Skip to main content

Trey Carlton Mullikin

Assistant Professor of Radiation Oncology
Radiation Oncology

Selected Publications


Knowledge-based deep residual U-Net (DRU) for synthetic CT generation using a single MR volume for frameless radiosurgery.

Journal Article J Appl Clin Med Phys · January 2026 PURPOSE: To develop a knowledge-based deep model for sCT generation from a single MR volume in LINAC-based frameless SRS, enabling the MR-only workflow without extra CT simulation. METHODS: A total of 139 patients were included in the study, with 120 used ... Full text Link to item Cite

Neurocognitive outcomes in patients with brain metastases: a systematic review.

Journal Article Lancet Oncol · December 2025 Multimodality therapy, including surgery, radiotherapy, and systemic therapy, has significantly improved overall survival for patients with brain metastases. However, treatment-related neurocognitive sequelae remain a major challenge in survivorship. Altho ... Full text Link to item Cite

Management outcomes for biopsy-proven radiation necrosis in patients with brain metastases in the era of immune-checkpoint blockade.

Journal Article J Neurooncol · October 2025 PURPOSE: Immunotherapy and stereotactic radiosurgery (SRS) are frequently combined in the management of brain metastases from non-small cell lung cancer (NSCLC) and melanoma. However, concurrent SRS and dual immune-checkpoint inhibition (ICPI) elevate the ... Full text Open Access Link to item Cite

Long-Term Outcomes After Reirradiation With Spine Stereotactic Body Radiation Therapy: Single-Institutional Retrospective Experience.

Journal Article Pract Radiat Oncol · September 3, 2025 Reirradiation of spinal metastases using stereotactic body radiation therapy (SBRT) presents clinical challenges, with limited patient outcomes data to guide decision-making. We report a retrospective, single-institutional experience of 107 lesions treated ... Full text Link to item Cite

Immediate 2-Stage breast reconstruction outcomes after proton or photon postmastectomy radiotherapy.

Journal Article Clin Transl Radiat Oncol · September 2025 PURPOSE: To evaluate the impact of postmastectomy radiotherapy (PMRT) on immediate breast reconstruction (IBR) outcomes among patients treated with proton or photon radiotherapy. MATERIAL AND METHODS: Patients who had undergone mastectomy, immediate breast ... Full text Link to item Cite

Clinical Parameters Associated With Intracranial Progression Burden Following an Initial Stereotactic Radiosurgery Course in a Multi-institutional Brain Metastases Cohort.

Journal Article Adv Radiat Oncol · September 2025 PURPOSE: Following initial stereotactic radiosurgery (SRS), risk factors for high-burden intracranial progression (ICP) necessitating whole brain radiation remain poorly characterized. We hypothesize that specific clinical parameters at initial SRS are ass ... Full text Link to item Cite

NCCN GuidelinesĀ® Insights: Non-Small Cell Lung Cancer, Version 7.2025.

Journal Article J Natl Compr Canc Netw · September 2025 The NCCN Guidelines for Non-Small Cell Lung Cancer (NSCLC) provide recommendations for the treatment of NSCLC. These NCCN Guidelines Insights discuss recent updates to the NCCN Guidelines, with a focus on systemic therapy options for the treatment of patie ... Full text Link to item Cite

Poly ADP Ribose Polymerase Inhibitors Potentiate Proton Therapy End-of-Range Effects by Accelerating Replication Forks and Promoting Transcription Conflict.

Journal Article Int J Radiat Oncol Biol Phys · August 27, 2025 PURPOSE: Poly ADP ribose polymerase inhibitors (PARPi) are being combined with photon and proton radiation therapy in clinical trials. We sought to investigate mechanisms of PARPi radiosensitization at varying linear energy transfer (LET) levels after obse ... Full text Link to item Cite

Multi-institutional Outcomes after Stereotactic Radiosurgery for Gastrointestinal Brain Metastases.

Journal Article Adv Radiat Oncol · July 2025 PURPOSE: To compare outcomes between gastrointestinal and nongastrointestinal patients with brain metastases after radiosurgery. METHODS AND MATERIALS: Retrospective cohort study identifying patients completing an initial course of radiosurgery between Jan ... Full text Link to item Cite

Seizure risk factors and management approaches in patients with brain metastases.

Journal Article Neurooncol Pract · June 2025 A significant proportion of patients with brain metastases experience a seizure event during their disease course, which can impact morbidity and long-term outcomes. A host of factors elevate the risk for seizures in patients with brain metastases, includi ... Full text Link to item Cite

Total brain dose estimation in single-isocenter-multiple-targets (SIMT) radiosurgery via a novel deep neural network with spherical convolutions.

