Honors & Awards

  • R&E Foundation Resident Research Grant, Radiological Society of North America (RSNA) (2023)
  • Early Career Oncologist Award, American Radium Society (ARS) (2023)
  • ASTRO Resident Recognition Award, American Society for Radiation Oncology (ASTRO) (2022)
  • Oncology Fellows Educational Award, National Comprehensive Cancer Network (NCCN) (2022)
  • Luther Brady Educational Grant, American College of Radiation Oncology (ACRO) (2022)
  • Invited Speaker Honorarium, American Association of Medical Dosimetrists (AAMD) (2022)
  • ASTRO Meeting Abstract Award and Travel Grant, American Society for Radiation Oncology (ASTRO) (2021)
  • Speaker Travel Honorarium, American Association of Medical Dosimetrists (AAMD) (2022)
  • Department of Medicine Award for Exceptional Service and Dedication during the COVID-19 Pandemic, Flushing Hospital Medical Center (2020)
  • Inductee, Gold Humanism Honor Society (2018)
  • Pilot Project Research Award, Lake Champlain Cancer Research Organization (2018)
  • President, UVM College of Medicine Student Council (2017-2019)
  • Annual Meeting Podium Presenter Travel Grant, Northern New England Clinical Oncology Society (Regional ASCO) (2017)
  • Collaboration Research Grant, Northern New England Clinical Oncology Society (Regional ASCO) (2017)
  • Exemplary Clinical Skills Award, UVM College of Medicine Foundations Awards (2017)
  • Vermont Medical Scholars Award, UVM College of Medicine (2016, 2017)
  • Annual Meeting Selection Committee Travel Award, Northern New England Clinical Oncology Society (Regional ASCO) (2016)
  • Student-Led Research Grant, Northern New England Clinical Oncology Society (Regional ASCO) (2016)
  • A & M Goran Scholar, UVM College of Medicine (2015-2019)
  • Chair of Student Leadership, UVM College of Medicine Student Council (2015-2019)
  • Winston Sargent Merit Medical Scholarship Recipient, UVM College of Medicine (2015)
  • Speaker Travel Honorarium, American Association of Medical Dosimetrists (AAMD) (2014)

Boards, Advisory Committees, Professional Organizations

  • Member, Communications Committee, American Society for Radiation Oncology (ASTRO) (2023 - Present)
  • Ex-Officio Member, Membership Committee, American Society for Radiation Oncology (ASTRO) (2022 - Present)
  • Member, History Committee, American Society for Radiation Oncology (ASTRO) (2022 - Present)
  • Communications Chair, ARS-ROCKET Presidential Task Force, American Radium Society (ARS) (2021 - Present)

Professional Education

  • Residency, Stanford University, Radiation Oncology (2024)
  • Professional Education, Wharton School of The University of Pennsylvania, Certificate, Business of Healthcare (2022)
  • Internship, Flushing Hospital Medical Center, Internal Medicine (2020)
  • Medical Education, University of Vermont Larner College of Medicine, MD, Research Emphasis Track (2019)
  • Board Certification, Medical Dosimetrist Certification Board, CMD (2009)
  • Undergraduate Education, State University of New York Stonybrook, BS, Radiation Therapy (2006)

All Publications

  • Predicting Adverse Cardiac Events After Radiotherapy for Locally Advanced Non-Small Cell Lung Cancer. JACC. CardioOncology No, H. J., Guo, F. B., Park, N. J., Kastelowitz, N., Rhee, J. W., Clark, D. E., Chin, A. L., Vitzthum, L. K., Horst, K. C., Moding, E. J., Loo, B. W., Diehn, M., Binkley, M. S. 2023; 5 (6): 775-787


