Scholars@Duke
Paul Wayne Sperduto

Paul Wayne Sperduto

Adjunct Professor in the Department of Radiation Oncology
Radiation Oncology
paul.sperduto@duke.edu
30 Duke Medicine Circle, Box 3085, Durham, NC 27710
30 Duke Medicine Circle, Box 3085, Durham, NC 27710

Selected Publications

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

Improved Survival and Prognostication in Melanoma Patients With Brain Metastases: An Update of the Melanoma Graded Prognostic Assessment.

Journal Article J Clin Oncol · June 2025 PURPOSE: Survival for patients with melanoma has recently improved. The propensity of melanoma to metastasize to the brain remains a common and serious feature of this disease. The purposes of this study were to evaluate prognostic factors for patients wit ... Full text Link to item Cite

Validation of the graded prognostic assessment and recursive partitioning analysis as prognostic tools using a modern cohort of patients with brain metastases.

Journal Article Neurooncol Pract · December 2024 BACKGROUND: Prognostic indices for patients with brain metastases (BM) are needed to individualize treatment and stratify clinical trials. Two frequently used tools to estimate survival in patients with BM are the recursive partitioning analysis (RPA) and ... Full text Link to item Cite

Concurrent Lapatinib With Brain Radiation Therapy in Patients With HER2+ Breast Cancer With Brain Metastases: NRG Oncology-KROG/RTOG 1119 Phase 2 Randomized Trial.

Journal Article Int J Radiat Oncol Biol Phys · April 1, 2024 PURPOSE: Lapatinib plus whole brain radiation therapy (WBRT) or stereotactic radiosurgery (SRS) was hypothesized to improve the 12-week intracranial complete response (CR) rate compared with either option of radiation therapy (RT) alone for patients with b ... 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

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

National Cancer Institute Collaborative Workshop on Shaping the Landscape of Brain Metastases Research: challenges and recommended priorities.

Journal Article Lancet Oncol · August 2023 Brain metastases are an increasing global public health concern, even as survival rates improve for patients with metastatic disease. Both metastases and the sequelae of their treatment are key determinants of the inter-related priorities of patient surviv ... Full text Link to item Cite

Graded Prognostic Assessment (GPA) for Patients With Lung Cancer and Brain Metastases: Initial Report of the Small Cell Lung Cancer GPA and Update of the Non-Small Cell Lung Cancer GPA Including the Effect of Programmed Death Ligand 1 and Other Prognostic Factors.

Journal Article Int J Radiat Oncol Biol Phys · September 1, 2022 PURPOSE: Patients with lung cancer and brain metastases represent a markedly heterogeneous population. Accurate prognosis is essential to optimally individualize care. In prior publications, we described the graded prognostic assessment (GPA), but a GPA fo ... Full text Link to item Cite

KHANS TREATMENT PLAN RAD ONCOLOGY 5E

Book · November 9, 2021 "This edition includes new chapters and updates of prior chapters designed to keep pace with the many exciting innovations in radiation oncology. ... Cite

Targeted therapy strategies for melanoma brain metastasis

Journal Article Neuro Oncology Advances · November 1, 2021 Melanoma is the most aggressive of the common forms of skin cancer. Metastasis to the central nervous system is one of the most common and deadly complications of this disease. Historically, melanoma patients with brain metastases had a median survival of ... Full text Cite

Targeted therapy strategies for melanoma brain metastasis.

Journal Article Neurooncol Adv · November 2021 Melanoma is the most aggressive of the common forms of skin cancer. Metastasis to the central nervous system is one of the most common and deadly complications of this disease. Historically, melanoma patients with brain metastases had a median survival of ... Full text Link to item Cite

Quality of Life and Adverse Events: Prognostic Relationships in Long-Term Ovarian Cancer Survival.

