|
 Mission Statement:
The Thoracic Oncology Center is a multidisciplinary program for patients with lung, esophageal, pleural, mediastinal, and chest wall tumors. Our pulmonary faculty and fellows are highly trained in preoperative assessment and bronchoscopic diagnosis of thoracic tumors. Important clinical and research efforts focus on the diagnosis, management and prevention of lung cancer. Through our combined state of the art research and clinical practices, the Boston University Center for Thoracic Oncology’s mission is to reduce lung cancer incidence, morbidity, and mortality.
Background:
The Thoracic Oncology Center, directed by Benedict Daly, MD, is a comprehensive program that provides a wide array of clinical and research services for lung cancer and other thoracic malignancies. The multidisciplinary team is composed of physicians experienced in thoracic surgery, medical oncology, radiation oncology, chest radiology, pathology, and pulmonary medicine. The team meets weekly to review diagnostic and treatment options for individual patients. Patients are seen by an entire team of physician experienced in this field.
 Boston Medical Center performs a high volume of surgeries for thoracic malignancies including robotic and minimally invasive surgical techniques. Our surgeons work together with the medical and radiation oncologists to participate in multiple clinical trials and develop treatment plans at every stage of lung cancer with a special emphasis in treatment options for patients with Stage IIIA and IIIB lung cancers.
Boston Medical Center’s pulmonologists play an integral role at the Thoracic Oncology Center. Faculty and first-year fellows help care for high-risk surgical candidates post-operatively through the consult service. Our dedicated pulmonologists along with two to three senior pulmonary fellows join with the thoracic surgeons in multidisciplinary conference and clinic to provide preoperative assessment and aid in bronchoscopic diagnosis of thoracic tumors. Third- year pulmonary fellows on their anaesthesiology rotation observe and participate in thoracic cases including Photodynamic Therapy (PDT), Radiofrequency Ablation (RFA), and Video-Assisted Thoracic Surgery (VATS) lobar resections. At the research center, the Lung Cancer Group works to identify genes responsible for a genetic predisposition to lung cancer so high risk patients can be targets for prevention and early detection.
Clinical Activities:
- Weekly Multidisciplinary Thoracic Conference. Patient’s clinical history, pathology, imaging and diagnostic studies are reviewed weekly by the multidisciplinary team to coordinate evaluation and treatment strategies.
- Weekly Multidisciplinary Clinic. Our pulmonologists work closely with the thoracic surgeons in a combined clinic aiding in diagnosis and assessing and preparing patients for treatment.
- Comprehensive Imaging Services including PET imaging, chest CT and MRI
- Diagnostic Services including fine needle aspiration, interventional bronchoscopy (bronchoscopic biospsies and fine needle aspiration), EUS, EBUS, mediastinoscopy, and thoracoscopy .
- Combined chemotherapy, radiation therapy and surgical resection to treat patients with locally advanced disease. Endobronchial therapy including Stent Placement, Thermal Laser Treatments, and Photodynamic Therapy (PDT) for obstructing lung and esophageal cancers. Endobronchial and endoscopic ultrasound FNA. directed by Dr. Michael Ebright.
- Radiofrequency Ablation as a minimally invasive method to treat lung tumors in patients who are unable to have an operation because of medical co-morbidities or refusal. Hiran Fernando , MD , MBBS, FRCS, Director of Minimally Invasive Thoracic Surgery at our institution is a leader in this procedure.
 Research Activities:
Basic Science Research
Current research initiatives of the Lung Cancer Group include molecular biology of non-small cell lung cancer, role of methylation in regulator genes of non-small cell lung cancers, and the identification of genes and proteins involved in the transition of primary tumors to invasive, metastatic tumors that may be targets in lung cancer treatment.
Translational-Clinical Research
The Lung Cancer and Bioinformatics Group has initiated a series of clinical studies aimed at developing early diagnostic tools for determining which cigarette smokers are at increased risk for developing lung cancer. Using high-throughput genomic and bioinformatic tools this group is performing cutting-edge research to develop a non-invasive biomarker for lung cancer in high-risk patients.
Clinical Trials
There are several ongoing clinical trials in the thoracic oncology center including:
RTOG R0229: a phase II trial of neoadjuvant therapy with concurrent chemotherapy and high dose radiotherapy followed by surgical resection and consolidative therapy for locally advanced non-small cell lung cancer (NSCLC).
