Patients that I see routinely ask me about the heart-related side effects from breast treatment. Today, I can provide them with even greater evidence that the techniques that we use today are safer and have less risk of cardiac injury.
This observation and debate has been ongoing for a long time in medical literature. Most recently, an article in the New England Journal of Medicine concluded that adjuvant radiotherapy for breast cancer increases the rate of ischemic heart disease. The authors conclude that the risk is associated with the dose of radiotherapy to the heart and begins a few years after the treatment. Dr. Kesarwala, an expert radiation oncologist from Bethesda, reviewed the data and provided a report in the April issue of the ACR Journal Advisor. She noted that “nearly 80% of ...
Stereotactic Ablative Radiotherapy is a new term that has been coined to describe the delivery of very high doses of radiation delivered over a handful of treatment sessions. This precise method targets small tumors located in the lung. This new treatment has been pioneered and studied extensively in patients who are not suitable candidates for an operation but have been diagnosed with early stage Non-Small Cell Lung Cancer.
The advantages of this approach are that the treatment can be completed in 1-2 weeks (including the planning time), and only requires 3-5 treatments. The treatment requires highly specialized planning and preparation and is delivered using state of the art linear accelerators like the CyberKnife®. Our team has been offering stereotactic ablative radiotherapy for over 4 years.
The results are outstanding for this population of patients. A number of studies have demonstrated that the local tumor co...
Dr. Vivek Mehta is the lead investigator for the following clinical trials currently available at the Swedish Cancer Institute:
Tomblyn MB, Goldman BH, Thomas CR, Benedetti J, Lenz H, Mehta VK, Beeker T, Gold PJ, Abbruzzese JL, Blanke CD. Radiotherapy as definitive treatment for locally advanced, unresectable esophageal cancer: a phase II study of the SWOG (S0414). Journal of Thoracic Oncology. Accepted for publication 2012
Mehta VK. Radiotherapy and erlotinib combined: review of the preclinical and clinical evidence. Frontiers of Radiation Oncology, published online: 10 April 2012
Rao M, Wu J, Cao D, Wong T, Mehta VK, Shepard D, Ye J. Dosimetric impact of breathing motion in lung SBRT treatment using IMRT and VMAT. International Journal of Radiation Oncology, Biology, Physics. Accepted for publication, 2012.
Wong T, Cao D, Rao M, McCune K, Shepard D, Mehta VK. Stereotactic body radiation therapy for lung cancer using volumetric modulated arc therapy. Proceedings – 9th Southeast Asia Congress of Medical Physics, Springer Science; accepted for publication Nov 2011.
Fesinmeyer, M.D., Mehta, V.K, Blough, D., Tock, Lori, Ramsey,S.D., Effect of Radiotherapy Interruptions on Survival in Medicare Enrollees with Local and Regional Head-and-Neck Cancer. February 2010; J. Radiation Oncology.
Rao M., Yang W., Chen F., Sheng K., Ye J., Mehta V.K., Shepard D., Cao D., Comparison of Elekta VMAT with Helical Tomotherapy and Fixed Field IMRT: Plan Quality, Delivery Efficiency and Accuracy. Med. Phys. Volume 37, Issue 3, pp. 1350-1359 (March 2010).
Gordon Buduhan, Shekhar Menon, Ralph Aye, Brian Louie, Vivek Mehta, Eric Vallières, Trimodality Therapy for Malignant Pleural Mesothelioma. Ann Thorac Surg September 2009; 88: 870-876..
