Junzo Chino

Overview:

Clinical Research in Gynecologic Malignancies, Breast Malignancies, Radiation Oncology Resident Education, Stereotactic Radiation Therapy, and Brachytherapy

Positions:

Associate Professor of Radiation Oncology

Radiation Oncology
School of Medicine

Member of the Duke Cancer Institute

Duke Cancer Institute
School of Medicine

Education:

M.D. 2004

Indiana University at Indianapolis

Director of Brachytherapy, Radiation Oncology

Duke University School of Medicine

Intern

Indiana University, School of Medicine

Resident, Radiation Oncology

Duke University School of Medicine

Chief Resident, Radiation Oncology

Duke University School of Medicine

American Board of Radiology (ABR)

American Board of Radiology

Publications:

The Affordable Care Act and suicide incidence among adults with cancer.

BACKGROUND: Patients with cancer are at an increased suicide risk, and socioeconomic deprivation may further exacerbate that risk. The Affordable Care Act (ACA) expanded insurance coverage options for low-income individuals and mandated coverage of mental health care. Our objective was to quantify associations of the ACA with suicide incidence among patients with cancer. METHODS: We identified US patients with cancer aged 18-74 years diagnosed with cancer from 2011 to 2016 from the Surveillance, Epidemiology, and End Results database. The primary outcome was the 1-year incidence of suicide based on cumulative incidence analyses. Difference-in-differences (DID) analyses compared changes in suicide incidence from 2011-2013 (pre-ACA) to 2014-2016 (post-ACA) in Medicaid expansion relative to non-expansion states. We conducted falsification tests with 65-74-year-old patients with cancer, who are Medicare-eligible and not expected to benefit from ACA provisions. RESULTS: We identified 1,263,717 patients with cancer, 812 of whom died by suicide. In DID analyses, there was no change in suicide incidence after 2014 in Medicaid expansion vs. non-expansion states for nonelderly (18-64 years) patients with cancer (p = .41), but there was a decrease in suicide incidence among young adults (18-39 years) (- 64.36 per 100,000, 95% CI =  - 125.96 to - 2.76, p = .041). There were no ACA-associated changes in suicide incidence among 65-74-year-old patients with cancer. CONCLUSIONS: We found an ACA-associated decrease in the incidence of suicide for some nonelderly patients with cancer, particularly young adults in Medicaid expansion vs. non-expansion states. Expanding access to health care may decrease the risk of suicide among cancer survivors.
Authors
Barnes, JM; Graboyes, EM; Adjei Boakye, E; Kent, EE; Scherrer, JF; Park, EM; Rosenstein, DL; Mowery, YM; Chino, JP; Brizel, DM; Osazuwa-Peters, N
MLA Citation
Barnes, Justin M., et al. “The Affordable Care Act and suicide incidence among adults with cancer.J Cancer Surviv, Apr. 2022. Pubmed, doi:10.1007/s11764-022-01205-z.
URI
https://scholars.duke.edu/individual/pub1515383
PMID
35368225
Source
pubmed
Published In
J Cancer Surviv
Published Date
DOI
10.1007/s11764-022-01205-z

Improving Radiation Therapy for Cervical Cancer.

Authors
Kidd, E; Harkenrider, M; Damast, S; Fields, E; Chopra, S; Chino, J
MLA Citation
Kidd, Elizabeth, et al. “Improving Radiation Therapy for Cervical Cancer.Int J Radiat Oncol Biol Phys, vol. 112, no. 4, Mar. 2022, pp. 841–48. Pubmed, doi:10.1016/j.ijrobp.2021.12.006.
URI
https://scholars.duke.edu/individual/pub1516155
PMID
35190051
Source
pubmed
Published In
Int J Radiat Oncol Biol Phys
Volume
112
Published Date
Start Page
841
End Page
848
DOI
10.1016/j.ijrobp.2021.12.006

Does Prophylactic Paraortic Lymph Node Irradiation Improve Outcomes in Women With Stage IIIC1 Endometrial Carcinoma?

