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Nicole A. Larrier

Associate Professor of Radiation Oncology
Radiation Oncology
Department of Radiation Oncolo, Box 3085, Durham, NC 27710
201 Trent Drive, Box 3085, Durham, NC 27710

Selected Publications


Pathologic Complete Response and Clinical Outcomes in Patients With Localized Soft Tissue Sarcoma Treated With Neoadjuvant Chemoradiotherapy or Radiotherapy: The NRG/RTOG 9514 and 0630 Nonrandomized Clinical Trials.

Journal Article JAMA Oncol · May 1, 2023 IMPORTANCE: Pathologic complete response (pCR) may be associated with prognosis in patients with soft tissue sarcoma (STS). OBJECTIVE: We sought to determine the prognostic significance of pCR on survival outcomes in STS for patients receiving neoadjuvant ... Full text Link to item Cite

An Analysis of Major Target Deviations in Craniospinal Irradiation Treatment Plans for Patients With Intermediate-Risk Medulloblastoma Within a Phase 3 Clinical Trial (Children's Oncology Group Study ACNS0331).

Journal Article Adv Radiat Oncol · 2023 PURPOSE: Craniospinal irradiation remains an essential and yet difficult part of the treatment of patients with medulloblastoma. Whereas technological advances offer promise of increased conformity, realiance on advanced technology is not without risk, and ... Full text Link to item Cite

Bone Sarcomas

Chapter · January 1, 2023 This chapter provides answers to practice-based questions with case studies covering the new principles of diagnosis, classification, staging, treatment, and outcomes in the rapidly advancing field of bone sarcomas. Bone sarcomas are rare, mesenchymal neop ... Full text Cite

Extent of tumor fibrosis/hyalinization and infarction following neoadjuvant radiation therapy is associated with improved survival in patients with soft-tissue sarcoma.

Journal Article Cancer Med · January 2022 INTRODUCTION: Current standard of care for most intermediate and high-grade soft-tissue sarcomas (STS) includes limb-preserving surgical resection with either neoadjuvant radiation therapy (NRT) or adjuvant radiation therapy. To date, there have been a few ... Full text Link to item Cite

Pediatric Hodgkin Lymphoma, Version 3.2021.

Journal Article J Natl Compr Canc Netw · June 30, 2021 Hodgkin lymphoma (HL) is a highly curable form of cancer, and current treatment regimens are focused on improving treatment efficacy while decreasing the risk of late effects of treatment. The NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines) ... Full text Link to item Cite

The Role of Radiotherapy for Chordoma Patients Managed With Surgery: Analysis of the National Cancer Database.

Journal Article Spine (Phila Pa 1976) · June 15, 2020 STUDY DESIGN: Retrospective review. OBJECTIVE: To determine if adjuvant radiation therapy (RT) improves overall survival (OS) following surgical resection of chordomas. SUMMARY OF BACKGROUND DATA: The role of RT for the treatment of chordomas remains incom ... Full text Link to item Cite

Pediatric Acute Lymphoblastic Leukemia, Version 2.2020, NCCN Clinical Practice Guidelines in Oncology.

Journal Article J Natl Compr Canc Netw · January 2020 Acute lymphoblastic leukemia (ALL) is the most common pediatric malignancy. Advancements in technology that enhance our understanding of the biology of the disease, risk-adapted therapy, and enhanced supportive care have contributed to improved survival ra ... Full text Link to item Cite

Revisiting the Role of Radiation Therapy in Chondrosarcoma: A National Cancer Database Study.

Journal Article Sarcoma · 2019 BACKGROUND: Although chondrosarcomas (CS) are mostly considered radioresistant, advancements in radiotherapy have brought attention to its use in these patients. Using the largest registry of primary bone tumors, the National Cancer Database (NCDB), we sou ... Full text Link to item Cite

Multifocal iris melanoma in a 2-year-old managed with I-125 plaque brachytherapy.

Journal Article J AAPOS · October 2017 We report a 23-month-old patient presenting with multifocal iris melanoma who underwent plaque brachytherapy with full corneal coverage. The lesion demonstrated several high-risk clinical and histopathologic features associated with iris melanoma in adults ... Full text Link to item Cite

Radiation Therapy for Soft Tissue Sarcoma: Indications and Controversies for Neoadjuvant Therapy, Adjuvant Therapy, Intraoperative Radiation Therapy, and Brachytherapy.