Mehta V.K., Dowlatshai K, Dooley W, Syzek E, Ahmad S, Griem KL, Dickler AT, Haile K, Wazer DE, Kurtzman S, Chadha M, Steven RE, Lerner A, Modin S, Elliott KW. Experience with an electronic brachytherapy technique for intracavitary accelerated partial breast irradiation. American Journal Clinical Oncology, August 2010; 33 (4): 327-35
Fesinmeyer MD, Mehta V.K., Tock L, Blough, D.,McDermott C, Ramsey S., Completion of Radiotherapy for Local and Regional Head and Neck Cancer in Medicare. Arch Otolaryngol Head Neck Surg. 2009;135(9):860-867
Benitez, P.R., Streeter, O., Vicini, F., Mehta, V.K., Quiet, C., Kusk, R., Hayes, M.K., Arthur, D., Kuerer, H., Freedman, G., Keisch, M., Dipetrill, T., Khan, D., Hudes, R., Preliminary Results and Evaluation of Mammosite Balloon Brachytherapy for Partial Breast Irradiation for Pure Ductal Carcinoma In Situ: a Phase II Clinical Study. American Journal Surgery 2006 Oct; 192(4): 427-33.
Mehta V.K., Wynn R., Reduction of Treatment Breaks and Radiation-Induced Esophagitis and Pneumonitis Using Amifostine Inunresectable Non-Small Cell Lung Cancer Patients Receiving Definitive Concurrent Chemotherapy and Radiation Therapy: A Prospective Community Based Clinical Trial. Seminars in Oncology 2005 Apr; 32 (2 Suppl 3):S99-104.
Mehta V.K., Radiation Pneumonitis and Fibrosis. J. Radiation Oncology 2005 Sep 1; 63(1):5-24.
Mehta V.K., Open Label Multi-center Trial of Subcutaneous Amifostine (Ethyol) in the Prevention of Radiation Induced Esophagitis and Pneumonitis in patients with Measurable, Unresectable Non-Small Cell Lung Cancer. Seminars in Oncology 2004; 31(suppl 18):42-46.
Koong A.C., Le Q.T., Ho A., Fong B., Fisher G., Cho C., Ford J., Poen J., Gibbs I.C., Mehta V.K., Kee S., Trueblood W., Yang G., Bastidas J.A. Phase I Study of Stereotactic Radiosurgery in Patients with Locally Advanced Pancreatic Cancer. J Radiation Oncology 2004; 58(4):1017-1021.
Mehta V. K., Goffinet D. Post Mastectomy Radiation Therapy after TRAM Flap Breast Reconstruction. The Breast Journal 2004; 10(2):118-22.
Mehta V.K., Ford J., Bastidas A.J., Cho, C., Jambalos, C., Poen, J., Koong, A.C., Lin A., Young, H., Fisher, G.A., A Phase II Trial of Preoperative 3D Conformal Radiotherapy, Protracted Venous Infusion 5-FU, Weekly CPT-11 Followed by Surgery for Ultrasound Staged T3 Rectal Cancer. J. Radiation Oncology 2003; 55(1):132-137.
Mehta V.K., Le, Q.T., Chang, S.D., Chenery, S., Adler, J.R., Fractionated Stereotactic Radiosurgery for Tumors Near the Optic Nerve. Technology in Cancer Research & Treatment 2002; 1(3):173-179.
Mehta V.K., Poen, J.C., Ford, J.M., Oberhelman, H.A., Vierra, M.A., Bastida, A.J., and Fisher, G.A., Protracted Venous Infusion 5-Fluorouracil with Concomitant Radiotherapy compared to Bolus 5-Fluorouracil for Unresectable Pancreatic Cancer. American Journal of Clinical Oncology, 2001; 24(2):155-59.
Smitt M.C., Mehta V.K., Is Diagnostic Review of Radiotherapy-Planning CT Scans Important in the Conformal Therapy Era? American Journal Roentgenol 2001 Sep; 177(3):521-4.
Gurung, R.A.R., Mehta, V.K., Relating Ethnic Identity, Acculturation, and Attitudes Toward Treating Minority Clients. Cultural Diversity and Ethnic Minority Psychology, 2001; 7(2):139-151.
