Christopher Kelsey

Overview:

Clinical trials that are currently enrolling patients include a study investigating lower doses of radiation therapy for patients with diffuse large B-cell lymphoma, with the goal of maintaining excellent tumor control but decreasing the risk of long-term side effects of treatment.

I also have an interest in genetic determinants of radiation sensitivity, predictors of local recurrence after surgery for lung cancer, radiation-induced lung injury, and the role of radiation therapy in advanced (stage III-IV) diffuse large B-cell lymphoma and Hodgkin lymphoma.

Positions:

Professor of Radiation Oncology

Radiation Oncology
School of Medicine

Member of the Duke Cancer Institute

Duke Cancer Institute
School of Medicine

Education:

B.S. 1998

Brigham Young University

M.D. 2002

University of Colorado, Colorado Springs

Grants:

Early Detection of Changes in Pulmonary Gas Exchange by Hyperpolarized Xe MRI

Administered By
Radiology
Awarded By
National Institutes of Health
Role
Co Investigator
Start Date
End Date

Early Detection of Changes in Pulmonary Gas Exchange by Hyperpolarized Xe MRI

Awarded By
National Institutes of Health
Role
Co Investigator
Start Date
End Date

Phase 1/2 Study of Stereotactic Body Radiation Therapy (SBRT) with or without GC4711 for Early Stage, Centrally Located or Large Non-Small Cell Lung Cancer (NSCLC)

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

Publications:

Recumbent Total Skin Electron Beam Therapy.

Purpose: Our purpose was to describe preliminary dosimetric and clinical results of a recumbent total skin electron beam therapy (TSEBT) technique and compare this to a conventional standing TSEBT technique. Methods and Materials: A customized treatment platform with recessed side wheels was constructed and commissioned for patients to be treated in a recumbent position. Dosimetric and clinical information was collected for patients treated with this new recumbent technique in addition to that of a cohort of patients treated contemporaneously using the conventional standing method. Dose delivery and clinical outcomes were compared for patients treated with the recumbent and standing techniques. Results: Between 2017 and 2019, 27 patients were treated with TSEBT with the recumbent (n = 13) or conventional standing technique (n = 14) at our institution. Measured dose at 15 body sites could be directly compared. Of these, 10 showed no significant difference between the two techniques while five sites showed significant differences in median measured dose, including the top of left shoulder, right biceps, bend of left elbow, upper back, and medial right thigh (P < .003). Measured dose was significantly higher with the standing technique at these sites with the exception of the upper back. Rates of complete response (25% vs 23%), partial response (50% vs 69%), and stable disease (17% vs 8%) were similar between the standing and recumbent cohorts, respectively (P = .78). Conclusions: We have developed, commissioned, and implemented a floor-based, recumbent technique that allows for treatment of patients who would otherwise not be eligible for TSEBT. Dosimetric and clinical measurements suggest that this technique is a viable alternative to the standing method.
Authors
Ackerson, BG; Wu, Q; Craciunescu, O; Oyekunle, T; Niedzwiecki, D; Gupton, J; Laug, P; Brumfield, K; Crain, E; Champ, CE; Kelsey, CR
MLA Citation
Ackerson, Bradley G., et al. “Recumbent Total Skin Electron Beam Therapy.Adv Radiat Oncol, vol. 6, no. 4, July 2021, p. 100698. Pubmed, doi:10.1016/j.adro.2021.100698.
URI
https://scholars.duke.edu/individual/pub1484270
PMID
34409205
Source
pubmed
Published In
Advances in Radiation Oncology
Volume
6
Published Date
Start Page
100698
DOI
10.1016/j.adro.2021.100698

Durable Control of Mycosis Fungoides after Sepsis: "Coley's Toxin?" Case Report and Review of the Literature.

Mycosis fungoides, along with Sezary syndrome, is the most common subtype of cutaneous T-cell lymphoma. In this report, we present a patient with advanced-stage mycosis fungoides, who after successful treatment of methicillin-resistant Staphylococcus aureus bacteremia had prolonged disease control off systemic therapy. While this may have been due to single-agent gemcitabine, which can result in long remission, we hypothesize that our patient's durable response was in part due to the immune response elicited after treatment of her severe infection.
Authors
Heyman, B; Kelsey, CR; Beaven, A
MLA Citation
Heyman, Benjamin, et al. “Durable Control of Mycosis Fungoides after Sepsis: "Coley's Toxin?" Case Report and Review of the Literature.Case Rep Hematol, vol. 2019, 2019, p. 1507014. Pubmed, doi:10.1155/2019/1507014.
URI
https://scholars.duke.edu/individual/pub1406377
PMID
31467737
Source
pubmed
Published In
Case Reports in Hematology
Volume
2019
Published Date
Start Page
1507014
DOI
10.1155/2019/1507014

Effective Pain Control With Very Low Dose Palliative Radiation Therapy for Patients With Multiple Myeloma With Uncomplicated Osseous Lesions.

