Jesse N Aronowitz

• M.D.
• Professor (Full) at University of Massachusetts Chan Medical School

Introduction: Hematuria can be a distressing and debilitating complication of urothelial carcinoma (UC) of the kidney for patients who are not candidates for surgery or ureteroscopic ablation. We retrospectively assessed the efficacy, tolerability, and safety of stereotactic body radiotherapy (SBRT) for controlling gross hematuria in this patient...

Cancer remains a significant medical challenge for modern health care. Therapies have improved. Chemotherapy can now be applied and targeted to specific expression products and biomarkers. Radiation therapy is directed to specific targets with applied image guidance including less normal tissue in the treatment fields. Surgery has improved with rob...

As treatment for prostate cancer matures with many options for local, regional and systemic care, patients are living longer. Coupled with aggressive therapy for oligometastatic disease and improvements in multiple treatment pathways including radiopharmacy, both disease-free and overall survival are improving for many patients. Success can also br...

This chapter details the history of radiation therapy, identifies essential components to a modern department of radiation therapy, and focuses on salient areas of improvement in patient outcome for the next generation of cancer patients. Tumor is more sensitive to radiation in an oxygenated environment; therefore a larger oxygen component to the t...

Although brachytherapy had been established as a highly effective modality for the treatment of cancer, its application was threatened by mid-20th century due to appreciation of the radiation hazard to health care workers. This review examines how the introduction of afterloading eliminated exposure and ushered in a brachytherapy renaissance. Copyr...

Purpose Nomograms once had a vital role in prostate brachytherapy practice. Although some of their functions have been assumed by computerized dosimetry, many programs still find them useful to determine the number and strength of seeds to be ordered in advance of the implant. As it has been demonstrated that brachytherapists differ in their implan...

This chapter in Cancer Concepts: a Guidebook for the Non-Oncologist describes the principles of Radiation Oncology. Radiation Oncology utilizes ionizing radiation to treat cancer (and occasionally a few benign conditions). Radiotherapy or radiation therapy (RT) was initially developed in conjunction with diagnostic radiology, but has evolved into a...

The modern prostate brachytherapy procedure is characterized by ultrasound guidance, template assistance, and a return to a “closed” transperineal approach. This review traces the introduction and evolution of these elements and charts the development of the procedure from the ashes of previous, failed efforts.

Purpose To outline the evolution of computerized brachytherapy treatment planning in the United States through a review of technological developments and clinical practice refinements. Material and methods A literature review was performed and interviews were conducted with six participants in the development of computerized treatment planning for...

Comment on: Pudendal entrapment neuropathy: a rare complication of pelvic radiation therapy. [Pain Physician. 2013]

Permanent prostate brachytherapy has been practiced for more than a century. This review examines the influence of earlier procedures on the modern transperineal ultrasound-directed technique. A literature review was conducted to examine the origin of current clinical practice. The dimensions of the modern brachytherapy seed, the prescription dose,...

Purpose: To assess Robert Abbe's career and contributions to brachytherapy, in the context of the work of contemporary European and American investigators. Methods and materials: Examination of his lectures and journal articles, as well as contemporaneous newspaper accounts, textbooks, and archival material. Results: Although not the first Ame...

Radium was the foundation of brachytherapy in the early decades of the 20th century. Despite being a most precious and perilous substance, it was mislaid with surprising frequency. This essay explores how it was lost, the efforts taken to recover it, and measures instituted to prevent mishandling. Review of contemporary literature, government publi...

Urologists had performed prostate brachytherapy for decades before New York's Memorial Hospital retropubic program. This paper explores the contribution of Willet Whitmore, Ulrich Henschke, Basil Hilaris, and Memorial's physicists to the evolution of the procedure. Literature review and interviews with program participants. More than 1000 retropubi...

To identify the earliest practitioners of prostate brachytherapy. Review of contemporary literature. Radiotherapy has been used for benign prostatic ailments as early as 1902. Prostate cancer was first treated by teletherapy in 1904. Several urologists, in Paris and Vienna, applied intracavitary radium for prostate disease in 1908-1909. We present...

PURPOSE: Examination of Geoffrey Keynes's contributions to brachytherapy and the management of breast cancer. METHODS AND MATERIALS: Review of publications and texts of the era. RESULTS: In an era when radical mastectomy was accepted as standard treatment for breast cancer, Keynes demonstrated that brachytherapy (with or without local excision) was...

