| Radiation Medicine Program - Research Bites
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Your source for the latest in RMP research
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Over the course of the COVID-19 pandemic, many research directions have emerged both across UHN and within RMP, with the aim of better understanding and responding to this rapidly evolving situation. RMP continues to advance cancer care and radiation medicine during these unprecedented times with innovative research ideas and strategies to minimize the impact of COVID-19 on our cancer patients. Read on to learn more.
 
Team members: Stephanie Lheureux, Michael Milosevic, Ivan Pasic (PIs; Lead: UHN)
The Princess Margaret is building a research platform to screen asymptomatic cancer patients for COVID-19; test new ways of detecting COVID-19 using saliva and blood samples; determine the rate at which COVID-19 antibodies develop; and evaluate the impact of cancer on COVID-19 and immune responses while patients are on active cancer therapy. This study is part of UHN’s U-DEPLOY protocol: an umbrella trial that aims to establish a novel cross-discipline framework to streamline and support early phase COVID-19 clinical trials across UHN and other academic centres, so they can be conducted in a timely manner.
 
Team members: Philip Wong, Alejandro Berlin, Jennifer Croke, Ali Hosni, Andrew Hope, Laura Dawson
A team of radiation oncologists are examining ways to safely reduce the number of radiation treatment sessions cancer patients receive by 30% during COVID-19. Appropriate patients will receive “hypofractionated” treatments with higher doses each day, but fewer treatment sessions. The project also aims to develop the necessary research and virtual care platforms to carefully monitor patient- and/or physician-reported toxicities and compare the efficacy of hypofractionated treatments to conventional treatments. If successful, this project will provide a sustainable strategy to fight the COVID-19 pandemic by reducing resource utilization without increasing collateral cancer-related deaths.
 
Team members: Jennifer Croke, Kawalpreet Singh
RMP is taking part in a pan-Canadian initiative to collect and track deviations in the delivery of radiotherapy during COVID-19. In order to best understand the impact of COVID-19 on clinical practice and adapt to this rapidly evolving situation, a standardized case report form was adopted from the Canadian Partnership for Quality Radiotherapy (CPQR) and translated into a data collection system within RMP that is linked to a master project database. Data requests are sent to >40 radiation oncologists on a biweekly basis with most of the fields pre-filled with information from existing electronic health information databases and systems to facilitate a quick turnaround.
 
