Hepel, Jaroslaw

Jaroslaw T Hepel

Professor of Neurosurgery, Professor of Radiation Oncology

Overview

Jaroslaw T. Hepel, MD, FACRO is an Associate Professor at The Warren Alpert Medical School of Brown University and serves as Director of the Stereotactic Radiotherapy and Radiosurgery Program and as Director of Academic Affairs for the Department of Radiation Oncology at the Lifespan Cancer Institute and Rhode Island Hospital. He also serves as Adjunct Associate Professor at Tufts University. He is board certified in radiation oncology by the American Board of Radiology.

Dr. Hepel received his undergraduate degree at Cornell University in 1997 with distinction in all subjects. He earned his medical degree at the University of Rochester in 2001, and then completed an internal medicine residency at the University of California Irvine Medical Center. He then went on to complete residency in the specialty of radiation oncology at Tufts Medical Center in Boston, MA.

Dr. Hepel has broad experience and knowledge, and is active in caring for patients with a wide range of malignant diseases. However, he holds a particular interest and clinical expertise in the treatment of breast cancer and lung cancer, and in stereotactic radiosurgery/radiotherapy for diseases involving the brain, spine, lung, and other sites. He is not only very active in the clinic but also has a keen academic interest and is active in research in these areas. He strives to improve treatment outcomes in regards to both achieving higher cure rates but also in minimizing treatment related side effects. He has published multiple book chapters and numerous scientific papers. He regularly presented his work at national meetings.

Dr. Hepel is also passionate about ensuring safe and high-quality radiation therapy for all cancer patients. He servers as the Medical Director of the American College of Radiation Oncology (ACRO) Accreditation Program which reviews the quality and safety programs of radiation oncology practices across the country.

Dr. Hepel is currently on the Board of Chancellors for the American College of Radiation Oncology (ACRO). He is also a member of the American Society of Therapeutic Radiology and Oncology (ASTRO), the American Brachytherapy Society (ABS), and the Massachusetts Medical Society (MMS).

For patient appointments call:

(401) 444-3600 - Rhodes Island Hospital

(401) 606-6010 - East Greenwich

(401) 444-2149 - Fax

Brown Affiliations

Research

Research Statement

Dr. Hepel has particular academic focus and research interest in breast cancer, stereotactic radiosurgery, and new technologies.

Dr. Hepel is involved in research in many aspects of breast cancer. He has been active in evaluating established and novel techniques for accelerated partial breast irradiation (APBI), an approach that strives to limit the impact of radiation treatment on the patient by focusing therapy to only the portion of the breast at risk for tumor recurrence. Non-invasive image-guided breast brachytherapy is a novel approach to APBI that is currently being pioneered at Rhode Island Hospital. In addition, he has evaluated risk stratification for ductal carcinoma in situ (DCIS) and ways to optimize planning and delivery of "boost" radiation.

Dr. Hepel also has a keen interest in radiosurgery or pin-point focused, high-dose radiation for multiple body sites. Stereotactic body radiation therapy (SBRT) has been shown to be very effective for early stage lung cancer. Dr. Hepel is evaluating use of SBRT combined with standard chemoradiation for the management of advanced lung cancer in order to try to improve upon the poor outcomes for this difficult to treat disease. He is also evaluating the role of radiosurgery in the treatment of brain metastases. Using both Gamma Knife and Cyberknife systems, he is evaluating clinical and treatment related parameters to optimize outcome for these patients. Furthermore, Dr. Hepel is involved with research pertaining to treatment of spinal tumors. The Cyberknife robotic radiosurgery system is uniquely suited for treatment of tumors involving the spine. Despite the close proximity of these lesions to the spinal cord, radiation can be sculpted to the target tumor and yet spare this sensitive structure.

Lastly, Dr. Hepel holds an interest in research of new technologies. This includes research on electronic brachytherapy, Accuboost, Cyberknife, as well as other promising technologies.

Through his research, Dr. Hepel strives to improve treatment outcomes for cancer patients in regards to both achieving higher likelihood of cure and minimizing normal tissue side effects.

