Predicting ocular outcomes, quality of life and survival after proton beam radiotherapy of choroidal melanoma

预测脉络膜黑色素瘤质子束放射治疗后的眼部结果、生活质量和生存率

• 批准号: 10203994
• 负责人: Armin Reza Afshar
• 金额: $ 21.04万
• 依托单位: UNIVERSITY OF CALIFORNIA, SAN FRANCISCO
• 依托单位国家: 美国
• 财政年份: 2017
• 资助国家: 美国
• 起止时间: 2017-09-30 至 2023-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10203994
• 关键词: Academy; Adult; Affect; Age; American; Anxiety; Biological Assay; Biometry; California; Caring; Cause of Death; Cellular Phone; Cessation of life; Choroid Melanoma; Chromosome 3; Clinic; Clinical; Clinical Research; Collaborations; Combined Modality Therapy; Comparative Study; Computerized Medical Record; Counseling; Data; Data Set; Database Management Systems; Diagnostic; Diagnostic tests; Disease; Employment Status; Excision; Eye; Fluorescent in Situ Hybridization; Fostering; Foundations; Future; Gender; Genetic; Goals; Health; Informed Consent; Interdisciplinary Study; International; K-Series Research Career Programs; Lead; Life; Liver; Longterm Follow-up; Malignant Neoplasms; Marital Status; Mental Depression; Mentors; Methodology; Modeling; Molecular; Moods; Morbidity - disease rate; Multicenter Studies; Neoplasm Metastasis; Ocular Melanoma; Oncology; Ophthalmology; Organ; Outcome; Pain; Pathologist; Patient Care; Patient Outcomes Assessments; Patient-Focused Outcomes; Patients; Personal Computers; Phototherapy; Publications; Quality of life; Questionnaires; Radiation therapy; Radiometry; Registries; Research Design; Research Training; Risk; San Francisco; Testing; Therapeutic; Training; Training Programs; Tumor stage; Universities; Uveal Melanoma; Validation; Vision; Visual; Visual Acuity; Writing; anxious; apprenticeship; career; chromosome 3 loss; clinical database; clinical practice; clinical predictors; cohort; electronic data; experience; facial disfigurement; improved; individual patient; laboratory experience; large datasets; malignant neoplasm of eye; molecular diagnostics; molecular pathology; multidisciplinary; next generation; next generation sequencing; novel; predictive modeling; prognostic; prognostic assays; prognostic model; prognostic of survival; programs; prospective; proton beam; psychologic; psychological outcomes; randomized trial; secondary analysis; social factors; statistics; tool; tumor

PROJECT SUMMARY/ABSTRACT I am applying for a Career Development Award (K23) in ocular oncology. A K23 will allow me to establish a clinical research program to enhance prognostication and improve holistic care for patients with choroidal melanoma. The proposed research and training will provide the foundation for an R01/UG1 proposal to develop an international ocular melanoma registry, fostering multi-center comparative studies with large datasets. My long-term career goals are to: 1) lead a multidisciplinary ocular oncology team at University of California, San Francisco (UCSF); 2) create a prospective database of clinical outcomes, molecular pathology data and patient- reported outcomes (PROs) to predict ocular outcomes, survival and quality of life (QOL); 3) advance randomized trials and multicenter collaboration in ocular oncology, to advance diagnostics and therapeutics. My training objectives are to: 1) master advanced biostatistics methodology, database management and study design through didactic courses and apprenticeships, working with renowned mentors in ocular oncology, molecular pathology and statistics; 2) understand molecular diagnostics in uveal melanoma and how to evaluate new prognostic and diagnostic tests in clinical practice, through mentored laboratory experiences with a pre-eminent molecular pathologist; 3) engage in multidisciplinary research, in collaboration with international colleagues, forming connections for future multi-center studies; and 4) become proficient in scientific writing. The specific aims of this project are to: 1) develop and validate prognostic models for predicting visual outcome, local tumor control and ocular conservation after proton beam radiotherapy for choroidal melanoma. We will test the hypothesis that radiation dosimetry predicts such outcomes better than baseline clinical features. 2): validate a targeted next-generation genetic sequencing (NGS) assay as a prognostic test for survival in choroidal melanoma. We hypothesize that NGS of choroidal melanoma reliably determines tumor lethality. 3): develop prognostic models for predicting PROs and QOL after proton beam radiotherapy for choroidal melanoma. We hypothesize that social factors are more predictive than ophthalmic features in determining PROs and QOL We will perform secondary analysis of an existing dataset of patients treated at the Liverpool Ocular Oncology Centre, mostly by the primary mentor (BD), to create and validate the prognostic models, which we will then evaluate in a cohort of patients at UCSF.

