Brian Czito

Overview:

Listed in Best Doctors in America. Listed in Top Doctors in North Carolina. His research interests include gastrointestinal malignancies, including treatment and integration of novel systemic agents with radiation therapy in the treatment of esophageal, gastric, hepatobiliary, pancreatic, colorectal and anal malignancies; phase I/II clinical trials evaluating novel systemic/targeted agents in conjunction with radiation therapy; investigation and optimization of the treatment of gastrointestinal malignancies, with focus on the above tumor sites.

Positions:

Professor of Radiation Oncology

Radiation Oncology
School of Medicine

Member of the Duke Cancer Institute

Duke Cancer Institute
School of Medicine

Education:

M.D. 1996

Medical College of Georgia School of Medicine

Intern

St. Joseph Mercy Health Systems

Resident

Massachusetts General Hospital

Chief Resident

Massachusetts General Hospital

American Board of Radiology (ABR)

American Board of Radiology

Grants:

Phase II Randomized Trial comparing Percutaneous Ablation to Hypofractionaed Image Guided Radiation Therapy in Veteran and Non-Veteran, Non-surgical Hepatocelluar Carcinoma Patients (PROVE-HCC)

Administered By
Radiation Oncology
Role
Principal Investigator
Start Date
End Date

Clinical Experience Guided Reinforcement Learning for Pancreas SBRT

Administered By
Radiation Oncology
Role
Collaborating Investigator
Start Date
End Date

AN ADAPTIVE PHASE I/II DOSE ESCALATION TRIAL OF STEREOTACTIC BODY RADIATION THERAPY IN COMBINATION WITH RADIOMODULATING AGENT GC4419 IN LOCALLY ADVANCED PANCREATIC ADENOCARCINOMA

Administered By
Radiation Oncology
Awarded By
Galera Therapeutics, Inc.
Role
Principal Investigator
Start Date
End Date

Publications:

Comparison of neoadjuvant chemoradiotherapy and neoadjuvant chemotherapy for esophageal cancer: a meta-analysis.

Aim: To compare the clinical efficacy of neoadjuvant chemoradiotherapy (nCRT) and neoadjuvant chemotherapy (nCT) for esophageal cancer. Methods: Randomized controlled trials reporting on the comparison of nCRT and nCT for esophageal cancer were identified. Results: Three eligible randomized controlled trials were identified and included with a total of 375 patients (189 nCRT, 186 nCT). Outcomes showed that compared with nCT group, R0 resection and pathologic complete response (pCR) rates were significantly increased in nCRT group. However, no significant difference was seen in 3- and 5-year progression-free survival or 3- and 5-year overall survival. Conclusion: The addition of radiotherapy to neoadjuvant chemotherapy results in higher R0 resection rate and pCR rate, without significantly impacting survival.
Authors
Jing, S-W; Qin, J-J; Liu, Q; Zhai, C; Wu, Y-J; Cheng, Y-J; Czito, BG; Wang, J
MLA Citation
Jing, Shao-Wu, et al. “Comparison of neoadjuvant chemoradiotherapy and neoadjuvant chemotherapy for esophageal cancer: a meta-analysis..” Future Oncol, vol. 15, no. 20, July 2019, pp. 2413–22. Pubmed, doi:10.2217/fon-2019-0024.
URI
https://scholars.duke.edu/individual/pub1395763
PMID
31269806
Source
pubmed
Published In
Future Oncol
Volume
15
Published Date
Start Page
2413
End Page
2422
DOI
10.2217/fon-2019-0024

Pancreatic adenocarcinoma, version 2.2014: featured updates to the NCCN guidelines.