Journal Article J Natl Cancer Inst · October 1, 2021 BACKGROUND: There is a critical need to identify patient characteristics associated with long-term ovarian cancer survival. METHODS: Quality of life (QOL), measured by the Functional Assessment of Cancer Therapy-Ovarian-Trial Outcome Index (FACT-O-TOI), in ... Full text Link to item Cite

A radiomics-based model for predicting local control of resected brain metastases receiving adjuvant SRS.

Journal Article Clin Transl Radiat Oncol · July 2021 PURPOSE: Adjuvant radiosurgery to the cavities of surgically resected brain metastases provides excellent local tumor control while reducing the risk of deleterious cognitive decline associated with whole brain radiotherapy. A subset of these patients, how ... Full text Link to item Cite

Biological Principles of Stereotactic Body Radiation Therapy (SBRT) and Stereotactic Radiation Surgery (SRS): Indirect Cell Death.

Journal Article Int J Radiat Oncol Biol Phys · May 1, 2021 PURPOSE: To review the radiobiological mechanisms of stereotactic body radiation therapy stereotactic body radiation therapy (SBRT) and stereotactic radiation surgery (SRS). METHODS AND MATERIALS: We reviewed previous reports and recent observations on the ... Full text Link to item Cite

Survival in Patients With Brain Metastases: Summary Report on the Updated Diagnosis-Specific Graded Prognostic Assessment and Definition of the Eligibility Quotient.

Journal Article J Clin Oncol · November 10, 2020 PURPOSE: Conventional wisdom has rendered patients with brain metastases ineligible for clinical trials for fear that poor survival could mask the benefit of otherwise promising treatments. Our group previously published the diagnosis-specific Graded Progn ... Full text Link to item Cite

Estrogen/progesterone receptor and HER2 discordance between primary tumor and brain metastases in breast cancer and its effect on treatment and survival.

Journal Article Neuro Oncol · September 29, 2020 BACKGROUND: Breast cancer treatment is based on estrogen receptors (ERs), progesterone receptors (PRs), and human epidermal growth factor receptor 2 (HER2). At the time of metastasis, receptor status can be discordant from that at initial diagnosis. The pu ... Full text Link to item Cite

Beyond an Updated Graded Prognostic Assessment (Breast GPA): A Prognostic Index and Trends in Treatment and Survival in Breast Cancer Brain Metastases From 1985 to Today.

Journal Article Int J Radiat Oncol Biol Phys · June 1, 2020 PURPOSE: Brain metastases are a common sequelae of breast cancer. Survival varies widely based on diagnosis-specific prognostic factors (PF). We previously published a prognostic index (Graded Prognostic Assessment [GPA]) for patients with breast cancer wi ... Full text Link to item Cite

Current multidisciplinary management of brain metastases.

Journal Article Cancer · April 1, 2020 Brain metastasis (BM), the most common adult brain tumor, develops in 20% to 40% of patients with late-stage cancer and traditionally are associated with a poor prognosis. The management of patients with BM has become increasingly complex because of new an ... Full text Link to item Cite

Development of a disease-specific graded prognostic assessment index for the management of sarcoma patients with brain metastases (Sarcoma-GPA).

Journal Article BMC Cancer · February 12, 2020 BACKGROUND: Brain metastases from sarcomatous lesions pose a management challenge owing to their rarity and the histopathological heterogeneity. Prognostic indices such as the Graded Prognostic Assessment (GPA) index have been developed for several primary ... Full text Link to item Cite

Indirect cell death and the LQ model in SBRT and SRS.

Journal Article J Radiosurg SBRT · 2020 High-dose hypofractionated SBRT and SRS indirectly kills substantial fractions of tumor cells via causing vascular damage. The LQ formula may work well for certain clinical cases of SBRT and SRS when the indirect/additional tumor cell death secondary to va ... Link to item Cite

Classification of Brain Metastases

Chapter · January 1, 2020 Patients with brain metastases are a heterogenous population. The epidemiology of brain metastases is addressed elsewhere in this textbook. In the past, outcomes were considered uniformly grim for all patients with brain metastases. We now know that outcom ... Full text Cite

Estimating survival in patients with gastrointestinal cancers and brain metastases: An update of the graded prognostic assessment for gastrointestinal cancers (GI-GPA).