Journal Article Surg Oncol Clin N Am · October 2016 Soft tissue sarcomas are rare mesenchymal cancers that pose a treatment challenge. Although small superficial soft tissue sarcomas can be managed by surgery alone, adjuvant radiotherapy in addition to limb-sparing surgery substantially increases local cont ... Full text Link to item Cite

A mouse-human phase 1 co-clinical trial of a protease-activated fluorescent probe for imaging cancer.

Journal Article Sci Transl Med · January 6, 2016 Local recurrence is a common cause of treatment failure for patients with solid tumors. Intraoperative detection of microscopic residual cancer in the tumor bed could be used to decrease the risk of a positive surgical margin, reduce rates of reexcision, a ... Full text Link to item Cite

Genitourinary

Journal Article · September 3, 2015 Full text Cite

Bone Sarcomas

Chapter · June 20, 2014 This chapter presents a series of case studies with questions related to bone sarcomas. The first case study is about a 17-year-old Caucasian male diagnosed with Ewing sarcoma of the left humerus. Other case studies include a 52-year-old Caucasian male wit ... Full text Cite

Practical radiation oncology for extremity sarcomas.

Journal Article Surg Oncol Clin N Am · July 2013 Soft tissue sarcomas are rare cancers. They should be managed by a multidisciplinary team with experience caring for these diverse malignancies. Local control is frequently achieved with a combination of radiation therapy and surgery. This article reviews ... Full text Link to item Cite

Renal shielding and dosimetry for patients with severe systemic sclerosis receiving immunoablation with total body irradiation in the scleroderma: cyclophosphamide or transplantation trial.

Journal Article Int J Radiat Oncol Biol Phys · March 15, 2011 PURPOSE: To describe renal shielding techniques and dosimetry in delivering total body irradiation (TBI) to patients with severe systemic sclerosis (SSc) enrolled in a hematopoietic stem cell transplant protocol. METHODS AND MATERIALS: The Scleroderma: Cyc ... Full text Link to item Cite

An image-guided technique for planning and verification of supine craniospinal irradiation.

Journal Article J Appl Clin Med Phys · January 31, 2011 We present a technique for planning and verification of craniospinal treatment with the patient in the supine position. Treatment delivery and verification is streamlined through the use of modern imaging techniques. Treatments use two lateral brain fields ... Full text Link to item Cite

An image-guided technique for planning and verification of supine craniospinal irradiation

Journal Article Journal of Applied Clinical Medical Physics · January 1, 2011 We present a technique for planning and verification of craniospinal treatment with the patient in the supine position. Treatment delivery and verification is streamlined through the use of modern imaging techniques. Treatments use two lateral brain fields ... Full text Cite

The clinical management of chondrosarcoma.

Journal Article Curr Treat Options Oncol · April 2009 Chondrosarcomas (CHS) represent a heterogeneous group of disorders ranging from indolent, low-grade tumors to aggressive, high-grade forms. Surgical resection represents the primary and preferred treatment modality for individuals with localized disease. R ... Full text Link to item Cite

Pathologic Complete Response and Clinical Outcomes in Patients With Localized Soft Tissue Sarcoma Treated With Neoadjuvant Chemoradiotherapy or Radiotherapy: The NRG/RTOG 9514 and 0630 Nonrandomized Clinical Trials.

Journal Article JAMA Oncol · May 1, 2023 IMPORTANCE: Pathologic complete response (pCR) may be associated with prognosis in patients with soft tissue sarcoma (STS). OBJECTIVE: We sought to determine the prognostic significance of pCR on survival outcomes in STS for patients receiving neoadjuvant ... Full text Link to item Cite

An Analysis of Major Target Deviations in Craniospinal Irradiation Treatment Plans for Patients With Intermediate-Risk Medulloblastoma Within a Phase 3 Clinical Trial (Children's Oncology Group Study ACNS0331).

Journal Article Adv Radiat Oncol · 2023 PURPOSE: Craniospinal irradiation remains an essential and yet difficult part of the treatment of patients with medulloblastoma. Whereas technological advances offer promise of increased conformity, realiance on advanced technology is not without risk, and ... Full text Link to item Cite

Bone Sarcomas

Chapter · January 1, 2023 This chapter provides answers to practice-based questions with case studies covering the new principles of diagnosis, classification, staging, treatment, and outcomes in the rapidly advancing field of bone sarcomas. Bone sarcomas are rare, mesenchymal neop ... Full text Cite

Extent of tumor fibrosis/hyalinization and infarction following neoadjuvant radiation therapy is associated with improved survival in patients with soft-tissue sarcoma.