Journal Article Med Phys · June 2025 BACKGROUND AND PURPOSE: Accurate prediction of normal brain dosimetric parameters is crucial for the quality control of single-isocenter multi-target (SIMT) stereotactic radiosurgery (SRS) treatment planning. Reliable dose estimation of normal brain tissue ... Full text Link to item Cite

Thymomas and Thymic Carcinomas, Version 2.2025, NCCN Clinical Practice Guidelines In Oncology.

Journal Article J Natl Compr Canc Netw · June 2025 Thymomas and thymic carcinomas are rare mediastinal tumors that originate in the thymus. Patients with thymoma may experience symptoms associated with autoimmune paraneoplastic diseases (such as myasthenia gravis), which typically do not occur in patients ... Full text Link to item Cite

A Critical Review of Immunomodulation in the Management of Inoperable Stage III NSCLC.

Journal Article Cancers (Basel) · May 30, 2025 The current standard of care for inoperable stage III non-small cell lung cancer (NSCLC) is concurrent chemotherapy and radiation therapy with consolidation durvalumab. Despite this approach, about 50% of patients will experience disease recurrence, with a ... Full text Link to item Cite

Assessment of minimum target dose as a predictor of local failure after spine SBRT.

Conference Radiother Oncol · June 2024 OBJECTIVES: Metastasis-directed stereotactic body radiation therapy (SBRT) has demonstrated robust clinical benefits in carefully selected patients, improving local control and even overall survival (OS). We assess a large database to determine clinical an ... Full text Link to item Cite

Determinants of Symptomatic Intracranial Progression After an Initial Stereotactic Radiosurgery Course.

Journal Article Adv Radiat Oncol · June 2024 PURPOSE: Clinical and imaging surveillance of patients with brain metastases is important after stereotactic radiosurgery (SRS) because many will experience intracranial progression (ITCP) requiring multidisciplinary management. The prognostic significance ... Full text Link to item Cite

Non-Small Cell Lung Cancer, Version 4.2024, NCCN Clinical Practice Guidelines in Oncology.

Journal Article J Natl Compr Canc Netw · May 2024 The NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines) for Non-Small Cell Lung Cancer (NSCLC) provide recommendations for the treatment of patients with NSCLC, including diagnosis, primary disease management, surveillance for relapse, and subs ... Full text Link to item Cite

Long-Term Intracranial Outcomes With Combination Dual Immune-Checkpoint Blockade and Stereotactic Radiosurgery in Patients With Melanoma and Non-Small Cell Lung Cancer Brain Metastases.

Journal Article Int J Radiat Oncol Biol Phys · April 1, 2024 PURPOSE: The intracranial benefit of offering dual immune-checkpoint inhibition (D-ICPI) with ipilimumab and nivolumab to patients with melanoma or non-small cell lung cancer (NSCLC) receiving stereotactic radiosurgery (SRS) for brain metastases (BMs) is u ... Full text Link to item Cite

Quantifying U-Net uncertainty in multi-parametric MRI-based glioma segmentation by spherical image projection.

Journal Article Med Phys · March 2024 BACKGROUND: Uncertainty quantification in deep learning is an important research topic. For medical image segmentation, the uncertainty measurements are usually reported as the likelihood that each pixel belongs to the predicted segmentation region. In pot ... Full text Link to item Cite

NCCN GuidelinesĀ® Insights: Mesothelioma: Pleural, Version 1.2024.

Journal Article J Natl Compr Canc Netw · March 2024 Mesothelioma is a rare cancer that originates from the mesothelial surfaces of the pleura and other sites, and is estimated to occur in approximately 3,500 people in the United States annually. Pleural mesothelioma is the most common type and represents ap ... Full text Link to item Cite

Diffuse Pneumonitis after Lutetium-177-PSMA-617 Treatment in a Patient with Metastatic Castration-Resistant Prostate Cancer.

Journal Article BMJ Case Rep · February 23, 2024 We present the case of a patient with heavily pretreated metastatic castration-resistant prostate cancer (mCRPC) who received lutetium Lu-177 vipivotide tetraxetan (also known as 177Lu-PSMA-617) due to progressive disease despite chemotherapy, hormonal the ... Full text Link to item Cite

Effects of Ataxia-Telangiectasia Mutated Variants on Radionecrosis and Local Control After Stereotactic Radiation Surgery for Non-Small Cell Lung Cancer Brain Metastases.