The NCCN Guidelines for Pancreatic Adenocarcinoma discuss the diagnosis and management of adenocarcinomas of the exocrine pancreas and are intended to assist with clinical decision-making. These NCCN Guidelines Insights summarize major discussion points from the 2014 NCCN Pancreatic Adenocarcinoma Panel meeting. The panel discussion focused mainly on the management of borderline resectable and locally advanced disease. In particular, the panel discussed the definition of borderline resectable disease, role of neoadjuvant therapy in borderline disease, role of chemoradiation in locally advanced disease, and potential role of newer, more active chemotherapy regimens in both settings.
Authors
Tempero, MA; Malafa, MP; Behrman, SW; Benson, AB; Casper, ES; Chiorean, EG; Chung, V; Cohen, SJ; Czito, B; Engebretson, A; Feng, M; Hawkins, WG; Herman, J; Hoffman, JP; Ko, A; Komanduri, S; Koong, A; Lowy, AM; Ma, WW; Merchant, NB; Mulvihill, SJ; Muscarella, P; Nakakura, EK; Obando, J; Pitman, MB; Reddy, S; Sasson, AR; Thayer, SP; Weekes, CD; Wolff, RA; Wolpin, BM; Burns, JL; Freedman-Cass, DA
MLA Citation
Tempero, Margaret A., et al. “Pancreatic adenocarcinoma, version 2.2014: featured updates to the NCCN guidelines..” J Natl Compr Canc Netw, vol. 12, no. 8, Aug. 2014, pp. 1083–93.
URI
https://scholars.duke.edu/individual/pub1135325
PMID
25099441
Source
pubmed
Published In
J Natl Compr Canc Netw
Volume
12
Published Date
Start Page
1083
End Page
1093

Association between neoadjuvant chemoradiation and survival for patients with locally advanced rectal cancer.

AIM: To examine the overall survival differences for the following neoadjuvant therapy modalities - no therapy, chemotherapy alone, radiation alone and chemoradiation - in a large cohort of patients with locally advanced rectal cancer. METHOD: Adults with clinical Stage II and III rectal adenocarcinoma were selected from the National Cancer Database and grouped by type of neoadjuvant therapy received: no therapy, chemotherapy only, radiotherapy only or chemoradiation. Multivariable regression methods were used to compare adjusted differences in perioperative outcomes and overall survival. RESULTS: Among 32 978 patients included, 9714 (29.5%) received no neoadjuvant therapy, 890 (2.7%) chemotherapy only, 1170 (3.5%) radiotherapy only and 21 204 (64.3%) chemoradiation. Compared with no therapy, chemotherapy or radiotherapy alone were not associated with any adjusted differences in surgical margin positivity, permanent colostomy rate or overall survival (all P > 0.05). With adjustment, neoadjuvant chemoradiation vs no therapy was associated with a lower likelihood of surgical margin positivity (OR 0.74, P < 0.001), decreased rate of permanent colostomy (OR 0.77, P < 0.001) and overall survival [hazard ratio (HR) 0.79, P < 0.001]. When compared with chemotherapy or radiotherapy alone, chemoradiation remained associated with improved overall survival (vs chemotherapy alone HR 0.83, P = 0.04; vs radiotherapy alone HR 0.83, P < 0.019). CONCLUSION: Neoadjuvant chemoradiation, not chemotherapy or radiotherapy alone, is important for sphincter preservation, R0 resection and survival for patients with locally advanced rectal cancer. Despite this finding, one-third of patients in the United States with locally advanced rectal cancer fail to receive stage-appropriate chemoradiation.
Authors
Sun, Z; Adam, MA; Kim, J; Turner, MC; Fisher, DA; Choudhury, KR; Czito, BG; Migaly, J; Mantyh, CR
MLA Citation
Sun, Z., et al. “Association between neoadjuvant chemoradiation and survival for patients with locally advanced rectal cancer..” Colorectal Dis, vol. 19, no. 12, Dec. 2017, pp. 1058–66. Pubmed, doi:10.1111/codi.13754.
URI
https://scholars.duke.edu/individual/pub1259112
PMID
28586509
Source
pubmed
Published In
Colorectal Dis
Volume
19
Published Date
Start Page
1058
End Page
1066
DOI
10.1111/codi.13754

Nonoperative management of rectal cancer.

