Researcher Profile

Researcher Profile

Nicholas Zaorsky, MD

Nicholas Zaorsky, MD

Assistant Professor, Department of Radiation Oncology
Assistant Professor, Department of Radiology
Assistant Professor, Department of Public Health Sciences
Scientific Program:Cancer Control
Disease Teams:
Breast Cancer
Genitourinary Cancer
Sarcoma Cancer
Thoracic Cancer
Institute for CyberScience (ICS) - Associate

Research Interests

Dr. Nicholas Zaorsky’s international research has several themes.

First, he writes guidelines for the treatment of prostate cancer. His work centers on the indications, contraindications, logistics and toxicities of different treatment modalities to ensure quality patient care and institutional standards.

Second, his work centers on oncologic meta-analyses, which combine international data to provide summary statements with the highest-level evidence to compare treatments. One of the themes of his work is dose fractionation in radiation oncology - the ideal doses that should be used to treat cancer.

Third, Dr. Zaorsky is an expert in oncology-epidemiology, that is, the study of public health and oncology. His works identify patients who are at highest risk of death from cancer vs. other causes and to compare the effectiveness of different treatment options for cancer. His work has led to the design of clinical trials that focus on lifestyle modification (such as with exercise therapy and diet) for the treatment of cancer.

At Penn State, Dr. Zaorsky has integrated these research interests in the design of his clinical trial Exercise + Radiation Therapy (EXERT). The American Cancer Society, National Comprehensive Cancer Network and American College of Sports Medicine recommend exercise therapy to improve outcomes and limit toxicity. However, to date, most clinical studies of exercise therapy are limited to patients receiving chemotherapy or those with localized (non-metastatic) breast or prostate cancer. The rationale for the EXERT study is that 60 percent of cancer patients receive radiation therapy, and few studies have assessed the role of radiation therapy and exercise therapy outside of localized prostate and breast cancer, two disease sites where survival is generally excellent, and toxicities are limited. The long-term goal is to identify potential for exercise therapy to improve radiation therapy treatment outcomes and toxicities among cancer patients.

  • Radiotherapy
  • Therapeutics
  • Prostatic Neoplasms
  • Neoplasms
  • Radiosurgery
  • Brachytherapy
  • Survival
  • Meta-Analysis
  • Neoplasm Metastasis
  • Non-Small Cell Lung Carcinoma
  • Systematic Reviews
  • Radiation

