Stephen Rosenberg

Stephen Rosenberg
Moffitt Cancer Center

MD, MS

About

135
Publications
5,905
Reads
How we measure 'reads'
A 'read' is counted each time someone views a publication summary (such as the title, abstract, and list of authors), clicks on a figure, or views or downloads the full-text. Learn more
1,233
Citations
Citations since 2017
94 Research Items
1054 Citations
2017201820192020202120222023050100150200250300
2017201820192020202120222023050100150200250300
2017201820192020202120222023050100150200250300
2017201820192020202120222023050100150200250300

Publications

Publications (135)
Article
MRI-guided radiotherapy is a novel and rapidly evolving technology that might enhance the risk-benefit ratio. Through direct visualisation of the tumour and the nearby healthy tissues, the radiation oncologist can deliver highly accurate treatment even to mobile targets. Each individual treatment can be customised to changing anatomy, potentially r...
Article
Full-text available
Despite magnetic resonance imaging (MRI) being a mainstay in the oncologic care for many disease sites, it has not routinely been used in early lung cancer diagnosis, staging, and treatment. While MRI provides improved soft tissue contrast compared to computed tomography (CT), an advantage in multiple organs, the physical properties of the lungs an...
Article
Full-text available
The treatment of central and ultracentral lung tumors with radiotherapy remains an ongoing clinical challenge. The risk of Grade 5 toxicity with ablative radiotherapy doses to these high-risk regions is significant as shown in recent prospective studies. Magnetic resonance (MR) image-guided adaptive radiotherapy (MRgART) is a new technology and may...
Article
Purpose: Current guidelines recommend surgery as standard of care for primary lung neuroendocrine tumor (LNET). Given that LNET is a rare clinical entity, there is a lack of literature regarding treatment of LNET with stereotactic body radiotherapy (SBRT). We hypothesized that SBRT could lead to effective locoregional tumor control and long-term o...
Article
Introduction: We hypothesized that concurrent ipilimumab with chemoradiotherapy (chemoRT) followed by maintenance nivolumab would be safe for patients with unresectable stage III NSCLC. We aimed to assess the safety (phase I) and the 12-month progression-free survival (PFS) (phase II) in a multi-institution prospective trial. Methods: Eligible p...
Article
Purpose/Objective(s) Stereotactic body radiation therapy (SBRT) is widely used for localized prostate cancer and implementation of MR-guided radiotherapy (MRgRT) has the advantage of smaller target margins and improved sparing of organs at risk. Here we evaluate outcomes and time required to treat using non-adaptive MRgRT for prostate SBRT at our i...
Article
Purpose/Objective(s) Real world outcomes related to pneumonitis in patients with locally advanced (LA) non-resectable non-small cell lung cancer (NSCLC) treated with concurrent chemoradiation (chemoRT) and consolidative durvalumab (D) may differ from those seen in prospective trials given selection biases and other variables in clinical trials. We...
Article
Purpose/Objective(s) MRgRT is used to treat UC lung lesions. Adaption is triggered if the original plan does not meet criteria of target coverage or organs at risk (OAR) constraints on recontoured anatomy of the day. Current MRgRT software does not provide composite dose delivered over the complete course, partly because daily anatomy changes make...
Article
Full-text available
Purpose/Objective(s) While dose-escalation is associated with improved local control (LC) for adrenal gland metastases (AGM), the proximity of gastrointestinal (GI) structures limits the dose that can be safely prescribed via CT-based stereotactic body radiation therapy (SBRT). The relative advantages of magnetic resonance guided SBRT (MRgSBRT), in...
Article
Purpose/Objective(s) Significant controversy remains over sufficient dose to minimize local failure (LF) for SBRT treatment of NSCLC treated to 50 Gy in 5 fractions (BED = 100). We hypothesized that dosimetric predictors can be determined by developing survival machine learning (SML) models, identifying highest impact features and determining cutof...
Article
Full-text available
Purpose/Objective Magnetic resonance-guided radiation therapy (MRgRT) utilization is rapidly expanding worldwide, driven by advanced capabilities including continuous intrafraction visualization, automatic triggered beam delivery, and on-table adaptive replanning (oART). Our objective was to describe patterns of 0.35Tesla(T)-MRgRT (MRIdian) utiliza...
