How a Radiation Oncologist Answers Patient Questions with Research

James B. Yu, MD, MHS, FASTRO, professor in the Department of Radiation Oncology and Applied Sciences, leader of the Genitourinary Radiation Oncology Program at Dartmouth Hitchcock Medical Center, and radiation oncology editorial advisory board member of the Journal ONCOLOGY®, has published over 390 manuscripts, so far, during his career as a radiation oncologist.¹

More specifically, comparative effectiveness research has always been a focus of his, dating back to when he started his career at Yale. The field, as Yu said, was great at answering questions in radiation oncology without the resources or connections to direct clinical data.

Two of his more recent publications are “Updated Analysis of Comparative Toxicity of Proton and Photon Radiation for Prostate Cancer” and “Comparative Effectiveness of SBRT”.^2,3

Transcript:

I [became] interested in these larger database studies, this family of research called “comparative effectiveness research”, mainly because there were limited clinical research opportunities at Yale when I started my career there in the late 2000s. There wasn’t a lot going on in terms of direct clinical innovation that we could directly research through case reports, so I had to look elsewhere for how to do research. My mentor there was a guy named Dr. Cary Gross—who’s a phenomenal researcher and very well known—but he’s an internal medicine and primary care physician with an interest in oncology, and he was doing these bigger retrospective, observational studies using Medicare claims and asking big questions in cancer. I was wondering whether we could ask questions in radiation oncology using these databases. It’s a way to do impactful [research] without having the direct clinical data at the institution that I was at. How do we pick studies to do? A lot of it begins in the clinic, where a patient comes [to us] and says, for example, “Doc, should I go get protons? Are they better than photons?” We had no answer for them, and I figured we would look at Medicare data and see whether there was a difference in, at least, toxicity there.

Reference

1. James B. Yu, MD, appointed to department of radiation oncology at Dartmouth Cancer Center, Geisel School of Medicine. News release. Dartmouth Health. February 28, 2025. Accessed March 5, 2025. https://tinyurl.com/35ve8ucd
2. Yu JB, DeStephano DM, Jeffers B, et al. Updated Analysis of Comparative Toxicity of Proton and Photon Radiation for Prostate Cancer. J Clin Oncol. 2024;42(16):1943-1952. doi:10.1200/JCO.23.01604
3. Shen J, Sritharan DV, Yu JB, Aneja S. Comparative Effectiveness of SBRT. Springer, Cham. 455-467. doi:10.1007/978-3-031-67743-4_33