Journal Article Adv Radiat Oncol · January 2024 PURPOSE: Genetic variants affecting the radiation response protein ataxia-telangiectasia mutated (ATM) have been associated with increased adverse effects of radiation but also with improved local control after conventional radiation therapy. However, it i ... Full text Link to item Cite

Impact of TP53 mutations on brain metastasis control in non-small cell lung cancer patients undergoing stereotactic radiosurgery.

Journal Article J Radiosurg SBRT · 2024 PURPOSE: To investigate whether TP53 variants may be correlated with overall survival and local control following stereotactic radiosurgery (SRS) for brain metastases (BMs) from non-small cell lung cancer (NSCLC). METHODS: Patients undergoing an initial co ... Link to item Cite

Rationale for Fractionated and Single-Session Approaches

Chapter · January 1, 2024 Stereotactic radiosurgery (SRS) delivers a high dose of radiation to an intracranial target in a single session. Modern planning capabilities and the ability to confirm and reproduce day-to-day setup positioning with on-board imaging and customized, reloca ... Full text Cite

Patient Selection

Chapter · January 1, 2024 Stereotactic body radiotherapy (SBRT) and stereotactic radiosurgery (SRS) techniques can deliver highly conformal ablative doses of radiotherapy to relatively small target volumes. These techniques are associated with excellent rates of local disease contr ... Full text Cite

Postmastectomy Intensity Modulated Proton Therapy: 5-Year Oncologic and Patient-Reported Outcomes.

Journal Article Int J Radiat Oncol Biol Phys · November 15, 2023 PURPOSE: To report oncologic, physician-assessed, and patient-reported outcomes (PROs) for a group of women homogeneously treated with modern, skin-sparing multifield optimized pencil-beam scanning proton (intensity modulated proton therapy [IMPT]) postmas ... Full text Link to item Cite

Study of linear energy transfer effect on rib fracture in breast patients receiving pencil-beamscanning proton therapy.

Journal Article ArXiv · October 31, 2023 PURPOSE: To study the effect of proton linear energy transfer (LET) on rib fracture in breast cancer patients treated with pencil-beam scanning proton therapy (PBS) using a novel tool of dose-LET volume histogram (DLVH). METHODS: From a prospective registr ... Link to item Cite

Mesothelioma: Peritoneal, Version 2.2023, NCCN Clinical Practice Guidelines in Oncology.

Journal Article J Natl Compr Canc Netw · September 2023 Mesothelioma is a rare cancer originating in mesothelial surfaces of the peritoneum, pleura, and other sites. These NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines) focus on peritoneal mesothelioma (PeM). The NCCN Guidelines for PeM provide ... Full text Link to item Cite

Proton Whole-Lung Irradiation: Initial Report of Outcomes.

Journal Article Int J Radiat Oncol Biol Phys · March 15, 2023 PURPOSE: Whole-lung irradiation is typically used in pediatric patients to decrease the risk of future lung metastases, but radiation dose to normal tissue is associated with long-term risks. Proton whole-lung irradiation (PWLI) provides an opportunity to ... Full text Link to item Cite

Development and validation of a recursive partitioning analysis-based pretreatment decision-making tool identifying ideal candidates for spine stereotactic body radiation therapy.

Journal Article Cancer · March 15, 2023 BACKGROUND: This study was aimed at developing and validating a decision-making tool predictive of overall survival (OS) for patients receiving stereotactic body radiation therapy (SBRT) for spinal metastases. METHODS: Three hundred sixty-one patients at o ... Full text Link to item Cite

Divergent Interpretations of Imaging After Stereotactic Body Radiation Therapy for Lung Cancer.

Journal Article Pract Radiat Oncol · 2023 PURPOSE: Conflicting information from health care providers contributes to anxiety among cancer patients. The purpose of this study was to investigate discordant interpretations of follow-up imaging studies after lung stereotactic body radiation therapy (S ... Full text Link to item Cite

Development and validation of a unifying pre-treatment decision tool for intracranial and extracranial metastasis-directed radiotherapy

Conference Frontiers in Oncology · January 1, 2023 Background: Though metastasis-directed therapy (MDT) has the potential to improve overall survival (OS), appropriate patient selection remains challenging. We aimed to develop a model predictive of OS to refine patient selection for clinical trials and MDT ... Full text Cite

Outcomes in Patients with Intact and Resected Brain Metastasis Treated with 5-Fraction Stereotactic Radiosurgery.

