Founded in 2006, the Department of Radiation Medicine and Applied Sciences (RMAS) at the University of California San Diego (UCSD) is comprised of a large and diverse faculty of clinicians and researchers devoted to providing high-quality patient care, the development and adoption of novel radiation oncology technologies, and the advancement of academic radiation medicine through research, education and training.
Over the last decade, the Department has experienced unprecedented growth and is now the major provider of Radiation Oncology services in the greater San Diego region and has also become an internationally-recognized academic center. Below is an overview of the Department as a whole, including its faculty, treatment centers, research and educational programs.
With the establishment of the UC San Diego Medical Center in the late 1960s, UC San Diego began offering Radiation Oncology services at its downtown location within the Hillcrest Medical Center. Academically, Radiation Oncology was a small division of the Department of Radiology and at its peak included only 3 radiation oncologists. It wasn't until the tenure of Dean Edward Holmes (2000-2006) that a decision was made to establish an independent Department of Radiation Oncology with the recruitment of Arno J. Mundt MD (right), an internationally-recognized academic radiation oncologist and educator, from the University of Chicago as the Founding Department Chair.
From its humble beginnings in 2006, the Department has rapidly grown over the intervening years to include over 50 faculty, multiple treatment centers throughout the San Diego region and beyond, with a new patient volume exceeding 5000 patients annually, making UC San Diego one of the largest Radiation Oncology Departments in the Western United States. Further growth is expected in the coming years with multiple new affiliations and centers outside of San Diego and abroad. In 2012, the Department officially changed its name to the
Department of Radiation Medicine and Applied Sciences.
Under the Chair, the Department leadership is comprised of: Casey Sandack MBA, Vice-Chair for Administration and Finance, and Todd Pawlicki PhD, Vice-Chair for Medical Physics. In 2016, an Advisory Board (RMAS Council) comprised of Vice-Chairs, Assistant Vice-Chairs (Cathryn Yashar MD, John Einck MD, Laura Cervino PhD, and Ajay Sandhu MD) along with elected junior faculty representatives was formed to provide additional and diverse input from the faculty as a whole.
Academically, the Department consists of five divisions: Clinical Radiation Oncology (CRO), Clinical and Translational Research (CTR), Medical Physics and Technology (MPT), Proton Therapy and Particle Research (PTPR), and Veterinary Oncology (VO). The individual faculty members in each Division are shown under People. The Academic Divisions are under the direction of the following Division Directors:
CLINICAL RADIATION ONCOLOGY
Under the Direction of Parag Sanghvi, MD, Associate Professor, the
Division of Clinical Radiation Oncology consists of the clinical radiation
oncologists at the main as well as the satellite sites.
MEDICAL PHYSICS AND TECHNOLOGY
Todd Pawlicki PhD FAAPM, Professor and Vice-Chair, was recruited as
Division Director in 2006 and oversees all clinical and research medical
physicists as well as technology researchers in the department. Several
division faculty members focus primarily on research and oversee post-doctoral
and graduate/undergraduate students.
CLINICAL AND TRANSLATIONAL RESEARCH
Loren Mell MD, Associate Professor, was named Division Director in 2009 and
oversees the clinical translational and basic research in the department and
is the Director of the Center for Translational Radiation Medicine and Imaging.
PROTON THERAPY AND PARTICLE RESEARCH
Under the Direction of Carl Rossi MD, Professor, the Division of Proton
Therapy and Particle Research consists of the proton radiation oncologists
and medical physicists at the California Protons Cancer Therapy Center.
Dr. Gregory Ogilvie, Professor and Director of the Angel Care
Veterinary Hospital, serves as the director of the Division of Veterinary
Oncology which also includes Dr. David Proulx who is double-boarded
in Veterinary Medical Oncology and Radiation Oncology Oncology.
The RMAS Department consists of 5 treatment centers in San Diego including 4 photon therapy centers [La Jolla, Encinitas(Coastal North County), 4S Ranch(Inland North County) and South Bay] as well as a new state-of-the-art proton center (Mira Mesa).
The Department is in the process of establishing multiple new centers throughout the San Diego Region through joint ventures, partnerships and new constructions. Affiliations and partnerships are also planned internationally. In addition, through the RMAS Global Health Program, an affiliation has been established with the Institut Curie in Dakar Senegal, West Africa.
La Jolla (Main Center)
The La Jolla facility consists of administrative space, faculty offices, research and clinical space on the first floor of the Moores Cancer Center including a dedicated brachytherapy suite, wide bore CT simulator and 3Tesla MRI, as well as a conference center. Adjacent to the Cancer Center is a new 16,000 sq foot Department expansion consisting of additional clinical and administrative space including faculty offices, a PET/CT scanner and a dosimetry suite. In La Jolla, there are 4 linear accelerators including 2 Varian True Beam units.