Journal Article Cancer Med · January 2022 INTRODUCTION: Current standard of care for most intermediate and high-grade soft-tissue sarcomas (STS) includes limb-preserving surgical resection with either neoadjuvant radiation therapy (NRT) or adjuvant radiation therapy. To date, there have been a few ... Full text Link to item Cite

Pediatric Hodgkin Lymphoma, Version 3.2021.

Journal Article J Natl Compr Canc Netw · June 30, 2021 Hodgkin lymphoma (HL) is a highly curable form of cancer, and current treatment regimens are focused on improving treatment efficacy while decreasing the risk of late effects of treatment. The NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines) ... Full text Link to item Cite

The Role of Radiotherapy for Chordoma Patients Managed With Surgery: Analysis of the National Cancer Database.

Journal Article Spine (Phila Pa 1976) · June 15, 2020 STUDY DESIGN: Retrospective review. OBJECTIVE: To determine if adjuvant radiation therapy (RT) improves overall survival (OS) following surgical resection of chordomas. SUMMARY OF BACKGROUND DATA: The role of RT for the treatment of chordomas remains incom ... Full text Link to item Cite

Pediatric Acute Lymphoblastic Leukemia, Version 2.2020, NCCN Clinical Practice Guidelines in Oncology.

Journal Article J Natl Compr Canc Netw · January 2020 Acute lymphoblastic leukemia (ALL) is the most common pediatric malignancy. Advancements in technology that enhance our understanding of the biology of the disease, risk-adapted therapy, and enhanced supportive care have contributed to improved survival ra ... Full text Link to item Cite

Revisiting the Role of Radiation Therapy in Chondrosarcoma: A National Cancer Database Study.

Journal Article Sarcoma · 2019 BACKGROUND: Although chondrosarcomas (CS) are mostly considered radioresistant, advancements in radiotherapy have brought attention to its use in these patients. Using the largest registry of primary bone tumors, the National Cancer Database (NCDB), we sou ... Full text Link to item Cite

Multifocal iris melanoma in a 2-year-old managed with I-125 plaque brachytherapy.

Journal Article J AAPOS · October 2017 We report a 23-month-old patient presenting with multifocal iris melanoma who underwent plaque brachytherapy with full corneal coverage. The lesion demonstrated several high-risk clinical and histopathologic features associated with iris melanoma in adults ... Full text Link to item Cite

Radiation Therapy for Soft Tissue Sarcoma: Indications and Controversies for Neoadjuvant Therapy, Adjuvant Therapy, Intraoperative Radiation Therapy, and Brachytherapy.

Journal Article Surg Oncol Clin N Am · October 2016 Soft tissue sarcomas are rare mesenchymal cancers that pose a treatment challenge. Although small superficial soft tissue sarcomas can be managed by surgery alone, adjuvant radiotherapy in addition to limb-sparing surgery substantially increases local cont ... Full text Link to item Cite

A mouse-human phase 1 co-clinical trial of a protease-activated fluorescent probe for imaging cancer.

Journal Article Sci Transl Med · January 6, 2016 Local recurrence is a common cause of treatment failure for patients with solid tumors. Intraoperative detection of microscopic residual cancer in the tumor bed could be used to decrease the risk of a positive surgical margin, reduce rates of reexcision, a ... Full text Link to item Cite

Genitourinary

Journal Article · September 3, 2015 Full text Cite

Bone Sarcomas

Chapter · June 20, 2014 This chapter presents a series of case studies with questions related to bone sarcomas. The first case study is about a 17-year-old Caucasian male diagnosed with Ewing sarcoma of the left humerus. Other case studies include a 52-year-old Caucasian male wit ... Full text Cite

Practical radiation oncology for extremity sarcomas.

Journal Article Surg Oncol Clin N Am · July 2013 Soft tissue sarcomas are rare cancers. They should be managed by a multidisciplinary team with experience caring for these diverse malignancies. Local control is frequently achieved with a combination of radiation therapy and surgery. This article reviews ... Full text Link to item Cite

Renal shielding and dosimetry for patients with severe systemic sclerosis receiving immunoablation with total body irradiation in the scleroderma: cyclophosphamide or transplantation trial.

Journal Article Int J Radiat Oncol Biol Phys · March 15, 2011 PURPOSE: To describe renal shielding techniques and dosimetry in delivering total body irradiation (TBI) to patients with severe systemic sclerosis (SSc) enrolled in a hematopoietic stem cell transplant protocol. METHODS AND MATERIALS: The Scleroderma: Cyc ... Full text Link to item Cite

An image-guided technique for planning and verification of supine craniospinal irradiation.

