Gita Suneja

Positions:

Associate Professor of Radiation Oncology

Radiation Oncology
School of Medicine

Associate Research Professor of Global Health

Duke Global Health Institute
Institutes and Provost's Academic Units

Member of the Duke Cancer Institute

Duke Cancer Institute
School of Medicine

Education:

M.D. 2008

Brown University

Intern, Internal Medicine

University of Pennsylvania School of Medicine

Resident, Radiation Oncology

University of Pennsylvania School of Medicine

Chief Resident, Radiation Oncology

University of Pennsylvania School of Medicine

Clinical Instructor, Radiationoncology

University of Pennsylvania School of Medicine

Assistant Professor, Radiation Oncology

University of Utah School of Medicine

Grants:

Publications:

Advanced stage at diagnosis and elevated mortality among US patients with cancer infected with HIV in the National Cancer Data Base.

BACKGROUND: People living with HIV (PLWH) are at an increased risk of developing several cancers, but to the authors' knowledge less is known regarding how HIV impacts the rate of progression to advanced cancer or death. METHODS: The authors compared stage of disease at the time of presentation and mortality after diagnosis between 14,453 PLWH and 6,368,126 HIV-uninfected patients diagnosed with cancers of the oral cavity, stomach, colorectum, anus, liver, pancreas, lung, female breast, cervix, prostate, bladder, kidney, and thyroid and melanoma using data from the National Cancer Data Base (2004-2014). Polytomous logistic regression and Cox proportional hazards regression were used to evaluate the association between HIV, cancer stage, and stage-adjusted mortality after diagnosis, respectively. Regression models accounted for the type of health facility at which cancer treatment was administered and the type of individual health insurance. RESULTS: HIV-infected patients with cancer were found to be more likely to be uninsured (HIV-infected: 5.0% vs HIV-uninfected: 3.3%; P < .0001) and were less likely to have private health insurance (25.4% vs 44.7%; P < .0001). Compared with those not infected with HIV, the odds of being diagnosed at an advanced stage of disease were significantly elevated in PLWH for melanoma and cancers of the oral cavity, liver, female breast, prostate, and thyroid (odds ratio for stage IV vs stage I range, 1.24-2.06). PLWH who were diagnosed with stage I to stage III disease experienced elevated mortality after diagnosis across 13 of the 14 cancer sites evaluated, with hazard ratios ranging from 1.20 (95% CI, 1.14-1.26) for lung cancer to 1.85 (95% CI, 1.68-2.04), 1.85 (95% CI, 1.51-2.27), and 2.93 (95% CI, 2.08-4.13), respectively, for cancers of the female breast, cervix, and thyroid. CONCLUSIONS: PLWH were more likely to be diagnosed with advanced-stage cancers and to experience elevated mortality after a cancer diagnosis, even after accounting for health care-related factors.
Authors
Coghill, AE; Han, X; Suneja, G; Lin, CC; Jemal, A; Shiels, MS
MLA Citation
URI
https://scholars.duke.edu/individual/pub1383631
PMID
31050361
Source
pubmed
Published In
Cancer
Published Date
DOI
10.1002/cncr.32158

Radiotherapy regimens in patients with nonmelanoma head and neck skin cancers.

BACKGROUND: To assess the effectiveness and outcomes of adjuvant radiotherapy regimens for nonmelanoma skin cancers (NMSC) of the head and neck, particularly for elderly patients. METHODS: A retrospective review of patients with head and neck NMSC was conducted. Radiotherapy dose per fraction regimens included ≤200, 240-250, 300-400, and 500-600 cGy. Demographics, tumor characteristics, local control (LC), regional control (RC), and survival outcomes were analyzed. RESULTS: Of the 90 patients with 140 disease sites, 76.6% were squamous cell carcinoma, 15.5% were basal cell carcinoma, and 7.7% were other histologies. The mean age at diagnosis was 72.1 years old. The most common location was preauricular (20.0%), followed by temple, scalp, cheek, and forehead. The overall LC and RC rates were 88.8% and 88.8%, respectively by patients, and 92.8% and 86.4%, respectively by treatment sites. Age, primary tumor location, T classification, N classification, overall stage, perineural invasion, comorbid disease, skull base invasion, and radiotherapy subgroup were significantly associated with disease-free and overall survival (P < 0.05). LC and RC were not significantly different among the radiotherapy dose subgroups. The mean survival was longer in patients treated with 240-250 cGy/fraction (50.3 months). There was no significant difference in radiotherapy toxicity between the subgroups. CONCLUSION: Short-term radiotherapy regimens for patients with locally or regionally advanced head and neck NMSC appear feasible and effective, particularly in elderly patients or those that cannot tolerate the length of standard regimens.
Authors
Dundar, Y; Cannon, RB; Hunt, JP; Monroe, M; Suneja, G; Hitchcock, YJ
MLA Citation
Dundar, Yusuf, et al. “Radiotherapy regimens in patients with nonmelanoma head and neck skin cancers..” Int J Dermatol, vol. 57, no. 4, Apr. 2018, pp. 441–48. Pubmed, doi:10.1111/ijd.13879.
URI
https://scholars.duke.edu/individual/pub1300427
PMID
29355917
Source
pubmed
Published In
Int J Dermatol
Volume
57
Published Date
Start Page
441
End Page
448
DOI
10.1111/ijd.13879

American Brachytherapy Society: Brachytherapy treatment recommendations for locally advanced cervix cancer for low-income and middle-income countries.