UC San Diego Moores Cancer Center (Main Building) (left) and the Radiation Oncology expansion (below) (Moores Cancer Center Building seen in the distance).
The La Jolla Facilities offer patients all the cutting-edge technologies including Varian True-Beam and AlignRT Image-Guidance (left).
San Diego Satellite Centers
The San Diego satellites (Encinitas, South Bay and 4S Ranch) are state of the start facilities equipped with new Varian accelerators (1 Encinitas, 2 South Bay and 1 4S Ranch). The South Bay facility also has a dedicated Electronic Brachytherapy (Xoft) Suite.
Encinitas (above left) and South Bay (above right) Radiation Oncology treatment centers.
The patient waiting room at the new In-Land North County treatment facility in 4S Ranch (left).
The California Protons Cancer Therapy Center is an over 100,000 square foot facility in Mira Mesa. This $225M state-of-the art facility consists of 5 treatment rooms including 3 gantry and 2 fixed beam rooms, making it one of the largest proton treatment centers in the world. The California Protons Cancer Therapy Center is the first in the United States to offer patients access to novel Varian proton technology. The Varian Dynamic Peak technology was specifically designed for pencil beam scanning used in proton therapy. The center also includes CT and MRI diagnostic imaging.
The entrance of the California Protons Cancer Therapy Center and lobby are shown above and in the upper right. A photo from the affiliation celebration is shown on the right, including new faculty from the California Protons Cancer Therapy Center.
As noted above, 2 additional San Diego facilities are planned in Vista (in conjunction with Tri-City Medical Center) and on the downtown UC San Diego campus in Hillcrest.
The new UC San Diego-Vantage Oncology Partnership brings three regional satellite centers (two in Temecula and one in El Centro) into the Department. UC San Diego is in discussions with Eisenhower Medical Center in Rancho Mirage.
On the left the location of the two Temecula
is shown and on the right are two radiation
oncologists who work at the El Centro center
(Drs. Woel and Vekilian).
Views of the Infusion
Oncology Center and front
Lobby of the Eisenhower
Under the auspices of the Global Health Program, the Department has affiliated with the Department of Radiation Oncology at the Institut Curie in Dakar Senegal. The department assists in training and education of Senegalese physicians, physicists and staff together with collaborators from the Radiating Hope Organization.
John Einck, Professor and Director of the Global Health Program (center), performing a brachytherapy insertion in Dakar Senegal. Brandon Fisher, the founder of Radiating Hope and Assistant Professor in the Department is shown on the left.
The UC San Diego Department of Radiation Medicine and Applied Sciences offers patients access to cutting-edge technologies for adult and pediatric tumors, including stereotactic radiosurgery (SRS), stereotactic body radiation therapy (SBRT), IMRT, IGRT and proton therapy. A wide variety of brachytherapy programs are also available for patients with breast, gynecologic, prostate, ocular and lung cancers.
Department clinicians attend 25 tumor boards at both the main campus, satellites and affiliates hospitals, including the VA, Rady Children's Hospital and Kaiser Permanente.
Conference Frequency Faculty Representative(s)
UC San Diego Moores Cancer Center
Breast Cancer Weekly Yashar, Einck
Brain Tumor Weekly Hattangadi, Sanghvi, Simpson
Gynecologic Oncology Bi-Monthly Yashar, Mell
Gastrointestinal (GI) Tumors Weekly JMurphy, Simpson
Head and Neck Cancer Weekly Mell, Sanghvi, Sharabi
Genitourinary (GU) Cancers Weekly Einck, Sandhu, Sharabi
Leukemia/Lymphoma/BMT Weekly Sanghvi
Soft Tissue/Bone Bi-Monthly Einck
Liver Weekly Simpson
Lung Weekly Sandhu, Urbanic
Molecular Weekly Mell
Rady Childrens Hospital
General Tumor Board Bi-Monthly
Brain Tumors Monthly
Breast Cancer Weekly Mundt, Urbanic
General Weekly Sandhu
Lung Cancer Weekly Sandhu, Urbanic
Liver Monthly Simpson
Kaiser Permanente Hospital
General Tumor Board Weekly Advani, JMurphy, Rahn, Sharabi
Breast Cancer Bi-Weekly Yashar, Einck, Mansy, Advani
Head and Neck Cancer Bi-Weekly Mell, Sanghvi
Pulmonary Bi-Weekly Sandhu
GU Bi-Monthly Rahn, Advani
Scripps Chula Vista Bi-Monthly Mansy, Rahn
Palomar Hospital Tumor Board Weekly Hoopes
Proton Center Weekly Urbanic
UC San Diego Radiation Oncology offers numerous cutting-edge clinical programs, many not available elsewhere in the region. Several clinical programs are highlighted below:
FRAMELESS BRAIN STEREOTACTIC RADIOSURGERY
The stereotactic radiosurgery (SRS) program at UC San Diego;is a joint program between Radiation Oncology and Neurosurgery. Initially using a customized bite-block and infrared-based localization, Department physicians have tremendous experience with frameless SRS in patients with malignant and benign CNS tumors and staff two multidisciplinary clinic with UC San Diego and Kaiser Neurosurgeons.