    Radiotherapy may cause grade ≥3 cardiac events, necessitating a better understanding of risk factors. The potential predictive role of imaging biomarkers with radiotherapy doses for cardiac event occurrence has not been studied.The aim of this study was to establish the associations between cardiac substructure dose and coronary artery calcium (CAC) scores and cardiac event occurrence.A retrospective cohort analysis included patients with locally advanced non-small cell lung cancer treated with radiotherapy (2006-2018). Cardiac substructures, including the left anterior descending coronary artery, left main coronary artery, left circumflex coronary artery, right coronary artery, and TotalLeft (left anterior descending, left main, and left circumflex coronary arteries), were contoured. Doses were measured in 2-Gy equivalent units, and visual CAC scoring was compared with automated scoring. Grade ≥3 adverse cardiac events were recorded. Time-dependent receiver-operating characteristic modeling, the log-rank statistic, and competing-risk models were used to measure prediction performance, threshold modeling, and the cumulative incidence of cardiac events, respectively.Of the 233 eligible patients, 61.4% were men, with a median age of 68.1 years (range: 34.9-90.7 years). The median follow-up period was 73.7 months (range: 1.6-153.9 months). Following radiotherapy, 22.3% experienced cardiac events, within a median time of 21.5 months (range: 1.7-118.9 months). Visual CAC scoring showed significant correlation with automated scoring (r = 0.72; P < 0.001). In a competing-risk multivariable model, TotalLeft volume receiving 15 Gy (per 1 cc; HR: 1.38; 95% CI: 1.11-1.72; P = 0.004) and CAC score >5 (HR: 2.51; 95% CI: 1.08-5.86; P = 0.033) were independently associated with cardiac events. A model incorporating age, TotalLeft CAC (score >5), and volume receiving 15 Gy demonstrated a higher incidence of cardiac events for a high-risk group (28.9%) compared with a low-risk group (6.9%) (P < 0.001).Adverse cardiac events associated with radiation occur in more than 20% of patients undergoing thoracic radiotherapy within a median time of <2 years. The present findings provide further evidence to support significant associations between TotalLeft radiotherapy dose and cardiac events and define CAC as a predictive risk factor.

    View details for DOI 10.1016/j.jaccao.2023.08.007

    View details for PubMedID 38205000

    View details for PubMedCentralID PMC10774791

  • Performance Analysis of a Radiation Oncology Educational Podcast. Journal of the American College of Radiology : JACR Wu, T. C., No, H. J., Rahimy, E., Kishan, A. U., Steinberg, M. L., Raldow, A. C., Beadle, B. M. 2023


    Asynchronous podcast education is a popular supplementary tool with up to 88% of medical residents reporting its use. Radiation Oncology podcasts remain scarce. We analyze the early performance, listenership, and engagement of the first education-specific Radiation Oncology medical podcast.Episode data and listener demographics were gathered from Spotify and Apple Podcasts. Episodes were case based, categorized by disease subsite, and reviewed by a board-certified radiation oncologist. Listenership was defined by the number of plays per day (ppd) on unique devices, averaged up to 60 days from publication. Episode engagement was defined as a percentage of plays on unique devices playing >40% of an episode within a single session. Quantitative endpoints included episode engagement and listenership. Pearson's correlation coefficient calculations were used for analysis.From July 2022 to March 2023, twenty total episodes had 13,078 total plays over 227 days. Median episode length was 13.8 minutes (range 9.2-20.1). Listener demographics included 54.4% male, 44.0% female, 1.3% not specified, and 0.3% non-binary, ranging from ages 18-22 (1%), 23-27 (13%), 28-34 (58%), 35-44 (22%), 45-59 (4%), and 60+ (2%) years. Episodes were played in 53 countries, with the most plays in North America (71.5%), followed by Asia (10.2%), Europe (8.2%), Oceania (8.0%), Africa (1.5%), and South America (0.5%). There was a 585.2% increase in listenership since initiation with median growth of 46.0% per month. Median listenership and engagement were 11.3 ppd (IQR, 10.3-13.8 ppd) and 81.4% (IQR, 72.0-84.2%) for all episodes, respectively. A significant negative relationship between episode length and engagement was observed (r(20) = -0.51, P=0.02). There were no statistically significant relationship between ppd and episode length (r(20) = -0.19, P=0.42).The significant rise in listenership, high episode engagement, and large international audience supports a previously unmet need in Radiation Oncology medical education that may be supplemented by podcasts.

    View details for DOI 10.1016/j.jacr.2023.06.026

    View details for PubMedID 37516159

  • Clinical LINAC-based electron FLASH: Pathway for practical translation to FLASH clinical trials: LINAC electron FLASH. International journal of radiation oncology, biology, physics No, H. J., Wu, Y. F., Dworkin, M. L., Manjappa, R., Skinner, L., Ashraf, M. R., Lau, B., Melemenidis, S., Viswanathan, V., Yu, A. S., Surucu, M., Schüler, E., Graves, E. E., Maxim, P. G., Loo, B. W. 2023


