Benjamin Cedars, MD

Reconstructive Urologist at Montefiore Einstein

[Lauren Jacobs MD @laurenjacobs_md]

Thank you, @IcahnMountSinai for highlighting our recent work on multi-course reirradiation for children with recurrent DIPG. Proud to contribute to expanding treatment possibilities for children facing this devastating disease. @StasLazarev for his leadership, and our incredible team for their dedication for advancing care for these patients.

https://t.co/XEd59wOulV

@StasLazarev @sindhu_kunal @MountSinaiRO @TischCancer

[Lauren Jacobs MD @laurenjacobs_md]

Proud to see our work on multi-course reirradiation for DIPG published in Practical Radiation Oncology!

DIPG remains one of the most devastating pediatric brain tumors, with few options at progression. Our study brings together the published worldwide experience of patients treated with ≥ 3 courses of RT, exploring the potential role of multi-course reirradiation in carefully selected patients.

These 12 patients represent a small and highly selected group, but their experiences raise an important possibility: for some children with progressive DIPG, a 3rd course of RT may provide meaningful palliation.

There is still much more to learn about who benefits, when to treat, and at what dose. We hope to take the next step at @MountSinaiRO with a prospective study designed to answer these questions.

Huge thank you to senior author & mentor @StasLazarev and to @BecherOren, @sindhu_kunal, @sgilheeney, @MountSinaiRO, @TischCancer & @ASTRO_org

#RadOnc #PedsOnc #DIPG

Multi-Course Reirradiation in Diffuse Intrinsic Pontine Glioma - Practical Radiation Oncology https://t.co/yfyeMDzioU

[Stanislav (Stas) Lazarev, MD @StasLazarev]

⚡️Just published: NEW STUDY ON MULTI-COURSE RT IN DIPG ⚡️

What happens when #DIPG progresses after re-irradiation?

💊 Systemic therapy?
🧪 Clinical trial?
🕊️ Hospice?
☢️ Or… can we irradiate the brainstem a third time, and could it actually help?

A few years ago, a family of a DIPG patient asked me exactly that. My immediate reaction was: "No, that would be too risky. Too dangerous. She’s already had radiation twice". But I kept thinking about it. 🤔 I spoke with several colleagues, reviewed the very limited literature, and eventually started asking a different question:

Do we actually know that a third course is too dangerous, or have we simply assumed it is?

We ultimately treated this patient with a carefully selected, low-dose third course of RT.

✨ She experienced significant improvement in symptoms.
⏳ She lived for nearly 9 months after that treatment.

That experience prompted us to look more systematically at this question.

📄 Our phenomenal resident Dr. Lauren Jacobs @laurenjacobs_md led this newly published study in #practicalRO, combining

🌎 2 patients treated at our institution + 10 previously published cases we identified in the literature = 12 patients total.

To our knowledge, this represents the entire published global experience with ≥3 courses of RT for DIPG.

📊 What did we find?

➡️ Median survival from diagnosis: 27 months
➡️ Symptomatic improvement after reRT was frequently reported
➡️ Despite substantial cumulative radiation doses, the limited available experience did not identify a clear signal of prohibitive toxicity

⚠️ Of course, this is only 12 highly selected patients. These retrospective observations cannot establish a survival benefit - or definitively tell us how safe a third course of RT is.

But they do suggest that perhaps the answer shouldn't automatically be “No.”

For carefully selected patients with progressive DIPG and few remaining options, low-dose multi-course reRT may provide meaningful palliation and deserves prospective study.

🔬 What’s next? We’re hoping to develop a prospective study at @MountSinaiRO to better define patient selection, dose, timing, benefit, and toxicity.

Sometimes patients and families ask questions we simply don't have good answers to.

💡 Those questions are often worth studying

@BecherOren @sindhu_kunal @QuadShotNews @TischCancer @MountSinaiRO @sgilheeney @ASTRO_org

[Lauren Jacobs MD @laurenjacobs_md]

Excited to share our recent publication on understanding patient priorities for religious and spiritual needs during radiation for gyn cancers!

@lymberis @KarynAGoodman @NYULH_RadOnc @MountSinaiRO
https://t.co/LMVSRQngmU

[Benjamin Cedars, MD @bcedars2024]

@ben_breyer @UroRecon @blakelyGU @UrologyUpstate Thank you! Kind words and high praise from a leader in the field

[Benjamin Cedars, MD @bcedars2024]

Incredibly excited to match at SUNY Upstate for reconstructive fellowship! Thank you for the warm welcome. I can’t wait to join you, Dr. Blakely, and the rest of the team in Syracuse @UroRecon @blakelyGU @UrologyUpstate

[Dmitriy Nikolavsky @UroRecon]

SUNY Upstate Reconstructive Fellowship @SocietyGURS is thrilled to have matched Dr. Benjamin Cedars @bcedars2024 from @UCSDHealth Welcome to the Recon Family! @blakelyGU @UpstateUroRes

[Stella Lymberis, MD @lymberis]

Proud of Lauren Jacobs, MD a medical student I mentored who presented our work at #ABSBrachy23 on the importance of religion and spirituality in helping gynecologic patients cope with GYN #radiation and #brachytherapy. #WomenWhoCurie #300in10 #ThisIsBrachytherapy #NYULangone

[Benjamin Cedars, MD @bcedars2024]

@UCSD_Urology Postponing elective cases reduces unnecessary exposure for patients and HCWs in high risk environment. Recent reports indicate intubation can aerosolize and transmit the virus #ucsdurochat

[Benjamin Cedars, MD @bcedars2024]

@EileenRByrne @UCSD_Urology This is a good point. Additionally a delayed peak in cases will allow us to better prepare for if/when our system becomes overwhelmed and thereby potentially save lives #ucsdurochat

[Benjamin Cedars, MD @bcedars2024]

@UCSD_Urology Re: residents. Limit unnecessary exposure. In addition to canceling clinic/cases, we could reduce the number of residents who round, hold the pager from home and only go in if necessary, use remote access for orders, etc #ucsdurochat

[Benjamin Cedars, MD @bcedars2024]

@UCSD_Urology Patients may feel that deferment of operations or appointments means certain conditions are less important/ do not warrant further attention on and could lead to loss to follow up