BACKGROUND: Osteolytic lesions are present in 75% of patients with multiple myeloma (MM) and frequently require palliation with radiation therapy (RT). Prior case series of patients with MM with bone pain undergoing palliative RT suggests doses ≥12 Gy (equivalent dose in 2Gy fractions, EQD2) provide excellent bone pain relief. However, recent advances in care and novel biologic agents have significantly improved overall survival and quality of life for patients with MM. We hypothesized that lower-dose RT (LDRT, EQD2 <12 Gy) offers an effective alternative to higher-dose RT (HDRT, EQD2 ≥12 Gy) for palliation of painful, uncomplicated MM bone lesions. METHODS: We retrospectively identified patients with MM treated with RT for uncomplicated, painful bone lesions and stratified by EQD2 ≥/< 12 Gy. Clinical pain response (CPR) rates, acute and late toxicity, pain response duration, and retreatment rates between LDRT and HDRT groups were analyzed. RESULTS: Thirty-five patients with 70 treated lesions were included: 24 patients (48 lesions) treated with HDRT and 11 patients (22 lesions) with LDRT. Median follow-up was 14 and 16.89 months for HDRT and LDRT, respectively. The median dose of HDRT treatment was 20 Gy versus 4 Gy in the LDRT group. The CPR rate was 98% for HDRT and 95% for LDRT. There was no significant difference in any-grade acute toxicity between the HDRT and LDRT cohorts (24.5% vs 9.1%, Χ2 P = .20). Pain recurred in 10% of lesions (12% HDRT vs 9.5% LDRT). Median duration of pain response did not significantly differ between cohorts (P = .91). Five lesions were retreated, 2 (9.5%) in the LDRT cohort, and 3 (6.3%) in the HDRT cohort. CONCLUSION: In this study, LDRT effectively palliated painful, uncomplicated MM bony lesions with acceptable CPR and duration of palliation. These data support prospective comparisons of LDRT versus HDRT for palliation of painful, uncomplicated MM bony lesions.
Authors
Price, JG; Niedzwiecki, D; Oyekunle, T; Arcasoy, MO; Champ, CE; Kelsey, CR; Salama, JK; Moravan, MJ
MLA Citation
Price, Jeremy G., et al. “Effective Pain Control With Very Low Dose Palliative Radiation Therapy for Patients With Multiple Myeloma With Uncomplicated Osseous Lesions.Adv Radiat Oncol, vol. 6, no. 4, July 2021, p. 100729. Pubmed, doi:10.1016/j.adro.2021.100729.
URI
https://scholars.duke.edu/individual/pub1488947
PMID
34258474
Source
pubmed
Published In
Advances in Radiation Oncology
Volume
6
Published Date
Start Page
100729
DOI
10.1016/j.adro.2021.100729

Nomogram Predicting Overall Survival Benefit of Stereotactic Ablative Radiotherapy for Early-Stage Non-Small Cell Lung Cancer.