    Ultra-high dose rate (UHDR) radiotherapy (RT) has produced the FLASH effect in preclinical models: reduced toxicity with comparable tumor control compared to conventional dose rate RT. Early clinical trials focused on UHDR RT feasibility using specialized devices. We explore the technical feasibility of practical electron UHDR RT on a standard clinical linear accelerator (LINAC).We tuned the program board of a decommissioned electron energy for UHDR electron delivery on a clinical LINAC, without hardware modification. Pulse delivery was controlled using the respiratory gating interface. A short SSD electron set-up with a standard scattering foil was configured and tested on an anthropomorphic phantom using circular blocks with 3-20 cm field sizes. Dosimetry was evaluated using radiochromic film and an ion chamber profiler.UHDR open field mean dose rates at 100, 80, 70, and 59 cm SSD were 36.82, 59.52, 82.01, and 112.83 Gy/s, respectively. At 80 cm SSD, mean dose rate was ∼60 Gy/s for all collimated field sizes, with an R80 depth of 6.1 cm corresponding to an energy of 17.5 MeV. Heterogeneity was <5.0% with asymmetry of 2.2 to 6.2%. The short SSD set-up was feasible under realistic treatment conditions simulating broad clinical indications on an anthropomorphic phantom.Short SSD and tuning for high electron beam current on a standard clinical LINAC can deliver flat, homogenous UHDR electrons over a broad, clinically relevant range of field sizes and depths with practical working distances, in a configuration easily reversible to standard clinical use.

    View details for DOI 10.1016/j.ijrobp.2023.04.011

    View details for PubMedID 37105403

  • Pulmonary Hemorrhage in Patients Treated with Thoracic Stereotactic Ablative Radiotherapy and Anti-Angiogenic Agents. Journal of thoracic oncology : official publication of the International Association for the Study of Lung Cancer Lau, B., Wu, Y. F., No, H. J., Ko, R. B., Devine, M., Das, M. S., Neal, J. W., Wakelee, H. A., Ramchandran, K., Gensheimer, M. F., Diehn, M., Chin, A. L., Loo, B. W., Vitzthum, L. K. 2023


    Severe pulmonary hemorrhage can occur in patients treated with thoracic stereotactic ablative radiotherapy (SABR) and vascular endothelial growth factor inhibitors (VEGFi). There is limited understanding of which patients are at risk for toxicity with the combination of thoracic SABR and VEGFis or how the risk differs over either therapy alone.We evaluated a prospectively maintained cohort of 690 patients with 818 pulmonary tumors treated with highly conformal SABR. Rates of any grade and grade-three-plus (G3+) pulmonary hemorrhage were compared between patients treated with or without VEGFi therapy across tumor locations. Outcomes were compared between patients treated with SABR + VEGFi and a propensity-matched cohort of those treated with VEGFi therapy alone.Treatment with VEGFi + SABR was associated with higher rates of G3+ pulmonary hemorrhage compared to those treated with SABR alone for the overall cohort (3-year incidence: 7.9% vs 0.6%, p<0.01) and those with central tumors (19.1% vs 3.3%, p=0.04). When further subdivided, there were significantly higher toxicity rates with VEGFi for the ultracentral (9.0% vs 45.0%, p = 0.044), but not central non-abutting tumors (0.0% vs 1.3% p = 0.69). There was an increased incidence of G3+ hemorrhage in patients treated with VEGFi + SABR compared to VEGFi alone (9.6 vs 1.3%, p=0.04).The combination of VEGFi and SABR was associated with an increased risk of high-grade pulmonary hemorrhage over either therapy alone. Low rates of toxicity were observed when excluding patients with SABR to ultracentral tumors and applying highly conformal SABR techniques.

    View details for DOI 10.1016/j.jtho.2023.04.007

    View details for PubMedID 37085030

  • Investigating and modeling positron emission tomography factors associated with large cell transformation from low-grade lymphomas. EJHaem Obeid, J. P., Hiniker, S. M., Schroers-Martin, J., Guo, H. H., No, H. J., Moding, E. J., Advani, R. H., Alizadeh, A. A., Hoppe, R. T., Binkley, M. S. 2023; 4 (1): 90-99


    Low-grade lymphomas have a 1%-3% annual risk of transformation to a high-grade histology, and prognostic factors remain undefined. We set to investigate the role of positron emission tomography (PET) metrics in identification of transformation in a retrospective case-control series of patients matched by histology and follow-up time. We measured PET parameters including maximum standard uptake value (SUV-max) and total lesion glycolysis (TLG), and developed a PET feature and lactate dehydrogenase (LDH)-based model to identify transformation status within discovery and validation cohorts. For our discovery cohort, we identified 53 patients with transformation and 53 controls with a similar distribution of follicular lymphoma (FL). Time to transformation and control follow-up time was similar. We observed a significant incremental increase in SUV-max and TLG between control, pretransformation and post-transformation groups (P < 0.05). By multivariable analysis, we identified a significant interaction between SUV-max and TLG such that SUV-max had highest significance for low volume cases (P = 0.04). We developed a scoring model incorporating SUV-max, TLG, and serum LDH with improved identification of transformation (area under the curve [AUC] = 0.91). Our model performed similarly for our validation cohort of 23 patients (AUC = 0.90). With external and prospective validation, our scoring model may provide a specific and noninvasive tool for risk stratification for patients with low-grade lymphoma.