Article
MRI-guided radiation therapy (MRgRT) enables real-time imaging during treatment and daily online adaptive planning. It is particularly useful for areas of treatment that have been previously excluded or restricted from ablative doses due to potential damage to adjacent normal tissue. In certain cases, ablative doses to metastatic lesions may be jus...
Article
The increased adoption of stereotactic body radiation therapy (SBRT) has allowed for delivery of higher doses, potentially associated with better outcomes, but at the risk of higher toxicity. The intimate association of radiosensitive organs at risk (e.g., stomach, duodenum, bowel) has historically limited the delivery of ablative doses to the panc...
Article
Full-text available
Purpose: Radiomics entails the extraction of quantitative imaging biomarkers (or radiomics features) hypothesized to provide additional pathophysiological and/or clinical information compared to qualitative visual observation and interpretation. This retrospective study explores the variability of radiomics features extracted from images acquired w...
Article
Background Online adaptive radiation therapy (ART) allows real-time plan generation and delivery to account for daily anatomical changes. Due to the time intense nature of this process, physicians frequently cover adaptive treatments for patients whose original treatment plan was prescribed by another provider. There is currently no published guida...
Article
Full-text available
Purpose/objective(s): Whole brain radiotherapy with hippocampal avoidance (HA-WBRT) is a technique utilized to treat metastatic brain disease while preserving memory and neurocognitive function. We hypothesized that the treatment planning and delivery of HA-WBRT plans is feasible with an MRI-guided linear accelerator (linac) and compared plan resu...
Article
Full-text available
Objective: Two benefits of MR-guided radiotherapy (MRgRT) are the ability to track target structures while treatment is being delivered and the ability to adapt plans daily for some lesions based on changing anatomy. These unique capacities come at two costs: increased capital for acquisition and greatly decreased workflow. An adaptive gated stere...
Article
Full-text available
Background Magnetic Resonance Image guided Stereotactic body radiotherapy (MRgRT) is an emerging technology that is increasingly used in treatment of visceral cancers, such as pancreatic adenocarcinoma (PDAC). Given the variable response rates and short progression times of PDAC, there is an unmet clinical need for a method to assess early RT respo...
Article
Full-text available
Purpose: To monitor intrafraction motion during spine stereotactic body radiotherapy(SBRT) treatment delivery with readily available technology, we implemented triggered kV imaging using the on-board imager(OBI) of a modern medical linear accelerator with an advanced imaging package. Methods: Triggered kV imaging for intrafraction motion management...
Preprint
Full-text available
Background: Epidermal growth factor receptor (EGFR) mutated non-small cell lung cancer (NSCLC) shows an impressive initial response to EGFR tyrosine kinase inhibitors (EGFR-TKI). However, resistance invariably develops, commonly involving the site of initial gross disease. Cytoreductive stereotactic body radiotherapy (SBRT) for thoracic oligoprogre...
Article
Background and Purpose The study objective was to determine whether longitudinal changes in patient-reported outcomes (PROs) were associated with survival among early-stage, non-small cell lung cancer (NSCLC) patients undergoing stereotactic body radiation therapy (SBRT). Materials and Methods Data were obtained from January 2015 through March 202...
Article
Purpose/Objective(s) Magnetic resonance imaging-guided radiation therapy (MRgRT) utilization is rapidly expanding worldwide, driven by advanced capabilities including continuous intrafraction visualization, automatic triggered beam delivery, and on-table adaptive replanning. Our objective was to describe patterns of 0.35T-MRgRT utilization in the U...
Article
Purpose/Objective(s) Medical student education in radiation oncology traditionally takes place in-person during 3rd or 4th year of medical school. Due to the COVID-19 pandemic, onsite clerkships were placed on hold, leading to virtual medical student clerkships in radiation oncology which incorporated didactics and hands-on learning. We sought to i...
Article
Purpose/Objective(s) Applications in radiation oncology residency have been on the decline in the past 3 years. This was attributed in part due to limited exposure to the field. We hypothesize that improving medical student enrollment into radiation oncology electives through virtual clerkships will increase interest and knowledge in the field. Ma...
Article
Full-text available
Purpose/Objective(s) Magnetic resonance image guided stereotactic body radiotherapy (MRgSBRT) is an advanced technology that may provide radiomic feature changes during treatment of adrenal lesions feasible for adaptation. Materials/Methods A prospectively maintained database was retrospectively reviewed for 24 patients with adrenal lesions who un...