Journal Article Adv Radiat Oncol · 2023 PURPOSE: Hypofractionated stereotactic radiosurgery (HF-SRS) with or without surgical resection is potentially a preferred treatment for larger or symptomatic brain metastases (BMs). Herein, we report clinical outcomes and predictive factors following HF-S ... Full text Link to item Cite

Development and validation of a unifying pre-treatment decision tool for intracranial and extracranial metastasis-directed radiotherapy.

Journal Article Front Oncol · 2023 BACKGROUND: Though metastasis-directed therapy (MDT) has the potential to improve overall survival (OS), appropriate patient selection remains challenging. We aimed to develop a model predictive of OS to refine patient selection for clinical trials and MDT ... Full text Open Access Link to item Cite

Long-term outcomes with reduced-dose whole-brain radiotherapy and a stereotactic radiosurgery boost for primary central nervous system lymphoma.

Journal Article Neurooncol Adv · 2023 BACKGROUND: Primary central nervous system lymphoma (PCNSL) is an aggressive diffuse large B-cell lymphoma. Treatment approaches are historically associated with neurotoxicity, particularly with high-dose whole-brain radiotherapy (WBRT). We hypothesized th ... Full text Link to item Cite

Outcomes of Proton Beam Therapy Compared With Intensity-Modulated Radiation Therapy for Uterine Cancer

Journal Article International Journal of Particle Therapy · January 1, 2023 Purpose: To compare Patient-Reported Outcomes version of the Common Terminology Criteria for Adverse Events (PRO-CTCAE) in patients with endometrial cancer receiving adjuvant pelvic radiation therapy with proton beam therapy (PT) versus intensity-modulated ... Full text Cite

Cost effectiveness of treatment strategies for high risk prostate cancer.

Journal Article Cancer · November 1, 2022 BACKGROUND: Patients with high-risk prostate cancer (HRPC) have multiple accepted treatment options. Because there is no overall survival benefit of one option over another, appropriate treatment must consider patient life expectancy, quality of life, and ... Full text Link to item Cite

Prognostic Model for Intracranial Progression after Stereotactic Radiosurgery: A Multicenter Validation Study.

Journal Article Cancers (Basel) · October 22, 2022 Stereotactic radiosurgery (SRS) is a standard of care for many patients with brain metastases. To optimize post-SRS surveillance, this study aimed to validate a previously published nomogram predicting post-SRS intracranial progression (IP). We identified ... Full text Link to item Cite

Proton therapy for the treatment of inflammatory breast cancer.

Journal Article Radiother Oncol · June 2022 PURPOSE: Inflammatory breast cancer (IBC) poses a radiotherapeutic challenge due to dermal lymphatic involvement, which often necessitates larger target volumes and chest wall boosts, making advanced planning techniques attractive to reduce exposure to nea ... Full text Link to item Cite

Thoracic Radiotherapy for Renal Cell Carcinoma Metastases: Local Control for the Management of Lung and Mediastinal Disease in the Modern Era.

Journal Article Clin Genitourin Cancer · April 2022 INTRODUCTION/BACKGROUND: Radiotherapy (RT) is an alternative local therapy to metastasectomy in the treatment of thoracic metastases from renal cell carcinoma (RCC), including the management of life-threatening disease. PATIENTS AND METHODS: We reviewed pa ... Full text Link to item Cite

Development and Assessment of a Predictive Score for Vertebral Compression Fracture After Stereotactic Body Radiation Therapy for Spinal Metastases.

Conference JAMA Oncol · March 1, 2022 IMPORTANCE: Vertebral compression fracture (VCF) is a potential adverse effect following treatment with stereotactic body radiation therapy (SBRT) for spinal metastases. OBJECTIVE: To develop and assess a risk stratification model for VCF after SBRT. DESIG ... Full text Link to item Cite

Cost-Effectiveness of Treatment Strategies for Spinal Metastases.

Journal Article Pract Radiat Oncol · 2022 PURPOSE: We analyzed the cost-effectiveness of standard palliative external beam radiation (EBRT, 8 Gy in 1 fraction), stereotactic body radiation therapy (SBRT, 24 Gy in 2 fractions), and radiofrequency ablation for painful spinal metastases. Single-fract ... Full text Link to item Cite

Development and Internal Validation of a Recursive Partitioning Analysis-Based Model Predictive of Pain Flare Incidence After Spine Stereotactic Body Radiation Therapy.

Journal Article Pract Radiat Oncol · 2022 PURPOSE: Pain flares are a common acute toxic effect after stereotactic body radiation therapy (SBRT) for spine metastasis. We aimed to identify a subset of patients with the highest rate of pain flare after spine SBRT to optimize prophylactic corticostero ... Full text Link to item Cite

Single and Multifraction Spine Stereotactic Body Radiation Therapy and the Risk of Radiation Induced Myelopathy.