Recent Publications


Zaorsky, NG, Zhang, Y, Walter, V, Tchelebi, LT, Chinchilli, VM & Gusani, NJ 2019, 'Clinical trial accrual at initial course of therapy for cancer and its impact on survival', JNCCN Journal of the National Comprehensive Cancer Network, vol. 17, no. 11, pp. 1309-1316.
Chowdhary, M, Chowdhary, A, Sen, N, Zaorsky, NG, Patel, KR & Wang, D 2019, 'Does the addition of chemotherapy to neoadjuvant radiotherapy impact survival in high-risk extremity/trunk soft-tissue sarcoma?', Cancer, vol. 125, no. 21, pp. 3801-3809.
Cummings, M, Lehrer, EJ, Drabick, J, Gusani, NJ, Trifiletti, DM & Zaorsky, N 2019, 'Exceptional responders in oncology: A systematic review and meta-analysis of patient level data', American Journal of Clinical Oncology: Cancer Clinical Trials, vol. 42, no. 8, pp. 624-635.
Dang, AT, Levin-Epstein, RG, Shabsovich, D, Cao, M, King, C, Chu, FI, Mantz, CA, Stephans, KL, Reddy, CA, Loblaw, DA, Cheung, P, Scorsetti, M, Cozzi, L, DeNittis, AS, Wang, Y, Zaorsky, N, Nickols, NG, Kupelian, PA, Steinberg, ML & Kishan, AU 2019, 'Gantry-Mounted Linear Accelerator–Based Stereotactic Body Radiation Therapy for Low- and Intermediate-Risk Prostate Cancer', Advances in Radiation Oncology.
Zaorsky, NG, Spratt, DE & Blanchard, P 2019, 'Re: Marco Moschini, Emanuele Zaffuto, Pierre I. Karakiewicz, et al. External Beam Radiotherapy Increases the Risk of Bladder Cancer When Compared with Radical Prostatectomy in Patients Affected by Prostate Cancer: A Population-based Analysis. Eur Urol 2019;75:319–28', European Urology, vol. 75, no. 4, pp. e96-e97.
Meng, MB, Wang, HH, Zaorsky, NG, Sun, BS, Zhu, L, Song, YC, Li, FT, Dong, Y, Wang, JS, Chen, HM, Yu, XY & Yuan, ZY 2019, 'Risk-adapted stereotactic body radiation therapy for central and ultra-central early-stage inoperable non-small cell lung cancer', Cancer Science, vol. 110, no. 11, pp. 3553-3564.
Lehrer, EJ, Peterson, JL, Zaorsky, N, Brown, PD, Sahgal, A, Chiang, VL, Chao, ST, Sheehan, JP & Trifiletti, DM 2019, 'Single versus Multifraction Stereotactic Radiosurgery for Large Brain Metastases: An International Meta-analysis of 24 Trials', International Journal of Radiation Oncology Biology Physics, vol. 103, no. 3, pp. 618-630.
Zaorsky, NG, Lehrer, EJ, Kothari, G, Louie, AV & Siva, S 2019, 'Stereotactic ablative radiation therapy for oligometastatic renal cell carcinoma (SABR ORCA): a meta-analysis of 28 studies', European Urology Oncology.
Zaorsky, NG, Zhang, Y, Tchelebi, LT, Mackley, HB, Chinchilli, VM & Zacharia, BE 2019, 'Stroke among cancer patients', Nature communications, vol. 10, no. 1, 5172.
Zaorsky, NG, Zhang, Y, Tuanquin, L, Bluethmann, SM, Park, HS & Chinchilli, VM 2019, 'Suicide among cancer patients', Nature communications, vol. 10, no. 1, 207.
Lee, CT, Lehrer, EJ, Aphale, A, Lango, M, Galloway, TJ & Zaorsky, NG 2019, 'Surgical excision, Mohs micrographic surgery, external-beam radiotherapy, or brachytherapy for indolent skin cancer: An international meta-analysis of 58 studies with 21,000 patients', Cancer, vol. 125, no. 20, pp. 3582-3594.
Correa, RJM, Louie, AV, Zaorsky, NG, Lehrer, EJ, Ellis, R, Ponsky, L, Kaplan, I, Mahadevan, A, Chu, W, Swaminath, A, Hannan, R, Onishi, H, Teh, BS, Muacevic, A, Lo, SS, Staehler, M & Siva, S 2019, 'The Emerging Role of Stereotactic Ablative Radiotherapy for Primary Renal Cell Carcinoma: A Systematic Review and Meta-Analysis', European Urology Focus, vol. 5, no. 6, pp. 958-969.
Malouff, TD, Vallow, LA, Waddle, MR, Kaleem, T, Zaorsky, NG, Royce, TJ, Stross, WC, May, B & Trifiletti, DM 2019, 'The Influence of Online Forums on Radiation Oncology Residency Program Selection', International Journal of Radiation Oncology Biology Physics, vol. 104, no. 5, pp. 1009-1011.
Chowdhary, M, Song, A, Zaorsky, NG & Shi, W 2019, 'Total skin electron beam therapy in mycosis fungoides—a shift towards lower dose?', Chinese clinical oncology, vol. 8, no. 1, 9.
Lin, D, Lehrer, EJ, Rosenberg, J, Trifiletti, DM & Zaorsky, NG 2019, 'Toxicity after radiotherapy in patients with historically accepted contraindications to treatment (CONTRAD): An international systematic review and meta-analysis', Radiotherapy and Oncology, vol. 135, pp. 147-152.