    View details for DOI 10.1002/jha2.615

    View details for PubMedID 36819184

    View details for PubMedCentralID PMC9928791

  • Serenity in the Bay International Journal of Radiation Oncology Biology Physics No, H. J. 2023; 115 (1): Cover Art
  • Regression of Malignant Pleural Mesothelioma in Absence of Chemotherapy or Surgery: A Case Series. Clinical lung cancer Nief, C. A., No, H. J., Louie, C. Y., Vitzthum, L., Das, M. 2022

    View details for DOI 10.1016/j.cllc.2022.10.002

    View details for PubMedID 36323592

  • Design and validation of a dosimetric comparison scheme tailored for ultra-high dose-rate electron beams to support multicenter FLASH preclinical studies. Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology Gonçalves Jorge, P., Melemenidis, S., Grilj, V., Buchillier, T., Manjappa, R., Viswanathan, V., Gondré, M., Vozenin, M. C., Germond, J. F., Bochud, F., Moeckli, R., Limoli, C., Skinner, L., Joshua No, H., Fred Wu, Y., Surucu, M., Yu, A. S., Lau, B., Wang, J., Schüler, E., Bush, K., Graves, E. E., Maxim, P. G., Loo, B. W., Bailat, C. 2022


    We describe a multicenter cross validation of ultra-high dose rate (UHDR) (>= 40 Gy/s) irradiation in order to bring a dosimetric consensus in absorbed dose to water. UHDR refers to dose rates over 100-1000 times those of conventional clinical beams. UHDR irradiations have been a topic of intense investigation as they have been reported to induce the FLASH effect in which normal tissues exhibit reduced toxicity relative to conventional dose rates. The need to establish optimal beam parameters capable of achieving the in vivo FLASH effect has become paramount. It is therefore necessary to validate and replicate dosimetry across multiple sites conducting UHDR studies with distinct beam configurations and experimental set-ups.Using a custom cuboid phantom with a cylindrical cavity (5 mm diameter by 10.4 mm length) designed to contain three type of dosimeters (thermoluminescent dosimeters (TLDs), alanine pellets, and Gafchromic films), irradiations were conducted at expected doses of 7.5 to 16 Gy delivered at UHDR or conventional dose rates using various electron beams at the Radiation Oncology Departments of the CHUV in Lausanne, Switzerland and Stanford University, CA.Data obtained between replicate experiments for all dosimeters were in excellent agreement (+/- 3 %). In general, films and TLDs were in closer agreement with each other, while alanine provided the closest match between the expected and measured dose, with certain caveats related to absolute reference dose.In conclusion, successful cross-validation of different electron beams operating under different energies and configurations lays the foundation for establishing dosimetric consensus for UHDR irradiation studies, and, if widely implemented, decrease uncertainty between different sites investigating the mechanistic basis of the FLASH effect.

    View details for DOI 10.1016/j.radonc.2022.08.023

    View details for PubMedID 36030934

  • Isolated Nodal Recurrence After Definitive Stereotactic Ablative Radiotherapy for Non-Small Cell Lung Cancer. Practical radiation oncology Devine, M., Merriott, D. J., No, H. J., Lau, B., Say, C., Yoo, C., Yi, E., Ko, R. B., Neal, J. W., Wakelee, H. A., Das, M., Loo, B. W., Diehn, M., Chin, A. L., Vitzthum, L. K. 2022


    Stereotactic ablative radiotherapy (SABR) results in high rates of primary tumor control for early-stage non-small cell lung cancer (NSCLC). For patients with isolated hilar or mediastinal nodal recurrences (INR) after SABR, the optimal salvage treatment strategy is unclear. The purpose of this study is to determine the rate of INR after SABR for early-stage NSCLC and to describe patterns of care and treatment outcomes after salvage therapy.This retrospective cohort study included 342 patients with Stage T1-3N0M0 NSCLC treated with definitive SABR from 2003-2018. We evaluated the incidence of INR and baseline factors between patients who did and did not experience INR. Among patients who experienced INR, we described treatment patterns and outcomes including overall (OS) and progression free survival (PFS) from the time of nodal failure using the Kaplan-Meier method.With a median follow-up of 3.3 years, the 3-year INR rate was 10.6% (6.6% -13.4%). Among the 34 patients experiencing INR, the 3-year rates of OS and PFS were 39.3% (24.4 - 63.3%) and 26.7% (14.1 - 50.3%), respectively. The 34 patients with INR were treated with RT alone (26.7 %), concurrent chemoradiotherapy (CRT) (43.3 %), chemotherapy alone (13.3%), or observation (16.7%). CRT had the best survival outcomes with a 3-year OS and PFS of 81.5% (61.1 - 100.0%) and 63.9% (40.7 - 100.0%), respectively. Of the patients treated with salvage RT or CRT, 14.3% experienced grade 3 toxicity with no patients having grade 4+ toxicity.INR occurred in approximately 10% of patients treated with SABR for early-stage NSCLC. The highest rates of OS an PFS among patients with INR were observed in those treated with salvage chemoradiotherapy.