Active Clinical Protocols:

BrUOG BR-291: Five Fraction Partial Breast Irradiation using Non-invasive Image-guided Breast Brachytherapy (NIBB)

BrUOG L-358: Durvalumab and Consolidation SBRT Following Chemoradiation for Locally Advanced Stage III Non-Small Cell Lung Cancer

AccuBoost APBI Registry: Clinical outcomes registry for breast cancer patients receiving APBI using Non-invasive Image-guided Breast Brachytherapy (NIBB)

Funded Research

Scholarly Work

MacAusland SG, Hepel JT, Chong FK, Galper SL, Gass JS, Ruthazer R, Wazer DE. An Attempt to Independently Verify the Utility of the Van Nuys Prognostic Index for Ductal Carcinoma In Situ. Cancer, 2007; 110(12):2648-53.

Hepel JT, Evans SB, Hiatt JR, Price LL, DiPetrillo T, Wazer DE, and MacAusland SG. Planning the Breast Boost: A Comparison of Three Techniques and Evolution of the Tumor Bed During Treatment. International Journal of Radiation Oncology, Biology, and Physics 2009; 74(2):458-463.

Hepel JT, Tokita M, MacAusland SG, Evans SB, Hiatt JR, Price LL, DiPetrillo T, Wazer DE. Toxicity of Three-Dimensional Conformal Radiotherapy for Accelerated Partial Breast Irradiation. International Journal of Radiation Oncology, Biology, and Physics 2009; 75(5):1290-1296.

Leonard KL, Solomon D, Hepel JT, Hiatt JR, Wazer DE, Dipetrillo TA. Axillary lymph node dose with tangential whole breast radiation in the prone versus supine position: A dosimetric study. Radiation Oncology 2012 May 18;7(1):72.

Leonard KL, Hepel JT, Hiatt JR, Dipetrillo TA, Price LL, Wazer DE. The Effect of Dose-Volume Parameters and Interfraction Interval on Cosmetic Outcome and Toxicity After 3-Dimensional Conformal Accelerated Partial Breast Irradiation. International Journal of Radiation Oncology, Biology, and Physics 2013; 85(3):623-9.

Hepel JT, Peter J, Hiatt JR, Patel S, Osibanjo O, Safran H, Curran B and DiPetrillo T. Dosimetric feasibility of dose escalation using SBRT boost for stage III non-small cell lung cancer. Frontiers in Oncology 2012; 2:124.

Hepel, JT and Wazer, DE. A Comparison of Brachytherapy Techniques for Partial Breast Irradiation. Brachytherapy, 2012;11(3):163-75.

P Rava, KL Leonard, S Sioshansi, B Curran, DE Wazer, R Cosgrove, G Noren, and JT Hepel.Survival among Patients with Greater than 10 Brain Metastases Treated with Stereotactic Radiosurgery. Journal of Neurosurgery 2013 Aug; 119(2):457-62.

Leonard KL, Hepel JT, Styczynski JR, Hiatt JR, Dipetrillo TA, and Wazer DE. Breast boost using noninvasive image-guided breast brachytherapy vs. external beam: a 2:1 matched-pair analysis. Clinical Breast Cancer 2013 Dec;13(6):455-9.

Rava P, Sioshansi S, DiPetrillo TA, Cosgrove GR, Melhus C, Wu J, Mignano J, Wazer DE, and Hepel JT. Local recurrence and survival following stereotactic radiosurgery for brain metastases from small-cell lung cancer practical radiation oncology. Practical Radiation Oncology 2015 Jan-Feb;5(1):e37-44.

Hepel JT, Hiatt JR, Sha S, Leonard KL, Graves TA, Wiggins DL, Mastras D, Pittier A, Brown University Oncology Research Group, and Wazer DE. The Rationale, Technique, and Feasibility of Partial Breast Irradiation Using Non-invasive Image-guided Breast Brachytherapy (NIBB). Brachytherapy 2014, Sep-Oct;13(5):493-501.

Hepel JT, Leonard KL, Hiatt JR, DiPetrillo TA, Wazer DE. Factors influencing eligibility for breast boost using noninvasive image-guided breast brachytherapy. Brachytherapy. 2014 Nov-Dec;13(6):579-83.

Leonard KL, Rivard MJ, Wazer DE, Hiatt JR, DiPetrillo TA, Sioshansi S, and Hepel JT. Prescription dose evaluation for APBI with noninvasive image-guided breast brachytherapy using equivalent uniform dose. Brachytherapy 2015 Jul-Aug;14(4):496-501.

Gorovets D, Rava P, Ebner KD, Tybor DJ, Cielo D, Puthawala Y, Kinsells TJ, DiPetrillo TA, Wazer DE, and Hepel JT. Predictors for long-term survival free from whole brain radiation therapy in patients treated with radiosurgery for limited brain metastases. Frontiers in Oncology 2015, May 11;5:110.