Journal Article Clin Transl Radiat Oncol · September 2019 BACKGROUND: Patients with gastrointestinal cancers and brain metastases (BM) represent a unique and heterogeneous population. Our group previously published the Diagnosis-Specific Graded Prognostic Assessment (DS-GPA) for patients with GI cancers (GI-GPA) ... Full text Link to item Cite

Survival and prognostic factors in patients with gastrointestinal cancers and brain metastases: have we made progress?

Journal Article Transl Res · June 2019 The literature describing the prognosis of patients with gastrointestinal (GI) cancers and brain metastases (BM) is sparse. Our group previously published a prognostic index, the Graded Prognostic Assessment (GPA) for GI cancer patients with BM, based on 2 ... Full text Link to item Cite

Tumor subtype and other prognostic factors in breast cancer patients with brain metastases: The updated graded prognostic assessment (Breast-GPA).

Conference Journal of Clinical Oncology · May 20, 2019 1079 Background: Brain metastases (BM) are a common and fatal complication of breast cancer but survival varies widely based on various prognostic factors (PF). Hence, patient counseling and therapeutic decisions should be indivi ... Full text Cite

Safety and Efficacy of a Five-Fraction Stereotactic Body Radiotherapy Schedule for Centrally Located Non-Small-Cell Lung Cancer: NRG Oncology/RTOG 0813 Trial.

Journal Article J Clin Oncol · May 20, 2019 PURPOSE: Patients with centrally located early-stage non-small-cell lung cancer (NSCLC) are at a higher risk of toxicity from high-dose ablative radiotherapy. NRG Oncology/RTOG 0813 was a phase I/II study designed to determine the maximum tolerated dose (M ... Full text Link to item Cite

GOG 8020/210: Risk stratification of lymph node metastasis, disease progression and survival using single nucleotide polymorphisms in endometrial cancer: An NRG oncology/gynecologic oncology group study.

Journal Article Gynecol Oncol · May 2019 OBJECTIVES: The ability to stratify a patient's risk of metastasis and survival permits more refined care. A proof of principle study was undertaken to investigate the relationship between single nucleotide polymorphisms (SNPs) in literature based candidat ... Full text Link to item Cite

Prognostic indices for patients with brain metastases

Chapter · January 1, 2019 Patients with brain metastases are a heterogenous population. The epidemiology of brain metastases is addressed elsewhere in this textbook. In the past, outcomes were considered uniformly grim for all patients with brain metastases. We now know that outcom ... Full text Cite

Patient Selection in SBRT and SRS

Chapter · January 1, 2019 Stereotactic body radiotherapy (SBRT) and stereotactic radiosurgery (SRS) techniques can deliver highly conformal ablative doses of radiotherapy to relative small target volumes. These techniques are associated with excellent rates of local disease control ... Full text Cite

Estimating survival for renal cell carcinoma patients with brain metastases: an update of the Renal Graded Prognostic Assessment tool.

Journal Article Neuro Oncol · November 12, 2018 BACKGROUND: Brain metastases are a common complication of renal cell carcinoma (RCC). Our group previously published the Renal Graded Prognostic Assessment (GPA) tool. In our prior RCC study (n = 286, 1985-2005), we found marked heterogeneity and variation ... Full text Link to item Cite

Survival and Prognostic Factors in Patients with Gastrointestinal Cancers and Brain Metastases

Conference International Journal of Radiation Oncology*Biology*Physics · November 2018 Full text Cite

Prognostic models for patients with brain metastases after stereotactic radiosurgery with or without whole brain radiotherapy: a validation study.

Journal Article J Neurooncol · November 2018 PURPOSE/OBJECTIVE(S): To compare the performance of five prognostic models [RTOG recursive partitioning analysis (RPA), Score Index for Radiosurgery in Brain Metastases (SIR), Barnholtz-Sloan-Kattan nomogram (BSKN), diagnosis-specific Graded Prognostic Ass ... Full text Link to item Cite

Effect of Targeted Therapies on Prognostic Factors, Patterns of Care, and Survival in Patients With Renal Cell Carcinoma and Brain Metastases.

