In this issue:

Upper Gastrointestinal (UGI) cancers include cancers of the esophagus, stomach, liver, pancreas, and bile ducts. Although less commonly diagnosed compared to some other cancer types, UGI cancers remain some of the most difficult to treat. In RMP, our GI Site Group is composed of a highly specialized and multidisciplinary team of radiation therapists, medical physicists, radiation oncologists, and allied health professionals. In this issue, explore how our UGI experts are breaking new ground in radiation treatment using state-of-the-art technology to improve survival and outcomes for our patients.

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The Reinforced MRI-Guided Online Adapted Radiotherapy Project

Team Members: Teo Stanescu, Oleksii Semeniuk, Tudor Fodor, Andrea Shessel, Cathy Carpino-Rocca, Michael Velec, Laura Dawson, Ali Hosni

Cancers of the UGI are some of the most complex to treat with radiation therapy. “Deviations can occur because the target and abdominal organs can change position, requiring us to make adjustments in dose delivery to adequately cover the target and avoid giving additional radiation to nearby organs-at-risk,” says Dr. Teo Stanescu, a medical physicist who is part of RMP’s UGI site group. The Reinforced MRI-Guided Online Adapted Radiotherapy Project Team aims to improve radiation precision and treatment efficiency for patients with upper GI diseases receiving treatment on the Unity MR-Linac (MRL) system. The MRL is a state-of-the-art radiation treatment device that uses magnetic resonance imaging (MRI) to guide radiation delivery in real time. Involving a multidisciplinary group of radiation therapists, medical physicists and radiation oncologists, the team is developing novel tools and techniques to advance radiation dose delivery planning to minimize toxicity, shorten treatment session times, and provide enhanced, individualized care for patients.

Dose-of-the-day (DOTD) assessments acquired after each treatment session will allow the team to adjust radiation dose between treatment sessions and define new clinical goals, so that patients can ultimately receive a superior clinical outcome than was initially conceived at the beginning of treatment planning. The team hopes to launch a pilot study in mid-Fall 2021 so that the innovative treatment can be delivered to patients in the clinic soon. “The new tools are expected to enhance our clinical processes. Patients will benefit from more advanced and efficient treatments.” Read the full interview with Dr. Teo Stanescu.

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• Arrowsmith C, Reiazi R, Welch ML, Kazmierski M, Patel T, Rezaie A, Tadic T, Bratman S, Haibe-Kains B. Automated detection of dental artifacts for large-scale radiomic analysis in radiation oncology. Phys Imaging Radiat Oncol. 2021 Apr 21;18:41-47.
• Chiu K, Hosni A, Huang SH, Tong L, Xu W, Lu L, Bayley A, Bratman S, Cho J, Giuliani M, Kim J, Ringash J, Waldron J, Spreafico A, Irish J, Gilbert R, Gullane P, Goldstein D, O'Sullivan B, Hope A.  The potential impact and usability of 8th edition TNM staging classification in oral cavity cancer. Clin Oncol (R Coll Radiol). 2021 Jul 11.
• Conroy L, Khalifa A, Berlin A, McIntosh C, Purdie TG. Performance stability evaluation of atlas-based machine learning radiation therapy treatment planning in prostate cancer. Phys Med Biol. 2021 Jun 22;66(13).
• Coolens C, Gwilliam MN, Alcaide-Leon P, de Freitas Faria IM, Ynoe de Moraes F.  Transformational role of medical imaging in (radiation) oncology. Cancers (Basel). 2021 May 23;13(11):2557.
• Croke J, Tosoni S, Ringash J.  "It's good for the soul:" perceptions of a formal junior faculty mentorship program at a large academic cancer centre. Radiother Oncol. 2021 Jul 10;162:119-123.
• Dhillon H, Shessel A, Moyo E, Rosewall T.  The Raystation conversation: multidisciplinary perceptions about training, leadership, and communication during implementation of new technology. J Med Imaging Radiat Sci. 2021 May 26.
• Gudi S, O'Sullivan B, Hosni A, Su J, Hope A, Ringash J, Hueniken K, Liu G, Tong L, Goldstein D, de Almeida J, Hansen AR, Bratman S, Cho J, Giuliani M, Hahn E, Kim J, Xu W, Waldron J, Huang SH. Outcome and treatment toxicity in East-Indian versus White-Canadian patients with oral cavity cancer following postoperative (chemo-)radiotherapy delivered under similar multidisciplinary care: a propensity-matched cohort study. Oral Oncol. 2021 Jun 24;120:105419.
• Huang SH, Chernock R, O'Sullivan B, Fakhry C. Assessment criteria and clinical implications of extranodal extension in head and neck cancer. Am Soc Clin Oncol Educ Book. 2021 May 19;41:265-278.
• Laperriere NJ. Protons for the management of adult patients with glioblastoma. Neuro Oncol. 2021 May 24.
• Reiazi R, Arrowsmith C, Welch M, Abbas-Aghababazadeh F, Eeles C, Tadic T, Hope AJ, Bratman SV, Haibe-Kains B.  Prediction of human papillomavirus (HPV) association of oropharyngeal cancer (OPC) using radiomics: the impact of the variation of CT Scanner. Cancers (Basel). 2021 May 8;13(9):2269.
• Rostami A, Bratman SV, Han K. Liquid biopsy goes viral: next-generation sequencing to enhance HPV detection. Clin Cancer Res. 2021 Jul 22.
• Safavi AH, Papadakos J, Papadakos T, Quartey NK, Lawrie K, Klein E, Storer S, Croke J, Millar BA, Jang R, Bezjak A, Giuliani ME.  Feedback delivery in an academic cancer centre: reflections from an R2C2-based microlearning course. J Cancer Educ. 2021 Jun 24.
• Stanescu T, Mousavi SH, Cole M, Barberi E, Wachowicz K.  Quantification of magnetic susceptibility fingerprint of a 3D linearity medical device. Phys Med. 2021 Jul;87:39-48.
• Tsang DS, Vargo JA, Goddard K, Breneman JC, Kalapurakal JA, Marcus KJ. Palliative radiation therapy for children with cancer. Pediatr Blood Cancer. 2021 May;68 Suppl 2:e28292.
• Villafuerte CJ, Shultz DB, Laperriere N, Gentili F, Heaton R, van Prooijen M, Cusimano MD, Hodaie M, Schwartz M, Berlin A, Payne D, Kalia SK, Bernstein M, Wang J, Zadeh G, Spears J, Tsang DS.  Radiation dose rate, biologically effective dose, and tumor characteristics on local control and toxicity after radiosurgery for acoustic neuromas. World Neurosurg. 2021 Aug;152:e512-e522.