Ebner D, Rava P, Gorovets D, Cielo D, and Hepel JT. Stereotactic Radiosurgery for Large Brain Metastases. Journal of Clinical Neuroscience 2015 Oct;22(10):1650-4.

Rava P, Rosenberg J, Jamorabo D, Sioshansi S, FitzGerald T, DiPetrillo T, Wazer DE, and Hepel JT. Feasibility and Safety of Cavity-Directed Stereotactic Radiosurgery for Brain Metastases. Advances in Radiation Oncology 2016 July-Sept; 1(3):141-147.

Rae A, Gorovets D, Rava P, Ebner D, Cielo MDD, Kinsella TJ, DiPetrillo TA, and Hepel JT. Management approach for recurrent brain metastases following upfront radiosurgery may affect risk of subsequent radiation necrosis. Advances in Radiation Oncology, 2016. 1(4):294-299.

Hepel JT, Leonard KL, Safran H, Ng T, Taber A, Khurshid H, Birnbaum A, BrUOG, Wazer DE and DiPetrillo T. SBRT Boost Following Concurrent Chemoradiation for Locally Advanced NSCLC: A Phase I Dose-escalation Study. International Journal of Radiation Oncology, Biology, and Physics, 2016 Dec 1;96(5):1021-1027.

Schuster J, Chipko C, Kasper M, Sha S, Ciuba D, Petrikas J, Kuruvilla A, Sandrapaty R, Quiet C, Anderson C, Benda R, Wazer D, Hepel J, Arthur D. Updated feasibility and reproducibility results of multi-institutional study of noninvasive breast tumor bed boost. Brachytherapy. 2016 Oct 6. S1538-4721(16)30547-5.

Daniel Gorovets, Diandra Ayala-Peacock, David J. Tybor, Paul Rava, Daniel Ebner, Deus Cielo, Georg Norén, David E. Wazer, Michael Chan, and Jaroslaw T. Hepel. Multi-institutional Nomogram Predicting Survival Free From Salvage Whole Brain Radiation After Radiosurgery in Patients With Brain Metastases. International Journal of Radiation Oncology, Biology, and Physics, 2017 Feb 1;97(2):246-253.

Ebner D, Gorovets D, Rava P, Cielo D, Kinsella TJ, DiPetrillo TA, and Hepel JT. Patients with long-term control of systemic disease are a favorable prognostic group for treatment of brain metastases with SRS alone. World Neurosurgery, 2016 Nov 9. S1878-8750(16)31154-8.

Hepel JT, Heron DE, Mundt AJ, Yashar C, Feigenberg S, Koltis G, Regine WF, Prasad D, Patel P, Sharma N, Hebert M, Wallis N, and Kuettel M. Comparison of On-Site verses On-Line Chart Reviews as Part of the American College of Radiation Oncology (ACRO) Accreditation Program. Journal of Oncology Practice 2017 May;13(5):e516-e521.

Koffer P, Chan J, Rava P, Gorovets D, Ebner D, Savir G, Cielo D, and Hepel JT. Repeat Stereotactic Radiosurgery for Locally Recurrent Brain Metastasis. World Neurosurgery 2017 Aug;104:589-593.

Abrams MJ, Koffer PP, Wazer DE, and Hepel JT. Post Mastectomy Radiotherapy Improves Survival in Male Breast Cancer. International Journal of Radiation Oncology, Biology, and Physics, 2017 Jun 1;98(2):384-391.

Ayala-Peacock DN, Attia A, Braunstein SE, Ahluwalia MS, Hepel JT, Chung C, Contessa J, Peiffer AM, Lucas JT, Isom S, Pajewski NM, Kotecha R, Stavas M, Ebner D, Taylor R, Onyeuku NE, Chao ST, Corso C, Ruiz J, Watabe K, Tatter SB, Zadeh G, Chiang VLS, Sneed PK, Fiveash JB, and Chan MD. Prediction of new brain metastases after Radiosurgery: Validation and analysis of performance of a multi-institutional nomogram. Journal of Neruooncology 2017 Nov;135(2):403-411.

Yu E, Huang D, Leonard KL, DiPetrillo T, Wazer DE, and Hepel JT. Analysis of Outcomes using Hypofractionated Tumor Bed Boost Combined with Hypofractionated Whole Breast Irradiation for Early Stage Breast Cancer. Clinical Breast Cancer 2017 May 25. pii: S1526-8209(17)30115-5.