Journal Article Int J Radiat Oncol Biol Phys · July 15, 2018 PURPOSE: To identify prognostic factors, define evolving patterns of care, and the effect of targeted therapies in a larger contemporary cohort of renal cell carcinoma (RCC) patients with new brain metastases (BM). METHODS AND MATERIALS: A multi-institutio ... Full text Link to item Cite

In Regard to Churilla et al.

Journal Article Int J Radiat Oncol Biol Phys · May 1, 2018 Full text Link to item Cite

Cumulative Doses to Brain and Other Critical Structures After Multisession Gamma Knife Stereotactic Radiosurgery for Treatment of Multiple Metastatic Tumors.

Journal Article Front Oncol · 2018 PURPOSE: Repeat stereotactic radiosurgery (SRS) is an attractive alternative to whole brain radiation therapy (WBRT) for treatment of recurrent brain metastases (BM). The purpose of this study is to determine the cumulative doses to the brain and critical ... Full text Link to item Cite

Estimating Survival in Melanoma Patients With Brain Metastases: An Update of the Graded Prognostic Assessment for Melanoma Using Molecular Markers (Melanoma-molGPA).

Journal Article Int J Radiat Oncol Biol Phys · November 15, 2017 PURPOSE: To update the Diagnosis-Specific Graded Prognostic Assessment (DS-GPA) for a markedly heterogeneous patient population, patients with melanoma and brain metastases, using a larger, more current cohort, including molecular markers. METHODS: The ori ... Full text Link to item Cite

Prognostic Factors in Patients with Renal Cell Carcinoma and Brain Metastases

Conference International Journal of Radiation Oncology*Biology*Physics · October 2017 Full text Cite

The Prognostic Value of BRAF, C-KIT, and NRAS Mutations in Melanoma Patients With Brain Metastases.

Journal Article Int J Radiat Oncol Biol Phys · August 1, 2017 PURPOSE: Brain metastases are a common problem in patients with melanoma, but little is known about the effect of gene mutations on survival in these patients. METHODS AND MATERIALS: We created a retrospective multi-institutional database of 823 patients w ... Full text Link to item Cite

Adjuvant radiation therapy, androgen deprivation, and docetaxel for high-risk prostate cancer postprostatectomy: Results of NRG Oncology/RTOG study 0621.

Journal Article Cancer · July 1, 2017 BACKGROUND: Phase 3 trials have demonstrated a benefit from adjuvant radiation therapy (ART) for men who have adverse factors at radical prostatectomy (RP). However, some patients have a high risk of progression despite ART. The role of systemic therapy wi ... Full text Link to item Cite

Estimating Survival in Patients With Lung Cancer and Brain Metastases: An Update of the Graded Prognostic Assessment for Lung Cancer Using Molecular Markers (Lung-molGPA).

Journal Article JAMA Oncol · June 1, 2017 IMPORTANCE: Lung cancer is the leading cause of cancer-related mortality in the United States and worldwide. As systemic therapies improve, patients with lung cancer live longer and thus are at increased risk for brain metastases. Understanding how prognos ... Full text Link to item Cite

Significance of Co-expression of Epidermal Growth Factor Receptor and Ki67 on Clinical Outcome in Patients With Anal Cancer Treated With Chemoradiotherapy: An Analysis of NRG Oncology RTOG 9811.

Conference Int J Radiat Oncol Biol Phys · March 1, 2017 PURPOSE: To measure co-expression of EGFR and Ki67 proteins in pretreatment tumor biopsies of anal cancer patients enrolled on NRG Oncology RTOG 9811, a phase III trial comparing 5-fluorouracil/mitomycin-C/radiation therapy (Arm A) versus 5-fluorouracil/ci ... Full text Link to item Cite

The Effect of Gene Alterations and Tyrosine Kinase Inhibition on Survival and Cause of Death in Patients With Adenocarcinoma of the Lung and Brain Metastases.

