Scholars@Duke
Rachel Catherine Blitzblau

Rachel Catherine Blitzblau

Associate Professor of Radiation Oncology
Radiation Oncology
rachel.blitzblau@duke.edu
Duke University/Radiation Onco, Box 3085, Durham, NC 27710
Morris Bldg White Zone Subbase, Box 3085, Durham, NC 27710

Selected Publications

Understanding and modeling human-AI interaction of artificial intelligence tool in radiation oncology clinic using deep neural network: a feasibility study using three year prospective data.

Journal Article Phys Med Biol · November 14, 2024 Objective.Artificial intelligence (AI) based treatment planning tools are being implemented in clinic. However, human interactions with such AI tools are rarely analyzed. This study aims to comprehend human planner's interaction with the AI planning tool a ... Full text Link to item Cite

NCCN Guidelines® Insights: Merkel Cell Carcinoma, Version 1.2024.

Journal Article J Natl Compr Canc Netw · January 2024 The NCCN Guidelines for Merkel Cell Carcinoma (MCC) provide recommendations for diagnostic workup, clinical stage, and treatment options for patients. The panel meets annually to discuss updates to the guidelines based on comments from expert review from p ... Full text Link to item Cite

Basal Cell Skin Cancer, Version 2.2024, NCCN Clinical Practice Guidelines in Oncology.

Journal Article J Natl Compr Canc Netw · November 2023 Basal cell carcinoma (BCC) is the most common form of skin cancer in the United States. Due to the high frequency, BCC occurrences are not typically recorded, and annual rates of incidence can only be estimated. Current estimated rates are 2 million Americ ... Full text Link to item Cite

Optimizing Adjuvant Treatment Recommendations for Older Women with Biologically Favorable Breast Cancer: Short-Course Radiation or Long-Course Endocrine Therapy?

Journal Article Curr Oncol · December 27, 2022 Omission of radiotherapy among older women taking 5 years of adjuvant endocrine therapy following breast conserving surgery for early-stage, hormone sensitive breast cancers is well-studied. However, endocrine therapy toxicities are significant, and many w ... Full text Link to item Cite

Early-stage Breast Cancer: Tailored External Beam Fractionation Approaches for Treatment of the Whole or Partial Breast.

Journal Article Semin Radiat Oncol · July 2022 Historically, radiotherapy fractionation for early-stage breast cancer primarily consisted of 1.8-2 Gy per fraction given once daily to a total dose of 45-66 Gy over 5-7 weeks for whole breast treatment. Partial breast treatment employed larger dose per fr ... Full text Link to item Cite

Postoperative Comprehensive Radiation with Curative Intent.

Journal Article Int J Radiat Oncol Biol Phys · July 1, 2022 Full text Link to item Cite

Utilization of neoadjuvant chemotherapy in high-risk, node-negative early breast cancer.

Journal Article Cancer Med · February 2022 BACKGROUND: Controversy exists regarding the optimal sequence of chemotherapy among women with operable node-negative breast cancers with high-risk tumor biology. We evaluated national patterns of neoadjuvant chemotherapy (NACT) use among women with early- ... Full text Link to item Cite

Breast Cancer

Chapter · 2022 Cite

Dosimetric variation in preoperative partial breast radiosurgery assessed by deformable image registrations.

Journal Article J Radiosurg SBRT · 2022 OBJECTIVE: To assess dosimetric variation caused by breast deformation in breast radiosurgery based on deformable image registration. METHODS: This study included 30 patients who were treated in the prone position for preoperative partial breast radiosurge ... Link to item Cite

NCCN Guidelines® Insights: Squamous Cell Skin Cancer, Version 1.2022.

Journal Article J Natl Compr Canc Netw · December 2021 The NCCN Guidelines for Squamous Cell Skin Cancer provide recommendations for diagnostic workup, clinical stage, and treatment options for patients with cutaneous squamous cell carcinoma. The NCCN panel meets annually to discuss updates to the guidelines b ... Full text Link to item Cite

Radiation Oncology Provider Telehealth Satisfaction: Survey Results From a Single NCI-Designated Institution.

Conference International journal of radiation oncology, biology, physics · November 2021 Purpose/objective(s)Telehealth (TH) for radiation oncology services has emerged as a new modality for care delivery and will likely persist beyond the COVID pandemic. Data regarding radiation oncology provider satisfaction of TH are limited and es ... Full text Cite

Clinical Experience With Machine Learning-Based Automated Treatment Planning for Whole Breast Radiation Therapy.