Team members: Chris McIntosh, Heather Ross, Patrik Rogalla, Derek Tsang, Andrew Hope, Tony Tadic, Tom Purdie, Yas Moayedi, Sonja Kandel, Farid Foroutan, Joe Duhamel
Cancer patients undergo cone beam CT (CBCT) imaging prior to radiation therapy as part of standard of care. For patients with breast, thoracic or upper GI malignancies, CBCT scans are a great source of lung CT data that may facilitate early COVID-19 detection without additional imaging. RMP investigators are part of a large team that is developing an AI system to rapidly screen CBCT images so the clinical team can be informed of any previously undiagnosed patients with COVID-19, and trigger necessary isolation and deep cleaning procedures to help prevent the spread of COVID-19. The AI system is being powered by data from a multi-institutional collaboration across UHN, which includes all thoracic imaging.
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Koch et al. describe the Princess Margaret experience in rapidly adapting treatment and risk mitigation strategies for breast cancer patients undergoing radiation therapy during COVID-19.
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Huang et al. describe the Princess Margaret experience in treating suitable head & neck cancer patients with hypofractionated radiotherapy alone vs. concurrent chemoradiotherapy during COVID‐19.
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Barry A, Apisarnthanarax S, O'Kane GM, Sapisochin G, Beecroft R, Salem R, Yoon SM, Lim YS, Bridgewater J, Davidson B, Scorsetti M, Solbiati L, Diehl A, Schuffenegger PM, Sham JG, Cavallucci D, Galvin Z, Dawson LA, Hawkins MA. Management of primary hepatic malignancies during the COVID-19 pandemic: Recommendations for risk mitigation from a multidisciplinary perspective. Lancet Gastroenterol Hepatol. 2020 Jun 5.
- Conway JL, Felder S, Tang J, Lukovic J, Han K, Liu Z, Milosevic M, Fyles A, Croke J. Long-term patient-reported distress in locally advanced cervical cancer patients treated with definitive chemoradiation. Clin Transl Radiat Oncol. 2020 Apr 16;23:1-8.
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Hahn E, Livergant J, Millar BA, Ringash J, Wong R, Dawson LA, Warde P, Cummings B, Barry A. Comments on the publication by Yerramilli et al titled "Palliative radiotherapy for oncologic emergencies in the setting of COVID-19: Approaches to balancing risks and benefits." Adv Radiat Oncol. 2020 May 11.
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Han K, Mendez L, D'Souza D, Velker V, Barnes E, Milosevic MF, Fyles A, Ferguson SE, Taggar A, Croke J, Donovan E, Leung E. Management of gynecologic cancer: Choosing radiotherapy wisely by 3 southern Ontario academic centers during the COVID-19 pandemic. Radiother Oncol. 13 July 2020.
- Huo M, Laperriere N, van Prooijen M, Shultz D, Coolens C, Hodaie M, Cusimano M, Gentili F, Zadeh G, Payne D, Schwartz M, Tsang DS. Efficacy of stereotactic radiosurgery for radiation-induced meningiomas. J Neurooncol. 2020 Apr 27.
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Javor J, Robbins M, Rosewall T, Craig T, Villafuerte CJ, Cummings B, Dawson L. Can conformity-based volumetric modulated arc therapy improve dosimetry and speed of delivery in radiation therapy to lumbosacral spine compared with conventional techniques? J Med Imaging Radiat Sci. 2020 May 18.
- Ng, SSW, Zhang H, Wang L, Citrin D, Dawson LA. Association of pro-inflammatory soluble cytokine receptors early during hepatocellular carcinoma stereotactic radiotherapy with liver toxicity. npj Precis. Onc. 2020 Jul 14; 4:17.
- Rostami A, Lambie M, Yu C, Stambolic V, Waldron JN, Bratman SV. Senescence, necrosis, and apoptosis govern circulating cell-free DNA release kinetics. Cell Rep. 2020 Jun 30;31(13):107830.
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Sanmamed N, Lee J, Berlin A, Craig T, Lao B, Rink A, Bayley A, Catton C, Sundaramurthy A, Foltz W, McPartlin A, Ghai S, Gospodarowicz M, Warde P, Ménard C, Chung P. Tumor-targeted dose escalation for localized prostate cancer using MR-guided HDR brachytherapy (HDR) or integrated VMAT (IB-VMAT) boost: Dosimetry, toxicity and health related quality of life. Radiother Oncol. 2020 May 21.
- Scorsetti M, Goodman KA, Seong J, Loi M, Huguet F, Dawson LA. Hepatocellular carcinoma (HCC) in the COVID-19 era: Primetime for stereotactic body radiotherapy and a lesson for the future? Oncologist. 2020 Jun 11.
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Shi W, Misra S, Li M, Su J, Chong LP, McCuske M, Williams J, Xu W, Ghoraie LS, Sutherland DR, Han K, Minden MD, Bratman SV, Yip KW, Liu FF. Inflammatory biomarkers, hematopoietic stem cells, and symptoms in breast cancer patients undergoing adjuvant radiation therapy. JNCI Cancer Spectr. 2020 May 8.
- Traverso A, Kazmierski M, Zhovannik I, Welch M, Wee L, Jaffray D, Dekker A, Hope A. Machine learning helps identifying volume-confounding effects in radiomics. Phys Med. 2020 Mar; 71:24-30.
- Vulpe H, Vanderpuyne V, Yarney J, Tosoni S, Ringash J, Kassam Z, Wong RKS. Design and implementation of a distant-learning clinical research mentorship program: The ACCRA-Toronto collaboration. JCO Glob Oncol. 2020 Jun; 6:919-928.
* Select publications with RMP first and/or last author shown. See the full list.
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Congratulations to Drs. Daniel De Carvalho and Scott Bratman on launching their UHN spin-off company, DNAMx Inc. Founded on their novel cell-free Methylated DNA Immunoprecipitation and high-throughput sequencing (cfMeDIP-seq) platform developed at the Princess Margaret, commercialization of this cutting-edge liquid biopsy technology will bring non-invasive cancer detection one step closer to patients on a global scale.
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Grants
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Meredith Giuliani
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Alex Vitkin
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Kathy Han
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Assessing the comprehensive training needs of informal caregivers of cancer patients. American Association for Cancer Education. Co-PIs: Giuliani M, Papadakos J. Co-Is: Hooey M, Deering J, Papadakos T, Thyagu S, Wiljer D. $4,768 USD.
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Curating a comprehensive, multi-modal education pathway for breast cancer patients and family. Breast Friends Conquer All Grant Competition, Princess Margaret. PI: Papadakos J. Co-Is: Giuliani M, Croke J, Papadakos T, Koch A, Forbes R, Westergard S, Snow M. $20,960 CAD.
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Novel polarized light methodology as a quantitative oncological prognostication tool. New Frontiers in Research Fund - Exploration, UHN. PIs Vitkin I, Nofech Mozes S, Khorasani M. Collaborator: Martel A. $250,000 CAD.
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SPARTACUS II - A randomized phase II feasibility trial on hypofractionated radiation versus conventional fractionation in endometrial cancers. Seed Grant, UTDRO. Co-PIs: Han K, Leung E, Gladwish A. Co-Is: Barnes T, Cheung P, Davidson M, Donovan E, Fyles A, Loblaw A, Skliarenko J, Taggar A, Yuen J. $50,000 CAD.
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Grant Resources
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