Mehta V.K., Poen J.C., Vierra, M.A., Oberhelman H.A, Ford J.M., Fisher, G.A., Niederhuber J. and Bastidas, A.J., Preoperative Chemo Radiotherapy for Marginally Resectable PancreaticCancer. Journal of Gastrointestinal Surgery, 2001; 5(1):27-35.
Mehta, V.K., and Goffinet, D.R., Unsuspected Abnormalities Noted on CT Treatment Planning Scans Obtained for Breast and Chest Wall Irradiation. J Radiation Oncology 2001; 49(3):723-5.
Mehta, V.K., Fisher, G., Ford, J.M., Poen, J.C., Vierra, M.A., Oberhelman, H.A., and Bastidas, A.J., Adjuvant Chemoradiotherapy for “Unfavorable” Carcinoma of the Ampulla of Vater: A Preliminary Report. Archives of Surgery 2001; 136:65-69.
Mehta, V.K., Poen, J., Ford, J., Young, H., Bastidas, A.J., Vierra, M.A., Edelstein, P., Fisher, G.A., Radiotherapy, Concomitant Protracted Venous Infusion 5-Fluorouracil, and Surgery for Ultrasound Stage T3/T4 Rectal Cancer. Dis Colon Rectum 2001; 44:52-58.
Mehta, V.K., Fisher, G.A., Ford, J.M., Oberhelman, H.A., Vierra, M.A., Bastidas, A.J., and Poen, J.C., Adjuvant Radiotherapy and Concomitant 5-Fluorouracil by Protracted Venous Infusion for Resected Pancreatic Cancer. J. Radiation Oncology 2000; 48:1483-1487.
Koong, A.C.*, Mehta, V.K.*, Le, Q.T., Fisher, G.A., Terris, D.J., Brown, J.M., Vierra, M.A, and Bastidas, A.J., A Pancreatic Tumors Show High Levels of Hypoxia. J. Radiation Oncology 2000; 48:919-922. *CO -FIRST AUTHORS
Mehta, V.K., Blume, G. Randomized Clinical Trial of Fluoxetine in a Patient with Persistent Fatigue. Journal of American Board of Family Practice 1995; 8:230-232.
Mehta V.K., Namboodiri, M.A.A., N-acetylaspartate as an Acetyl Source in the Nervous System. Molecular Brain Research 1995; 31:151-57.
Mehta V.K., Hao W., Brooks-Worrell B., Palmer J., Low dose Interleukin-1 and Tumor Necrosis Factor Individually Stimulate Insulin Release But in Combination Cause Suppression. European Journal of Endocrinology 1994; 130:208-14.
Hao W., Li L., Mehta V.K., Lernmark A., Palmer J., The Functional State of the Beta Cell Affects Expression of Both Forms of Glutamic Acid Decarboxylase. Pancreas 1994; 9:558-562.
Mehta V.K., Hao W., Brooks-Worrell B., Palmer J., The Functional State of the Beta Cell Modulates Interleukin-1 and Tumor Necrosis Factor Induced Cytotoxicity. Lymphokine and Cytokine Research 1993; 12:255-259.
Mehta V.K., Pancreatic Cancer. In: Medical Radiology – Radiation Oncology: An Evidence-Based Approach. Edited by Jiade J. Lu and Luther W. Brady. (2008)
Mehta V.K., Fisher GA. Carcinoma of the Ampulla of Vater. In: Medicine, Surgery, and Gynecology. Edited by M Perry, F Talavera, M Kahn, S Plantz, M. Zevitz. EMedicine, 2000. (in press)
Mehta VK, Fisher GA. Gastric Cancer. In: Medicine, Surgery, and Gynecology. Edited by M Perry, F Talavera, M Kahn, S Plantz, M Zevitz. EMedicine, 2000. (in press)
Mehta VK, Palmer J. The natural history of the IDDM disease process. In: Palmer J, ed., Prediction, Prevention, and Genetic Counseling in IDDM. New York: John Wiley and Sons, 1996:1-17.