Journal Article Adv Radiat Oncol · 2021 PURPOSE: The machine learning-based automated treatment planning (MLAP) tool has been developed and evaluated for breast radiation therapy planning at our institution. We implemented MLAP for patient treatment and assessed our clinical experience for its p ... Full text Open Access Link to item Cite

Optimizing Radiation Therapy to Boost Systemic Immune Responses in Breast Cancer: A Critical Review for Breast Radiation Oncologists.

Journal Article Int J Radiat Oncol Biol Phys · September 1, 2020 Immunotherapy using immune checkpoint blockade has revolutionized the treatment of many types of cancer. Radiation therapy (RT)-particularly when delivered at high doses using newer techniques-may be capable of generating systemic antitumor effects when co ... Full text Link to item Cite

Overall health at diagnosis predicts the risk of complications within the first year after breast cancer diagnosis.

Journal Article Breast Cancer Res Treat · July 2020 PURPOSE: Breast cancer patients with overall poor health are at a greater risk of both complications during treatment and mortality from competing causes. We sought to determine the association of pre-existing comorbidities on treatment-related complicatio ... Full text Link to item Cite

Clinical Experience of the Machine Learning-based Automated Treatment Planning Tool for Breast Radiotherapy

Conference INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS · 2020 Cite

Immediate Breast Reconstruction Allows for the Timely Initiation of Postmastectomy Radiation Therapy.

Journal Article Plast Reconstr Surg · September 2019 BACKGROUND: Complications from breast reconstruction may delay postmastectomy radiation therapy and impact breast cancer outcomes. The authors hypothesized that immediate breast reconstruction may be associated with delays in the initiation of radiation, b ... Full text Link to item Cite

Erratum to: Blitzblau RC, Horton JK. First, Do No Harm. Int J Radiat Oncol Biol Phys 2019;103:295-296.

Journal Article International Journal of Radiation Oncology*Biology*Physics · July 2019 Full text Cite

Surgical Resection of the Primary Tumor in Women With De Novo Stage IV Breast Cancer: Contemporary Practice Patterns and Survival Analysis.

Journal Article Ann Surg · March 2019 OBJECTIVE: We evaluated patterns of surgical care and their association with overall survival among a contemporary cohort of women with stage IV breast cancer. BACKGROUND: Surgical resection of the primary tumor remains controversial among women with stage ... Full text Link to item Cite

First, Do No Harm.

Journal Article Int J Radiat Oncol Biol Phys · February 1, 2019 Full text Link to item Cite

Goal-Driven Beam Setting Optimization for Whole-Breast Radiation Therapy.

Journal Article Technol Cancer Res Treat · January 1, 2019 PURPOSE: To develop an automated optimization program to generate optimal beam settings for whole-breast radiation therapy driven by clinically oriented goals. MATERIALS AND METHODS: Forty patients were retrospectively included in this study. Each patient' ... Full text Open Access Link to item Cite

Automatic Planning of Whole Breast Radiation Therapy Using Machine Learning Models.

Journal Article Front Oncol · 2019 Purpose: To develop an automatic treatment planning system for whole breast radiation therapy (WBRT) based on two intensity-modulated tangential fields, enabling near-real-time planning. Methods and Materials: A total of 40 WBRT plans from a single institu ... Full text Open Access Link to item Cite

Findings on Surveillance Imaging After Preoperative Partial Breast Irradiation for Early Stage Breast Cancer.

Journal Article Int J Radiat Oncol Biol Phys · November 15, 2018 PURPOSE: To evaluate the mammographic sequelae of preoperative accelerated partial breast irradiation (APBI) delivered via either stereotactic radiosurgery or a conventionally fractionated regimen. METHODS AND MATERIALS: This multicenter, retrospective stu ... Full text Link to item Cite

Image-Guided Radiation Therapy (IGRT) for Preoperative Partial Breast Radiosurgery: A Single-Institution Experience

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

The Association of Extent of Axillary Surgery and Survival in Women with N2-3 Invasive Breast Cancer.

Journal Article Ann Surg Oncol · October 2018 BACKGROUND: Although surgical management of the axilla for breast cancer continues to evolve, axillary lymphadenectomy remains the standard of care for women with advanced nodal disease. We sought to evaluate national patterns of care in axillary surgery, ... Full text Link to item Cite

Merkel Cell Carcinoma, Version 1.2018, NCCN Clinical Practice Guidelines in Oncology.