Surgery has long been the primary curative modality for localized rectal cancer. Neoadjuvant chemoradiation has significantly improved local control rates and, in a significant minority, eradicated all disease. Patients who achieve a pathologic complete response to neoadjuvant therapy have an excellent prognosis, although the combination treatment is associated with long-term morbidity. Because of this, a nonoperative management (NOM) strategy has been pursued to preserve sphincter function in select patients. Clinical and radiographic findings are used to identify patients achieving a clinical complete response to chemoradiation, and they are then followed with intensive surveillance. Incomplete, nonresponding and those demonstrating local progression are referred for salvage with standard surgery. Habr-Gama and colleagues have published extensively on this treatment strategy and have laid the groundwork for this approach. This watch-and-wait strategy has evolved over time, and several groups have now reported their results, including recent prospective experiences. Although initial results appear promising, several significant challenges remain for NOM of rectal cancer. Further study is warranted before routine implementation in the clinic.
Authors
Torok, JA; Palta, M; Willett, CG; Czito, BG
MLA Citation
Torok, Jordan A., et al. “Nonoperative management of rectal cancer..” Cancer, vol. 122, no. 1, Jan. 2016, pp. 34–41. Pubmed, doi:10.1002/cncr.29735.
URI
https://scholars.duke.edu/individual/pub1105366
PMID
26599064
Source
pubmed
Published In
Cancer
Volume
122
Published Date
Start Page
34
End Page
41
DOI
10.1002/cncr.29735

Is diaphragm motion a good surrogate for liver tumor motion?

PURPOSE: To evaluate the relationship between liver tumor motion and diaphragm motion. METHODS AND MATERIALS: Fourteen patients with hepatocellular carcinoma (10 of 14) or liver metastases (4 of 14) undergoing radiation therapy were included in this study. All patients underwent single-slice cine-magnetic resonance imaging simulations across the center of the tumor in 3 orthogonal planes. Tumor and diaphragm motion trajectories in the superior-inferior (SI), anterior-posterior (AP), and medial-lateral (ML) directions were obtained using an in-house-developed normalized cross-correlation-based tracking technique. Agreement between the tumor and diaphragm motion was assessed by calculating phase difference percentage, intraclass correlation coefficient, and Bland-Altman analysis (Diff). The distance between the tumor and tracked diaphragm area was analyzed to understand its impact on the correlation between the 2 motions. RESULTS: Of all patients, the mean (±standard deviation) phase difference percentage values were 7.1% ± 1.1%, 4.5% ± 0.5%, and 17.5% ± 4.5% in the SI, AP, and ML directions, respectively. The mean intraclass correlation coefficient values were 0.98 ± 0.02, 0.97 ± 0.02, and 0.08 ± 0.06 in the SI, AP, and ML directions, respectively. The mean Diff values were 2.8 ± 1.4 mm, 2.4 ± 1.1 mm, and 2.2 ± 0.5 mm in the SI, AP, and ML directions, respectively. Tumor and diaphragm motions had high concordance when the distance between the tumor and tracked diaphragm area was small. CONCLUSIONS: This study showed that liver tumor motion had good correlation with diaphragm motion in the SI and AP directions, indicating diaphragm motion in the SI and AP directions could potentially be used as a reliable surrogate for liver tumor motion.
Authors
Yang, J; Cai, J; Wang, H; Chang, Z; Czito, BG; Bashir, MR; Palta, M; Yin, F-F
MLA Citation
Yang, Juan, et al. “Is diaphragm motion a good surrogate for liver tumor motion?.” Int J Radiat Oncol Biol Phys, vol. 90, no. 4, Nov. 2014, pp. 952–58. Pubmed, doi:10.1016/j.ijrobp.2014.07.028.
URI
https://scholars.duke.edu/individual/pub1045190
PMID
25223297
Source
pubmed
Published In
Int J Radiat Oncol Biol Phys
Volume
90
Published Date
Start Page
952
End Page
958
DOI
10.1016/j.ijrobp.2014.07.028