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:

A Multi-Institutional Analysis of Adjuvant Chemotherapy and Radiation Sequence in Women With Stage IIIC Endometrial Cancer.

PURPOSE: Our purpose was to evaluate the effect of sequence and type of adjuvant therapy for patients with stage IIIC endometrial carcinoma (EC) on outcomes. METHODS AND MATERIALS: In a multi-institutional retrospective cohort study, patients with stage IIIC EC who had surgical staging and received both adjuvant chemotherapy and radiation therapy (RT) were included. Adjuvant treatment regimens were classified as adjuvant chemotherapy followed by sequential RT (upfront chemo), which was predominant sequence; RT with concurrent chemotherapy followed by chemotherapy (concurrent); systemic chemotherapy before and after RT (sandwich); adjuvant RT followed by chemotherapy (upfront RT); or chemotherapy concurrent with vaginal cuff brachytherapy alone (chemo-brachy). Overall survival (OS) and recurrence-free survival (RFS) rates were estimated by the Kaplan-Meier method. RESULTS: A total of 686 eligible patients were included with a median follow-up of 45.3 months. The estimated 5-year OS and RFS rates were 74% and 66%, respectively. The sequence and type of adjuvant therapy were not correlated with OS or RFS (adjusted P = .68 and .84, respectively). On multivariate analysis, black race, nonendometrioid histology, grade 3 tumor, stage IIIC2, and presence of adnexal and cervical involvement were associated with worse OS and RFS (all P < .05). Regardless of the sequence of treatment, the most common site of first recurrence was distant metastasis (20.1%). Vaginal only, pelvic only, and paraortic lymph node (PALN) recurrences occurred in 11 (1.6%),15 (2.2 %), and 43 (6.3 %) patients, respectively. Brachytherapy alone was associated with a higher rate of PALN recurrence (15%) compared with external beam radiation therapy (5%) P < .0001. CONCLUSIONS: The sequence and type of combined adjuvant therapy did not affect OS or RFS rates. Brachytherapy alone was associated with a higher rate of PALN recurrence, emphasizing the role of nodal radiation for stage IIIC EC. The vast proportion of recurrences were distant despite systemic chemotherapy, highlighting the need for novel regimens.
Authors
Hathout, L; 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
MLA Citation
Hathout, Lara, et al. “A Multi-Institutional Analysis of Adjuvant Chemotherapy and Radiation Sequence in Women With Stage IIIC Endometrial Cancer.Int J Radiat Oncol Biol Phys, Mar. 2021. Pubmed, doi:10.1016/j.ijrobp.2021.02.055.
URI
https://scholars.duke.edu/individual/pub1475703
PMID
33677053
Source
pubmed
Published In
Int J Radiat Oncol Biol Phys
Published Date
DOI
10.1016/j.ijrobp.2021.02.055

Oncologic Imaging/Oncologic Anatomy

Inside the Sixth Edition of this now-classic reference, you will discover encyclopedic coverage of topics ranging from basic science to sophisticated computer-based radiation therapy treatment planning and supportive care.
Authors
Christensen, J; Chino, J; Kelsey, C; Marks, L
MLA Citation
Christensen, Jared, et al. “Oncologic Imaging/Oncologic Anatomy.” Perez & Brady’s Principles and Practice of Radiation Oncology, Lippincott Williams & Wilkins, 2013.
URI
https://scholars.duke.edu/individual/pub1461950
Source
manual
Published Date

Multi-material 3D Printing in Brachytherapy– Prototyping Teaching Tools

Authors
Campelo, S; Subashi, E; Chang, Z; Meltsner, SG; Chino, JP; Craciunescu, OI
MLA Citation
Campelo, S., et al. “Multi-material 3D Printing in Brachytherapy– Prototyping Teaching Tools.” International Journal of Radiation Oncology*Biology*Physics, vol. 108, no. 3, Elsevier BV, 2020, pp. e437–e437. Crossref, doi:10.1016/j.ijrobp.2020.07.2525.
URI
https://scholars.duke.edu/individual/pub1468344
Source
crossref
Published In
International Journal of Radiation Oncology, Biology, Physics
Volume
108
Published Date
Start Page
e437
End Page
e437
DOI
10.1016/j.ijrobp.2020.07.2525

Opioid-associated deaths in patients with cancer: A population study of the opioid epidemic over the past 10 years.

