WELCOME TO OUR PROGRAM!!!

Tufts-NEMC/Brown Radiation Oncology

What we have to offer you:What we have to offer you:

Good collegial relationships between faculty and residents

Non-malignant, cooperative atmosphereSupportive group of co-residentsBountiful opportunities for research Extensive electronic resources for board

preparation and learning

What we have to offer you:What we have to offer you:

Highly supportive chairman & faculty dedicated to resident education

Friday is a PROTECTED ACADEMIC DAY dedicated to all day lecture and without clinical responsibility

Richard Miller (radbio) & Allan Caggiano (physics) give board prep class to just us on an alternating basis

Typical Friday Schedule (in Typical Friday Schedule (in Boston)Boston)

8:00 cancer grand rounds9-10:00 journal club 10:00-11:45 clinical teaching12:00 departmental noon lecture1:00-2:00 physics2:00-3:00 radiation biology3:00-5:00 independent research/study

The Residents, 2007

Where our residents go:Where our residents go:

Class of 2007: 1 private practiceClass of 2006: 1 academicClass of 2005: 1 academic, 1 private

practiceClass of 2004: 1 academic, 2 private

practice

Where our residents have Where our residents have published in the recent pastpublished in the recent past

Cancer International Journal of Radiation Oncology Biology Physics American Journal of Clinical Oncology Brachytherapy Urology Technology in Cancer Research and Treatment Urological Oncology Nature Immunology Molecular Microbiology Journal of Bacteriology

National Meetings where our National Meetings where our residents have presented their residents have presented their

work, both oral and posterwork, both oral and poster American Society of Therapeutic Radiation and

Oncology (3/7 residents in program now have had orals, 7/7 have had posters)

American College of Radiation Oncology American Medical Association American Brachytherapy Society (2 orals in past 2

years, including 1 plenary session) World Conference of Interventional Oncology Society of Surgical Oncology American Urological Association

PubMed Faculty Citations PubMed Faculty Citations (and counting…)(and counting…)

Dr. David Wazer 113 Dr. Mark Rivard 85 Dr. Tom Dipetrillo 44 Dr. Brigid O’Connor 26 Dr. Gene Cardarelli 11 Jessica Hiatt, M.S. 3 Dr. Chris Melhus 5 Dr. John Mignano 3 Dr. Jody Morr 3 Dr. Stephanie MacAusland 1 Dr. Mohammed Puthawala 1

Resident PublicationsResident Publications

1st year- 12nd year- 23rd year- 4,44th year- 5,6,4

Our Board ScoresOur Board Scores

NEMC/ Brown residents consistently score in the upper quartile in comparison to their peers.

Our oral board pass rate on first try: one oral board failure in 10 years

Rank on RRC ranking report 10/74 We do take the in-service on a yearly basis, which

is for our benefit, not for evaluation by faculty

Our Hospitals:Our Hospitals:

Tufts-NEMC Hospital and the Floating Hospital for Children

Rhode Island Hospital with Women and Infant’s hospital and Hasbro Children’s Hospital

Clinical rotations are in 3 months blocks between these 2 centers, time will be split anywhere from 70/30 to 50/50 to 30/70 depending on the schedule and what clinical areas need attention from your case logs

About Tufts-NEMCAbout Tufts-NEMC The oldest permanent medical facility in New

England, founded 1796 as Boston Dispensary 451 inpatient beds

– 210 - medical/surgical– 46 - adult intensive care– 66 - pediatric (including 12 pediatric

psychiatric beds)– 62 - pediatric and neonatal intensive care– 23 - post-partum– 20 - adult psychiatric– 24 - bassinets

Tufts-NEMC is adjacent to the city’s Theater District and Chinatown

Tufts-NEMC: Leader in Cancer Tufts-NEMC: Leader in Cancer CareCare

1968. Established as the first independent Department of Radiation Oncology in Boston and we were one of the earliest academic centers in the country.

1968. Installed the first Betatron Treatment machine in Boston - at that time the most powerful high-energy accelerator for treating cancer available in the city.

1992. One of the earliest hospitals in Boston to develop a linear accelerator incorporating a radiosurgery system for treating brain tumors.

1992. One of the earliest hospital in Boston to routinely use computerized three-dimensional treatment planning to more accurately deliver radiation to tumors.

1995. One of the first six centers in the world to install intensity modulated radiotherapy (IMRT) equipment and to develop many of the techniques for cancer treatment that are used today worldwide. IMRT is regarded as one of the most important treatment innovations in radiotherapy in the past 35 years.