ACOSOG-Z4032: a randomized phase III study of sublobar resection versus sublobar resection plus brachytherapy in high-risk patients with non-small cell lung cancer, 3 cm or smaller.
CTSU #C140503: A Phase III Randomized Trial of Lobectomy versus Sublobar Resection for Small (less than or equal to 2 cm) Peripheral Non-Small Cell Lung Cancer.
ACOSOG #Z4033: A Pilot Study of Radiofrequency Ablation in High-Risk Patients with Stage Ia Non-Small Cell Lung Cancer or smaller.
The Boston University Research Center lists the ongoing clinical trials for lung cancer prevention, small cell lung cancer, and NSCLC trials at our institution.
Investigators/Personnel:
| Thoracic Surgery |
Radiology |
|
Benedict Daly, MD Administrative Director
Hiran C. Fernando, MD
Harold Lazar, MD
Ara Ketchedjian, MD
Michael Ebright, MD |
|
Bill Arndt, MD
Elizabeth Oates, MD
Gustavo Mercier |
|
Mary Clancy, NP
Carmel Fitzgerald, NP
Nancy Paul, NP
Janet Thompson, NP
Clinical Trials:
Donna Morelli, BS |
|
|
| Oncology |
Pathology |
|
Ken Zaner, MD Associate Director
Timothy Cooley |
|
Carl O’Hara, MD |
|
|
|
|
| Radiation Oncology |
Gastroenterology |
|
Lisa Kachnic, MD, Associate Director
Gregory Russo, MD |
|
Brian Jacobson, MD |
|
|
|
|
| Pulmonary Medicine |
Staff |
|
Jerome Brody, MD
Christine Campbell-Reardon, MD
Hasmeena Kathuria, MD
Frank Schembri, MD |
|
Reva McCarthy, Executive Assistant
Mary Jane Estrada
Julie Ferriter-Thomas |
Selected Publications
- Recht A, Ancukiewicz M, Alm El-Din MA, Lu XQ, Martin C, Berman SM, Hirsch AE, Kachnic LA, Katz A, Macdonald S, Nedea EA, Stevenson MA, Powell SN, Taghian Lung Dose-Volume Parameters and the Risk of Pneumonitis for Patients Treated With Accelerated Partial-Breast Irradiation Using Three-Dimensional Conformal Radiotherapy.AG. J Clin Oncol. 2009
- Daly BD, Fernando HC, Ketchedjian A, Dipetrillo TA, Kachnic LA, Morelli DM, Shemin RJ. Pneumonectomy after high-dose radiation and concurrent chemotherapy for nonsmall cell lung cancer. Ann Thorac Surg. 2006 Jul;82(1):227-31
- Ketchedjian A, Daly BD, Fernando HC, Florin L, Hunter CJ, Morelli DM, Shemin RJ. Location as an important predictor of lymph node involvement for pulmonary adenocarcinoma. J Thorac Cardiovasc Surg. 2006 Sep;132(3):544-8
- Fernando HC, Murthy SC, Hofstetter W, Shrager JB, Bridges C, Mitchell JD, Landreneau RJ, Clough ER, Watson TJ; Society of Thoracic Surgeons. The Society of Thoracic Surgeons practice guideline series: guidelines for the management of Barrett’s esophagus with high-grade dysplasia. Ann Thorac Surg. 2009 Jun;87(6):1993-2002.
- Cesaretti JA, Pennathur A, Rosenstein BS, Swanson SJ, Fernando HC. Stereotactic radiosurgery for thoracic malignancies. Ann Thorac Surg. 2008 Feb;85(2):S785-91. Review
- Fernando HC. Radiofrequency ablation to treat non-small cell lung cancer and pulmonary metastases. Ann Thorac Surg. 2008 Feb;85(2):S780-4. Review.
- Morgan, R., Kachnic, L., Summer, R. Update on Radiation-induced Lung Injury following Therapy for Thoracic Malignancy. Current Respiratory Medicine. 1:3. 2005.
- El-Sherif A, Luketich JD, Landreneau RJ, Fernando HC New therapeutic approaches for early stage non-small cell lung cancer. Surg Oncol. 2005 Jul; 14(1): 27-32.