Attention has recently turned to the development of a novel frameless bite block-less SRS approach using 3-D surface video cameras.
The 3D surface of the patient is monitored in real-time. UC San Diego was the first center in the world to offer this novel approach.
Select RMAS SRS Publications:
Pan H et al. Frameless real time surface guided-radiosurgery: clinical outcomes for brain metastases.
Nath S, et al. Single-isocenter frameless intensity modulated stereotactic radiosurgery for simultaneous treatment of multiple metastases: clinical experience.
Int J Radiat Oncol Biol Phys 2010;78:91-7
Marcus LP et al. Cumulative intracranial tumor volume enhances the prognostic value of the lung-specific graded prognostic assessment model.
Lau SK et al. Single isocenter frameless volumetric modulated arc radiosurgery for multiple intracranial metastases.
UC San Diego Radiation Oncology has brachytherapy programs in multiple disease sites, including breast cancer, prostate cancer, gynecologic tumors, lung cancer and ocular tumors.
Dr. Catheryn Yashar, Chief of the Breast Oncology Service, and Medical Physicist Daniel Scanderbeg PhD, were pioneers in the treatment of early stage breast cancer patients using the novel brachytherapy SAVI device.
Another tumor frequently treated with brachytherapy at UC San Diego is prostate cancer. In 2009, Dr. John Einck, Chief of the Prostate Brachytherapy Service, was recruited to develop a new prostate brachytherapy program together with medical physicist Dan Scandebeg PhD. Patients with early stage disease are treated with LDR brachytherapy and high risk patients undergo HDR brachytherapy in conjunction with external beam irradiation.
The opening of the expanded South Bay facility in 2015 added considerable capacity to the Xoft electronic brachytherapy skin cancer treatment program in South Bay. Currently, over 1200 electronic brachytherapy treatments are delivered annually at that facility. Expansion of the program to include gynecologic cancer is plannedfor the coming year.
Select RMAS Brachytherapy Publications:
Schwarz JK et al. Consensus statement for brachytherapy for the treatment of medically inoperable endometrial cancer.
Brachytherapy 2015 ;14:587
Paravati A et al. Clinical and cosmetic outcomes in patients treated with HDR electronic brachytherapy for non-melanoma skin cancer.
Pract Radiat Oncol 2015;5:e659
Yashar C, Scanderbeg D, et al. Initial clinical experience with the Strut-Adjusted Volume Impalnt (SAVI) breast brachytherapy device for accelerated partial breast irradiation: first 100 patients with more than 1 year of follow-up.
Int J Radiat Oncol Biol Phys 2011;80:765
Eskander RM et al. Comparison of computed tomography and magnetic resonance imaging in cervical cancer brachytherapy target contouring.
Int J Gynecol Cancer 2010;21:47-53
IGRT AND IMRT IN GYNECOLOGIC CANCER
UC San Diego physicians have a long history and experience applying novel radiation approaches in gynecologic cancers. Dr. Arno Mundt pioneered the use of IMRT in gynecology patients over a decade ago. In a series of outcome series, he demonstrated that IMRT was highly effective at reducing the risk of long term side effects in these women.
Illustration of the target volume (left) used in a cervical cancer patient undergoing IMRT and the treatment plan (right) in this patient.
Dr. Catheryn Yashar, Chief of the Gynecologic Oncology Service, and Dr. Loren Mell, Director of the Division of Clinical and Translational Research have built on this experience by incorporating novel imaging techniques for treatment planning and in-room imaging for optimizing treatment delivery. Drs. Mundt, Yashar and Mell are frequent invited lecturers on novel radiation technologies in cervical cancer and other gynecologic tumors at national and international symposia and conferences. In addition, both Drs. Yashar and Mell serve on the editorial board of the International Journal of Radiation Oncology, Biology and Physics. The former Senior Gynecologic Oncology Editor at the Red Journal, Dr. Arno J. Mundt is the Co-Section Editor for Gynecologic Oncology for the on-line resource Up-to-Date.
Select RMAS Gynecologic IGRT and IMRT Publications:
Liang Y et al.
