Faculty Appointments
Patient Care Settings
Neurology, Radiation Oncology
Credentials
Education
2011
MD | Case Western Reserve University
Post-doctoral Training & Residency
07/01/2016 - 06/30/2020
Residency in Radiation Oncology at University of Rochester Medical Center
07/01/2012 - 06/30/2015
Residency in Neurology at Johns Hopkins Bloomberg School of Public Health
06/23/2011 - 06/30/2012
Internship in Internal Medicine at Fletcher Allen Health Care-MCHV Campus (USA)
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Awards
2018
Holman Research Pathway
2018
Roentgen Resident/Fellow Research Award
Sponsor: Radiological Society of North America
2017 - 2019
Red Journal Reviewer Trainee Program
Sponsor: American Society for Therapeutic Radiation Oncology
2013
Seed Grant Award
Sponsor: American Medical Association
2001 - 2005
National Merit Scholar
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Clinical Trials
Early Telehealth Visits for Discussion of Advanced Directives for Patients Newly Diagnosed With High Grade Glioma: Impact on Patient Care and Satisfaction
Lead Researcher: Sara J Hardy
High grade gliomas (HGGs) are rapidly progressive brain tumors resulting in death for most patients between 6 months and 2 years after diagnosis. It is important for patients with HGG to discuss and document their wishes at the end of life. However, many of these patients experience early changes in cognition which impede their decision-making. For this reason, these patients should have early discussions with their providers. However, implementation of this remains challenging in clinical practice.
In this study, we will create an Early STructured Advanced care Referrals by Telehealth (Early START) visit for patients soon after their initial oncology visit. A checklist and pre-visit guide were developed to help guide the visit for both the provider and patient. Providers will receive special training in running these visits. Caregivers and/or family members will be encouraged to participate. Visits will be done using video or telephone and recorded. For patients who do not have access to technology for these visits, it will be provided. After the visit, patients, caregivers and/or family who participated, and providers will fill out surveys to address feasibility of having these extra visits and improve the visits for future. Patients will be followed until death. Caregivers and/or family who participated will be asked about whether end of life was in line with the patient's wishes. We will also use the patient's medical record to assess other aspects of end of life. We will compare end of life outcomes with other similar patients treated at our center.
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A Prospective Pilot Study of Cognitive Changes in Patients Receiving Partial Brain Radiation: Development of a Radiation Dose-toxicity Model for Neuroanatomic Targets
Lead Researcher: Sara J Hardy
Cranial radiation therapy (RT), commonly used to treat benign and malignant brain tumors, can lead to cognitive impairments in domains not related to neuroanatomic structures directly impacted by the tumor. The study will prospectively enroll 75 patients with benign and low-grade brain tumors who will undergo partial brain RT, with either conventionally fractionated or hypofractionated schedules. Subjects will receive MRI scans at baseline, 6 months, and 12 months. Given the role of the limbic system in key cognitive functions affected by RT, researchers have a particular interest in characterizing MRI changes in the limbic system and thalamus in relation to memory and related processes.
Specific Aims:
To examine objective neurocognitive changes over time. The investigators hypothesize that they will see RT-induced neurocognitive impairment in up to 50% of patients after cranial RT.
To examine changes in brain tissue (via MRI) induced by off-target RT in patients with benign and low-grade brain tumors. The investigators specifically hypothesize that comapping of RT dose and MRI changes in the thalamus and limbic system (i.e., thalamic nuclei, hippocampus, fornix, hypothalamus/mammillary bodies, limbic lobe, cingulum) will be most distorted by off-target RT.
To examine the relationship between MRI changes for key neuroanatomic structures identified in Aim 1 with objective neurocognitive testing. The investigators hypothesize that cognitive decline will be correlated with damage revealed by MRI to limbic and thalamic structures.
This research will help to define which neuroanatomic structures are most at risk from RT-induced damage and will help ultimately establish new dose constraint guidelines for important structures to improve cognitive outcomes.
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Publications
Journal Articles
2/4/2022
Belcher EK, Culakova E, Gilmore NJ, Hardy SJ, Kleckner AS, Kleckner IR, Lei L, Heckler C, Sohn MB, Thompson BD, Lotta LT, Werner ZA, Geer J, Hopkins JO, Corso SW, Rich DQ, van Wijngaarden E, Janelsins MC. "Inflammation, Attention, and Processing Speed in Patients with Breast Cancer before and after Chemotherapy." Journal of the National Cancer Institute.. 2022 Feb 4; Epub 2022 Feb 04.
2/25/2020
Milano MT, Bates JE, Budnik J, Qiu H, Hardy S, Cummings MA, Baumgart MA, Maggiore RJ, Mulford DA, Usuki KY. "Risk of brain metastases in T1-3N0 NSCLC: a population-based analysis." Lung cancer management.. 2020 Feb 25; 9(1):LMT25. Epub 2020 Feb 25.
12/2019
Milano MT, Hardy SJ, Chowdhry AK. "Nivolumab without brain radiotherapy is insufficient for the treatment of most patients with brain metastases from clear cell renal cell carcinoma." Annals of translational medicine.. 2019 Dec; 7(Suppl 8):S366.
Books & Chapters
2018
Chapter Title: Hypopituitarism
Book Title: Adult CNS Radiation Oncology
Author List: Hardy S; Shafiq I; Milano M; Vates E; Constine L
Published By: Springer International Publishing AG 2018
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