Dr. Sause: Clinical, Research, and Administration. Vilija N. Avizonis, MD Radiation Oncologist; Intermountain Medical Center; Murray, Utah

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1 Dr. Sause: Clinical, Research, and Administration Vilija N. Avizonis, MD Radiation Oncologist; Intermountain Medical Center; Murray, Utah Objectives: Identify Dr. Sause's educational achievements Discuss Dr. Sause's achievements in education, clinical research, practice of radiation oncology, and cancer program developent

2 Education: BORN AND RAISED YOUNGSTOWN, OH BS BIOLOGY, MARQUETTE UNIVERSITY MD, MEDICAL COLLEGE OF WISCONSIN INTERNSHIP, LDS HOSPITAL RADIATION ONCOLOGY, LDS HOSPITAL (WITH ROTATIONS AT U OF UTAH, U OF WISCONSIN, MD ANDERSON CANCER CENTER, U SOUTHERN CALIFORNIA)

3 Dedication to teaching: CLINICAL PROFESSOR OF RADIATION ONCOLOGY, UNIVERSITY OF UTAH ORAL BOARD EXAMINER, AMERICAN BOARD OF RADIOLOGY WRITTEN EXAM COMMITTEE, AMERICAN BOARD OF RADIOLOTY ASTRO EDUCATION COMMITTEE ASTRO PROGRAM COMMITTEE ASCO PROGRAM COMMITTEE AMERICAN RADIUM SOCIETY PROGRAM COMMITTEE ASSOCIATE EDITOR, INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY, BIOLOGY, PHYSICS PROGRAM DIRECTOR ASTRO REFRESHER COURSE CONTRIBUTOR RADIATION ONCOLOGY SELF ASSESSMENT PROGRAM

4 Dedication to Patient Care: In 1978, Dr. Sause joined the Radiation Oncology Department at LDS Hospital and thus began his long relationship with Intermountain Healthcare.

5 Dedication to Research: OVER 150 PEER REVIEWED PUBLICATIONS 16 BOOK CHAPTERS PRINCIPAL OR CO INVESTIGATOR OF 17 NATIONAL AND INTERNATIONAL COOPERATIVE GROUP PROTOCOLS

6 Cooperative research groups: NRG RADIATION THERAPY ONCOLOGY GROUP SOUTHWEST ONCOLOGY GROUP GYNECOLOGIC ONCOLOGY GROUP EASTERN COOPERATIVE ONCOLOGY GROUP

7 Dedication to Research, RTOG: PRINCIPAL INVESTIGATOR, LDS HOSPITAL CHAIRMAN OF LUNG COMMITTEE PUBLICATIONS COMMITTEE (CHAIR) NOMINATING COMMITTEE DATA MONITORING COMMITTEE NOMINATED TO BE CHAIR OF RTOG, DECLINED TO HEAD CANCER PROGRAM AT INTERMOUNTAIN HEALTHCARE

8 Dedication to Research, Other cooperative Groups: SWOG BRAIN COMMITTEE, VICE CHAIR GOG CO INVESTIGATOR ECOG PHASE III AND INTERGROUP MONITORING COMMITTEE CTEP 5 YEAR PLAN SUBCOMMITTEE, DISEASE ORIENTED STRATEGIES NCI CONSENSUS COMMITTEE ON LUNG CANCER NORTH CENTRAL CANCER TREATMENT GROUP, EXTERNAL DATA MONITORING COMMITTEE NCI LUNG CANCER CONCEPT EVALUATION PANEL CO CHAIR THORACIC STEERING COMMITTEE FOR CTEP (NCI)

9 First Radiation Publication: Radiation Therapy of Head and Neck Tumors: A randomized study of treatment in air vs. treatment in hyperbaric oxygen. IJROBP 1979; 5(10)