Journal Article J Natl Compr Canc Netw · June 2018 This selection from the NCCN Guidelines for Merkel Cell Carcinoma (MCC) focuses on areas impacted by recently emerging data, including sections describing MCC risk factors, diagnosis, workup, follow-up, and management of advanced disease with radiation and ... Full text Link to item Cite

The Effect of Hospital Volume on Breast Cancer Mortality.

Journal Article Ann Surg · February 2018 OBJECTIVE: The aim of this study was to determine whether hospital volume was associated with mortality in breast cancer, and what thresholds of case volume impacted survival. BACKGROUND: Prior literature has demonstrated improved survival with treatment a ... Full text Link to item Cite

Cardiac Morbidity and Radiation Therapy for Breast Cancer.

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

Radiation therapy for the whole breast: Executive summary of an American Society for Radiation Oncology (ASTRO) evidence-based guideline.

Journal Article Pract Radiat Oncol · 2018 INTRODUCTION: The purpose of this guideline is to offer recommendations on fractionation for whole breast irradiation (WBI) with or without a tumor bed boost and guidance on treatment planning and delivery. METHODS AND MATERIALS: The American Society for R ... Full text Link to item Cite

Patient Age and Tumor Subtype Predict the Extent of Axillary Surgery Among Breast Cancer Patients Eligible for the American College of Surgeons Oncology Group Trial Z0011.

Journal Article Ann Surg Oncol · November 2017 BACKGROUND: The American College of Surgeons Oncology Group (ACOSOG) Z0011 trial established the safety of omitting axillary lymph node dissection (ALND) for early-stage breast cancer patients with limited nodal disease undergoing lumpectomy. We examined t ... Full text Link to item Cite

Cost Implications of an Evidence-Based Approach to Radiation Treatment After Lumpectomy for Early-Stage Breast Cancer.

Journal Article J Oncol Pract · April 2017 INTRODUCTION: Breast cancer treatment costs are rising, and identification of high-value oncology treatment strategies is increasingly needed. We sought to determine the potential cost savings associated with an evidence-based radiation treatment (RT) appr ... Full text Link to item Cite

Development of an Ultra-Fast, High-Quality Whole-Breast Radiation Therapy Treatment Planning System

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

Whose Disease Will Recur After Mastectomy for Early Stage, Node-Negative Breast Cancer? A Systematic Review.

Journal Article Clin Breast Cancer · December 2015 Effective local control is associated with improved overall survival, particularly for women with early-stage cancers. No other local therapy is typically offered to women with T1-2 N0 breast cancer after mastectomy, although in select women the 5-year loc ... Full text Link to item Cite

Biological Subtype Predicts Risk of Locoregional Recurrence After Mastectomy and Impact of Postmastectomy Radiation in a Large National Database.

Journal Article Int J Radiat Oncol Biol Phys · November 1, 2015 PURPOSE: To evaluate locoregional recurrence (LRR) after mastectomy and impact of postmastectomy radiation (PMRT) by breast cancer subtype. METHODS AND MATERIALS: Between 2000 and 2009, 5673 patients with stage I to III breast carcinoma underwent mastectom ... Full text Link to item Cite

Preoperative Single-Fraction Partial Breast Radiation Therapy: A Novel Phase 1, Dose-Escalation Protocol With Radiation Response Biomarkers.

Journal Article Int J Radiat Oncol Biol Phys · July 15, 2015 PURPOSE: Women with biologically favorable early-stage breast cancer are increasingly treated with accelerated partial breast radiation (PBI). However, treatment-related morbidities have been linked to the large postoperative treatment volumes required for ... Full text Link to item Cite

Abstract P2-12-07: The association between exercise behavior and patient-reported outcomes in women with early breast cancer receiving locoregional radiation therapy

Conference Cancer Research · May 1, 2015 AbstractPurpose/Objectives: RT is associated with acute treatment-related complications that can lead to poor quality of life (QOL) and fatigue. Exercise has been shown in other cancer treatment settings to ... Full text Cite

Abstract P1-15-10: Low utilization of hypofractionated radiotherapy for the treatment of early-stage breast cancer in the US

Conference Cancer Research · May 1, 2015 AbstractBackground: Large randomized controlled trials have shown that hypofractionated whole breast irradiation (HF-WBI) is not inferior to or more toxic than conventionally fractionated whole breast irradi ... Full text Cite

The use of adjuvant radiotherapy in elderly patients with early-stage breast cancer: changes in practice patterns after publication of Cancer and Leukemia Group B 9343.