    View details for DOI 10.1016/j.prro.2022.06.013

    View details for PubMedID 35858658

  • Characterization of Metastatic Non-Small Cell Lung Cancer and Oligometastatic Incidence in an Era of Changing Treatment Paradigms. International journal of radiation oncology, biology, physics No, H. J., Raja, N., Von Eyben, R., Das, M., Roy, M., Myall, N., Neal, J., Wakelee, H., Chin, A., Diehn, M., Loo, B. W., Chang, D. T., Pollom, E. L., Vitzthum, L. K. 2022


    Due to the limitations of current staging systems and evolving definitions, there are limited data on oligometastatic non-small cell lung cancer (NSCLC) epidemiology. The purpose of this study is to evaluate metastatic disease burden and the incidence of oligometastatic disease using recent clinical trial edibility criteria.A cohort of patients with metastatic NSCLC, diagnosed from 2016 to 2019, were randomly sampled from a curated tumor registry. Definitions for oligometastatic disease were obtained from relevant clinical trials. The Stanford Cancer Institute Research Database (SCIRDB) was used to identify baseline patient factors, systemic and local therapy, extent and location of metastatic lesions, and survival outcomes.Among 120 patients presenting with metastatic NSCLC, the majority had de novo metastatic disease (75%) with a median of 4 metastatic lesions involving 3 organ systems. 37.5% would have been eligible for at least one oligometastatic trial with 28.3% meeting criteria for MDACC, 20.0% for NRG-LU002, 6.7% for SINDAS and 16.7% for SABR-COMET. By adding malignant pleural effusions (MPE) and early progression as exclusionary criteria, only 54.1% of patients with ≤3 synchronous metastases were eligible for consideration of local therapy. Early progression on systemic therapy was associated with worse survival (10.0 vs. 42.4 months, p < 0.001), whereas presence of MPE was not. Of those tumors identified as oligometastatic, 44.4% received local therapy and 28.9% underwent ablative therapy to all sites. There was a trend towards greater overall survival (44.4 vs 24.9 months, p=0.055) and progression free survival (8.0 vs. 5.4 months, p=0.06) in patients meeting eligibility for at least one oligometastatic trial.Around 48% of patients with metastatic NSCLC had ≤3 metastases at presentation and 28% met clinical trial criteria for oligometastatic disease. Future research is needed to better define the oligometastatic state and identify patients most likely to benefit from local therapy.

    View details for DOI 10.1016/j.ijrobp.2022.04.050

    View details for PubMedID 35654305

  • Active Surveillance for Early Stage Lung Cancer. Clinical lung cancer Payne, R. G., Anker, C. J., Sprague, B. L., No, H. J., Lin, S. H., Lester-Coll, N. H. 2022


    OBJECTIVES: Data describing outcomes for patients with early stage lung cancer who undergo expectant management is lacking, despite evidence of a sub-population with indolent malignancies. We used the National Cancer Data Base (NCDB) to identify factors associated with active surveillance for early stage lung cancer. Additionally, we sought to describe outcomes of three different care plans: active surveillance, no treatment, and Stereotactic Body Radiation Therapy (SBRT).METHODS: Patients diagnosed in 2010 to 2017 with early stage lung cancer who underwent active surveillance, no treatment, and SBRT were retrospectively identified in the NCDB. Multinomial logistic regression was used to assess care plan selection. Kaplan Meier analysis was used to assess overall survival (OS).RESULTS: We identified 30,107 patients that met our inclusion criteria: 838 (3%) underwent active surveillance, 6388 patients (21%) received no treatment, and 22,881 (76%) underwent SBRT. Black race (relative risk ratio (RRR): 1.66) and older age (RRR: 1.02) were significant positive predictors of active surveillance selection. Conversely, higher tumor stage (RRR: 0.26) and squamous cell carcinoma (RRR: 0.35) were significant negative predictors of active surveillance selection. Kaplan Meier analysis revealed a longer median OS associated with active surveillance compared to no treatment at 49.3 months versus 26.5 months, respectively. SBRT OS was 43.1 months.CONCLUSIONS: We identified a population of lung cancer patients who underwent expectant management with favorable outcomes. Additionally, we identified factors associated with active surveillance selection. The selection of active surveillance over no treatment was associated with significantly longer OS.