Prospective study of functional bone marrow-sparing intensity modulated radiation therapy with concurrent chemotherapy for pelvic malignancies. Int J Radiat Oncol Biol Phys 2013;85:406
Hasselle MD, et al. Clinical outcomes of intensity-modulated pelvic radiation therapy for carcinoma of the cervix. Int J Radiat Oncol Biol Phys 2011;80:1436
Rose BS, et al. Normal tissue complication probability modeling of acute hematologic toxicity in cervical cancer patients undergoing chemoradioterhapy. Int J Radiat Oncol Biol Phys 2011;79:80
Tyagi N et al. Daily on-line cone beam computed tomography to assess interfractional motion in patientswith intact cervical cancer. Int J Radiat Oncol Biol Phys 2011;80:273
As the sole provider of radiation oncology services to Rady Children's Hospital, the UC San Diego Radiation Oncology Department treats all children undergoing radiotherapy in the San Diego region.
Select RMAS Pediatric Publications:
Nath SK, et al. Observed magnetic resonance imaging changes in pediatric patients treated with stereotactic radiosurgery. Childs Nervous Syst 2011;27:399
Keshavarzi S, Meltzer H et al. Initial clinical experience with frameless optically guided stereotactic radiosurgery/radiotherapy in pediatric patients. Childs Nerv Syst 2009;25:837
In 2013, UC San Diego formed a partnership with the California Protons Cancer Therapy Center. Currently 8 UC San Diegoradiation oncologists are credentialed at the Proton Center and all California Protons Cancer Therapy Center physicians and physicists have department faculty appointments. Under the direction of Carl Rossi MD, Medical Director of the Center and Director of the Division of Proton Therapy and Particle Research, the center opened in later 2013 in nearby Mira Mesa and includes 5 treatment rooms (3 gantry, 2 fixed beam), making it one of the largest proton therapy centers in the United States. In addition, there are ancillary MRI and CT diagnostic imaging facilities on site.
The California Protons Cancer Therapy Center (left) is an over $225M 100,000 square foot facility in nearby Mira Mesa. Carl Rossi MD and Lei Dong PhD, Director of Physics at the Proton Center are shown at right in front of the cyclotron.
A proton treatment plan (left) in a patient with left-sided breast cancer. This highly conformal approach allows treatment of the entire breast and internal mammary nodal region with virtually no dose to the underlying lung and heart.
The UC San Diego-California Protons Cancer Therapy Center Partnership includes rotations for all the UC San Diego radiation oncology and medical physics residents and joint research programs. Dr. Jim Urbanic serves as the UC San Diego Proton Medical Director.
Select RMAS Proton Publications:
Talcott JA, Rossi C et al.
Patient-reported long-term outcomes after conventional and high-dose combined proton and photon radiation for early prostate cancer. JAMA 2010;303:1046
Yang et al. Comprehensive analysis of proton range uncertainties related to patient stopping-power-ratio uncertainties using the stoichiometric calibration.
Phys Med Biol 2012;57:4095
VETERINARY ONCOLOGY COLLABORATION
The department is currently establishing clinical, research and educational collaborations with veterinary oncologists at the Angel Care Cancer Center in San Diego. To this end, faculty appointments have been proposed for two academic veterinarians specializing in oncology: Gregory Ogilvie DVM and David Proulx DVM. Joint educational programs, research grants and clinical trials are planned.
Radiation Oncology facilities at Angel Care Cancer Center: Left: a cat undergoing radiation therapy under general anesthesia and right: a state-of-the-art linear accelerator.
Stereotactic Radiosurgery on a dog (left) with a paranasal sinus tumor (right)performed at the Encinitas facility.
Select RMAS Veterinary Oncology Publications:
Rossi G, et al. Ex vivo evaluation of imatinib mesylate for induction of cell death on canine neoplastic mast cells with mutations in c-Kit exon 11 via apoptosis. Vet Res Commun 2013 (in press)
Gentschev I et al.
Characterization and evaluation of a new oncolytic vaccinia virus strain LIVP6.1.1 for canine cancer therapy.Bioengineered 2013;4(2):84-9
Green M et al.
Diagnosis and treatment of tracheal basal cell carcinoma in a Maine coon and long-term outcome.J Am Anim Hosp Assoc 2012;48(4):273
STEREOTACTIC BODY RADIATION THERAPY (SBRT )
SBRT is a common treatment approach at UC San Diego in a variety of tumor sites including lung, spine and liver tumors. All patients with lung and liver SBRT are planned using 4DCT and frequently treated with respiratory-gating.
Select RMAS SBRT Publications:
Simpson D et al. Lung stereotactic body radiotherapy for early stage NSCLC with prior pneumonectomy—a case report. J Natl Compr Cancer Netw 2014 ;12 :1513
Nath S et al.