Conference Cancer · January 15, 2015 BACKGROUND: The Cancer and Leukemia Group B (CALGB) 9343 randomized phase 3 trial established lumpectomy and adjuvant therapy with tamoxifen alone, rather than both radiotherapy and tamoxifen, as a reasonable treatment course for women aged >70 years with ... Full text Link to item Cite

Dosimetric comparison of preoperative single-fraction partial breast radiotherapy techniques: 3D CRT, noncoplanar IMRT, coplanar IMRT, and VMAT.

Journal Article J Appl Clin Med Phys · January 8, 2015 The purpose of this study was to compare dosimetric parameters of treatment plans among four techniques for preoperative single-fraction partial breast radiotherapy in order to select an optimal treatment technique. The techniques evaluated were noncoplana ... Full text Link to item Cite

Dosimetric comparison of preoperative single-fraction partial breast radiotherapy techniques: 3D CRT, noncoplanar IMRT, coplanar IMRT, and VMAT

Journal Article Journal of Applied Clinical Medical Physics · January 1, 2015 The purpose of this study was to compare dosimetric parameters of treatment plans among four techniques for preoperative single-fraction partial breast radiotherapy in order to select an optimal treatment technique. The techniques evaluated were noncoplana ... Cite

Exercise behavior and patient-reported outcomes in women with early breast cancer receiving locoregional radiation therapy.

Journal Article Pract Radiat Oncol · 2015 PURPOSE: Radiation therapy is associated with acute treatment-related complications that can lead to decreased quality of life (QOL). Exercise has been shown in other cancer treatment settings to improve negative outcomes. We conducted a prospective pilot ... Full text Link to item Cite

A phase 1 trial of preoperative partial breast radiation therapy: Patient selection, target delineation, and dose delivery.

Journal Article Pract Radiat Oncol · 2015 PURPOSE: Diffusion of accelerated partial breast irradiation into clinical practice is limited by the need for specialized equipment and training. The accessible external beam technique yields unacceptable complication rates, likely from large postoperativ ... Full text Link to item Cite

A PHASE II TRIAL OF BALLOON-CATHETER PARTIAL BREAST BRACHYTHERAPY OPTIMIZATION IN THE TREATMENT OF STAGE 0, I AND IIA BREAST CARCINOMA.

Journal Article J Radiat Oncol · December 2014 OBJECTIVES: (a) To prospectively determine if multidwell position dose delivery can decrease skin dose and resultant toxicity over single dwell balloon-catheter partial breast irradiation, and (b) to evaluate whether specific skin parameters could be safel ... Full text Link to item Cite

Whole-breast radiation therapy: the long and short of it.

Journal Article Int J Radiat Oncol Biol Phys · December 1, 2014 Full text Link to item Cite

Abstract P5-14-04: Preoperative single-fraction partial breast radiotherapy – Initial results from a novel phase I dose-escalation protocol with exploration of radiation response biomarkers

Conference Cancer Research · December 15, 2013 AbstractPurpose/Objectives(s): Women with biologically favorable early stage breast cancer are increasingly treated with accelerated partial breast techniques. However, many alternative techniques require co ... Full text Cite

Radiotherapy after mastectomy.

Journal Article Surg Oncol Clin N Am · July 2013 Classic randomized trials documented the benefit of postmastectomy radiotherapy in women with node-positive or locally advanced breast cancer. Modern advances in surgical therapy, systemic therapy, and radiotherapy, however, along with an improved understa ... Full text Link to item Cite

Treatment planning technique in patients receiving postmastectomy radiation therapy.

Journal Article Pract Radiat Oncol · 2013 Many of the technical subtleties involved in postmastectomy radiation treatment planning will never be addressed in a robust clinical trial setting. However, these issues are faced daily by practicing radiation oncologists with little to guide them in the ... Full text Link to item Cite

Rare BRCA1 haplotypes including 3'UTR SNPs associated with breast cancer risk.

Journal Article Cell Cycle · January 1, 2011 Genetic markers identifying women at an increased risk of developing breast cancer exist, yet the majority of inherited risk remains elusive. While numerous BRCA1 coding sequence mutations are associated with breast cancer risk, BRCA1 mutations account for ... Full text Link to item Cite

MicroRNA binding-site polymorphisms as potential biomarkers of cancer risk.

Journal Article Mol Diagn Ther · December 1, 2010 Identification of people or populations at risk for developing cancer is a key to improved screening programs and earlier detection, with the hope of a commensurate reduction in cancer mortalities. Genetic alterations that change gene expression levels hav ... Full text Link to item Cite

A KRAS-variant in ovarian cancer acts as a genetic marker of cancer risk.