Journal Article Int J Radiat Oncol Biol Phys · October 1, 2016 PURPOSE: Lung cancer remains the most common cause of both cancer mortality and brain metastases (BM). The purpose of this study was to assess the effect of gene alterations and tyrosine kinase inhibition (TKI) on median survival (MS) and cause of death (C ... Full text Link to item Cite

The Effect of Gene Mutations on Survival in Patients With Melanoma Following the Development of Brain Metastases

Conference INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS · October 1, 2016 Link to item Cite

Khan's Treatment Planning in Radiation Oncology

Book · June 17, 2016 New to this edition: Up-to-date material throughout reflects the most current practices in radiation oncology treatment. New chapters discuss the pros and cons of recent developments in the field: Role of Protons vs. ... Cite

Integrating bevacizumab and radiation treatment of brain metastasis: is there sense and sensibility in this approach?

Journal Article Ann Transl Med · January 2016 The incidence of brain metastasis has increased over the past decade. Standard treatment options for brain metastases include whole brain radiation therapy (WBRT), stereotactic radiosurgery (SRS) and surgery for patients with operable lesions and either ma ... Full text Link to item Cite

Indirect Tumor Cell Death After High-Dose Hypofractionated Irradiation: Implications for Stereotactic Body Radiation Therapy and Stereotactic Radiation Surgery.

Conference Int J Radiat Oncol Biol Phys · September 1, 2015 PURPOSE: The purpose of this study was to reveal the biological mechanisms underlying stereotactic body radiation therapy (SBRT) and stereotactic radiation surgery (SRS). METHODS AND MATERIALS: FSaII fibrosarcomas grown subcutaneously in the hind limbs of ... Full text Link to item Cite

A hypothesis: indirect cell death in the radiosurgery era.

Journal Article Int J Radiat Oncol Biol Phys · January 1, 2015 Full text Link to item Cite

Pituitary and pituitary region tumors: Viewpoint—fractionated radiation therapy

Chapter · January 1, 2015 Pituitary region tumors, including functional and nonfunctional pituitary adenomas, meningiomas, and craniopharyngiomas, are important and distinct benign entities that have both distinct and shared management issues. It is important to have multidisciplin ... Full text Cite

Secondary analysis of RTOG 9508, a phase 3 randomized trial of whole-brain radiation therapy versus WBRT plus stereotactic radiosurgery in patients with 1-3 brain metastases; poststratified by the graded prognostic assessment (GPA).

Conference Int J Radiat Oncol Biol Phys · November 1, 2014 PURPOSE: Radiation Therapy Oncology Group (RTOG) 9508 showed a survival advantage for patients with 1 but not 2 or 3 brain metastasis (BM) treated with whole-brain radiation therapy (WBRT) and stereotactic radiosurgery (SRS) versus WBRT alone. An improved ... Full text Link to item Cite

Radiobiological basis of SBRT and SRS.

Journal Article Int J Clin Oncol · August 2014 Stereotactic body radiation therapy (SBRT) and stereotactic radiosurgery (SRS) have been demonstrated to be highly effective for a variety of tumors. However, the radiobiological principles of SBRT and SRS have not yet been clearly defined. It is well know ... Full text Link to item Cite

The accuracy of predicting survival in individual patients with cancer.

Journal Article J Neurosurg · January 2014 OBJECT: Estimating survival time in cancer patients is crucial for clinicians, patients, families, and payers. To provide appropriate and cost-effective care, various data sources are used to provide rational, reliable, and reproducible estimates. The accu ... Full text Link to item Cite

In reply to Robins et al.

Journal Article Int J Radiat Oncol Biol Phys · August 1, 2013 Full text Link to item Cite

The effect of tumor subtype on the time from primary diagnosis to development of brain metastases and survival in patients with breast cancer.