    View details for DOI 10.1016/j.cllc.2022.01.001

    View details for PubMedID 35307270

  • Progression Versus Radiation Treatment Changes After Stereotactic Ablative Radiation Therapy of a Liver Metastasis PRACTICAL RADIATION ONCOLOGY No, H. J., Negrete, L. M., Pollom, E. L., Wakelee, H. A., Chang, D. T., Vitzthum, L. K. 2022; 12 (1): 1-2
  • FLASH Radiation Therapy Principles, Technology, and Clinical Translation AAMD 47th Annual Meeting No, H. J., Wu, Y. F., et al 2022
  • Validation of a Novel Cone-Less Set-up for Electron FLASH Radiation Delivery on a Clinical-Use Linear Accelerator Wu, Y. F., No, H. J., Manjappa, R., Skinner, L., Yu, S. J., Lau, B., Surucu, M., Schueler, E., Bush, K., Graves, E. E., Maxim, P. G., Loo, B. W. ELSEVIER SCIENCE INC. 2021: S139
  • Pulmonary Hemorrhage in Patients Treated With Thoracic Stereotactic Ablative Radiotherapy and Anti-Angiogenic Agents Lau, B., No, H. J., Wu, Y. F., Ko, R. B., Devine, M., Das, M., Neal, J. W., Ramchandran, K. J., Wakelee, H. A., Shaheen, S., Diehn, M., Chin, A. L., Loo, B. W., Vitzthum, L. ELSEVIER SCIENCE INC. 2021: E423
  • Feasibility of Clinically Practical Ultra-High Dose Rate (FLASH) Radiation Delivery by a Reversible Configuration of a Standard Clinical-Use Linear Accelerator No, H. J., Wu, Y. F., Manjappa, R., Skinner, L., Lau, B., Melemenidis, S., Yu, S. J., Surucu, M., Schueler, E., Bush, K., Graves, E. E., Maxim, P. G., Loo, B. W. ELSEVIER SCIENCE INC. 2021: S32
  • Pulmonary Hemorrhage in Patients Treated with Thoracic Stereotactic Ablative Radiotherapy and Anti-Angiogenic Agents Lau, B., No, H., (Fred) Wu, Y., Devine, M., Ko, R., Loo, B., Diehn, M., Chin, A., Vitzthum, L. LIPPINCOTT WILLIAMS & WILKINS. 2021: S105
  • Treatment Patterns for Isolated Nodal Recurrences in Non-Small Cell Lung Cancer After Definitive Stereotactic Ablative Radiotherapy No, H., Devine, M., Lau, B., Loo, B., Diehn, M., Chin, A., Vitzthum, L. LIPPINCOTT WILLIAMS & WILKINS. 2021: S109
  • Technological Basis for Clinical Trials in FLASH Radiation Therapy: A Review Applied Radiation Oncology Wu, Y., No, H. J., Breitkreutz, D. Y., Mascia, A. E., Moeckli, R., Bourhis, J., Schüler, E., Maxim, P. G., Loo Jr., B. W. 2021; 10 (2): 6-14
  • A Randomized Split-Body Feasibility Trial of Single-Fraction FLASH vs Conventional Electron Radiotherapy Using a Standard Clinical Linear Accelerator for Adults with Multi-Lesional Primary Cutaneous Lymphomas Flash Radiotherapy and Particle Therapy (FRPT) Conference Dworkin, M., No, H. J., et al 2021
  • Treatment Related Risk Factors for Percutaneous Endoscopic Gastrostomy (PEG) Tube Placement in Locally Advanced Head and Neck Squamous Cell Carcinoma (LA-HNSCC) No, H. J., Tam, M. M., Wu, P. ELSEVIER SCIENCE INC. 2020: 1214
  • Active Surveillance for Medically Inoperable Stage IA Lung Cancer in the Elderly CUREUS No, H. J., Lester-Coll, N. H., Seward, D. J., Sidiropoulos, N., Gagne, H. M., Nelson, C. J., Garrison, G. W., Kinsey, C., Lin, S. H., Anker, C. J. 2018; 10 (10): e3472


