Dr. Yu is a Professor Radiation Oncology at Dartmouth Hitchcock Medical Center. His research centers on general 5 themes: 1) Cancer Epidemiology and Population Outcomes, 2) The comparative effectiveness of new radiation technologies, 3) Health related quality of life (HRQoL) of patients who undergo radiation treatment, 4) New applications of radiosurgery with new and emerging systemic therapies for cancer, and 5) Clinical trials establishing new standards of care for genitourinary cancers.
Cancer epidemiology and outcomes: We found that being Asian was not a risk factor for developing sebaceous carcinoma of the eyelid – overturning an assumption that had been held for decades. We have estimated the benefit of colorectal cancer screening on cancer incidence. We published research showing that patients who undergo alternative non-medical treatment as their initial cancer treatment have a worse survival compared to those patients who undergo recommended medical therapy. Finally, we have investigated the differential association of peer influence on adoption of two efficient radiotherapy practices, finding that peer influence seemed to influence post-lumpectomy radiotherapy more than palliative radiotherapy, perhaps indicative of the influence of multidisciplinary discussion.
Comparative Effectiveness of New Radiation Oncology Technologies: Using the Medicare Chronic Conditions Warehouse (CCW) – a large and comprehensive database of national Medicare claims, we discovered that proton radiotherapy was more expensive and only marginally beneficial for patients with prostate cancer, and that stereotactic body radiotherapy (SBRT) was less expensive and slightly more toxic than standard IMRT. Through this work, I have become a recognized leader in the performance of comparative effectiveness research for radiation oncology and presented on impact of new radiation oncology technology dissemination at the Institute of Medicine on July 20, 2015. We updated this work in 2024 with the SEER-Medicare database and published our results in the JCO. With collaborators at Columbia University Irving Medical Center, we are currently investigating the comparative toxicity of focal prostate ablation and radiotherapy.
Health related quality of life (HRQoL) of patients who undergo radiation treatment: In an individual patient meta-analysis, we found that SBRT was better tolerated than moderately hypofractionated radiotherapy with regards to patient reported outcomes. This work has formed the basis for the NCI-designated cooperative group national clinical trial NRG Oncology NRG GU-005 study comparing two radiation fractionation schedules for prostate cancer, for which I served as the radiation oncology and quality of life co-chair.
New applications of radiosurgery with new and emerging systemic therapies for cancer: We found that the use of EGFR targeted therapies does not preclude the importance of brain directed radiotherapy. Current work with collaborators at the Yale Gamma Knife center investigates the survival of patients diagnosed with EGFR mutant NSCLC and subsequent brain metastases who have been pre-treated with EGFR targeted CNS penetrant therapies vs. those who present de-novo.
Clinical trials establishing new standards of care for genitourinary cancers: I serve as the HRQoL/PRO and Radiation Oncology chair for the recently completed NRG GU005 study, as well as PRO chair for NRG GU009 (PREDICT-RT), and PRO co-chair for NRG GU013 (HIGH-FIVE). I am radiation co-chair for the SWOG S2427 concept (BRIGHT) and Health Care Utilization Chair for NRG CC014 (PREEMPT). I am the PI for the ongoing Pfizer/Myovant/Sumitomo Pharma funded SBRT and Ultrashort GnRH Agonist Relugolix (SUGAR) randomized phase II study.