy after treatment, the risk of late effects after radiotherapy (RT) is of particular importance for patients with Hodgkin lymphoma (HL). Both deep inspiration breath hold (DIBH) and proton therapy have been shown to reduce the dose to normal tissues for mediastinal HL, but the impact of these t...