Todd A. Pezzi

Radiation therapy dose is associated with improved survival for unresected anaplastic thyroid carcinoma: Outcomes from the National Cancer Data Base

The outcomes of patients with unresected anaplastic thyroid carcinoma (ATC) from the National Cancer Data Base (NCDB) were assessed, and potential correlations were explored between radiation therapy (RT) dose and overall survival (OS).

Atypical medullary carcinoma of the breast has similar prognostic factors and survival to typical medullary breast carcinoma: 3,976 cases from the National Cancer Data Base.

Medullary breast carcinoma (MBC) is a subtype with a more favorable prognosis. Tumors with some, but not all, characteristics of MBC are classified as atypical medullary carcinoma of the breast (AMCB).

Treatment and survival of patients with insular thyroid carcinoma: 508 cases from the National Cancer Data Base

Insular thyroid carcinoma (ITC) is a rare but aggressive thyroid malignancy.

Oropharyngeal squamous cell carcinoma in the veteran population: Association with traditional carcinogen exposure and poor clinical outcomes

A significant fraction of oropharyngeal squamous cell carcinoma (SCC) cases is associated with traditional carcinogens; in these patients, treatment response and clinical outcomes remain poor.

Oropharyngeal squamous cell carcinoma in the veteran population

A significant fraction of oropharyngeal squamous cell carcinoma (SCC) cases is associated with traditional carcinogens; in these patients, treatment response and clinical outcomes remain poor.

Coexisting right nonrecurrent and right recurrent inferior laryngeal nerves: a rare and controversial entity

Variations in the course of the recurrent laryngeal nerve (RLN) can occur, including the development of a nonrecurrent inferior laryngeal nerve (NRILN). Rarely, both a right RLN and a right NRILN have been reported in the same patient, merging before they enter the larynx. A case is presented, including images, and the literature concerning this rare anatomical finding is reviewed, including studies suggesting alternative explanations for these cases. Fourteen previously reported cases of coexisting RLN and NRILN were identified, all involving the right side. Some cases were associated with an anomalous origin of the right subclavian artery and some were not. The alternative explanations that a communicating branch of the sympathetic nerve, which joins the RLN, is mistaken for an NRILN or that a collateral branch from an NRILN is mistaken for an RLN in these cases are also considered. Surgeons must be aware of these unusual variations to minimize nerve injury during neck surgery.

Outcomes and toxicity following high-dose radiation therapy in 15 fractions for non-small cell lung cancer

PURPOSE Accelerated hypofractionated radiation therapy (AHRT) is increasingly used for select lung cancer patients. We evaluated clinical outcomes and predictors of pulmonary/esophageal toxicity in patients treated with ≥52.5 Gy in 15 fractions. METHODS AND MATERIALS We evaluated 229 patients treated with radiation therapy doses ≥52.5 Gy in 15 fractions for non-small cell lung cancer from January 2009 through January 2016. Toxicity was scored using Common Terminology Criteria for Adverse Events, v4.0. Univariate and multivariate logistic regression was used to identify predictors of toxicity. Overall survival, progression-free survival, and local control were estimated using the Kaplan-Meier method. Predictors of clinical outcome were modeled using Cox proportional hazards regression. RESULTS Median follow-up was 7 months. Forty-two patients (19%) developed grade ≥2 pneumonitis, and 9 (4%) developed grade ≥3 esophagitis. In multivariate analysis, age >75 years (odds ratio [OR], 2.56; 95% confidence interval [CI], 1.24-5.25; P = .01) and percentage of lung volume receiving doses of >10 Gy higher than 32% were associated with grade ≥2 pneumonitis (OR, 2.79; 95% CI, 1.39-5.79; P = .005). On univariate analysis, esophagus mean dose ≥17 Gy (OR, 10.14; 95% CI, 1.82-189.8; P = .006), gross tumor volume size ≥71 cm3 (P = .002), and planning target volume size ≥409 cm3 (P = .02) were associated with development of grade ≥3 esophagitis. In patients with stage II/III disease (n = 73), median local control was not reached, median overall survival was 14 months, and median progression-free survival was 6 months. CONCLUSIONS AHRT in 15 fractions can be safe and effective. Consideration for using AHRT with immunotherapy and sequential chemotherapy for improved out-of-radiation field and distant control is warranted.

Radiation Therapy is Independently Associated With Worse Survival After R0 Resection for Stage I-II Non–Small Cell Lung cancer: An Analysis of the National Cancer Data Base

Background The 1998 post-operative radiotherapy meta-analysis for lung cancer showed a survival detriment associated with radiation for stage I–II resected non-small cell lung cancer (NSCLC), but has been criticized for including antiquated radiation techniques. We analyzed the National Cancer Database (NCDB) to determine the impact of radiation after margin-negative (R0) resection for stage I–II NSCLC on survival.