The practice of brachytherapy was in steep decline in the mid-20th century, largely because of safety issues. This article explores the innovations that revitalized brachytherapy with special attention to the introduction of low-energy seeds for permanent implantation. Literature review; interviews; and the memos, records, and correspondence of Don...

Exploration of Howard Atwood Kelly's contributions to gynecologic brachytherapy. Review of contemporary journals, texts, newspaper accounts, and the memoirs of Kelly's associates. Information from unpublished material, including Kelly's handwritten notes and diaries, was culled from the Alan Mason Chesney Archives of the Johns Hopkins Medical Insti...

Objective: The purpose of this article is to review the history of permanently implanted brachytherapy sources and to establish methods of identifying radon sources and discussing appropriate management. Conclusion: There are likely thousands of people bearing radon seeds that continue to emit radiation decades after implantation. They can be id...

To determine whether there is an optimal type of mathematical equation for predicting seed and activity requirements for permanent prostate brachytherapy. Four institutions with extensive brachytherapy experience each submitted details of more than 40 implants. The data was used to generate power and linear equations to reflect the relationship bet...

Despite the existence of guidelines for permanent prostate brachytherapy, it is unclear whether there is interinstitutional consensus concerning the parameters of an ideal implant. Three institutions with extensive prostate brachytherapy expertise submitted information regarding their implant philosophy and dosimetric constraints, as well as data o...

Adenocarcinoma of the prostate remains a significant public health problem and a prevalent cancer in men. Prostate-specific antigen used as a biomarker has established a clear migration of patients towards earlier-stage disease at presentation. However, in spite of process improvements in traditional therapies including surgery, radiation therapy,...

Adenocarcinoma of the prostate remains a significant public health problem and a prevalent cancer in men. Prostate-specific antigen used as a biomarker has established a clear migration of patients towards earlier-stage disease at presentation. However, in spite of process improvements in traditional therapies including surgery, radiation therapy,...

To investigate the earliest attempts to use man-made isotopes for prostate brachytherapy. Two radiogold brachytherapy programs were analyzed, using literature review and interviews of participants. Although (198)Au has been discredited as a source for permanent prostate brachytherapy, the major flaw in the reviewed programs was the misapplication o...

Radiation therapy has been integral to cancer patient care. The skin is an intentional and unintentional target of therapy, and is sensitive to the volume of normal tissue in the radiation therapy treatment field, daily treatment dose (fractionation), and total treatment dose. We must understand the relationship of these factors to patient outcome...

Intracavitary treatment of gynecologic cancers has been the anchor of brachytherapy, and perhaps the greatest success of radiotherapy, for over a century. The woman who first performed the procedure was neither a surgeon nor radiologist, but an electrotherapeutist who began her career as an alienist. She pursued a prolific academic career despite b...

Objective: The objective is to explore the events that led to the implementation of X-radiation for medical purposes within months of its discovery. Conclusion: The century-long experience with electrotherapeutics and the concurrent adoption of ultraviolet light therapy, facilitated the swift inclusion of X-radiation into medical practice.

To compare outcomes of patients treated with low-dose-rate (LDR) adjuvant brachytherapy (BT) + external beam radiation therapy (EBRT) vs. high-dose-rate (HDR) adjuvant BT + EBRT. Thirty-seven patients with soft tissue sarcoma (STS) were treated with pre- or postoperative external beam irradiation and postoperative LDR or HDR BT. There was no signif...

Hermann Strebel (1868-1943) made vital early contributions to the modality of brachytherapy by proposing afterloading and crossfiring [1, 2], two basic principles of modern remote-controlled brachytherapy. He was also one of the earliest to propose the use of radium for therapy of skin afflictions. At various times in his career he was a dermatolog...

The first part of this article [1] recounting the history of electricity and of electrotherapeutics closed with the contribution of Charles Coulomb (1736-1806), Luigi Galvani (1737-1798), Pierre Bertholon (1742-1800) and Jean-Paul Marat (1743-1793). This second installment continues chronologically with the story with Alessandro Volta (1745-1827) a...