项目总结/摘要 我正在申请眼部肿瘤学的职业发展奖（K23）。K23可以让我建立一个 临床研究计划，以加强诊断和改善脉络膜患者的整体护理 黑素瘤拟议的研究和培训将为R 01/UG 1提案提供基础， 建立国际眼部黑色素瘤登记处，促进多中心比较研究， 数据集。 我的长期职业目标是：1）在加州大学领导一个多学科的眼部肿瘤团队， San弗朗西斯科（UCSF）; 2）创建临床结局、分子病理学数据和 患者报告结果（PRO），以预测眼部结果、生存率和生活质量（QOL）; 3） 眼科肿瘤学的随机试验和多中心合作，以推进诊断和治疗。 我的培养目标是：1）掌握先进的生物统计学方法，数据库管理， 通过教学课程和学徒制学习设计，与眼内知名导师合作 肿瘤学、分子病理学和统计学; 2）了解葡萄膜黑色素瘤的分子诊断学， 如何通过指导实验室在临床实践中评估新的预后和诊断测试 与杰出的分子病理学家的经验; 3）从事多学科研究，合作 与国际同行，为未来的多中心研究建立联系;以及4）精通 科学写作。 本项目的具体目标是：1）开发和验证预测视觉的预测模型 脉络膜质子束放射治疗后的结果、局部肿瘤控制和眼球保护 黑素瘤我们将检验辐射剂量测定法预测这些结果优于基线的假设 临床特征2）：验证靶向下一代基因测序（NGS）测定作为预后测试 对于脉络膜黑色素瘤的存活率。我们假设脉络膜黑色素瘤的NGS可靠地决定了 肿瘤致死率3）：建立预测质子束放疗后PRO和QOL的预后模型 脉络膜黑色素瘤我们假设社会因素比眼科特征更能预测 确定PRO和QOL我们将对现有的接受治疗的患者数据集进行二次分析， 利物浦眼肿瘤中心，主要由主要导师（BD）创建和验证 预后模型，然后我们将在UCSF的一组患者中进行评估。

项目成果

Systemic Corticosteroid Use after Central Serous Chorioretinopathy Diagnosis.

中心性浆液性脉络膜视网膜病变诊断后全身使用皮质类固醇。

• DOI: 10.1016/j.ophtha.2020.06.056
• 发表时间: 2021
• 期刊: Ophthalmology
• 影响因子: 13.7
• 作者: Azad,AmeeD;Zhou,Maggie;Afshar,ArminR;Bakri,SophieJ;Pershing,Suzann
• 通讯作者: Pershing,Suzann

The diagnostic utility of next-generation sequencing on FNA biopsies of melanocytic uveal lesions.

新一代测序对黑素细胞葡萄膜病变 FNA 活检的诊断效用。

• DOI: 10.1002/cncy.22264
• 发表时间: 2020
• 期刊: Cancer cytopathology
• 影响因子: 3.4
• 作者: Han,LucyM;Khanafshar,Elham;Afshar,ArminR;Calkins,SarahM
• 通讯作者: Calkins,SarahM

The Relative Impact of Patient, Physician, and Geographic Factors on Variation in Primary Rhegmatogenous Retinal Detachment Management.

患者、医生和地理因素对原发性孔源性视网膜脱离治疗变化的相对影响。

• DOI: 10.1016/j.ophtha.2019.04.019
• 发表时间: 2020
• 期刊: Ophthalmology
• 影响因子: 13.7
• 作者: Vail,Daniel;Pershing,Suzann;Reeves,Mary-Grace;Afshar,ArminR
• 通讯作者: Afshar,ArminR

Uveal Melanoma and the IRIS® Registry (Intelligent Research in Sight): A Pilot Analysis and Future Directions.

葡萄膜黑色素瘤和 IRIS® 注册（智能研究展望）：试点分析和未来方向。

• DOI: 10.1016/j.oret.2022.10.019
• 发表时间: 2023
• 期刊: Ophthalmology. Retina
• 作者: Uner,OgulE;Aronow,MaryE;Mruthyunjaya,Prithvi;Materin,MiguelA;Stacey,AndrewW;Wilson,Matthew;Afshar,Armin;Skalet,AlisonH
• 通讯作者: Skalet,AlisonH

Neuro-Ophthalmologic Monitoring of Leaking Arachnoid Cysts.

蛛网膜囊肿渗漏的神经眼科监测。

• DOI: 10.1097/wno.0000000000001440
• 发表时间: 2021
• 期刊: Journal of neuro-ophthalmology : the official journal of the North American Neuro-Ophthalmology Society
• 作者: Jarocki,Adrienne;Liao,Eric;DeLott,LindseyB
• 通讯作者: DeLott,LindseyB