Article
Purpose/Objective(s) We hypothesized that escalated biological effective dose (BED) via stereotactic body radiation therapy (SBRT) would improve outcomes for patients with borderline resectable (BRPC) and locally advanced pancreatic cancer (LAPC). Materials/Methods A retrospective review was performed on consecutive patients who received pancreas...
Article
Purpose/Objective(s) We hypothesized that the addition of concurrent ipilimumab (IPI) with chemoradiotherapy followed by consolidative nivolumab (NIVO) would be safe and tolerable for patients with unresectable stage III non-small cell lung cancer (NSCLC). We report early outcomes and toxicity associated with this regimen in a phase I/II clinical t...
Article
Purpose/Objective(s) Prescription dose for lung SBRT remains a controversial topic. Based on previous experience, a BED of 100 Gy is necessary to maximize tumor control, though many have advocated higher prescription doses (or dosimetric “hot spots”). To analyze this "imbalanced" problem (few events) and identify which factors affect not only event...
Article
Purpose/Objective(s) Whole brain radiotherapy with hippocampal avoidance (HA-WBRT) is a technique utilized to treat extensive metastatic brain disease while preserving memory and neurocognitive function. We hypothesized that the treatment planning and delivery of HA-WBRT plans is feasible with an MRI-guided linear accelerator (Linac) and compared p...
Article
Full-text available
The implementation of the radiation oncology alternative payment model (RO-APM) has raised concerns regarding the development of MRI-guided adaptive radiotherapy (MRgART). We sought to compare technical fee reimbursement under Fee-For-Service (FFS) to the proposed RO-APM for a typical MRI-Linac (MRL) patient load and distribution of 200 patients. I...
Article
Full-text available
Background: The use of stereotactic body radiation therapy (SBRT) is widely utilized for treatment of localized prostate cancer. Magnetic-resonance-guided radiotherapy (MRgRT) was introduced in 2014 and has recently been implemented in SBRT for prostate cancer as it provides an opportunity for smaller margins and adaptive daily planning. Currently...
Article
Full-text available
Purpose The number of U.S. fourth year medical students applying to radiation oncology has decreased over the past few years. We conducted a survey of fourth year medical students in order to examine factors that may be impacting the decision to pursue radiation oncology. Methods and Materials An anonymous online survey was sent to medical student...
Article
Full-text available
Introduction Pancreatic adenocarcinoma (PAC) has some of the worst treatment outcomes for any solid tumor. PAC creates substantial difficulty for effective treatment with traditional RT delivery strategies primarily secondary to its location and limited visualization using CT. Several of these challenges are uniquely addressed with MR-guided RT. We...
Article
The increasing complexity of healthcare emphasizes the need for continued physician leadership and leadership training. This study aims to determine baseline attitudes toward the perceptions and utility of a leadership development curriculum (LDC) for radiation oncology (RO) residents. A novel longitudinal LDC was implemented for RO residents at ou...
Preprint
Background: We hypothesized that the radiosensitivity index (RSI), would classify non-small cell lung cancer (NSCLC) patients into radioresistant (RR) or radiosensitive (RS). Methods: We identified resected pathologic stage III NSCLC. For the radiation group (RT) group, at least 45 Gy of external beam radiation was required. mRNA was extracted from...
Article
External beam radiotherapy (XRT) is a widely used cancer treatment, yet responses vary dramatically among patients. These differences are not accounted for in clinical practice, partly due to a lack of sensitive early response biomarkers. We hypothesize that quantitative magnetic resonance imaging (MRI) measures reflecting tumor heterogeneity can p...
Article
Full-text available
Aims To assess the safety and efficacy of MR-guided stereotactic body radiation therapy (MRgSBRT) for cardiac metastases. Materials/methods This single institution retrospective analysis evaluated our experience with MRgSBRT for cardiac metastases. Response rate was compared between pre-RT and post-RT imaging. Symptomatic changes were also tracked...
Article
MR-guided adaptive radiation therapy (RT) is emerging as an integral treatment modality for certain applications and is poised to become an exciting opportunity for greater treatment precision and personalization. However, this is still a relatively nascent technology and only a few institutions and programs have access to this technology for clini...