OBJECTIVES: To develop and validate a nomogram that predicts overall survival (OS) for patients with early-stage non-small cell lung cancer (NSCLC) treated with stereotactic ablative radiotherapy (SABR) vs. observation. MATERIALS AND METHODS: Adults with biopsy-proven T1-T2N0 NCSLC treated with SABR (30-70 Gy in 1-10 fractions with biologically effective dose ≥100 Gy10) or observation between 2004 and 2015 in the National Cancer Database (NCDB) were identified. Propensity score was used to match SABR and observation cohorts on prognostic demographic and clinicopathologic factors identified by logistic regression. Using backward selection, a multivariable Cox proportional hazard was identified predicting 2- and 5-year OS via a nomogram. Model prediction accuracy was assessed by time-dependent receiver operating characteristic (ROC) curves and integrated area under the ROC curve (AUC) analysis. RESULTS: A total of 22,073 adults met inclusion criteria and 4418 matched pairs (total n = 8836) were identified for nomogram development. The factors most strongly associated with improved OS on multivariable analysis included younger age (HR 0.82 by decade, P < .001), female sex (HR 0.81, P < .001), lower comorbidity index (HR 0.65 for 0 vs. ≥3, P < .001), smaller tumor size (HR 0.60 for ≤3 cm vs. 5.1-7 cm, P < .001), adenocarcinoma histology (P < .001), and receipt of SABR (P < .001). Interaction between SABR and histology was significantly associated with OS (P = .017). Relative to adenocarcinoma, patients with squamous cell carcinoma who were observed (HR 1.44, 95% CI 1.33-1.56) or treated with SABR (HR 1.24, 95% CI 1.14-1.35) had significantly worse OS. The nomogram demonstrated fair accuracy for predicting OS, with an integrated time-dependent AUC of 0.694 over the entire follow-up period. CONCLUSION: This nomogram estimates OS at 2 and 5 years based on whether medically inoperable early-stage NSCLC patients receive SABR or elect for observation. Incorporation of other variables not captured within the NCDB may improve the model accuracy.
Authors
Jacobs, CD; Mehta, K; Gao, J; Wang, X; Salama, JK; Kelsey, CR; Torok, JA
MLA Citation
Jacobs, Corbin D., et al. “Nomogram Predicting Overall Survival Benefit of Stereotactic Ablative Radiotherapy for Early-Stage Non-Small Cell Lung Cancer.Clin Lung Cancer, June 2021. Pubmed, doi:10.1016/j.cllc.2021.06.008.
URI
https://scholars.duke.edu/individual/pub1489730
PMID
34301453
Source
pubmed
Published In
Clin Lung Cancer
Published Date
DOI
10.1016/j.cllc.2021.06.008

Radiogenomic Analysis of Locally Advanced Lung Cancer Based on CT Imaging and Intratreatment Changes in Cell-Free DNA.

The radiologic appearance of locally advanced lung cancer may be linked to molecular changes of the disease during treatment, but characteristics of this phenomenon are poorly understood. Radiomics, liquid biopsy of cell-free DNA (cfDNA), and next-generation sequencing of circulating tumor DNA (ctDNA) encode tumor-specific radiogenomic expression patterns that can be probed to study this problem. Preliminary findings are reported from a radiogenomic analysis of CT imaging, cfDNA, and ctDNA in 24 patients (median age, 64 years; range, 49-74 years) with stage III lung cancer undergoing chemoradiation on a prospective pilot study (NCT00921739) between September 2009 and September 2014. Unsupervised clustering of radiomic signatures resulted in two clusters that were associated with ctDNA TP53 mutations (P = .03) and changes in cfDNA concentration after 2 weeks of chemoradiation (P = .02). The radiomic features dissimilarity (hazard ratio [HR] = 0.56; P = .05), joint entropy (HR = 0.56; P = .04), sum entropy (HR = 0.53; P = .02), and normalized inverse difference (HR = 1.77; P = .05) were associated with overall survival. These results suggest heterogeneous and low-attenuating disease without a detectable ctDNA TP53 mutation was associated with early surges of cfDNA concentration in response to therapy and a generally better prognosis. Keywords: CT-Quantitative, Radiation Therapy, Lung, Computer Applications-3D, Oncology, Tumor Response, Outcomes Analysis Clinical trial registration no. NCT00921739 Supplemental material is available for this article. © RSNA, 2021.
Authors
Lafata, KJ; Corradetti, MN; Gao, J; Jacobs, CD; Weng, J; Chang, Y; Wang, C; Hatch, A; Xanthopoulos, E; Jones, G; Kelsey, CR; Yin, F-F
MLA Citation
Lafata, Kyle J., et al. “Radiogenomic Analysis of Locally Advanced Lung Cancer Based on CT Imaging and Intratreatment Changes in Cell-Free DNA.Radiol Imaging Cancer, vol. 3, no. 4, Apr. 2021, p. e200157. Pubmed, doi:10.1148/rycan.2021200157.
URI
https://scholars.duke.edu/individual/pub1484672
PMID
34114913
Source
pubmed
Published In
Radiol Imaging Cancer
Volume
3
Published Date
Start Page
e200157
DOI
10.1148/rycan.2021200157