Journal Article Cancer Res · August 15, 2010 Featured Publication Ovarian cancer (OC) is the single most deadly form of women's cancer, typically presenting as an advanced disease at diagnosis in part due to a lack of known risk factors or genetic markers of risk. The KRAS oncogene and altered levels of the microRNA (miR ... Full text Link to item Cite

Surveillance, Epidemiology, and End Results (SEER) database analysis of microcystic adnexal carcinoma (sclerosing sweat duct carcinoma) of the skin.

Journal Article Am J Clin Oncol · April 2010 Featured Publication BACKGROUND: Microcystic adnexal carcinoma (MAC) is a very rare cancer of the skin. It has only been described previously in case reports and small retrospective series. OBJECTIVE: To analyze and summarize data from the National Cancer Institute, Surveillan ... Full text Link to item Cite

Dystrophin and utrophin isoforms are expressed in glia, but not neurons, of the avian parasympathetic ciliary ganglion.

Journal Article Brain Res · July 7, 2008 Featured Publication Muscular dystrophy patients often show cognitive impairment, in addition to muscle degeneration caused by dystrophin gene defects. The cognitive impairments lead to speculation that the dystrophin protein family may play a key role at neuronal synapses. Dy ... Full text Link to item Cite

Analysis of primary CD30+ cutaneous lymphoproliferative disease and survival from the Surveillance, Epidemiology, and End Results database.

Journal Article J Clin Oncol · March 20, 2008 Featured Publication PURPOSE: Primary CD30+ cutaneous lymphoproliferative disease (PCLPD) is a spectrum of indolent cutaneous T-cell lymphomas. The primary intention of the analysis of the National Cancer Institute Surveillance, Epidemiology, and End Results (SEER) database wa ... Full text Link to item Cite

Analysis of Gastric MALT Lymphomas Identified in the SEER Database

Conference International Journal of Radiation Oncology*Biology*Physics · November 2007 Full text Cite

Characterization of Non-Gastric MALT Lymphomas Identified in the SEER Database

Conference International Journal of Radiation Oncology*Biology*Physics · November 2007 Full text Cite

Regulatory mechanisms that govern nicotinic synapse formation in neurons.

Journal Article J Neurobiol · December 2002 Featured Publication Individual cholinoceptive neurons express high levels of different neuronal nicotinic acetylcholine receptor (nAChR) subtypes, and target them to the appropriate synaptic regions for proper function. This review focuses on the intercellular and intracellul ... Full text Link to item Cite

Expression of a variant form of the glutamate transporter GLT1 in neuronal cultures and in neurons and astrocytes in the rat brain.

Journal Article J Neurosci · March 15, 2002 Featured Publication To identify glutamate transporters expressed in forebrain neurons, we prepared a cDNA library from rat forebrain neuronal cultures, previously shown to transport glutamate with high affinity and capacity. Using this library, we cloned two forms, varying in ... Full text Link to item Cite

NMDA and glutamate evoke excitotoxicity at distinct cellular locations in rat cortical neurons in vitro.

Journal Article J Neurosci · December 1, 2000 Featured Publication The development of cortical neurons in vivo and in vitro is accompanied by alterations in NMDA receptor subunit expression and concomitant modifications in the pharmacological profile of NMDA-activated ionic currents. For example, we observed that with dec ... Full text Link to item Cite

Receptor targeting and heterogeneity at interneuronal nicotinic cholinergic synapses in vivo.

Journal Article J Physiol · May 15, 2000 Featured Publication Within a single neuron the correct targeting of the diverse neurotransmitter receptor types to discrete synaptic regions is crucial for proper function. However, the molecular mechanisms that underlie neuronal receptor clustering and targeting are still la ... Full text Link to item Cite

The glutamate transport inhibitor L-trans-pyrrolidine-2,4-dicarboxylate indirectly evokes NMDA receptor mediated neurotoxicity in rat cortical cultures.

Journal Article Eur J Neurosci · September 1996 Featured Publication Because of the well-documented importance of glutamate uptake in protecting neurons against glutamate toxicity, we were interested in testing the effects of L-trans-pyrrolidine-2,4-dicarboxylate (PDC) on rat cortical cultures. This compound is a substrate ... Full text Link to item Cite

Comparison of the potency of competitive NMDA antagonists against the neurotoxicity of glutamate and NMDA.

Journal Article J Neurochem · September 1994 Featured Publication The object of this investigation was to determine whether glutamate uptake affects the apparent potency of the competitive antagonists DL-2-amino-5-phosphonovalerate and CGS-19755 in blocking NMDA receptor-mediated neurotoxicity. In astrocyte-rich rat cort ... Full text Link to item Cite