Locoregional and distant failure following image-guided stereotactic body radiation for early-stage primary lung cancer.Radiother Oncol 2011;99:12
Videtic GM et al.
A Randomized Phase 2 Study Comparing 2 Stereotactic Body Radiation Therapy Schedules for Medically Inoperable Patients With Stage I Peripheral Non-Small Cell Lung Cancer: NRG Oncology RTOG 0915 (NCCTG N0927).Int J Radiat Oncol Biol Phys. 2015 Nov 15;93(4):757-64
The RMAS Department Research Programs are grouped together under the Center for Translational Radiation Medicine and Imaging (CTRMI). With the opening of the new Clinical Translational Research Institute (CTRI) in the 2016, the CTRMI physician and physicist faculty will be relocated to the CTRI building (shown at right). See individual research faculty under People.
Schematic floor plan for the dedicated RMAS Research space in the CTRI (the 4th floor offices and adjoining research space is shown in light green). A separate wet lab area is on the lower level. In addition to the CTRMI, the RMAS Department has dedicated lab space in the Moores Cancer Center Building, housing the labs of both Drs Advani and Sharabi.
Drs. Simpson, Hattangadi-Gluth, Mell and Mundt at the ribbon-cutting of the new CTRI in Spring 2016. Dr. Mell serves at the Director of the Center for Translational Radiation Medicine and Imaging (CTRMI).
The Department is committed to the success of the Research Faculty and the Center as thus provides considerable annual infrastructure and staff support ($250K/year) and Department Seed Grants ($300K/year). In addition, the Department provides annual support for research recruitment packages, totaling $375K in 2015.
Department Research is divided into 5 main areas: Outcomes Research, Technology Research, Imaging Research, Basic Science Research, and Clinical Trials Research. Several of the Department Researchers and their programs are highlighted below.
Loren Mell MD is an Associate Professor and Director of the Division of Clinical and Translational Research and the Director of the Center for Translational Medicine and Imaging. His primary focus has been on the development and application of novel radiation approaches in patients with cervical cancer and other malignancies. He is the founder and Principal Investigator of an international radiation cooperative group focused on the use of advanced technologies in women with cervical cancer, with members throughout the United States and in 25 foreign countries.
Dr. Mell has developed novel planning approaches to reduce bone marrow toxicity in patients receiving chemoradiotherapy, a major barrier to increasing treatment intensity. An ASCO Young Investigator Award recipient, Dr. Mell has developed statistically-based approaches to identify critical BM areas which can be spared during treatment. He has also investigated, together with Graeme Bydder MD (Radiology), novel imaging approaches to characterize BM sub-regions, many of which were developed here at UC San Diego.
T2* Pulse Echo MR image (left) of
a cervical cancer patient undergoing treatment used map areas of hematopoetically active bone marrow (middle).
Select Mell Lab Publications:
Carmona R et al. Improved method to stratify elderly patients with cancer at risk for competing events. J Clin Oncol 2016
Carmona R et al.Fat composition changes in bone marrow during chemotherapy and radiation therapy.Int J Radiat Oncol Biol Phys 2014;90:155
Zakeri K et al.Competing events and costs of clinical trials: Analysis of a randomized trial in prostate cancer.Radiother Oncol 2015;115:114
In 2009, Dr. Sunil Advani, Associate Professor, joined the Department launching our Basic Science Program. He currently serves as the Associate Director for Basic Science Research in the Division of Clinical and Translational Research,
His initial work focused on interactions of ionizing radiation and vaccinia viruses. Preliminary data suggest that irradiating tumors prior to virus administration significantly increases viral replication and cell kill. Experiments are underway to explore the mechanism of this interaction which laid the foundation for a clinical trial currently underway combining virus, chemotherapy and radiation in locally advanced head and neck cancer patients.
Dr. Advani is also closely collaborating with other basic scientists in the Cancer Center including David Cheresh PhD and Nobel Laureate Roger Tsien PhD.
Select Advani Lab Publications:
Advani S et al.Kinase-independent role for CRAF-driving tumour radioresistance via CHK2.Nature Commun 2015;6:8154
Buckel L et al.Tumor radiosensitization by monomethyl auristatin E: mechanism of action and targeted delivery.Cancer Res 2015;75:1376-87
Dr. Hattangadi-Gluth, Assistant Professor is the Associate Director for Imaging Research in the Division of Clinical and Translational Research. Her research focuses on the use of innovative functional MRI in radiation planning, measuring response to radiation in brain tissue, and neurocognition and quality of life after brain radiation therapy.