Journal Article J Neurooncol · May 2013 Our group has previously published the Diagnosis-Specific Graded Prognostic Assessment (GPA) showing the prognostic factors associated with survival in patients with brain metastases (BM). The purpose of this study is to investigate the relationship of bre ... Full text Link to item Cite

A phase 3 trial of whole brain radiation therapy and stereotactic radiosurgery alone versus WBRT and SRS with temozolomide or erlotinib for non-small cell lung cancer and 1 to 3 brain metastases: Radiation Therapy Oncology Group 0320.

Journal Article Int J Radiat Oncol Biol Phys · April 1, 2013 BACKGROUND: A phase 3 Radiation Therapy Oncology Group (RTOG) study subset analysis demonstrated improved overall survival (OS) with the addition of stereotactic radiosurgery (SRS) to whole brain radiation therapy (WBRT) in non-small cell lung cancer (NSCL ... Full text Link to item Cite

In regard to Yamamoto et al.

Journal Article Int J Radiat Oncol Biol Phys · November 15, 2012 Full text Link to item Cite

Reply to M.C. Chamberlain et al

Journal Article Journal of Clinical Oncology · September 10, 2012 Full text Cite

A nomogram for individualized estimation of survival among patients with brain metastasis.

Journal Article Neuro Oncol · July 2012 PURPOSE: An estimated 24%-45% of patients with cancer develop brain metastases. Individualized estimation of survival for patients with brain metastasis could be useful for counseling patients on clinical outcomes and prognosis. METHODS: De-identified data ... Full text Link to item Cite

Effect of tumor subtype on survival and the graded prognostic assessment for patients with breast cancer and brain metastases.

Journal Article Int J Radiat Oncol Biol Phys · April 1, 2012 PURPOSE: The diagnosis-specific Graded Prognostic Assessment (GPA) was published to clarify prognosis for patients with brain metastases. This study refines the existing Breast-GPA by analyzing a larger cohort and tumor subtype. METHODS AND MATERIALS: A mu ... Full text Link to item Cite

Summary report on the graded prognostic assessment: an accurate and facile diagnosis-specific tool to estimate survival for patients with brain metastases.

Journal Article J Clin Oncol · February 1, 2012 PURPOSE: Our group has previously published the Graded Prognostic Assessment (GPA), a prognostic index for patients with brain metastases. Updates have been published with refinements to create diagnosis-specific Graded Prognostic Assessment indices. The p ... Full text Link to item Cite

Radiotherapeutic and surgical management for newly diagnosed brain metastasis(es): An American Society for Radiation Oncology evidence-based guideline.

Journal Article Pract Radiat Oncol · 2012 PURPOSE: To systematically review the evidence for the radiotherapeutic and surgical management of patients newly diagnosed with intraparenchymal brain metastases. METHODS AND MATERIALS: Key clinical questions to be addressed in this evidence-based Guideli ... Full text Link to item Cite

Reply to Drs. mulvenna and holt

Journal Article International Journal of Radiation Oncology Biology Physics · November 15, 2011 Full text Cite

The effect of tumor subtype on survival and the graded prognostic assessment (GPA) for patients with breast cancer and brain metastases.

Conference Journal of Clinical Oncology · September 20, 2011 238 Background: The Diagnosis-Specific Graded Prognostic Assessment (DS-GPA) was published to clarify prognosis for patients with brain metastases. This study refines the existing Breast GPA by analyzing a larger cohort and tumor ... Full text Cite

Diagnosis-specific prognostic factors, indexes, and treatment outcomes for patients with newly diagnosed brain metastases: a multi-institutional analysis of 4,259 patients.

Journal Article Int J Radiat Oncol Biol Phys · July 1, 2010 PURPOSE: Controversy endures regarding the optimal treatment of patients with brain metastases (BMs). Debate persists, despite many randomized trials, perhaps because BM patients are a heterogeneous population. The purpose of the present study was to ident ... Full text Link to item Cite

Stereotactic radiosurgery in the management of brain metastases from primary thyroid cancers.