Wang, HH, Wu, ZQ, Qian, D, Zaorsky, NG, Qiu, MH, Cheng, JJ, Jiang, C, Wang, J, Zeng, XL, Liu, CL, Tian, LJ, Ying, GG, Meng, MB, Hao, XS & Yuan, ZY 2018, 'Ablative Hypofractionated Radiation Therapy Enhances Non-Small Cell Lung Cancer Cell Killing via Preferential Stimulation of Necroptosis In Vitro and In Vivo', International Journal of Radiation Oncology Biology Physics, vol. 101, no. 1, pp. 49-62.
Alonso, C, Dutta, SW, Mitra, N, Landsburg, DJ, Zaorsky, NG, Grover, S, Peterson, J & Trifiletti, DM 2018, 'Adult nodular lymphocyte-predominant Hodgkin lymphoma: treatment modality utilization and survival', Cancer medicine, vol. 7, no. 4, pp. 1118-1126.
Churilla, TM, DeMora, L, Handorf, E, Zaorsky, NG, Dong, Y, Denlinger, CS, Sigurdson, ER & Meyer, JE 2018, 'Deviations From Standard Chemoradiation Among Early-Stage Anal Cancer Patients', International Journal of Radiation Oncology Biology Physics, vol. 100, no. 4, pp. 945-949.
Zaorsky, NG, Lehrer, EJ, Handorf, E & Meyer, JE 2019, 'Dose escalation in stereotactic body radiation therapy for pancreatic cancer', American Journal of Clinical Oncology: Cancer Clinical Trials, vol. 42, no. 1, pp. 46-55.
Zaorsky, N, Ahmed, AA, Zhu, J, Yoo, SK, Fuller, CD, Thomas, CR, Choi, M & Holliday, EB 2019, 'Industry Funding Is Correlated With Publication Productivity of US Academic Radiation Oncologists', Journal of the American College of Radiology, vol. 16, no. 2, pp. 244-251.
Du, S, Zhou, L, Alexander, GS, Park, K, Yang, L, Wang, N, Zaorsky, NG, Ma, X, Wang, Y, Dicker, AP & Lu, B 2018, 'PD-1 Modulates Radiation-Induced Cardiac Toxicity through Cytotoxic T Lymphocytes', Journal of Thoracic Oncology, vol. 13, no. 4, pp. 510-520.
Zaorsky, N, Lee, CT, Zhang, E & Galloway, TJ 2018, 'Skin CanceR Brachytherapy vs External beam radiation therapy (SCRiBE) meta-analysis', Radiotherapy and Oncology, vol. 126, no. 3, pp. 386-393.
Tchelebi, L, Zaorsky, N & Mackley, H 2018, 'Stereotactic body radiation therapy in the management of upper GI malignancies', Biomedicines, vol. 6, no. 1, 7.
Lehrer, EJ, McGee, HM, Peterson, JL, Vallow, L, Ruiz-Garcia, H, Zaorsky, NG, Sharma, S & Trifiletti, DM 2018, 'Stereotactic radiosurgery and immune checkpoint inhibitors in the management of brain metastases', International journal of molecular sciences, vol. 19, no. 10, 3054.
Lehrer, EJ, Peterson, J, Brown, PD, Sheehan, JP, Quiñones-Hinojosa, A, Zaorsky, NG & Trifiletti, DM 2019, 'Treatment of brain metastases with stereotactic radiosurgery and immune checkpoint inhibitors: An international meta-analysis of individual patient data', Radiotherapy and Oncology, vol. 130, pp. 104-112.