 * Select publications with RMP first and/or last author. See the full list.

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Awards and Distinctions

Grants

• Evaluation of conformal radiation therapy in the treatment of gastric cancer. CREMS Summer Program, UofT Temerty Faculty of Medicine. PI: Lukovic J. Co-Is: Stanescu T, Wong R, Chen J. $2,750.
• Exploring family physician training needs to improve cancer care. READS Grants Program, American Association of Cancer Education (AACE). PIs: Sherwood M, Giuliani M. Co-Is: Kulasegaram M, Martimianakis T, Kucharski E, Papadakos J. $5,000 USD.
• SPECT-CT Guided ELEctive Contralateral Neck Treatment (SELECT) for patients with lateralized oropharyngeal cancer: a phase III randomized controlled trial. CCTG-HN.11, Cancer Therapy and Evaluation Program (CTEP), NIH/NCI .PIs: Parulekar WR, de Almeida JR, Hosni A. Co-Is: Bahig H, Belzile M, Chen BE, Chepeha D, Christopoulos A, Eskander A, Hilton J, Krahn MD, Lai SY, Martino R, Patel MR, Prisman E, Ringash J, Waldron J, Zhang H. $1,785,000.
• Stereotactic MR-Only Adaptive Radiation Therapy (SMART) for hepatobiliary malignancy: initial clinical experience and workflow technical challenges. OneWalk Resident/Fellow start-up Grant, UHN. PIs: Hosni A, Guimond E. Co-I: Stanescu T. $5,000.
• The characterization and therapeutic targeting of aberrant metabolic and inflammatory signaling in chronic lymphedema. Project Grant, CIHR.  PI: Liu FF. Co-Is: Haibe-Kains B, Haykal S, Kwan J, Reed M, Yip K. $971,550.
• The Harmonized Interventions to Maintain health via Appropriate risk factor modification and Lifestyle changes in Pediatric, Adolescent & Young Adult Cancer Survivors (HIMALAYAS) Trial. CCS/CIHR. Co-PIs: Hodgson D, Thavendiranathan P, Abdel-Qadir H, Awadalla P, Charpentier D, Gupta A, Goddard K, Davis MK, Lau B, Nathan P, Oh P, Paterson I, Gyenes GT, Tournoux F. $2,260,000.
• The human touch in cancer. PM Grand Challenge, PM. PIs: Giuliani M, Papadakos J. Co-Is: Jones J, Nissim R, Papadakos T, Deering J, Thyagu S, Matthew A, Cil T, Rodin G. $150,000.

 * Select grants with RMP PI/co-PI

Grant Resources