Conference J Neurooncol · June 2010 Patients with metastatic well-differentiated thyroid cancer have a generally favorable long-term outcome although multi-organ involvement is a known marker of poor prognosis. Brain metastases are rare, occurring in less than 1% of patients with thyroid can ... Full text Link to item Cite

Twenty-year survival in glioblastoma: a case report and molecular profile.

Journal Article Int J Radiat Oncol Biol Phys · November 15, 2009 BACKGROUND: The prognosis for patients with glioblastoma (GB) remains grim. Historically, the median survival has been 6 to 9 months. Recent research has improved the outcome slightly. A computer search of the literature reveals few long-term survivors. ME ... Full text Link to item Cite

A validation study of a new prognostic index for patients with brain metastases: the Graded Prognostic Assessment.

Journal Article J Neurosurg · December 2008 OBJECT: The purpose of this study was to validate a new prognostic index for patients with brain metastases. This index, the Graded Prognostic Assessment (GPA), is based on an analysis of 1960 patients whose data were extracted from the Radiation Therapy O ... Full text Link to item Cite

In Reply to Drs. Nieder and Molls

Journal Article International Journal of Radiation Oncology Biology Physics · December 1, 2008 Full text Cite

In Reply to Drs. Weltman and Brandt

Journal Article International Journal of Radiation Oncology Biology Physics · March 15, 2008 Full text Cite

A new prognostic index and comparison to three other indices for patients with brain metastases: an analysis of 1,960 patients in the RTOG database.

Journal Article Int J Radiat Oncol Biol Phys · February 1, 2008 PURPOSE: The purpose of this study is to introduce a new prognostic index for patients with brain metastases and compare it with three published indices. Treatment for brain metastases varies widely. A sound prognostic index is thus important to guide both ... Full text Link to item Cite

Whole brain radiation therapy with or without stereotactic radiosurgery boost for patients with one to three brain metastases: phase III results of the RTOG 9508 randomised trial.

Journal Article Lancet · May 22, 2004 BACKGROUND: Brain metastases occur in up to 40% of all patients with systemic cancer. We aimed to assess whether stereotactic radiosurgery provided any therapeutic benefit in a randomised multi-institutional trial directed by the Radiation Therapy Oncology ... Full text Link to item Cite

A review of stereotactic radiosurgery in the management of brain metastases.

Journal Article Technol Cancer Res Treat · April 2003 This review addresses the epidemiology, historical reports, current issues, data and controversies involved in the management of brain metastases. The literature regarding surgery, whole brain radiation therapy, stereotactic radiosurgery or some combinatio ... Full text Link to item Cite

A multi-institutional review of radiosurgery alone vs. radiosurgery with whole brain radiotherapy as the initial management of brain metastases.

Journal Article Int J Radiat Oncol Biol Phys · July 1, 2002 PURPOSE: Data collected from 10 institutions were reviewed to compare survival probabilities of patients with newly diagnosed brain metastases managed initially with radiosurgery (RS) alone vs. RS + whole brain radiotherapy (WBRT). METHODS AND MATERIALS: A ... Full text Link to item Cite

Radiosurgery for patients with brain metastases: a multi-institutional analysis, stratified by the RTOG recursive partitioning analysis method.

Journal Article Int J Radiat Oncol Biol Phys · October 1, 2001 PURPOSE: To estimate the potential improvement in survival for patients with brain metastases, stratified by the Radiation Therapy Oncology Group (RTOG) recursive partitioning analysis (RPA) class and treated with radiosurgery (RS) plus whole brain radioth ... Full text Link to item Cite

Effects of advanced nursing care on quality of life and cost outcomes of women diagnosed with breast cancer.

Journal Article Oncol Nurs Forum · July 2000 PURPOSE/OBJECTIVES: To evaluate quality of life (QOL) and cost outcomes of advanced practice nurses' (APNs') interventions with women diagnosed with breast cancer. DESIGN: Randomized clinical trial. SETTING: Integrated healthcare system in a midwestern sub ... Link to item Cite

Purchasing oncology services. Kerr L. White Institute/American Cancer Society Task Force on Purchasing Oncology Services.