Journal Article Adv Radiat Oncol · 2022 PURPOSE: This study reports on the risk of radiation-induced myelitis (RM) of the spinal cord from a large single-institutional experience with 1 to 5 fraction stereotactic body radiation therapy (SBRT) to the spine. METHODS AND MATERIALS: A retrospective ... Full text Link to item Cite

Outcomes in Intact and Resected Brain Metastasis Patients Treated with Five-Fraction Stereotactic Radiosurgery

Conference INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS · 2022 Cite

Evaluation of Pretreatment Magnetic Resonance Elastography for the Prediction of Radiation-Induced Liver Disease

Journal Article Advances in Radiation Oncology · November 1, 2021 Purpose: Magnetic resonance (MR) elastography (E) is a noninvasive technique for quantifying liver stiffness (LS) for fibrosis. This study evaluates whether LS is associated with risk of developing radiation-induced liver disease (RILD) in patients receivi ... Full text Cite

Intensity Modulated Proton Therapy for Hepatocellular Carcinoma: Initial Clinical Experience

Journal Article Advances in Radiation Oncology · July 1, 2021 Purpose: Our purpose was to assess the safety and efficacy of intensity modulated proton therapy (IMPT) for the treatment of hepatocellular carcinoma (HCC). Methods and Materials: A retrospective review was conducted on all patients who were treated with I ... Full text Cite

Intensity-modulated proton therapy (IMPT) treatment of angiosarcoma of the face and scalp

Journal Article International Journal of Particle Therapy · June 1, 2021 Purpose: To successfully plan and treat a patient with diffuse angiosarcoma involving the face and scalp with intensity-modulated proton therapy (IMPT) before surgical resection. Materials and Methods: A patient presented to the radiation oncology departme ... Full text Cite

Adjuvant brachytherapy for FIGO stage I serous or clear cell endometrial cancer.

Journal Article Int J Gynecol Cancer · June 2021 OBJECTIVES: Optimal adjuvant treatment for early-stage clear cell and serous endometrial cancer remains unclear. We report outcomes for women with surgically staged International Federation of Gynecology and Obstetrics (FIGO) stage I clear cell, serous, an ... Full text Link to item Cite

Chemoradiotherapy for patients with locally advanced or unresectable extra-hepatic biliary cancer

Journal Article Journal of Gastrointestinal Oncology · December 1, 2020 Background: Although surgical resection is the preferred curative-intent treatment option for patients with non-metastatic, extra-hepatic biliary cancer (EBC), radiotherapy (RT) or chemoradiotherapy (CRT) may be utilized in select cases when surgical resec ... Full text Cite

Association of tumor genomic factors and efficacy for metastasis-directed stereotactic body radiotherapy for oligometastatic colorectal cancer.

Journal Article Radiother Oncol · May 2020 PURPOSE/OBJECTIVE(S): To report tumor genomic factors associated with overall survival (OS) and local failure (LF) for patients with colorectal cancer (CRC) who received metastasis-directed stereotactic body radiation therapy (SBRT). MATERIALS/METHODS: Thi ... Full text Link to item Cite

First Year Medical Student Peer Nominations of Professionalism: A Methodological Detective Story about Making Sense of Non-Sense.

Journal Article Anat Sci Educ · January 2019 This article explores the assessment of professionalism within a cohort of medical students during a sequential 13-week medical school histology and anatomy course. Across seven data points, students were asked to identify a professionalism role model from ... Full text Link to item Cite

Clinical characteristics and outcomes in biclonal gammopathies.

Journal Article Am J Hematol · May 2016 A single monoclonal protein typically characterizes monoclonal gammopathies, but a small proportion may have more than one M protein identifiable. In the setting of symptomatic multiple myeloma (MM), the development of a new monoclonal protein following th ... Full text Link to item Cite

A retrospective analysis of outcomes of dalteparin use in pediatric patients: a single institution experience.

Journal Article Thromb Res · August 2015 BACKGROUND: Dalteparin is a commonly used low molecular weight heparin (LMWH) with extensive safety data in adults. With distinct advantages of once daily dosing and relative safety in renal impairment, it has been used off-label in pediatric practice; how ... Full text Link to item Cite

Improving Confidence in Competencies for International Medical Trips Using a Curriculum with Simulation.

Journal Article Minn Med · 2015 Many incoming medical and undergraduate students seek out international medical mission trips to supplement their education and training. However, few have the necessary skills to perform simple clinical tasks such as taking vital signs or conducting an in ... Link to item Cite