Her current work involves the quantitative and neuro-anatomic analysis of radiation-induced white matter compromise in the brain and correlation to cognitive impairment. This is an innovative and ground-breaking endeavor with direct implications on treatment planning and cognitive-sparing brain radiotherapy. Dr. Hattangadi-Gluth is a recent recipient of a K Award from the UC San Diego Clinical Translational Research Institute (CTRI) supporting her work.
Select Hattangadi-Gluth Lab Publications:
Karunamuni R,et al.Dose-Dependent Cortical Thinning After Partial Brain Irradiation in High-Grade Glioma.Int J Radiat Oncol Biol Phys 2016;94:297
Marshall DC et al.Disclosure of Industry Payments to Physicians: An Epidemiologic Analysis of Early Data From the Open Payments Program.Mayo Clin Proc 2016;91:84
Marshall DC et al.Management patterns of patients with cerebral metastases who underwent multiple stereotactic radiosurgeries.J Neurooncol 2016
Associate Professor Dr. Jim Murphy's research interests revolve around improving healthcare delivery in radiation oncology, with a focus on three areas: eliminating treatment disparity, reducing cost, and increasing quality of care. With treatment disparity he has partnered with Elena Martinez on a large-scale epidemiology project in metastatic colorectal cancer where they have discovered that racial differences in referral patterns and subsequent treatment account for a substantial portion of the inferior survival that minority patients experience. This study will help identify barriers that once tackled will reduce racial disparity and improve outcomes and was accepted for publication in the prestigious Journal of the National Cancer Institute (JNCI).
With cost, ongoing research will help define the magnitude and impact of patient out-of-pocket cost for health care in patients receiving radiation therapy. This research will quantify this potentially substantial underreported burden for cancer patients. Dr. Murphy is a recent recipient of several research grants including a K Award from the Clinical Translational Research Institute, a Young Investigator Award from the NCCN and Grants from the Radiologic Society of North America (RSNA) and the American Society for Clinical Oncology (ASCO).
Select Murphy Lab Publications:
Boero IJ et al.Modern Radiation Therapy and Cardiac Outcomes in Breast Cancer. Int J Radiat Oncol Biol Phys 2016;94(4):700-8.
Boero IJ et al.
Importance of Radiation Oncologist Experience Among Patients With Head-and-Neck Cancer Treated With Intensity-Modulated Radiation Therapy. J Clin Oncol. 2016;34:684-90
Boero IJ et al.The impact of radiotherapy costs on clinical outcomes in breast cancer. Radiother Oncol. 2015;117:393-9
Dr. Simpson is an Assistant Professor and his research is focused on the use of non-invasive bioimaging markers in oncology and incorporation of novel imaging modalities into radiation treatment planning. His primary research project is designed to evaluate the diagnostic accuracy of restricted spectrum imaging (RSI), a novel MRI diffusion technique, for pre-surgical assessment of treatment response in patients undergoing neoadjuvant radiation therapy for rectal cancer (see below). RSI offers several advantages over other radiographic modalities traditionally used in rectal cancer including improved tumor conspicuity and improved specificity for differentiating tumor from inflammation, thus making it an attractive biomarker for treatment response in rectal cancer. The goal of this research is to provide an image-based approach for determining which patients would be optimal candidates for rectal-sparing treatment.
Dr. Simpson is also working towards a secondary long-term project aimed at developing a functional imaging technique that is capable of imaging the immune response within tumors. Emerging evidence suggests that tumor immune cells play a key role in tumor behavior, and multiple studies have shown improved outcomes in various cancer types with immunotherapy agents such as ipilimumab and nivolumab. However, responses to these
therapies are only seen in a fraction of patients, and presently there are no reliable methods to identify which patients will benefit from these therapies. His research group is developing a novel radiotracer,
68Ga-tilmanocept (left), as a putative "immuno-imaging" agent. This tracer is a receptor-targeted molecule that binds to receptors found on tumor-associated macrophages that have been shown to inhibit immune responses within tumors. This agent has potential as a non-invasive prognostic marker that may help to direct cancer therapy at an individual level.
Select Simpson Lab Publications:
Simpson DR et al.Targeting the PI3K/AKT/mTOR pathway in squamous cell carcinoma of the head and neck. Oral Oncol. 2015 ;51:291-8:
Simpson DR et al.Clinical Outcomes of Computed Tomography-Based Volumetric Brachytherapy Planning for Cervical Cancer.Int J Radiat Oncol Biol Phys. 2015;;93:150
Simpson DR et al.Normal tissue complication probability analysis of acute gastrointestinal toxicity in cervical cancer patients undergoing intensity modulated radiation therapy and concurrent cisplatin.Int J Radiat Oncol Biol Phys. 2012
Recruited from Wake Forest University in 2014, Dr. James Urbanic joins the Department as an Associate Professor and Associate Division Chief for Clinical Trials in the Division of Clinical and Translational Research. He is actively involved in national cooperative group trials sponsored by the Alliance and NRG Networks.