Tufts-NEMC: Leader in Cancer Tufts-NEMC: Leader in Cancer CareCare

1999. Installed the only Gamma Knife in Massachusetts for brain tumor radiosurgery.

2002. Installed the first MammoSite device in Boston for accelerated breast conservation radiotherapy.

2007. Installed BSD 500 Hyperthermia Treatment unit 2007. Installed the first AccuBoost breast brachytherapy

system in Massachusetts for minimally-invasive image-guided conformal radiation therapy.

2007. Installed the first Elekta Axesse linear accelerator in the world, for image-guided radiation therapy (IGRT). This system provides advanced tumor localization and targeting for sterotactic body radiation therapy (SBRT) for virtually any anatomic site.

2009. Plan for Proton Treatment Center to open. Install Still River System Monarch250

Tufts-NEMC Radiotherapy Tufts-NEMC Radiotherapy Capabilities & EquipmentCapabilities & Equipment

Leksell Gamma Knife 2 Linac’s: Elekta Axesse (fully IGRT, SBRT

capable) & Varian 2100 Orthovoltage unit Accuboost HDR Brachytherapy Ocular plaques for Choroidal Melanoma, Cs-131

and I-125 Hyperthermia Total Skin Electron Therapy, Total Body

Irradiation APBI via Mammosite or 3DCRT External Beam Lung wedge resection with LDR brachytherapy

Tufts NEMC Radiation StaffTufts NEMC Radiation Staff

4 full time physicists 1 full time dosimetrist 1 Chief Therapist, 5 full time therapists, 1 part

time therapist 2.5 full time nurses 3 part time attendings (DEW, TD, and JM), 1 full

time attending, and 1 full time attending to be hired this season, start 7/08

We treat 40-45 patients per day on 2 linacs

Tufts-NEMCTufts-NEMC

Dedicated tumor boards for breast, cutaneous, head and neck, CNS, lymphoma, thoracic, GI, GYN

Multidiscliplinary clinics for breast and CNS

Very active peds program in association with Floating Hospital for Children

Tufts Floating Hospital for Tufts Floating Hospital for ChildrenChildren

5 dedicated pediatric hematologist-oncologists

2 pediatric surgeons, 1 pediatric urologist, 3 pediatric orthopedists

Case loads at Case loads at Tufts-NEMC/BrownTufts-NEMC/Brown

80% of training programs have to send their residents on away rotations to fulfill peds requirements (12 cases)

We fulfill all peds case requirements easily without need to go anywhere else.

Brachytherapy numbers consistently high

About Rhode Island HospitalAbout Rhode Island Hospital

719 bed acute care not for profit hospital founded in 1863, affiliated with Brown Medical school

Mission: The mission of Rhode Island Hospital is to be at the forefront of patient care by creating, applying and sharing the most advanced knowledge in health care.

The hospital admits more than 30,000 patients yearly and its surgeons perform approximately 10,500 inpatient operations and more than 14,400 outpatient procedures yearly

RIH- A Leader in Cancer CareRIH- A Leader in Cancer Care 1992- Rhode Island Hospital is one of the first centers in the United States and one of

two in New England to offer Gamma Knife radiosurgery. 2000- Rhode Island Hospital becomes the third site in New England to offer

intensity modulated radiation therapy (IMRT) for cancer treatment. 2002- Rhode island Hospital was first state in new england to offer Mammosite 2003- Rhode Island Hospital performs a first-of-its-kind combination of treatment for

recurring lung cancer by combining High Dose Rate brachytherapy with radiofrequency ablation.

2004- Rhode Island Hospital is the first in the country to use new microwave ablation technology to treat cancer and led the national clinical trial of the new technology.

2005- Rhode Island Hospital becomes the first in New England to offer the newest image—guided radiation technology for cancer treatment, the Trilogy stereotactic system.

2007- Rhode Island Hospital is one of only nine sites in the country to begin offering Xoft electronic brachytherapy, a cutting edge technology that delivers localized, non—radioactive radiation treatment directly to cancer sites.

Rhode Island Hospital Radiation Rhode Island Hospital Radiation Capabilities & EquipmentCapabilities & Equipment

Leksell Gamma Knife Certificate of Need Under Review for Cyberknife Varian Trilogy with full IGRT/SBRT capabilities 2 additional linacs, both Varian 2100CD. Non-MLC unit to be

upgraded this year to Elekta Synergy versus Varian 2100 EX New CT Sim early 2008, Phillips multi-slice large bore (16

slice) with bellows and gating capability to replace existing CT sim

Superficial Hyperthermia with BSD 500 unit Xoft electronic brachytherapy 3D CRT APBI, MammoSite, and prone breast

RIH Radiation StaffRIH Radiation Staff

8 full time physicists (1 in gamma knife)3 full time dosimetrists2 Chief Therapists, 11 therapists5 full time nurses4 full time attendings, 1 part-time attending

(DEW) We treat 90-110 patients per day on 3 linacs

RIH RIH

Specific multidisciplinary weekly tumor boards for adult CNS, head and neck, GYN, general peds, peds CNS, breast (2 separate tumor boards- WIH, RIH), thoracic, GI.