<jats:p> 230 </jats:p><jats:p> Background: Over 40,000 Americans died due to opioid overdose in 2016; the epidemic is a top public health concern. Opioids are commonly used for cancer associated pain but it is unknown what risks for overdose exist in this vulnerable population. Methods: De-identified death certificate data was obtained via the National Center for Health Statistics. Death certificates contain 1 underlying cause of death and up to 20 contributing causes, as well as demographic data. All deaths due to opioids were included from 2006-2016; if present, cancer was noted as a contributing cause. Opioid death incidence was calculated from both the US and estimated cancer survivor population. Chi and R squared tests assessed for differences. Results: From 2006-2016, there were 895 deaths due to opioids in cancer patients compared to 193,500 in the non-cancer population. Opioid deaths increased from 5.33 to 8.97 per 100,000 people in the general population (significant time trend, p &lt; 0.001, polynomial fit, R<jats:sup>2</jats:sup> 0.99). Opioid deaths increased in the cancer population from 0.52 to 0.66 per 100,000 (significant time trend, p &lt; 0.001, linear fit, R<jats:sup>2</jats:sup> 0.24, slope = 0.018). Cancer patients who died due to opioid use were different from those who died due to opioids in the general population including: higher education (12.7 vs 6.9% at least a college degree), more women (38.5 vs 29.2%), fewer whites (82.3 vs 84.2%), more Hispanics (94.5 vs 91.3%), and fewer single patients (24.2 vs 48.1%) [all p &lt; 0.001, except race p = 0.027]. Cancer patients also had older median age (57 years, IQR 50-65 vs median 42 years, IQR 31-51). 22% of opioid deaths were in lung cancer patients, followed by GI (21%), head &amp; neck (12%), hematological (11%), and GU cancers (10%). Conclusions: Death from opioids as the primary cause noted on death certificates are 10 times less likely to occur in cancer patients versus the general population. There was a slight increase in opioid deaths in cancer patients; however, overall, there was not the sharp growth seen in the general population. Cancer patients at risk for opioid overdose are different than those at risk in the general population and care should be taken when planning effective treatment of cancer-related pain. </jats:p>
MLA Citation
Chino, Fumiko Ladd, et al. “Opioid-associated deaths in patients with cancer: A population study of the opioid epidemic over the past 10 years.Journal of Clinical Oncology, vol. 36, no. 30_suppl, American Society of Clinical Oncology (ASCO), 2018, pp. 230–230. Crossref, doi:10.1200/jco.2018.36.30_suppl.230.
URI
https://scholars.duke.edu/individual/pub1383311
Source
crossref
Published In
Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology
Volume
36
Published Date
Start Page
230
End Page
230
DOI
10.1200/jco.2018.36.30_suppl.230

Incidence of comorbidities on death certificate data in women with gynecological cancers.

<jats:p> e17127 </jats:p><jats:p> Background: Risk factors for the development of gynecological cancers are known to vary; however, the effect on mortality is uncertain. Methods: Using CDC Wonder Database, death certificate data, all women who died of cancer in the United States from 2003-2016 were included if a cancer diagnosis was listed as a primary or contributing cause. Cases were then divided into gynecological (GYN) cancer or not, and thereafter characterized as cervical, ovarian, uterine, or other. Other causes contributing to death (comorbidities were then captured via ICD10 codes listed on death certificates and grouped into similar disease states. Chi-squared and Mann-Whitney U tests were performed for statistical significance. Results: Of 35,324,091 death certificates, 4,177,823 deaths were women with cancer listed as a cause of death. 440,792 were gynecological cancer, with cervical cancer in 62,807; uterine cancer in 134,420; ovarian cancer in 221,119; and other gynecological cancers in 25,946. Women with GYN cancers were more likely to have intestinal obstruction (2.7% vs 0.7%, OR 4.05), ascites (0.7% vs 0.2%, OR 3.30), HIV (0.1% vs 0.05%, OR 1.53), kidney disease (4.7% vs 3.6%, OR 1.33), and thrombo-embolic disorders (4.3% vs 3.5%, OR 1.25) when compared to non-GYN cancers (all p &lt; 0.00001). Uterine cancer was more likely to have diabetes-related comorbidities (6.4% vs 3.8%, OR 1.75), metabolic syndrome (9.5% vs 6.1%, OR 1.60), thrombo-embolic disorders (5.5% vs 3.8%, OR 1.48), ischemic heart disease (5.0% vs 3.6%, OR 1.43), than other GYN cancers (all p &lt; 0.00001). Cervical cancer was more associated with HIV (0.3% vs 0.03%, OR 10.73) and tobacco-related disorders (4.7% vs 1.9%, OR 2.56). Ovarian cancer was more associated with ascites (1.1% vs 0.4%, OR 2.93), intestinal obstruction (3.5% vs 1.8%, OR 2.04), and pleural effusion (1.1% vs 0.6%, OR 1.92) (all p &lt; 0.00001). Conclusions: Comorbidities contributing to death significantly differ amongst gynecological cancers and non-gynecological cancers, which has relevance to strategies that can be differentially employed to reduce mortality. In particular, women with uterine cancer may benefit from reduction in risk of diabetes, ischemic heart disease, and embolic disorders; those with cervical cancer may benefit from smoking cessation and optimal HIV management. </jats:p>
Authors
McLaughlin, ME; Suneja, G; Chino, JP
MLA Citation
McLaughlin, Mary Elizabeth, et al. “Incidence of comorbidities on death certificate data in women with gynecological cancers.Journal of Clinical Oncology, vol. 37, no. 15_suppl, American Society of Clinical Oncology (ASCO), 2019, pp. e17127–e17127. Crossref, doi:10.1200/jco.2019.37.15_suppl.e17127.
URI
https://scholars.duke.edu/individual/pub1415654
Source
crossref
Published In
Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology
Volume
37
Published Date
Start Page
e17127
End Page
e17127
DOI
10.1200/jco.2019.37.15_suppl.e17127