Megan Dann Fesinmeyer, Mehta, V.K, David Blough, Lauri Tock, Scott D. Ramsey, Effect of Radiotherapy Interruptions on Survival in Medicare Enrollees with Local and Regional Head-and-Neck Cancer. Corrected Proof, February 2010; J. Radiation Oncology, DOI: 10.1016/ j.ijrobp.2009.08.004
T.P. Wong, M. Rao, D. Cao, J. Ye, D. Shepard, V. Mehta, Image Guided Stereotactic Body Radiotherapy for Lung Cancer Using 4D Treatment Planning and On-line Cone-beam CT. J. Radiation Oncology, Vol.75, No.3, Supplement 2009.
C.R. Thomas, B.H. Goldman, J.K. Benedetti, H.J. Lenz, T.A. Baker, L. Hammond-Thelin, Mehta, V.K. , C.M. Fenoglio-Preiser, J.L. Abbruzzese, C.D. Blanke Etuximab (C225) Plus Cisplatin (CDDP) Irinotecan (CPT11) and Thoracic Radiotherapy (TRT) Definitive Treatment for Locally-advanced, Clinically Unresectable Esophageal Cancer: A Southwest Oncology Group (SWOG) Phase II Trial with Molecular Correlates (S0414). J. Radiation Oncology, November 2009 , Vol. 75, Issue 3, Supplement, Page S168
W. Logan, J. Ye, V. Mehta, B. Douglas, Evaluation of Block Margin and Dose Heterogeneity in Extracranial Stereotactic Radiotherapy of the Lung with 1cm MLC Leaves. J. Radiation Oncology, Vol.75, No.3, Supplement 2009.
J. Ye, T. Wong, D. Cao, M. Afghan, D. Shepard, V. Mehta, Is it Necessary to Acquire Post Shift Verification Cone Beam CT? J. Radiation Oncology Supplement 2008, Vol.72, No.1, Pg S648-9
D.M. Shepard, D. Cao, M.K.N. Afghan, V. K. Mehta, Dysphagia Optimized Head and Neck Volumetric Modulated Arc Therapy. J. Radiation Oncology September 2008, Vol. 72, Issue 1, pS25.
T. Wong, K. McCune, J. Ye, D. Cao, M. Afghan, D. Shepard, V. Mehta Evaluation of Tumor Response and an Adaptive Treatment Strategy in Lung Radiotherapy using Cone-beam CT. J. Radiation Oncology Supplement 2008, Vol. 72, No. 1, pS604
D. Cao, M.K.N. Afghan, J. Ye, T.P. Wong, V. Mehta, D.M. Shepard, Treatment Planning and Delivery of Volume Modulated Arc Therapy (VMAT). J. Radiation Oncology Supplement 2008, Vol. 72, No. 1, pS26
M.K.N. Afghan, D. Cao, V. Mehta, T. Wong, J. Ye, D. Shepard, Volumetric Modulated Arc Therapy for Prostate Cancer. J. Radiation Oncology, Supplement 2008, Vol. 72, No. 1,pg S665-666
A. Shiu, C.H. Wang, J. Ye, C. Cotrutz, R. Meier, V. Mehta, S. Vermeulen, E.L. Chang. Dose Distribution Comparison for the IGR Treatment Using CyberKnife versus LINAC IMRT Stereotactic Body Radiotherapy. J. Radiation Oncology, Nov 2007, Vol 69, Issue 3, pS689
V.K. Mehta, J. Ye, T. Wong, D. Cao, D. Shepard, Use of Daily kV Cone Beam CT to Evaluate Two Off-Line Correction Strategies for IGRT in Thoracic and Abdominal Radiotherapy. J. Radiation Oncology, Vol. 69, No.3, Supplement 2007,pS726
V.K. Mehta, J. Ye, D. Cao, D. Shepard, T. Wong, Evaluation of a Motion-Encompassing Treatment Strategy for Treating Non-Small Cell Lung Cancer. J. Radiation Oncology, Vol. 69, No.3, Supplement 2007, pS503-504