Journal Article J Appl Clin Med Phys · January 31, 2011 We present a technique for planning and verification of craniospinal treatment with the patient in the supine position. Treatment delivery and verification is streamlined through the use of modern imaging techniques. Treatments use two lateral brain fields ... Full text Link to item Cite

An image-guided technique for planning and verification of supine craniospinal irradiation

Journal Article Journal of Applied Clinical Medical Physics · January 1, 2011 We present a technique for planning and verification of craniospinal treatment with the patient in the supine position. Treatment delivery and verification is streamlined through the use of modern imaging techniques. Treatments use two lateral brain fields ... Full text Cite

The clinical management of chondrosarcoma.

Journal Article Curr Treat Options Oncol · April 2009 Chondrosarcomas (CHS) represent a heterogeneous group of disorders ranging from indolent, low-grade tumors to aggressive, high-grade forms. Surgical resection represents the primary and preferred treatment modality for individuals with localized disease. R ... Full text Link to item Cite

Stereotactic body radiotherapy for lesions of the spine and paraspinal regions.

Journal Article Int J Radiat Oncol Biol Phys · April 1, 2009 PURPOSE: To describe our experience and clinical strategy for stereotactic body radiotherapy (SBRT) of spinal lesions. METHODS AND MATERIALS: Thirty-two patients with 33 spinal lesions underwent computed tomography-based simulation while free breathing. Gr ... Full text Link to item Cite

WE‐C‐BRC‐02: Combined Dynamic Contrast Enhanced Magnetic Resonance Imaging (DCE‐MRI) and Magnetic Resonance Thermal Imaging (MRTI) for Optimal Hyperthermia Treatment of Advanced Extremity Sarcomas: Fifteen Patients Update

Conference Medical Physics · January 1, 2009 Purpose: To deliver optimal hyperthermia (HT) treatments for patients with advanced extremity sarcomas using DCE‐MRI and MRTI Method and Materials: Patients were treated on a protocol using radiotherapy consisting of 45 Gy and once a week HT for 5 weeks in ... Full text Cite

Efficacy of high-dose chemotherapy or standard salvage therapy in patients with recurrent medulloblastoma.

Journal Article Neuro Oncol · October 2008 The efficacy of high-dose chemotherapy (HDC) or standard salvage therapy was evaluated in patients with recurrent medulloblastoma (MBL) using retrospective chart review of all patients with recurrent MBL treated at Duke University Medical Center between 19 ... Full text Link to item Cite

Intensity-modulated radiotherapy for resected mesothelioma: the Duke experience.

Journal Article Int J Radiat Oncol Biol Phys · July 15, 2008 PURPOSE: To assess the safety and efficacy of intensity-modulated radiotherapy (IMRT) after extrapleural pneumonectomy for malignant pleural mesothelioma. METHODS AND MATERIALS: Thirteen patients underwent IMRT after extrapleural pneumonectomy between July ... Full text Link to item Cite

Integration of cone-beam CT in stereotactic body radiation therapy.

Journal Article Technol Cancer Res Treat · April 2008 This report describes the technique and initial experience using cone beam CT (CBCT) for localization of treatment targets in patients undergoing stereotactic body radiation therapy (SBRT). Patients selected for SBRT underwent 3-D or 4-D CT scans in a cust ... Full text Link to item Cite

Cone-beam CT localization of internal target volumes for stereotactic body radiotherapy of lung lesions.

Journal Article Int J Radiat Oncol Biol Phys · December 1, 2007 PURPOSE: In this study, we investigate a technique of matching internal target volumes (ITVs) in four-dimensional (4D) simulation computed tomography (CT) to the composite target volume in free-breathing on-board cone-beam (CB) CT. The technique is illustr ... Full text Link to item Cite

The impact of induction chemotherapy and the associated tumor response on subsequent radiation-related changes in lung function and tumor response.