McTyre E, Ayala-Peacock D, Contessa J, Corso C, Chiang V, Chung C, Fiveash J, Ahluwalia M, Kotecha R, Chao S, Attia A, Henson A, Hepel J, Braunstein S, Chan M Multi-Institutional Competing Risks Analysis of Distant Brain Failure and Salvage Patterns after Upfront Radiosurgery without Whole Brain Radiotherapy for Brain Metastasis. Ann Oncol. 2018 Feb 1;29(2):497-503.

Shah C, Vicini F, Shaitelman SF, Hepel J, Keisch M, Arthur D, Khan AJ, Kuske R, Patel R, Wazer DE. The American Brachytherapy Society consensus statement for accelerated partial-breast irradiation. Brachytherapy 2018 Jan - Feb;17(1):154-170.

Hepel JT, Arthur D, Shaitelman S, Polgár C, Todor D, Zoberi I, Kamrava M, Major T, Yashar C, and Wazer DE. American Brachytherapy Society Consensus Report for Accelerated Partial Breast Irradiation Using Interstitial Multicatheter Brachytherapy. Brachytherapy 2017 Sep - Oct;16(5):919-928.

Nihaal Mehta, Peter J. Zavitsanos, Krisztina Moldovan, Adetokunbo Oyelese, Jared S. Fridley, Ziya Gokaslan, Timothy J. Kinsella, and Jaroslaw T. Hepel. Local Failure and Vertebral Body Fracture Risk using Multi-fraction SBRT for Spine Metastases. Advances in Radiation Oncology 2018 Apr 10;3(3):245-251.

Hepel JT, Yashar C, Leonard KL, Einck JP, Sha S, DiPetrillo T, Wiggins D, Graves TA, Edmonson D; Brown University Oncology Research Group, Wazer DE. Five fraction accelerated partial breast irradiation using noninvasive image-guided breast brachytherapy: Feasibility and acute toxicity. Brachytherapy. 2018 Sep - Oct;17(5):825-830.

Zavitsanos PJ, Wazer DE, Hepel JT, Wang Y, Singh K, and Leonard KL. BRCA1 Mutations Associated with Increased Risk of Brain Metastases in Breast Cancer. Amer. J. of Clin. Onc. 2018 Dec;41(12):1252-1256.

Hughes RT, Masters AH, McTyre ER, Farris MK, Chung C, Page BR, Kleinberg LR, Hepel J, Contessa JN, Chiang V, Ruiz J, Watabe K, Su J, Fiveash JB, Braunstein S, Chao S, Attia A, Ayala-Peacock DN, Chan MD. Initial SRS for patients with 5-15 brain metastases: results of a multi-institutional experience. Int J Radiat Oncol Biol Phys. 2019 Aug 1;104(5):1091-1098.

Tom MC, Hepel JT, Patel R, Kamrava M, Badiyan SN, Cohen GN, Shah C. The American Brachytherapy Society consensus statement for electronic brachytherapy. Brachytherapy. 2019 May - Jun;18(3):292-298.

Foster B, Sindhu K, Hepel J, Wazer D, Graves T, Taneja C, Wiggins D, Leonard K. Three-Dimensional Bioabsorbable Tissue Marker Placement is Associated with Decreased Tumor Bed Volume Among Patients Receiving Radiation Therapy for Breast Cancer. Pract Radiat Oncol. 2019 Mar;9(2):e134-e141.

Nack E, Koffer P, Blumberg C, Leonard KL, Huber KE, Fenton MA, Dizon DS, Wazer DE, and Hepel JT. New Cardiac Abnormalities Following Radiation Therapy in Breast Cancer Patients Treated with Trastuzumab. Clinical Breast Cancer 2019 Jun;20(3):246-252.

Riina MD, Rashad R, Cohen S, Brownlee Z, Sioshansi S, Hepel J, Chatterjee A, and Huber KE. The Effectiveness of Intra-Operative Clip Placement in Improving Radiotherapy Boost Targeting Following Oncoplastic Surgery. Pract Radiat Oncol. 2019 Sep-Oct;10(5):e348-e356.

Sean A. Roles, Jaroslaw Hepel, Kara L. Leonard, David E. Wazer, Gene A. Cardarelli, Michelle L. Schwer, Ziad H. Saleh, Eric E. Klein, James M. Brindle, Mark J. Rivard. Novel and Programmatic Improvements to the Workflow Associated with the AccuBoost Breast Brachytherapy Procedure. Brachytherapy 2020 May-Jun;19(3):372-379.