Multidisciplinary clinics for breast

Women and Infant’s HospitalWomen and Infant’s Hospital

Women & Infants Hospital of Rhode Island is one of the nation’s leading specialty hospitals for women

The primary teaching affiliate of Brown Medical School for obstetrics, gynecology and newborn pediatrics

Women and Infant’s HospitalWomen and Infant’s Hospital Women & Infants houses:

137 Adult beds60 Neonatal Intensive Care beds60 Newborn bassinets10 Operating rooms

In 2005, saw 90,000 patients Women & Infants Hospital has dedicated gyn onc

fellows, breast health fellows, dedicated breast surgeons

The site of an active general and gynecological surgical program with more than 8,800 procedures performed last year.

WIHWIH The Program in Women’s Oncology at Women & Infants

Hospital is the state’s largest focused cancer program dedicated to women. Program includes a prospective, multidisciplinary tumor board process.

The Program in Women’s Oncology offers a comprehensive Cancer Risk Assessment and Prevention program accredited by the American College of Surgeons.

Women & Infants’ Program in Women’s Oncology is a full member in the National Cancer Institute’s Gynecologic Oncology Group (GOG), The program is also a Teaching Hospital Cancer Program as approved by the American College of Surgeons Commission on Cancer.

2006, Women & Infants began offering intraperitoneal (IP) chemotherapy treatment for women with advanced ovarian cancer.

Both RIH and WIH offer axillary u/s with FNA, not available in any Boston hospital but available at MDACC

Hasbro Children’s HospitalHasbro Children’s Hospital

7 pediatric hem oncs4 pediatric surgeons

Our lab is focused on understanding the various aspects of normal and carcinogenic breast development, with the emphasis on stromal-epithelial interactions involved during progression and metastasis.

Mike Chan has been studying the role of estrogen in the mobilization of endothelial progenitor cells from the bone marrow.

Katie Huber is investigating the effect of radiation on the tumorigenic subpopulation of breast cancer cells commonly referred to as breast cancer stem cells.

Kuperwasser LabKuperwasser Lab

•Department Laboratory Animal Maintenance

•Fluorescent, Confocal, and Dissecting Microscopes with Digital Imaging in the Lab and an Electron Microscopy Core Facility

•Histology Core Facility

•DNA/Protein Core Facility

•Flow Cytometry Facility

•PCR, RT-quantitative PCR, Fluorescence Luminometer, 2 fully equipped tissue culture rooms, and a well-funded lab with lots of friendly, knowledgeable lab-mates.

Lab ResourcesLab Resources

Lab FacilitiesLab Facilities

We have an excellent animal facility that cares for our laboratory animals. You must check on them weekly at a minimum and they must be able to contact you in case of an emergency, but otherwise they are completely cared for.

In the lab we have three beautiful microscopes with digital imaging for data analysis and storage. There is also an electron microscopy core facility at Tufts.

Other time saving, high quality core facilities are available for histology, DNA sequencing, making PCR primers, performing proteomic and microarray analyses, and flow cytometry. The Cytometry center has machines for 4 and 16 color sorting and analysis. Mike also works with a home-made system that does in vivo cytometry.

MORI, has 17 faculty members currently and occupies a space of more than 31,000 square feet in the 75 Kneeland Street research building. Its mission is to explore the molecular mechanisms of neoplastic transformation and to promote the translation of basic research findings into the clinic.

About Providence the cityAbout Providence the city

Providence is New England’s second largest city, with a population of approximately 160,000. As the state capital, it is the hub of the state’s business, governmental and cultural activities.

The city is home of the Museum of Art at the Rhode Island School of Design, the Tony Award-winning Trinity Repertory Theater Company, the Rhode Island Philharmonic Orchestra, Roger Williams Park Zoo, and the many educational and social activities of Brown University.

Providence is located within easy driving distance of nearly every Rhode Island suburb.

Boston is a one-hour drive to the north and New York City is approximately three and a half hours to the south.

Cape Cod, Martha’s Vineyard, Nantucket and the major ski areas of New Hampshire and Vermont are all within a few hours of Providence.

Federal Hill restaurants rival Boston’s North End for quality Italian!!

Boston the CityBoston the City

So you commute to Providence?So you commute to Providence?

Residency program sponsors a furnished 3 bedroom 2nd story resident apartment with 3 miles of RIH to make commuting easier

Commute takes 50 minutes from downtown Boston

Option available to live in Providence as well If you are couples matching, your other half could

consider ranking Providence hospitals