He serves as the PI (or co-PI) of multiple cooperative group trials including CALGB 31102 and RTOG 1328, both focusing on concomitant chemoradiotherapy in locally advanced lung cancer. Dr. Urbanic is also the UC San Diego Proton Center Medical Director.
Select Urbanic Lab Publications:
Kilburn JM et al.
Is a Clinical Target Volume (CTV) Necessary in the Treatment of Lung Cancer in the Modern Era Combining 4-D Imaging and Image-guided Radiotherapy (IGRT)?Cureus. 2016;8(1):e466.
Videtic GM et al.
A Randomized Phase 2 Study Comparing 2 Stereotactic Body Radiation Therapy Schedules for Medically Inoperable Patients With Stage I Peripheral Non-Small Cell Lung Cancer: NRG Oncology RTOG 0915 (NCCTG N0927).Int J Radiat Oncol Biol Phys. 2015;93:757-64
Kilburn JM et al.Image guided radiation therapy may result in improved local control in locally advanced lung cancer patients.Pract Radiat Oncol. 2015
Dr. Kevin Moore is an Associate Professor and the Deputy Director of the Division of Medical Physics and Technology. Together with physicist and physician collaborators, he is developing novel knowledge-based treatment planning approaches in stereotactic radiosurgery for benign and malignant tumors.
Knowledge-based planning involves applying prior knowledge from large datasets of previously treated patients in order to optimize treatment planning of new patients, significantly improving plan quality. Initially applied to head/neck and prostate cancer patients undergoing conventional fractionation, Dr. Moore is also applying this novel approach to optimizing clinical trials.
Select Moore Lab Publications:
Shiraishi S et al.Knowledge-based prediction of three-dimensional dose distributions for external beam radiotherapy.Med Phys. 2016;43:378
Moore KL et al.Quantifying Unnecessary Normal Tissue Complication Risks due to Suboptimal Planning: A Secondary Study of RTOG 0126.Int J Radiat Oncol Biol Phys. 2015;92:228-35
Olsen La et al.Automated radiation therapy treatment plan workflow using a commercial application programming interface.Pract Radiat Oncol. 2014;4:358-67
The Sharabi lab is focused on understanding the fundamental interactions between radiation and the immune system and identifying strategies to combine radiation with immunotherapy. Dr. Sharabi has a M.D and Ph.D. in Immunology and completed his Residency in Radiation Oncology at Johns Hopkins. His long term goal is to directly advance patient care and improve outcomes in cancer patients though translational research.
While at Johns Hopkins, Dr. Sharabi published one of the first studies combining stereotactic radiation with anti-PD-1 checkpoint blockade immunotherapy. His work identified a role for stereotactic radiation in inducing antigen specific anti-tumor immune responses and that antigen cross presentation may be required for the immune stimulatory effects of radiation. Additionally his work demonstrated that stereotactic radiation can induce antigen-specific memory T-cells.
In order to translate these findings into the clinic,Dr. Sharabi is involved in a number of clinical trials. He is a Co-Investigator on J1382: A Pilot Study of Stereotactic RadioSurgery combined with Ipilimumab in Patients with Newly Diagnosed Melanoma Metastases in the Brain and Spine. He is also a Co-Investigator on J13158: Evaluation of Immunologic Responses in HPV-Associated Oropharyngeal Carcinoma Patients Receiving Chemoradiation Therapy at Johns Hopkins Hospital. At UC San Diego he is the Principle Investigator on a Phase II Randomized study to determine the benefit of adding SBRT to checkpoint blockade immunotherapy.
Select Sharabi Lab Publications:
Sharabi AB et al.Radiation and checkpoint blockade immunotherapy: radiosensitisation and potential mechanisms of synergy.Lancet Oncol. 2015;16:e498-509
Sharabi AB et al.Stereotactic radiation therapy combined with immunotherapy: augmenting the role of radiation in local and systemic treatment.Oncology (Williston Park). 2015;29:331-40
Dr. Cerviño's interest lies in the application of engineering and development of technology towards image-guided radiation therapy, motion management, and safety and quality in radiotherapy.
An area Dr. Cerviño is actively working on is medical imaging in radiotherapy, with projects such as deformable registration for dose accumulation in gynecological brachytherapy, tumor location
identification, and surface imaging. Some of these projects overlap with motion management, where Dr. Cerviño is interested on tumor motion characterization, imaging of moving tumors, and surrogate tracking. In the last couple of years, Dr. Cerviño has participated in several safety and quality projects. Development of web tools to perform quality assurance and re-structuring of peer review has been her main focus.
