Joseph M. Herman, MD, MSc

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Articles

ACR Appropriateness Criteria® Borderline and Unresectable Pancreas Cancer

William Small, Jr, MD;John P. Hayes, MD;W. Warren Suh, MD, MPH;May Abdel-Wahab, MD, PhD;Ross A. Abrams, MD;Nilofer Azad, MD;Prajnan Das, MD, MS, MPH;Jadranka Dragovic, MD;Karyn A. Goodman, MD;Salma K. Jabbour, MD;William E. Jones III, MD;Andre A. Konski, MD, MBA, MA;Albert C. Koong, MD, PhD;Rachit Kumar, MD;Percy Lee, MD;Timothy M. Pawlik, MD;Joseph M. Herman, MD, MSc

July 15th 2016

These guidelines review the use of radiation, chemotherapy, and surgery in borderline and unresectable pancreas cancer. Radiation technique, dose, and targets were evaluated, as was the recommended chemotherapy, administered either alone or concurrently with radiation. This report will aid clinicians in determining guidelines for the optimal treatment of borderline and unresectable pancreatic cancer.

ACR Appropriateness Criteria® Rectal Cancer: Metastatic Disease at Presentation

Karyn A. Goodman, MD;Sarah A. Milgrom, MD;Joseph M. Herman, MD, MSc;May Abdel-Wahab, MD, PhD;Nilofer Azad, MD;A. William Blackstock, MD;Prajnan Das, MD;Theodore S. Hong, MD;Salma K. Jabbour, MD;William E. Jones III, MD;Andre A. Konski, MD, MBA, MA;Albert C. Koong, MD, PhD;Rachit Kumar, MD;Miguel Rodriguez-Bigas, MD;William Small, Jr, MD;Charles R. Thomas, Jr, MD;W. Warren Suh, MD

October 15th 2014

The management of rectal cancer in patients with metastatic disease at presentation is highly variable. Although chemoradiation is standard for patients with stage II/III rectal cancer, its role in the metastatic setting is controversial.

Intensity-Modulated Radiation Therapy for Anal Cancer: An Obvious yet Complicated Transition

Joseph M. Herman, MD, MSc;Charles R. Thomas, Jr, MD

August 15th 2010

Primary surgery with an abdominoperineal resection (APR) was historically the standard of care for localized anal squamous cell carcinoma. APR achieved 40%-70% survival rates at five years, with local failures from 27%-47%.[1,2] With modern technology and radiation dose escalation, external beam radiation therapy (EBRT) studies have improved complete response rates, decreased morbidity, and improved sphincter preservation rates. Nigro et al added 5-fluorouracil (5FU) and mitomycin C (MMC) to concurrent EBRT [3,4] and impressive complete response rates inspired other groups to investigate the role of chemotherapy as a component of sphincter-preserving therapy. The European Organization for Research and Treatment of Cancer (EORTC) and United Kingdom Coordinating Committee on Cancer Research (UKCCCR) studies reported improved local control and colostomy-free survival when chemotherapy (5FU/MMC) was administered in conjunction with radiation.[5,6] The five-year survival rate for patients receiving standard chemoradiation approaches 70%; however, 20%-40% experience grade 3-4 toxicity, and administration with MMC causes profound hematologic toxicity.