Mehta, V.K., E. Vallieres, J. Ye, K. McCune, G. Buduhan, R. Aye, B. Louie, M. Abboud-Finch, T. Wong. Early Results of Adjuvant IG-IMRT Following Extrapleural Pneumonectomy (EPP) for Malignant Pleural Mesothelioma; Journal of Thoracic Oncology. 3(11) Supplement 4:S263-S305, November 2008
Fesinmeyer MD, Mehta V, Blough DK, Barron RL, Ramsey SD. A retrospective evaluation of radiation therapy treatment patterns among Medicare enrollees with H&N cancer. J. Radiation Oncology, September 2008, Vol 72, Issue 1, pS422
Meier R, Mehta V, Vermeulen S, Young R. Dose-response and dose-complication relationships in stereotactic radiosurgery for trigeminal neuralgia. J. Radiation Oncology Sep 2004, Vol 60, Issue 1, p5-24
Su C, Mehta VK, Ravikumar L, Shah R, Pinto H, Halpern J, Koong A, Goffinet D, Le QT. Phase II randomized study comparing oral aloe vera (AV) versus placebo to prevent RT related mucositis in patients with head and neck (HN) neoplasm’s. J. Radiation Oncology, September 2004; 60(1):171-7.
Mehta VK, Meier R, Gilrein J, Vermeulen S, Young R. Gamma Knife Radiosurgery for Treatment of Trigeminal Neuralgia. J. Radiation Oncology, 2003; 57, 2, supplement, 13, Abstract#21
Meier R, Hatton J, Mehta VK. Forward-Planning Breast IMRT Early Clinical Experience. J. Radiation Oncology, October 2003, Vol. 57, Issue 2, supplement page S369, Abstract #2042
C.R. King, Mehta, V.K, S.L. Hancock, Radiotherapy after radical prostatectomy: improved outcomes when combined with transient androgen suppression. J. Radiation Oncology, October 2002, Vol. 54, Issue 2, Supplement, Pages 63-64
Mehta VK, Fisher G, Ford J, Edelstein P, Poen J. Preoperative chemoradiotherapy for ultrasound staged T3, T4, or N+ Rectal Cancer. Radiotherapy and Oncology. Vol 58 (suppl 1), 2001, pS35 (Abstract 123).
Mehta VK, Fisher G, Ford J, Bastidas A, Vierra M, Poen J. Adjuvant Chemoradiotherapy for carcinoma of the ampulla of Vater. Radiotherapy and Oncology. Vol 58, 2001, pS37 (Abstract 127).
Mehta VK, Fisher G, Ford J, Bastidas JA, Vierra M, Oberhelman H, and Poen J. Preoperative Chemoradiotherapy for Marginally Resectable Pancreatic Cancer. The Cancer Journal, vol 6 (2), 2000, p101 (Abstract 15).
Mehta VK, Edelstein P, Poen J, Fisher G, Ford J. Preoperative chemoradiotherapy for locally advanced rectal cancer. Proceedings of ASCO vol 19, 2000, p309a (abstract 1221).
Koong A, Mehta VK, Le QT, Giaccia AJ, Ibrahim H, Terris D, Fisher G, Vierra M, and Bastidas A. Tumor hypoxia in human pancreatic and peripancreatic cancers. Proceedings of ASCO vol 19, 2000, p657a (Abstract 2592).
L. Xing, S. Crooks, J.G. Li, C. Ozhasoglu, Y. Chen, A. Beavis, Mehta VK, D. Goffinet, and A.L. Boyer. Incorporating respiratory motion into the design of intensity maps in IMRT treatment of breast cancer. J. Radiation Oncology 2000, Vol 48, No. 3, p199 (Abstract 175).