    Objectives Treatment for stage IA lung cancer may be too aggressive an approach in elderly patients with competing co-morbidities. We report outcomes for those electing active surveillance (AS) and investigate factors that may predict indolent disease. Materials and methods Retrospective review was performed for 12 consecutive patients, ≥70 years old, with medically inoperable stage IA, T1N0M0 lung cancer and significant co-morbidities, who chose AS with radiation therapy (RT) reserved for clear disease progression. Collected data included Charlson-Deyo Comorbidity Index (CDCI) grades, histology, and tumor size changes. Volume doubling time (VDT) calculations used a modified Schwartz equation. Results Fifteen nodules underwent AS in 12 patients; three patients had more than one nodule. Median age of all patients was 78 (range, 71-85). All patients' CDCI grades were ≥1, 7 were ≥2. Eleven of 12 patients were deemed to be at high-risk for falls. Twelve nodules in 12 patients were biopsied; adenocarcinoma the prevailing common (47%) histology. The median, one, two and three year patient freedom-from-RT values were 21.4 months (95% CI: 11.6-not reached), 81%, 43%, and 29%, respectively. Median VDT of treated vs. untreated nodules was 189 days (range, 62-infinite) vs. 1153 days (range, 504-infinite), respectively. No patient progressed regionally or distantly, and there have been no cancer-related deaths. Due to cardiovascular events, two patients died and one remains on hospice. Median duration of AS for those still continuing computed tomography (CT) surveillance is 35.1 months. Conclusion Selected elderly patients with stage IA lung cancer and significant co-morbidities may undergo AS without detriment in outcome. Prospective AS studies are warranted.

    View details for DOI 10.7759/cureus.3472

    View details for Web of Science ID 000458694700011

    View details for PubMedID 30648024

    View details for PubMedCentralID PMC6318089

  • Effect of Tumor Volume Doubling Time on Prognosis for Stage I Non-small Cell Lung Cancers No, H., Gagne, H. M., Nelson, C. J., Kinsey, M., Garrison, G., Kikut, J., Gentchos, G., Seward, D., Sidiropoulos, N., Folefac, E., Leavitt, B., Ashikaga, T., Dragnev, K., Lin, S. H., Anker, C. J. ELSEVIER SCIENCE INC. 2017: E487
  • Active Surveillance for Elderly Stage IA Non-Small Cell Lung Cancer Patients No, H., Kikut, J., Garrison, G., Sidiropoulos, N., Leavitt, B., Gentchos, G., Lin, S. H., Anker, C. J. ELSEVIER SCIENCE INC. 2017: 232
  • Effect of Tumor Volume Doubling Time on Prognosis for Stage I Non-Small Cell Lung Cancers: An Update NNECOS Annual Meeting No, H. J., Seward, D., et al 2017
  • Breast, chest wall, and nodal irradiation with prone set-up: Results of a hypofractionated trial with a median follow-up of 35 months PRACTICAL RADIATION ONCOLOGY Shin, S., No, H., Vega, R., Fenton-Kerimian, M., Maisonet, O., Hitchen, C., DeWyngaert, J., Formenti, S. 2016; 6 (4): E81–E88


    To test clinical feasibility, safety, and toxicity of prone hypofractionated breast, chest wall, and nodal radiation therapy.Following either segmental or total mastectomy with axillary node dissection, patients were treated in an institutional review board-approved prospective trial of prone radiation therapy to the breast, chest wall, and supraclavicular and level III axillary lymph nodes. A dose of 40.5 Gy/15 fractions with a concomitant daily boost to the tumor bed of 0.5 Gy (total dose, 48 Gy) was prescribed. In postmastectomy patients, the same treatment was prescribed, but without a tumor bed boost. The primary endpoint was incidence of >grade 2 acute skin toxicity. The secondary endpoints were feasibility of treatment using prone set-up, compliance with protocol-defined dosimetric constraints, and incidence of late toxicity. A dosimetric comparison was performed between protocol plans (prone) and nonprotocol plans (supine), targeting the same treatment volumes.Sixty-nine patients with stage IB-IIIA breast cancer enrolled in this trial. Surgery was segmental mastectomy (n = 45), mastectomy (n = 23), and bilateral mastectomy (n = 1), resulting in 70 cases. None experienced >grade 2 acute skin toxicity according to the Common Terminology Criteria for Adverse Events, v 3.0, meeting our primary endpoint. Ninety-six percent of patients could be treated with this technique prone. However, 17 plans (24%) exceeded protocol constraints to the brachial plexus. Maximum long-term toxicity was 1 grade 2 arm lymphedema, 1 grade 3 breast retraction, and no occurrence of brachial plexopathy. Dosimetric comparison of protocol with nonprotocol plans demonstrated significantly decreased lung and heart doses in prone plans.Prone hypofractionated breast, chest wall, and nodal radiation therapy is safe and well tolerated in this study. Although the initial pattern of local and regional control is encouraging, longer follow-up is warranted for efficacy and late toxicity assessment, particularly to the brachial plexus.