Zaorsky, NG, Showalter, TN, Ezzell, GA, Nguyen, PL, Assimos, DG, D'Amico, AV, Gottschalk, AR, Gustafson, GS, Keole, SR, Liauw, SL, Lloyd, S, McLaughlin, PW, Movsas, B, Prestidge, BR, Taira, AV, Vapiwala, N & Davis, BJ 2017, 'ACR Appropriateness Criteria for external beam radiation therapy treatment planning for clinically localized prostate cancer, part II of II', Advances in Radiation Oncology, vol. 2, no. 3, pp. 437-454.
Expert Panel on Radiation Oncology-Prostate: 2017, 'ACR Appropriateness Criteria® external beam radiation therapy treatment planning for clinically localized prostate cancer, part I of II', Advances in Radiation Oncology, vol. 2, no. 1, pp. 62-84.
De Bari, B, Stish, B, Ball, MW, Habboush, Y, Sargos, P, Krengli, M, Bossi, A, Stabile, A, Sole Pesutic, C, Lestrade, L, Smeenk, RJ, Jereczek-Fossa, BA, Zilli, T, Créhange, G, Alongi, F, Zaorsky, N & Ozsahin, M 2017, 'Adult prostatic sarcoma: A contemporary multicenter Rare Cancer Network study', Prostate, vol. 77, no. 10, pp. 1160-1166.
Zaorsky, NG, Churilla, TM, Egleston, BL, Fisher, SG, Ridge, JA, Horwitz, EM & Meyer, JE 2017, 'Causes of death among cancer patients', Annals of Oncology, vol. 28, no. 2, pp. 400-407.
Wang, HH, Deng, L, Wen, QL, Zhang, CZ, Zaorsky, NG, Zhang, BL, Chen, J, Zeng, XL, Cui, YL, Shi, YY, Hou, HL, Wang, W, Jiang, B, Wang, J, Pang, QS, Zhao, LJ, Yuan, ZY, Wang, P & Meng, MB 2017, 'Early postoperative radiotherapy is associated with improved outcomes over late postoperative radiotherapy in the management of completely resected (R0) Stage IIIA-N2 nonsmall cell lung cancer', Oncotarget, vol. 8, no. 38, pp. 62998-63013.
Dong, Y, Zaorsky, NG, Li, T, Churilla, TM, Viterbo, R, Sobczak, ML, Smaldone, MC, Chen, DYT, Uzzo, RG, Hallman, MA & Horwitz, EM 2018, 'Effects of interruptions of external beam radiation therapy on outcomes in patients with prostate cancer', Journal of Medical Imaging and Radiation Oncology, vol. 62, no. 1, pp. 116-121.
Zaorsky, NG, Lee, CT, Zhang, E, Keith, SW & Galloway, TJ 2017, 'Hypofractionated radiation therapy for basal and squamous cell skin cancer: A meta-analysis', Radiotherapy and Oncology, vol. 125, no. 1, pp. 13-20.
Zaorsky, NG, Shaikh, T, Ruth, K, Sharda, P, Hayes, SB, Sobczak, ML, Hallman, MA, Smaldone, MC, Chen, DYT & Horwitz, EM 2017, 'Prostate Cancer Patients With Unmanaged Diabetes or Receiving Insulin Experience Inferior Outcomes and Toxicities After Treatment With Radiation Therapy', Clinical Genitourinary Cancer, vol. 15, no. 2, pp. 326-335.e3.
Zaorsky, NG, Williams, GR, Barta, SK, Esnaola, NF, Kropf, PL, Hayes, SB & Meyer, JE 2017, 'Splenic irradiation for splenomegaly: A systematic review', Cancer Treatment Reviews, vol. 53, pp. 47-52.
Williams, NL, Dan, T, Zaorsky, N, Garg, S & Den, RB 2017, 'The Role of Genomic Techniques in Predicting Response to Radiation Therapy', Oncology (Williston Park, N.Y.), vol. 31, no. 7, pp. 562-570.
Zaorsky, N, Davis, BJ, Nguyen, PL, Showalter, TN, Hoskin, PJ, Yoshioka, Y, Morton, GC & Horwitz, EM 2017, 'The evolution of brachytherapy for prostate cancer', Nature Reviews Urology, vol. 14, no. 7, pp. 415-439.
Williams, NL, Dan, T, Zaorsky, N, Garg, S & Den, RB 2017, 'The role of genomic techniques in predicting response to radiation therapy', ONCOLOGY (United States), vol. 31, no. 7, pp. 1-11.