10 PI of joint SWOG and GOG trial for stage IIB-IVA cervix cancer with negative paraaortic nodes: GOG 85 Standard whole pelvis XRT with: 5FU + Cisplatin Or Oral Hydroxyurea This was the first clinical trial to use cisplatin, now standard, in cervix cancer Significant Improvement in progression free survival and overall survival in the 5FU + Cisplatin arm Life threatening leukopenia more common in the Hydroxyurea arm

11 RTOG (Intergroup): Randomized phase III study of radiation vs. radiation plus chemotherapy in non small cell lung cancer Standard once daily radiation Induction chemotherapy then standard radiation Twice daily radiation 1 yr survival of 60% and median survival of 13.8 months for chemo > radiation statistically superior to the other 2 treatment arms JNCI 87: , 1995

12 RTOG 9309: A trial of radiotherapy + chemotherapy with or without surgical resection in stage III non-small-cell lung cancer T1 3pN2M0 (surgically staged but not resected) 2 cycles cisplatin + etoposide then 45Gy radiotherapy Then resection vs. continued radiation to 61 Gy 2 more cycles of chemotherapy Overall survival 23.6 months resected, 22.2 months without (p=.24) 5 year survival 27% resected, 21% with higher radiation dose (p=.10) No difference in survival whether patients were treated with surgery or additional radiation Lancet 374: , 2009

13 RTOG (Intergroup): Sequential vs. concurrent chemotherapy and radiation therapy for Stage III non small cell lung cancer: Sequential cisplatin and vinblastine then 60 Gy XRT Concomitant cisplatin and vinblastine with 60 Gy XRT Concomitant cisplatin and etoposide with BID XRT, 69.6 Gy 5 year survivals: 5%, 8% and 6% respectively Median survivals: 14.6, 17.0 and 15.6 months respectively JNCI 103(19): , 2011 Chest 117(2): , 2000

14 Other Studies: Radiation dose fraction size in melanoma: No difference in CR or PR for 4 x 800cGy vs. 20 x 250cGy. (IJROBP 20;429 32, RTOG 9506: Selective bladder preservation for TURB then cisplatin + 5FU + XRT 66% 3 year survival with bladder preservation. (The Oncologist 5:471 76, 2000) Combined adjuvant radiation and interferon alpha 2b in melanoma potential for increased radiation toxicity. (IJROBP 52: , 2002) Low dose adjuvant radiation post prostatectomy in high risk prostate cancer potentially improves PSA control. (Urology 69:295 99, 2007) Short term mammography demonstrated no benefit to postradiation mammograms less than 1 year after radiation. (IJROBP 83:519 24, 2012)

15 Plus publications in: Brain metastases Pediatrics Breast cancer treatment toxicity Endometrial cancer Ovarian cancer Prostate cancer Colorectal cancer

16 Professional Societies: AMERICAN COLLEGE OF RADIOLOGY (FELLOW) RADIOLOGIC SOCIETY OF NORTH AMERICA AMERICAN SOCIETY OF THERAPEUTIC RADIATION ONCOLOGY AMERICAN SOCIETY OF CLINICAL ONCOLOGY AMERICAN ENDOCURIETHERAPY SOCIETY AMERICAN THORACIC SOCIETY AMERICAN MEDICAL ASSOCIATION UTAH MEDICAL ASSOCIATION UTAH STATE RADIOLOGIC SOCIETY AMERICAN RADIUM SOCIETY AMERICAN COLLEGE OF CHEST PHYSICIANS INTERNATIONAL SOCIETY OF INTRAOPERATIVE RADIATION THERAPY

17 FACR Induction

18 Cancer Services Leader at IHC: Subspecialized tumor conferences Multidisciplinary cancer clinics Subspecialized working groups for both retrospective and prospective studies for both quality improvement and research Establishment of data warehouse of all sources of cancer data within IHC Expansion of cancer clinical trials to include multiple cooperative group studies

19

20

21 Lastly: HUSBAND TO SUE FATHER TO MATT, ANDY, MAGGIE AND WILL

22 GRANDFATHER TO WILLIAM

23 Mentor, Friend, Coworker and Colleague and to many

24

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