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Colson, Yolonda

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Colson

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Yolonda

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Colson, Yolonda
Author's Publications: search.filters.isAuthorOfPublication.54f54964-70b2-4303-9f3d-d530ba0d70ce

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    Green Herring Syndrome: Bacterial Infection in Patients With Mucormycosis Cavitary Lung Disease
    (Oxford University Press, 2014) Peixoto, Driele; Hammond, Sarah; Issa, Nicolas; Madan, Rachna; Gill, Ritu; Milner, Danny; Colson, Yolonda; Koo, Sophia; Baden, Lindsey; Marty, Francisco
    Mucormycosis is a life-threatening fungal disease in patients with hematological malignancies. The diagnosis of pulmonary mucormycosis is particularly challenging. We describe 3 mucormycosis cases with an uncommon presentation in patients whose cavitary lung disease was attributed to well documented bacterial infection, although evolution and reassessment established mucormycosis as the underlying disease.
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    Low Incidence of Chest Wall Pain with a Risk-Adapted Lung Stereotactic Body Radiation Therapy Approach Using Three or Five Fractions Based on Chest Wall Dosimetry
    (Public Library of Science, 2014) Coroller, Thibaud; Mak, Raymond; Lewis, John H.; Baldini, Elizabeth; Chen, Aileen; Colson, Yolonda; Hacker, Fred; Hermann, Gretchen; Kozono, David; Mannarino, Edward; Molodowitch, Christina; Wee, Jon; Sher, David J.; Killoran, Joseph
    Purpose To examine the frequency and potential of dose-volume predictors for chest wall (CW) toxicity (pain and/or rib fracture) for patients receiving lung stereotactic body radiotherapy (SBRT) using treatment planning methods to minimize CW dose and a risk-adapted fractionation scheme. Methods: We reviewed data from 72 treatment plans, from 69 lung SBRT patients with at least one year of follow-up or CW toxicity, who were treated at our center between 2010 and 2013. Treatment plans were optimized to reduce CW dose and patients received a risk-adapted fractionation of 18 Gy×3 fractions (54 Gy total) if the CW V30 was less than 30 mL or 10–12 Gy×5 fractions (50–60 Gy total) otherwise. The association between CW toxicity and patient characteristics, treatment parameters and dose metrics, including biologically equivalent dose, were analyzed using logistic regression. Results: With a median follow-up of 20 months, 6 (8.3%) patients developed CW pain including three (4.2%) grade 1, two (2.8%) grade 2 and one (1.4%) grade 3. Five (6.9%) patients developed rib fractures, one of which was symptomatic. No significant associations between CW toxicity and patient and dosimetric variables were identified on univariate nor multivariate analysis. Conclusions: Optimization of treatment plans to reduce CW dose and a risk-adapted fractionation strategy of three or five fractions based on the CW V30 resulted in a low incidence of CW toxicity. Under these conditions, none of the patient characteristics or dose metrics we examined appeared to be predictive of CW pain.
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    Outcomes by Tumor Histology and KRAS Mutation Status After Lung Stereotactic Body Radiation Therapy for Early-Stage Non–Small-Cell Lung Cancer
    (Elsevier BV, 2015) Mak, Raymond; Hermann, Gretchen; Lewis, John H.; Aerts, Hugo J.W.L.; Baldini, Elizabeth; Chen, Aileen; Colson, Yolonda; Hacker, Fred; Kozono, David; Wee, Jon; Chen, Yu-Hui; Catalano, Paul; Wong, Kwok-Kin; Sher, David J.
    BACKGROUND: We analyzed outcomes after lung stereotactic body radiotherapy (SBRT) for early-stage non-small cell lung-carcinoma (NSCLC) by histology and KRAS genotype. PATIENTS AND METHODS: We included 75 patients with 79 peripheral tumors treated with SBRT (18 Gy × 3 or 10 to 12 Gy × 5) at our institution from 2009 to 2012. Genotyping for KRAS mutations was performed in 10 patients. Outcomes were analyzed by the Kaplan-Meier method/Cox regression, or cumulative incidence method/Fine-Gray analysis. RESULTS: The median patient age was 74 (range, 46 to 93) years, and Eastern Cooperative Oncology Group performance status was 0 to 1 in 63%. Tumor histology included adenocarcinoma (44%), squamous cell carcinoma (25%), and NSCLC (18%). Most tumors were T1a (54%). Seven patients had KRAS-mutant tumors (9%). With a median follow-up of 18.8 months among survivors, the 1-year estimate of overall survival was 88%, cancer-specific survival (CSS) 92%, primary tumor control 94%, and freedom from recurrence (FFR) 67%. In patients with KRAS-mutant tumors, there was a significantly lower tumor control (67% vs. 96%; P = .04), FFR (48% vs. 69%; P = .03), and CSS (75% vs. 93%; P = .05). On multivariable analysis, histology was not associated with outcomes, but KRAS mutation (hazard ratio, 10.3; 95% confidence interval, 2.3-45.6; P = .0022) was associated with decreased CSS after adjusting for age. CONCLUSION: In this SBRT series, histology was not associated with outcomes, but KRAS mutation was associated with lower FFR on univariable analysis and decreased CSS on multivariable analysis. Because of the small sample size, these hypothesis-generating results need to be studied in larger data sets.
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    Identification of Metastatic Nodal Disease in a Phase 1 Dose-Escalation Trial of Intraoperative Sentinel Lymph Node Mapping in Non–small Cell Lung Cancer Using Near-Infrared Imaging
    (Elsevier BV, 2013-09) Gilmore, Denis M.; Khullar, Onkar V.; Jaklitsch, Michael; Chirieac, Lucian; Frangioni, John V.; Colson, Yolonda
    Objectives Early stage non-small cell lung cancer (NSCLC) has a high recurrence rate and poor 5-yearsurvival, particularly if lymph nodes are involved. Our objective was to perform a dose escalationstudy to assess safety and feasibility of intraoperative near-infrared (NIR) fluorescence imaging toidentify the first tumor draining lymph nodes, i.e. sentinel lymph nodes (SLN) in NSCLCpatients. Methods A dose escalation Phase I clinical trial assessing real-time NIR imaging followingperitumoral injection of 3.8 – 2500 μg indocyanine green (ICG) was initiated inpatients with suspected stage I/II NSCLC. Visualization of lymphatic migration, SLN identification,and adverse events were recorded. Results Thirty eight patients underwent ICG injection and NIR imaging via thoracotomy(n=18) or thoracoscopic imaging (n=20). SLN identification increased with ICG dosewith <25% SLN detected in dose cohorts ≤600ug vs 89% success at≥1000 μg. Twenty six NIR+ SLNs were identified in fifteenpatients, with seven NIR+ SLNs (six patients) harboring metastatic disease onhistologic analysis. Metastatic nodal disease was never identified in patients with a histologicallynegative NIR+ SLN. No adverse reactions were noted. Conclusion NIR-guided SLN identification with ICG was safe and feasible in this initial doseescalation trial. ICG doses ≥ 1000ug yielded nearly 90% intrathoracic SLNvisualization, with presence or absence of metastatic disease in the SLN directly correlating withfinal nodal status of the lymphadenectomy specimen. Further studies are needed to optimize imagingparameters and confirm sensitivity and specificity of SLN mapping in NSCLC using this promisingimaging technique.