PURPOSE: Most cervix cancer cases occur in low-income and middle-income countries (LMIC), and outcomes are suboptimal, even for early stage disease. Brachytherapy plays a central role in the treatment paradigm, improving both local control and overall survival. The American Brachytherapy Society (ABS) aims to provide guidelines for brachytherapy delivery in resource-limited settings. METHODS AND MATERIALS: A panel of clinicians and physicists with expertise in brachytherapy administration in LMIC was convened. A survey was developed to identify practice patterns at the authors' institutions and was also extended to participants of the Cervix Cancer Research Network. The scientific literature was reviewed to identify consensus papers or review articles with a focus on treatment of locally advanced, unresected cervical cancer in LMIC. RESULTS: Of the 40 participants invited to respond to the survey, 32 responded (response rate 80%). Participants were practicing in 14 different countries including both high-income (China, Singapore, Taiwan, United Kingdom, and United States) and low-income or middle-income countries (Bangladesh, Botswana, Brazil, India, Malaysia, Pakistan, Philippines, Thailand, and Vietnam). Recommendations for modifications to existing ABS guidelines were reviewed by the panel members and are highlighted in this article. CONCLUSIONS: Recommendations for treatment of locally advanced, unresectable cervical cancer in LMIC are presented. The guidelines comment on staging, external beam radiotherapy, use of concurrent chemotherapy, overall treatment duration, use of anesthesia, applicator choice and placement verification, brachytherapy treatment planning including dose and prescription point, recommended reporting and documentation, physics support, and follow-up.
Authors
Suneja, G; Brown, D; Chang, A; Erickson, B; Fidarova, E; Grover, S; Mahantshetty, U; Nag, S; Narayan, K; Bvochora-Nsingo, M; Viegas, C; Viswanathan, AN; Lin, MY; Gaffney, D
MLA Citation
Suneja, Gita, et al. “American Brachytherapy Society: Brachytherapy treatment recommendations for locally advanced cervix cancer for low-income and middle-income countries..” Brachytherapy, vol. 16, no. 1, Jan. 2017, pp. 85–94. Pubmed, doi:10.1016/j.brachy.2016.10.007.
URI
https://scholars.duke.edu/individual/pub1162288
PMID
27919654
Source
pubmed
Published In
Brachytherapy
Volume
16
Published Date
Start Page
85
End Page
94
DOI
10.1016/j.brachy.2016.10.007

Chemoradiation versus chemotherapy or radiation alone in stage III endometrial cancer: Patterns of care and impact on overall survival.

PURPOSE: We aimed to investigate the patterns-of-care and overall survival (OS) benefit of aCRT versus adjuvant monotherapy (aMT), defined as either chemotherapy or radiation alone, utilizing a large national registry of patients. PATIENTS AND METHODS: Adult patients with stage III endometrial adenocarcinoma diagnosed from 2004 to 2013 were included. Logistic and Cox regression modeling was used to identify factors predictive of receipt of aCRT and OS, respectively. Survival analysis was performed with Kaplan Meier and log-rank analysis. Propensity score matching and sensitivity analysis was performed to address selection bias and presence of potential confounding variables. RESULTS: A total of 21,027 patients were identified: 11,435 (54.4%) patients received aMT, while 9592 (45.6%) received aCRT. Utilization of aCRT increased over the study period (p<0.01). Factors predictive of receiving aCRT include private insurance (OR: 1.67, 95% CI: 1.30-2.14), Medicare (OR: 1.33, 95% CI: 1.01-1.75), FIGO stage IIIC disease (OR: 1.36, 95% CI: 1.19-1.54), lymphovascular space invasion (OR: 1.14, 95% CI: 1.03-1.27), and lymph node surgery performed (OR: 1.42, 95% CI: 1.15-1.74). Median survival in years for aCRT, RT, and CT was 10.3, 7.1, and 5.6, respectively (p<0.001). Compared to aMT, aCRT was associated with a decrease risk of death on multivariate analysis (HR: 0.62, 95% CI: 0.56-0.70). The benefit of aCRT over aMT persisted after propensity score matching. CONCLUSION: The use of aCRT for stage III endometrial cancer is increasing. Multiple clinical and demographic factors were predictive of aCRT use. When compared to chemotherapy or radiation alone, aCRT is associated with an OS benefit.
Authors
Boothe, D; Orton, A; Odei, B; Stoddard, G; Suneja, G; Poppe, MM; Werner, TL; Gaffney, DK
MLA Citation
Boothe, Dustin, et al. “Chemoradiation versus chemotherapy or radiation alone in stage III endometrial cancer: Patterns of care and impact on overall survival..” Gynecol Oncol, vol. 141, no. 3, June 2016, pp. 421–27. Pubmed, doi:10.1016/j.ygyno.2016.03.021.
URI
https://scholars.duke.edu/individual/pub1144286
PMID
27005441
Source
pubmed
Published In
Gynecol Oncol
Volume
141
Published Date
Start Page
421
End Page
427
DOI
10.1016/j.ygyno.2016.03.021

Correction: Cancer Incidence following Expansion of HIV Treatment in Botswana.

Authors
Dryden-Peterson, S; Medhin, H; Kebabonye-Pusoentsi, M; Seage, GR; Suneja, G; Kayembe, MKA; Mmalane, M; Rebbeck, T; Rider, JR; Essex, M; Lockman, S
MLA Citation
Dryden-Peterson, Scott, et al. “Correction: Cancer Incidence following Expansion of HIV Treatment in Botswana..” Plos One, vol. 10, no. 9, 2015. Pubmed, doi:10.1371/journal.pone.0138742.
URI
https://scholars.duke.edu/individual/pub1144292
PMID
26376079
Source
pubmed
Published In
Plos One
Volume
10
Published Date
Start Page
e0138742
DOI
10.1371/journal.pone.0138742