Journal Article Cancer · June 15, 2000 BACKGROUND: A multidisciplinary panel representing various stakeholders in the health care delivery and oncology services marketplace was convened to develop specific criteria for healthcare purchasers to consider when evaluating the structures and process ... Link to item Cite

Prognostic factors after conservative surgery and radiation therapy for early stage breast cancer.

Journal Article Am J Clin Oncol · April 1998 A retrospective review was conducted of all early-stage breast cancer patients treated with breast-conservation surgery plus radiation therapy (BCS/RT) to determine mortality and recurrence rates and to evaluate prognostic factors for these outcomes. Betwe ... Full text Link to item Cite

35. RTOG 9508: A prospective randomized trial of stereotactic radiosurgery and whole brain radiation therapy versus whole brain radiation therapy alone in patients with 1-3 brain métastases patients; results and salvage therapy analyses

Journal Article Cancer Journal · December 1, 1996 Purpose/Objective: To determine if Stereotactic radiosurgery (SRS) after conventional whole brain radiation therapy (WERT) improves overall survival when compared to WERT alone in patients with 1-3 brain métastases. Materials / Methods: Between 1/96 and 6/ ... Cite

Stereotactic radiosurgery in pediatric patients.

Journal Article Pediatr Neurol · October 1996 Although stereotactic radiosurgery has been studied extensively in adults, the data demonstrating its efficacy in children is limited. Medical records were reviewed to identify the indications for and outcomes of patients treated with this modality. Linear ... Full text Link to item Cite

Stereotactic radiosurgery for recurrent malignant gliomas.

Journal Article J Clin Oncol · July 1995 PURPOSE: To evaluate the role of stereotactic radiosurgery in the management of recurrent malignant gliomas. PATIENTS AND METHODS: We treated 35 patients with large (median treatment volume, 28 cm3) recurrent tumors that had failed to respond to convention ... Full text Link to item Cite

Neuropsychological effects of cranial radiation: current knowledge and future directions.

Journal Article Int J Radiat Oncol Biol Phys · February 15, 1995 Radiation is an invaluable therapeutic tool in the treatment of cancer, with well-established palliative and curative efficacy. As patient survival has improved, attention has focused on long-range treatment side effects. One such adverse effect, neuropsyc ... Full text Link to item Cite

The in vitro radiosensitization of human glioblastoma with pentoxifylline.

Journal Article Am J Clin Oncol · October 1993 There is evidence that pentoxifylline may be both a radioprotector of normal tissue and a radiosensitizer of tumor cells. This article reviews this evidence and then describes our own laboratory study to determine whether pentoxifylline is a radiosensitize ... Full text Link to item Cite

Photodynamic therapy for chest wall recurrence in breast cancer.

Journal Article Int J Radiat Oncol Biol Phys · July 1991 Photodynamic therapy is the use of a sensitizer (dihematoporphyrin ethers) which is preferentially retained in tumor cells and activated by subsequent light delivery resulting in a selective tumoricidal effect. Between 1986 and 1989, we treated 20 patients ... Full text Link to item Cite

Spontaneous regression of squamous cell lung carcinoma with adrenal metastasis.

Journal Article Chest · October 1988 A 61-year-old man was found to have squamous cell carcinoma of the left hilum with metastasis to the left adrenal gland documented by needle aspiration. About two years later, the primary tumor is not detectable, and the adrenal gland is of normal size on ... Full text Link to item Cite

Knee flexion contractures in myelodysplasia.

Journal Article South Med J · July 1986 From 1976 to 1982, 12 children with myelodysplasia had surgery at our institution for knee flexion contractures (21 affected knees). Follow-up was a minimum of 18 months and averaged 47 months. Soft tissue lengthening of the hamstring tendons and release o ... Full text Link to item Cite