PURPOSE: To evaluate the impact of prophylactic paraortic lymph node (PALN) radiation therapy (RT) on clinical outcomes in patients with International Federation of Obstetrics and Gynecology 2018 stage IIIC1 endometrial cancer (EC). METHODS AND MATERIALS: A multi-institutional retrospective study included patients with International Federation of Obstetrics and Gynecology 2018 stage IIIC1 EC lymph node assessment, status postsurgical staging, followed by adjuvant chemotherapy and RT using various sequencing regimens. Overall survival (OS) and recurrence-free survival (RFS) rates were estimated by the Kaplan-Meier method. Univariable and multivariable analysis were performed by Cox proportional hazard models for RFS/OS. In addition, propensity score matching was used to estimate the effect of the radiation field extent on survival outcomes. RESULTS: A total of 378 patients were included, with a median follow-up of 45.8 months. Pelvic RT was delivered to 286 patients, and 92 patients received pelvic and PALN RT. The estimated OS and RFS rates at 5 years for the entire cohort were 80% and 69%, respectively. There was no difference in the 5-year OS (77% vs 87%, P = .47) and RFS rates (67% vs 70%, P = .78) between patients treated with pelvic RT and those treated with pelvic and prophylactic PALN RT, respectively. After propensity score matching, the estimated hazard ratios (HRs) of prophylactic PALN RT versus pelvic RT were 1.50 (95% confidence interval, 0.71-3.19; P = .28) for OS and 1.24 (95% confidence interval, 0.64-2.42; P = .51) for RFS, suggesting that prophylactic PALN RT does not improve survival outcomes. Distant recurrence was the most common site of first recurrence, and the extent of RT field was not associated with the site of first recurrence (P = .79). CONCLUSIONS: Prophylactic PALN RT was not significantly associated with improved survival outcomes in stage IIIC1 EC. Distant metastasis remains the most common site of failure despite routine use of systemic chemotherapy. New therapeutic approaches are necessary to optimize the outcomes for women with stage IIIC1 EC.
Authors
Yoon, J; Fitzgerald, H; Wang, Y; Wang, Q; Vergalasova, I; Elshaikh, MA; Dimitrova, I; Damast, S; Li, JY; Fields, EC; Beriwal, S; Keller, A; Kidd, EA; Usoz, M; Jolly, S; Jaworski, E; Leung, EW; Donovan, E; Taunk, NK; Chino, J; Natesan, D; Russo, AL; Lea, JS; Albuquerque, KV; Lee, LJ; Hathout, L
MLA Citation
Yoon, Jennifer, et al. “Does Prophylactic Paraortic Lymph Node Irradiation Improve Outcomes in Women With Stage IIIC1 Endometrial Carcinoma?Pract Radiat Oncol, vol. 12, no. 2, Mar. 2022, pp. e123–34. Pubmed, doi:10.1016/j.prro.2021.10.002.
URI
https://scholars.duke.edu/individual/pub1502538
PMID
34822999
Source
pubmed
Published In
Pract Radiat Oncol
Volume
12
Published Date
Start Page
e123
End Page
e134
DOI
10.1016/j.prro.2021.10.002

Role of stereotactic body radiotherapy in gynecologic radiation oncology.

Stereotactic body radiotherapy (SBRT, also referred to as stereotactic ablative radiotherapy (SABR)) has been used in the treatment of primary and metastatic solid tumors, and increasingly so in gynecologic oncology. This review article aims to summarize the current literature describing the utility of SBRT in the primary, recurrent, and limited metastatic settings for gynecologic malignancies. The use of SBRT in both retrospective and prospective reports has been associated with adequate control of the treated site, particularly in the setting of oligometastatic disease. It is not, however, recommended as an alternative to brachytherapy for intact disease unless all efforts to use brachytherapy are exhausted. While phase I and II trials have established the relative safety and potential toxicities of SBRT, there remains a dearth of phase III randomized evidence, including the use of immunotherapy, in order to better establish the role of this technique as a method of improving more global outcomes for our patients with gynecologic cancers.
Authors
Shenker, R; Stephens, SJ; Davidson, B; Chino, J
MLA Citation
Shenker, Rachel, et al. “Role of stereotactic body radiotherapy in gynecologic radiation oncology.Int J Gynecol Cancer, vol. 32, no. 3, Mar. 2022, pp. 372–79. Pubmed, doi:10.1136/ijgc-2021-002466.
URI
https://scholars.duke.edu/individual/pub1513280
PMID
35256426
Source
pubmed
Published In
Int J Gynecol Cancer
Volume
32
Published Date
Start Page
372
End Page
379
DOI
10.1136/ijgc-2021-002466

Secondary Prevention, Not Secondary Importance: Embracing Survivorship Concerns and HRT After Cervical Cancer Radiation Therapy.

Authors
Damast, S; Chino, J
MLA Citation
Damast, Shari, and Junzo Chino. “Secondary Prevention, Not Secondary Importance: Embracing Survivorship Concerns and HRT After Cervical Cancer Radiation Therapy.Int J Radiat Oncol Biol Phys, vol. 112, no. 2, Feb. 2022, pp. 414–16. Pubmed, doi:10.1016/j.ijrobp.2021.09.028.
URI
https://scholars.duke.edu/individual/pub1516156
PMID
34998535
Source
pubmed
Published In
Int J Radiat Oncol Biol Phys
Volume
112
Published Date
Start Page
414
End Page
416
DOI
10.1016/j.ijrobp.2021.09.028