The aim of this article is to identify the earliest (pre-1935) journals that contain the word cancer in their title. Although the earliest radiological journals in Europe and the USA are relatively widely known, the same cannot be said for cancer journals. The earliest journal we have been able to identify that contains the word 'cancer' was publis...

Although brachytherapy has been used in the management of soft tissue sarcoma for decades, there is little published data regarding dose and toxicity. We performed an interim analysis of our high dose-rate experience to establish dosing guidelines. We analyzed our first 12 soft tissue sarcoma patients treated with high dose-rate brachytherapy as tu...

The objective of our study was to quantify the operator's radiation exposure resulting from performing permanent prostate brachytherapy without fluoroscopic guidance. We measured the dose to the hands and body of an unshielded brachytherapist performing 46 consecutive implants, using a Mick applicator. Our results showed that the mean dose per impl...

Although radical prostatectomy was introduced in 1905, few cases of prostate cancer were diagnosed at a stage amenable to curative resection. Megavoltage equipment that could safely deliver a curative dose of radiation to the prostate did not become widely available until the 1960's. To fill this therapeutic void, leading urologists often turned to...

As more patients are treated for their primary malignancy with cure or increased disease-free intervals, injury to normal tissues will become more detectable and an important endpoint for study. Future protocols will probably be modified based on toxicity endpoints. In Hodgkin's disease, current protocols use response-based treatment strategies to...

We present a chronological review of the growth points in the knowledge of electricity, especially as applied to medicine§. Commencing with the ancient Greeks and ending with cancer electrotherapeutics at the turn of the 20th century, our history is arranged in chronological order by the birth years of the investigators. William Gilbert (1540-1603)...

Modern imaging and dosimetry technology are invaluable for defining a three-dimensional target when tumour can be visualised; it is far more difficult to identify a target volume after the tumour has been excised. The Paris system was devised prior to the introduction of modern high dose rate (HDR) equipment, and cannot utilize the flexibility that...

To conduct a multi-institutional comparison of prostate brachytherapy pre-implant dosimetry of Pd-103 and I-125. Eight experienced brachytherapists submitted Pd-103 and I-125 monotherapeutic and boost pre-implant dosimetry plans for central review. All 32 plans were calculated using the same transrectal ultrasound volumetric study. Seeds of any str...

Investigators in Europe, Canada, and the United States recently established a definitive role for adjuvant systemic chemotherapy following resection of early-stage non–small cell lung cancer (NSCLC). This was no small accomplishment, as upward of 20 randomized trials had previously been conducted. The role of postoperative radiotherapy (PORT) has b...

Purpose: To conduct a multi‐institutional comparison of prostate brachytherapy preimplant dosimetry for Pd‐103 and I‐125. Method and Materials: Eight experienced brachytherapists submitted Pd‐103 and I‐125 monotherapeutic and boost preimplant dosimetry plans for central review. All 32 plans were calculated using the same transrectal ultrasound volu...

Recent studies suggest that radiation therapy (RT) dose escalation in early-stage non-small-cell lung cancer (NSCLC) is feasible when 3-dimensional therapy is used. However, the accompanying prolongation of the treatment course when standard fractionation is used could be suboptimal from a practical and biologic standpoint. We report results of a c...

To investigate the impact of anesthesia selection on prostate gland swelling, acute toxicity, and implant quality. The outcome of prostate brachytherapy is dependent on the dose intensity and distribution. Preoperative and intraoperative planning are intended to optimize radiation delivery, but do not account for the impact of postoperative swellin...

This project examined the hypothesis that Mirels' rating system for impending pathologic fractures is reproducible, valid, and applicable across various experience levels and training backgrounds. Twelve true clinical histories and corresponding radiographs for patients with femoral metastatic lesions were reviewed by 53 participants from five expe...

Purpose: To investigate the origins of prostate brachytherapy. Methods and Materials: A review of contemporary journals and texts was conducted. Results: Prostate brachytherapy was performed frequently by leading urologists before 1930. Both temporary and permanent implant techniques were developed using radium and radon through intracavitary and i...

To chronicle the development of radioactive sources for permanent implantation. Review of contemporary literature. The value of ionizing radiation in the treatment of malignancy was appreciated soon after Roentgen's and Becquerel's discoveries. Brachytherapy was developed to treat tumors that were poorly controlled by early X-ray equipment. Sources...