Mehta VK, Chang SD, Chenery S, Adler JR, and Le QT. Fractionated Stereotactic Radiosurgery for Tumors Near the Optic Nerve. Neuro-Oncology 2000, Vol 2, p281 (Abstract 145).
Mehta VK, Chen Y, Xing L, Goffinet DR, Fisher GA, Le QT. IMRT for Hypofractionated Radiotherapy for Unresectable Liver Lesions. Radiology 2000, Vol 217, p147 (abstract 203RO).
Mehta VK, Fisher GA, Ford J, Edelstein P, Poen J. Three dimensional conformal radiotherapy and concurrent protracted venous infusion 5-FU for locally advanced rectal cancer: The Stanford University Experience. Proceedings of ASCO, vol 13, 1999.
“Partial Breast Radiotherapy Options.” American Society of Breast Surgeons Annual Meeting, March 18, 2005, Los Angeles, CA.
“Electronic Brachytherapy for Partial Breast Radiotherapy.” ACRO Annual Meeting, February 25, 2005, Las Vegas, NV.
“A Trial of Amifostine to Reduce Acute Toxicity in Chemoradiotherapy in NSCLCa.” North Carolina Lung Cancer Consortium, November 2004, St. Thomas, US Virgin Islands.
“Radiation Pneumonitis and Esophagitis Associated with Chemoradiotherapy in NSCLCa.” Cytoprotection Congress, May 2004, Montego Bay, Jamaica.
“State of the Art Management of T3 Rectal Cancer.” Stanford GI Oncology Symposium, October 2004, Palo Alto, CA.
“Preoperative Chemoradiotherapy for Resectable Rectal Cancer.” GI Oncology Symposium, June 2003, Palo Alto, CA.
“Preoperative Chemoradiotherapy for ultrasound staged T3, T4, or N+ Rectal Cancer”, International Congress of Radiation Oncology, January 2001, Melbourne, Australia.
“Adjuvant Chemoradiotherapy for Resected High Risk Gastric Cancer: A Phase II Trial”, Gastrointestinal Research Conference, November 2000, Orlando, FL.
“Motion Tracking for Respiratory Motion in Radiosurgery” ASTRO Annual Meeting, October 2000, Boston, MA.
“Review of Treatment Planning Scans, Unsuspected Abnormalities” Oncology Symposium, October 2000, Boston, MA
Streeter O, Silverstein M, Vicini F, Mehta VK, Quiet C, Kuerer H, Strom E, Freedman G, Arthur D, DiPetrillo T, Keisch M, Hayes MK. A Phase II Clinical study to evaluate the efficacy of the Mammosite as the sole radiation technique for patients with pure ductal carcinoma in situ. National Consortium of Breast Centers, Las Vegas, NV. February 27-March 2, 2005.
Streeter O, Vicini F, Mehta VK, Quiet C, Kuerer H, Strom E, Freedman G, Arthur D, DiPetrillo T, Keisch M, Hayes MK. Phase II Clinical study to evaluate the efficacy of the Mammosite as the sole radiation technique for patients with pure ductal carcinoma in situ. St Gallen Oncology Conference, St Gallen, Switzerland, Jan 26-29, 2005.
“Fractionated stereotactic radiosurgery for tumors near the optic nerve”, Society for Neuro-Oncology Annual Meeting, October 2000, Chicago, IL.
“Preoperative Chemoradiotherapy for Marginally Resectable Pancreatic Tumors”, American Radium Society Annual Meeting, April 2000, London, England.
“Single Fraction Stereotactic Radiosurgery for Unresectable Pancreatic Cancer”, Linac Radiosurgery Meeting, December 1999, Orlando, FL.
“Bolus 5-FU versus Protracted Venous Infusion 5-FU with radiotherapy in the management of pancreatic cancer: A comparison of Two Protocols”, RSNA Annual Meeting, November 1999, Chicago, IL.