Article
Purpose: Consolidative thoracic radiotherapy (TRT) has been shown to improve outcomes for patients with extensive stage small cell lung cancer (ES-SCLC). We hypothesized that the addition of ipilimumab (IPI) and nivolumab (NIVO) after TRT would improve outcomes for patients with ES-SCLC. Materials and methods: Eligibility required stable disease...
Preprint
Full-text available
Purpose External beam radiotherapy (XRT) is a widely used cancer treatment, yet responses vary dramatically between patients. These differences are not accounted for in clinical practice, in part due to a lack of sensitive biomarkers of early response. In this work, we test the hypothesis that quantification of intratumor heterogeneity is a sensiti...
Article
Full-text available
Emergence of the COVID-19 crisis has catalyzed rapid paradigm shifts throughout medicine. Even after the initial wave of the virus subsides, a wholesale return to the prior status quo is not prudent. As a specialty that values the proper application of new technology, radiation oncology should strive to be at the forefront of harnessing telehealth...
Article
Radiation training programs are designed to prepare graduates for independent practice, with metrics in place to assess appropriateness of clinical decision-making. Here, we investigated the self-assessed preparedness of US graduates during the transition to independent practice.An anonymous, Internet-based survey was distributed to recent graduate...
Article
Background Radiation induced CT changes may be apparent following completion of TRT. We sought to quantify differences in radiation-associated densities on serial CT scans of patients with ES-SCLC treated with TRT alone versus TRT followed by combined IPI and NIVO. Methods Between 2016 and 2018, patients at a single institution with ES-SCLC who ac...
Article
The cover image is based on the Original Research Using adaptive magnetic resonance image‐guided radiation therapy for treatment of inoperable pancreatic cancer by Soumon Rudra et al., DOI: 10.1002/cam4.2100.
Article
Full-text available
Background: Adaptive magnetic resonance imaging-guided radiation therapy (MRgRT) can escalate dose to tumors while minimizing dose to normal tissue. We evaluated outcomes of inoperable pancreatic cancer patients treated using MRgRT with and without dose escalation. Methods: We reviewed 44 patients with inoperable pancreatic cancer treated with M...
Article
Full-text available
The Charting Outcomes resource is useful in gauging an applicant’s competiveness for a given specialty. However, many variables are not reported in Charting Outcomes that may influence an applicant’s ability to match. A significant proportion of applicants record their experiences in an anonymous, self-reported applicant spreadsheet. We analyzed fa...
Article
Purpose: Studies have shown that an additional mean dose of 1 Gy to the heart can increase the relative risk of cardiac events. The purpose of this study was to quantify the dose delivered to the heart and left anterior descending artery (LAD) in a series of patients with left-sided breast cancer (BC) or ductal carcinoma in situ treated with multi...
Article
Full-text available
Purpose Daily magnetic resonance (MR)–guided radiation has the potential to improve stereotactic body radiation therapy (SBRT) for tumors of the liver. Magnetic resonance imaging (MRI) introduces unique variables that are untested clinically: electron return effect, MRI geometric distortion, MRI to radiation therapy isocenter uncertainty, multileaf...
Article
Full-text available
Background: Total skin electron beam therapy (TSEBT) is an effective treatment in mycosis fungoides. Total skin helical tomotherapy (TSHT) may be an alternative to TSEBT and may offer several dosimetric and treatment advantages. There are currently very few published treatment results using TSHT in place of TSEBT for treatment of mycosis fungoides...
Article
Full-text available
Magnetic resonance-guided radiation therapy (MRgRT) offers advantages for image guidance for radiotherapy treatments as compared to conventional computed tomography (CT)-based modalities. The superior soft tissue contrast of magnetic resonance (MR) enables an improved visualization of the gross tumor and adjacent normal tissues in the treatment of...
Article
Primary leiomyosarcoma is a rare tumor in the CNS, with few reported cases. Here, we describe a case of a primary intracranial leiomyosarcoma of the tentorium cerebelli. A 43-year-old woman presented with headache, acute vision loss, and difficulty speaking. MRI revealed a large heterogeneous-enhancing occipital mass, which was subsequently resecte...
Article
Objective: Patients are turning to the Internet more often for cancer-related information. Oncology organizations need to ensure that appropriately written information is available for patients online. The aim of this study was to determine whether the readability of radiation oncology online patient information (OPI) provided by RTAnswers (RTAnsw...