Select Cervino Lab publications:
Harry T et al. Cardiac dosimetric evaluation of deep inspiration breath-hold level variances using computed tomography scans generated from deformable image registration displacement vectors.Med Dosim. 2016;41:22-7
Zhen et al.A segmentation and point-matching enhanced efficient deformable image registration method for dose accumulation between HDR CT images.Phys Med Biol. 2015;60:2981-3002.
A Professor in the Division of Medical Physics and Technology, Dr. Moiseenko's research focuses on three main areas: outcomes analysis, functional imaging for radiotherapy optimization and Monte Carlo simulation.
Select Moiseenko Lab Publications:
Kimsey F et al.
Dose-Response Model for Chest Wall Tolerance of Stereotactic Body Radiation Therapy. Semin Radiat Oncol. 2016;26:129-34.
Moiseenko V et al.
Biological dosimetry to assess risks of health effects in victims of radiation accidents: Thirty years after Chernobyl. Radiother Oncol. 2016
Lucido JJ et al.
A method to perform multi-scale Monte Carlo simulations in the clinical setting.
Lucido JJ, Popescu IA, Moiseenko V. Radiat Prot Dosimetry. 2015 Sep;166(1-4):356-60
In addition to the above dedicated research faculty, many of the clinical faculty also performed clinical outcomes and other research projects. Examples of recent clinical research publications by clinical faculty are shown below.
As the long-time Residency Program Director at the University of Chicago, Dr. Mundt was committed to establishing a Radiation Oncology residency program at UC San Diego upon his arrival. Moreover, as a member of the national accreditation committee for Medical Physics Residency Programs, he was also committed to developing a Residency Program in Medical Physics at UC San Diego. See Education and Training for details about the various education/training programs.
The Radiation Oncology residency program was approved by in 2010 initially with 4 residents. In 2012, the complement was increased to 8 and in 2014 to 12. Dr. John Einck (right), who previously served as the Program Director at the University of Washington, is the Residency Program Director. Dr. Derek Brown (left) is the Medical Physics Residency Director.
The current Medical Physics Residents are:
Shyam Jani PhD (far left) 1st Year and Adam Yock PhD (2nd from left) 2nd YearTze Lim PhD (2nd from right) and Samantha Llyod PhD (far right) will join the Department in 2016, the first class of 2 physics residents.
The current Medical Residents are:
The 3 new residents who will be joining the department in July 2016 are:
In March 2016, the following 3 medical students were matched and will join the Department in July 2017:
Aaron Simon MD PhD
Christine Feng MD
Deborah Marshall MD
The Radiation Oncology faculty members are very involved with medical student education and oversee multiple courses including the 4th Year clerkship, the 3rd Year Selective rotation and two research electives. Radiation Oncology is part of the 2nd year curriculum as well. The Director of Medical Student Education is Jim Murphy MD.
Dr. Mell (far left) and Dr. Mundt (far right) with 4th Year Medical Students Brent Rose (2nd from left), Daniel Simpson (3rd from left) and Sameer Nath (2nd from right). Dr. Mundt "hooding" Dr. Simpson. Both Drs. Simpson and Rose are currently UC San Diego faculty following their residencies at UC San Diego and Harvard, respectively.
Faculty members also participate in national education programs for Radiation Oncologists and Medical Physicists, sponsored by ASTRO and AAPM. Facultyeducation efforts even include yearly educational programs for San Diego High School students at a variety of schools. Each year, Dr. Yashar provides lectures and tours of the Department to high school girls interested in careers in medicine and science as part of the BE WISE (Better Education for Women in Science and Engineering) Program.
Catheryn Yashar MD, Associate Professor and Director of Medical Student Education, presenting to BE WISE students at the Moores Cancer Center
In 2010, the Department launched the UC San Diego Radiation Oncology Learning Center offering e-learning classes on a variety of cancer topics and treatment procedures to physicians and physicists worldwide. On-line classes are currently available on SBRT, SRS and Paperless Technologies. Dr. Derek Brown was named the Learning Center Director in 2014.
Learning Center Brochurehttp://radonc.ucsd.edu/lc/index.asp
A component of the Learning Center is remote treatment planning, providing centers around the world the opportunity to offer their patients sophisticated treatment planning despite their lack of new software and experienced personnel.
In addition, the Department sponsors on-site training courses for the employees of vendors. The extremely popular Cancer 101 course is held quarterly in the Department for new Varian employees, providing participants with an in-depth review of oncology focusing on the role of radiation oncology in the treatment of adult and pediatric patients.