- Fernando HC, Hoyos AD, Lanreneau RJ, Gilbert S, Gooding WE, Nuenaventura PO, Christie NA, Belani C, Luketich JD Radiofrequency ablation for the treatment of non-small cell lung cancer in marginal surgical candidates.J Thorac Cardiovasc Surg. 2005 Mar;129(3):639-44.
- Fernando HC, Santos RS, Benfield JR, Grannis FW, et al Lobar and sublobar resection with and without brachytherapy for small stage IA non-small cell lung cancer. J Thorac Cardiovasc Surg. 2005 Feb; 129(2): 261-7.
- Dahm-Daphi J, Hubbe P, Horvath F, El-Awady RA, Bouffard KE, Powell SN, Willers H. Non-homologous end-joining of site-specific but not of radiation-induced DNA double-strand breaks is reduced in the presence of wild-type p53. Oncogene. 2005; 14:1663-1672
- Daly, BDT, Trimodality for Non-Small Cell Lung Cancer. Proceedings of the General Thoracic Surgical Symposium at the 84th Annual Meeting of the American Association for Thoracic Surgery Toronto, Canada April 25, 2004 pp 16-19.
- Zhang J, Willers H, Feng Z, Ghosh JC, Kim S, Weaver DT, Chung JH, Powell SN, Xia F. Chk2 phosphorylation of BRCA1 regulates DNA double-strand break repair. Mol Cell Biol. 2004; 24(2):708-18.
- Willers H, Dahm-Daphi J, Powell SN. Repair of radiation damage to DNA. Br J Cancer. 2004; 90(7):1297-301.
- Romanova LY, Willers H, Blagosklonny MV, Powell SN. The interaction of p53 with replication protein A mediates suppression of homologous recombination. Oncogene. 2004; 23(56):9025-33.
- Daly BDT. Eventration of the Diaphragm. Chapter xxx in Yang SC and Cameron DE. Current Therapy in Thoracic and Cardiovascular Surgery. Harcourt Health Sciences. St. Louis, 2004
- Spira,A, Derti,A, Chettier,R, BrodyJS, DeLisi C. Integrating gene expression, comparative genomics and functional proteomics via the yeast interactome: application to human lung cancer. Submitted 2004.
- Fernando HC, Sasatomi E, Christie NA, Buenaventura PO, Finkelstein SD, Yousem SA, Soose R, Close JM, Luketich JD. Comparison of mutational changes in involved N1 lymph nodes to primary tumor in stage II non-small cell lung cancer: A pilot study. J Thorac CV 2004; 127:87-91
- Jacobson BC, Crawford JM, Farraye FA. Gastrointestinal Tract Endoscopic and Tissue Processing Techniques. In: Odze RD, Goldblum JR, Crawford JM, eds. Surgical Pathology of the GI Tract, Liver, Biliary Tract and Pancreas. Philadelphia: Saunders, 2003.
- Lazar H.L.: Disorders of the Trachea, Chest Wall, Pleura, Mediastinum and Lung. In Becker J (ed.): Essentials of Surgery. W.B. Saunders Co., In Press
- O’Hara, C.J., Reed, W.P., Banner, B.F. Biopsy Principles, Tumor Pathology and Tumor Markers, Cancer Manual, 1996, 9th Edition, Chapter 5.
- Powell, S.N. and Kachnic, L.A. The Roles of BRCA 1 and BRCA 2 in Homologous Recombination, DNA Replication Fidelity and the Cellular Response to Ionizing Radiation. Oncogene. 2003 Sep 1; 22 (37):5784-90. Review
- Lee W, Daly BDT, DiPetrillo, TA, Morelli DM, Neuschatz AC, Morr J, Rivard MJ. Limited Resection for Lung Cancer: Observed Local Control with Implantation of I-125 Brachytherapy Seeds. Ann Thorac Surg. 75:237-243, 2003
- Akerley, W., R. Lee, K. Zaner, N. Ready, T. Mega, H. Safran and T. Kennedy. Phase II Trial of Weekly Paclitaxel and Gemcitabine for Previously Untreated Stage IIIB-IV Non-Small-Cell Lung Cancer. Submitted
LINKS:
For Patients:
To schedule a clinic visit, refer a patient, or speak with one of our physicians, please contact us at:
Doctors Office Building
Pulmonary/Allergy/Asthma
720 Harrison Avenue, 4th Floot, Suite 402
Boston, MA 02118
617-638-7480
|
|