McTyre ER, Soike MH, Farris M, Ayala-Peacock DN, Hepel JT, Page BR, Shen C, Kleinberg L, Contessa JN, Corso C, Chiang V, Henson-Masters A, Cramer CK, Ruiz J, Pasche B, Watabe K, D'Agostino R, Su J, Laxton AW, Tatter SB, Fiveash JB, Ahluwalia M, Kotecha R, Chao ST, Braunstein SE, Attia A, Chung C, Chan MD. Multi-institutional validation of brain metastasis velocity, a recently defined predictor of outcomes following stereotactic radiosurgery. Radiother Oncol. 2020 Jan;142:168-174.

Hepel JT, Leonard KL, Sha S, Graves TA, Wiggins DL, Mastras D, Pittier A, BrUOG, and Wazer DE. Phase II Trial of Accelerated Partial Breast Irradiation (APBI) using Non-Invasive Image Guided Breast Brachytherapy (NIBB). Int J Radiat Oncol Biol Phys. 2020. Dec 1;108(5):1143-1149.

Leonard KL, Wazer DE, Listo M, and Hepel JT. Mammographically-guided non-invasive breast brachytherapy: Pre-operative partial breast radiotherapy markedly improves targeting accuracy and decreases irradiated volume. Brachytherapy 2020 Dec 5:S1538-4721(20)30232-4. doi: 10.1016/j.brachy.2020.10.013. Online ahead of print.

Jaroslaw T. Hepel, Kara L. Leonard, Mark Rivard, Rashmi Benda, Ann Pittier, Dean Mastras, Sandra Sha, Leann Smith, Michael Kerley, Paul G. Kocheril, Tushar R. Shah, Andrea McKee, John Chinault, Bushra Rana, and David E. Wazer. Multi-institutional Registry Study Evaluating the Feasibility and Toxicity of Accelerated Partial Breast Irradiation (APBI) Using Non-invasive Image-guided Breast Brachytherapy (NIBB). Brachytherapy, 2021. Feb 25:S1538-4721(21)00002-7. doi: 10.1016/j.brachy.2021.01.002. Online ahead of print.

Hepel JT and Wazer DE. Should a woman age 70 to 80 years receive radiation after breast-conserving surgery? Journal of Clinical Oncology, 2013; 31(19):2377-81.

Hepel, JT. Late Toxicity and Cosmetic Outcomes Related to Interstitial Multi-catheter Brachytherapy for Partial Breast Irradiation. Brachytherapy, 2014; 13(1):23-26.

Hepel JT and Wazer DE. A flawed study should not define a new standard of care. International Journal of Radiation Oncology, Biology, and Physics 2015 Feb 1;91(2):255-7.

Hepel JT and Wazer DE. Update on Partial Breast Irradiation. Clinical Breast Cancer 2020, Apr 17:S1526-8209(20)30081-1. doi: 10.1016/j.clbc.2020.04.003. Online ahead of print.

Mutter RW and Hepel JT. Onc Scan: Accelerated Partial Breast Irradiation. International Journal of Radiation Oncology, Biology, and Physics 2020, Dec 1;108(5):1123-1128.

Hepel JT and Wazer DE. Partial breast radiation is the preferred standard of care for the majority of women with early stage breast cancer. Journal of Clinical Oncology 2020 Jul 10;38(20):2268-2272.

Background

Education and Training

Year	Degree	Institution
2001	MD	University of Rochester
1997	BA	Cornell University

Honors and Awards

2014 Dean’s Excellence in Teaching Award, Warren Alpert Medical

School of Brown University

2015 Fellowship in the American College of Radiation Oncology

(FACRO)

2015 Dean’s Excellence in Teaching Award, Warren Alpert Medical

School of Brown University

2015 Educator of the Year, Association of Residents in Radiation

Oncology (ARRO)

2015 Top Doctor 2015, Castle Connolly

2016 Top Doctor 2016, Castle Connolly

2017 Top Doctor 2017, Castle Connolly

2018 Top Doctor 2018, Castle Connolly

2019 Top Doctor 2019, Castle Connolly

2019 Top Doctors 2019, Rhode Island Monthly

2020 Top Doctor 2020, Castle Connolly

2020 Top Doctors 2020, Rhode Island Monthly

2021 Top Doctor 2021, Castle Connolly

2021 Top Doctors 2021, Rhode Island Monthly

Researchers@Brown