    View details for DOI 10.1016/j.prro.2015.10.022

    View details for Web of Science ID 000378626600001

    View details for PubMedID 26723552

  • Anal Cancer Outcomes in Patients Treated With Intensity Modulated Compared to 3-Dimensional Radiation Therapy Cooper, B. T., Bitterman, D. S., Grew, D., No, H. S., Sanfilippo, N. J., Du, K. L. ELSEVIER SCIENCE INC. 2015: E165
  • Hypofractionated, Prone Accelerated Breast, and Nodal Irradiation: Results at a Median Follow-up of 33 Months Shin, S., No, H. S., Fenton-Kerimian, M. B., Maisonet, O. G., Hitchen, C., DeWyngaert, J. K., Formenti, S. C. ELSEVIER SCIENCE INC. 2015: E20
  • Dosimetric Comparison of Two Intensity Modulated Radiation Therapy Regimens in Patients with Head and Neck Cancer ASTRO Annual Meeting Shin, S. M., No, H. J., et al 2015
  • Dosimetric Comparison of Two Intensity Modulated Radiation Therapy Regimens in Patients with Nasopharyngeal Carcinoma LARS Conference Shin, S. M., McCarthy, A. K., No, H. J., et al 2015
  • Breast Cancer Radiation Therapy (RT) in Developing Countries: A Technique for Simple Prone Treatment Planning No, H. J., Galavis, P. E., Jozsef, G., Formenti, S. C. ELSEVIER SCIENCE INC. 2014: S262
  • Limits and Possibilities of a Simplistic Approach to Whole Breast Radiation Therapy Planning Hipp, E., Osa, E., No, H., Rosman, M., Formenti, S., Jozsef, G. WILEY. 2014: 312
  • Limits and Possibilities of a Simplistic Approach to Whole Breast Radiation Therapy Planning Hipp, E., Osa, E., No, H., Rosman, M., Formenti, S., Jozsef, G. WILEY. 2014: 312-+

    View details for DOI 10.1118/1.4888711

    View details for Web of Science ID 000436939600027

  • Reproducibility in Prone Breast Cancer Treatments AAMD Annual Meeting No, H. J., Coonce, M., et al 2014
  • Phase I/II Study of Prone Accelerated IMRT to Treat the Breast, Level 3 Axilla, and Supraclavicular Nodes Sethi, R. A., Jozsef, G., No, H., Goldberg, J. D., Formenti, S. C. ELSEVIER SCIENCE INC. 2012: S114
  • Comparison of three-dimensional versus intensity-modulated radiotherapy techniques to treat breast and axillary level III and supraclavicular nodes in a prone versus supine position RADIOTHERAPY AND ONCOLOGY Sethi, R. A., No, H., Jozsef, G., Ko, J. P., Formenti, S. C. 2012; 102 (1): 74–81


    To determine the optimal method of targeting breast and regional nodes in selected breast cancer patients after axillary dissection, we compared the results of IMRT versus no IMRT, and CT-informed versus clinically-placed fields, in supine and prone positions.Twelve consecutive breast cancer patients simulated both prone and supine provided the images for this study. Four techniques were used to target breast, level III axilla, and supraclavicular fossa in either position: a traditional three-field three-dimensional conformal radiotherapy (3DCRT) plan, a four-field 3DCRT plan using a posterior axillary boost field, and two techniques using a CT-informed target volume consisting of an optimized 3DCRT plan (CT-planned 3D) and an intensity-modulated radiotherapy (IMRT) plan. The prescribed dose was 50 Gy in 25 fractions.CT-planned 3D and IMRT techniques improved nodal PTV coverage. Supine, mean nodal PTV V50 was 50% (3-field), 59% (4-field), 92% (CT-planned 3D), and 94% (IMRT). Prone, V50 was 29% (3-field), 42% (4-field), 97% (CT-planned 3D), and 95% (IMRT). Prone positioning, compared to supine, and IMRT technique, compared to 3D, lowered ipsilateral lung V20.Traditional 3DCRT plans provide inadequate nodal coverage. Prone IMRT technique resulted in optimal target coverage and reduced ipsilateral lung V20.

    View details for DOI 10.1016/j.radonc.2011.09.008

    View details for Web of Science ID 000300654700013

    View details for PubMedID 21993404

  • IMRT versus Fixed-beam Technique for Regional Nodal Coverage in Breast Cancer Patients in a Prone versus Supine Treatment Position Sethi, R. A., No, H., Jozsef, G., Formenti, S. C. ELSEVIER SCIENCE INC. 2009: S203