Journal Article Int J Radiat Oncol Biol Phys · April 1, 2007 PURPOSE: To assess the impact of induction chemotherapy, and associated tumor shrinkage, on the subsequent radiation-related changes in pulmonary function and tumor response. METHODS AND MATERIALS: As part of a prospective institutional review board-approv ... Full text Link to item Cite

TU‐EE‐A2‐05: Challenges in Limiting Kidney Dose When Delivering Total Body Irradiation (TBI) for Patients with Severe Systemic Sclerosis (SSc)

Conference Medical Physics · January 1, 2007 Purpose: To describe challenges in limiting kidney dose when delivering TBI to SSc patients enrolled on a multicenter Phase II/III SCOT (Scleroderma Cyclophosphamide or Transplantation) protocol. Material and Methods: The SCOT protocol uses a preparative r ... Full text Cite

SU‐FF‐T‐252: Improvement of Localization Accuracy by Using 3D Cone Beam CT for Stereotactic Body Radiation Therapy of Liver, Lung and Spine Lesions

Conference Medical Physics · January 1, 2007 Purpose: To compare treatment isocenter placement based on OBI 2D kV imaging and OBI 3D‐CBCT imaging for patients undergoing SBRT, and compare the CBCT based isocenter shifts among liver, lung and spine lesions. Material and Methods: 119 SBRT fractions wer ... Full text Cite

Assessing the ability of the antiangiogenic and anticytokine agent thalidomide to modulate radiation-induced lung injury.

Journal Article Int J Radiat Oncol Biol Phys · October 1, 2006 PURPOSE: Thalidomide has broad anticytokine properties, which might protect normal tissues in patients undergoing chemoradiotherapy. The purpose of this study was to determine the maximal tolerated dose of thalidomide when used in combination with vinorelb ... Full text Link to item Cite

SU‐FF‐J‐125: Therapy Assessment Using a Full Time Point (fTP) Pharmacokinetic Analysis of Dynamic Contrast‐Enhanced Magnetic Resonance Imaging (DCE‐MRI): Role of Region of Interest (ROI) Selection in Three Tumor Sites

Conference Medical Physics · January 1, 2006 Background: DCE‐MRI has great potential to provide routine assessment of cancer treatment response. The contrast agent preferentially accumulates in tumors due to increased tumor vascular permeability. The MR based parameters that can be used for treatment ... Full text Cite

SU‐FF‐T‐66: A Technique for Cone‐Beam CT‐Guided Stereotactic Body Radiation Therapy

Conference Medical Physics · January 1, 2006 Purpose: To develop and assess a technique using cone‐beam CT (CBCT) to localize treatment targets for stereotactic body radiation therapy (SBRT). Material and Methods: Patients selected for SBRT had 3‐D or 4‐D CT simulation with immobilization. GTV, CTV, ... Full text Cite

Intracranial Ewing sarcoma.

Journal Article Pediatr Blood Cancer · November 2005 The occurrence of primary extraosseous Ewing sarcoma (EES) of the central nervous system (CNS) has only rarely been reported in the literature. It is important to distinguish this entity from the more common central primitive neuroectodermal tumor (PNET) o ... Full text Link to item Cite

Intra-abdominal desmoid tumor after successful treatment for Hodgkin disease.

Journal Article Pediatr Blood Cancer · October 15, 2005 The risk of second malignancies after successful treatment for Hodgkin disease can be considerable. The most common malignancies are solid tumors arising in irradiated sites, such as the breast and thyroid gland after mantle field radiation. Sarcomas and o ... Full text Link to item Cite

Recent progress in defining mechanisms and potential targets for prevention of normal tissue injury after radiation therapy.

Journal Article Int J Radiat Oncol Biol Phys · May 1, 2005 The ability to optimize treatments for cancer on the basis of relative risks for normal tissue injury has important implications in oncology, because higher doses of radiation might, in some diseases, improve both local control and survival. To achieve thi ... Full text Link to item Cite

The protective effect of recombinant human keratinocyte growth factor on radiation-induced pulmonary toxicity in rats.

Journal Article Int J Radiat Oncol Biol Phys · December 1, 2004 PURPOSE: Radiation-induced lung toxicity is a significant dose-limiting side effect of radiotherapy for thoracic tumors. Recombinant human keratinocyte growth factor (rHuKGF) has been shown to be a mitogen for type II pneumocytes. The purpose of this study ... Full text Link to item Cite

Mouse embryonic stem cells carrying one or two defective Msh2 alleles respond abnormally to oxidative stress inflicted by low-level radiation.

Journal Article Proc Natl Acad Sci U S A · September 29, 1998 Chronic oxidative stress may play a critical role in the pathogenesis of many human cancers. Here, we report that mouse embryonic stem (ES) cells deficient in DNA mismatch repair responded abnormally when exposed to low levels of ionizing radiation, a stre ... Full text Link to item Cite