Shaikh, T, Churilla, T, Murphy, C, Zaorsky, NG, Haber, A, Hallman, M & Meyer, JE 2016, '97O: Overtreatment of patients with clinically diagnosed early stage lung cancer', Journal of Thoracic Oncology, vol. 11, no. 4, pp. S99.
Avkshtol, V, Dong, Y, Hayes, SB, Hallman, MA, Price, RA, Sobczak, ML, Horwitz, EM & Zaorsky, NG 2016, 'A comparison of robotic arm versus gantry linear accelerator stereotactic body radiation therapy for prostate cancer', Research and Reports in Urology, vol. 8, pp. 145-158.
Zaorsky, NG, Ricco, AG, Churilla, TM, Horwitz, EM & Den, RB 2016, 'ASTRO APEx® and RO-ILS™ are applicable to medical malpractice in radiation oncology', Future Oncology, vol. 12, no. 22, pp. 2643-2657.
Shaikh, T, Churilla, TM, Murphy, CT, Zaorsky, NG, Haber, A, Hallman, MA & Meyer, JE 2016, 'Absence of pathological proof of cancer associated with improved outcomes in early-stage lung cancer', Journal of Thoracic Oncology, vol. 11, no. 7, pp. 1112-1120.
Zaorsky, N & Horwitz, EM 2016, Brachytherapy for Prostate Cancer: An Overview. in Prostate Cancer: Science and Clinical Practice: Second Edition. Elsevier Inc., pp. 399-411.
Zaorsky, N, Shaikh, T, Murphy, CT, Hallman, MA, Hayes, SB, Sobczak, ML & Horwitz, EM 2016, 'Comparison of outcomes and toxicities among radiation therapy treatment options for prostate cancer', Cancer Treatment Reviews, vol. 48, pp. 50-60.
Zaorsky, NG, Keith, SW, Shaikh, T, Nguyen, PL, Horwitz, EM, Dicker, AP & Den, RB 2018, 'Impact of Radiation Therapy Dose Escalation on Prostate Cancer Outcomes and Toxicities', American Journal of Clinical Oncology: Cancer Clinical Trials, vol. 41, no. 4, pp. 409-415.
Shaikh, T, Li, T, Murphy, CT, Zaorsky, NG, Bleicher, RJ, Sigurdson, ER, Carlson, R, Hayes, SB & Anderson, P 2016, 'Importance of Surgical Margin Status in Ductal Carcinoma In Situ', Clinical Breast Cancer, vol. 16, no. 4, pp. 312-318.
Yoo, SK, Ahmed, AA, Ileto, J, Zaorsky, N, Deville, C, Holliday, EB, Wilson, LD, Jagsi, R & Thomas, CR 2017, 'Industry Funding Among Leadership in Medical Oncology and Radiation Oncology in 2015', International Journal of Radiation Oncology Biology Physics, vol. 99, no. 2, pp. 280-285.
Zaorsky, NG, Churilla, TM, Ruth, K, Hayes, SB, Sobczak, ML, Hallman, MA, Smaldone, MC, Chen, DYT & Horwitz, EM 2016, 'Men's health supplement use and outcomes in men receiving definitive intensity-modulated radiation therapy for localized prostate cancer1-3', American Journal of Clinical Nutrition, vol. 104, no. 6, pp. 1583-1593.
Wang, HH, Cui, YL, Zaorsky, NG, Lan, J, Deng, L, Zeng, XL, Wu, ZQ, Tao, Z, Guo, WH, Wang, QX, Zhao, LJ, Yuan, ZY, Lu, Y, Wang, P & Meng, MB 2016, 'Mesenchymal stem cells generate pericytes to promote tumor recurrence via vasculogenesis after stereotactic body radiation therapy', Cancer Letters, vol. 375, no. 2, pp. 349-359.
Meng, MB, Wang, HH, Cui, YL, Wu, ZQ, Shi, YY, Zaorsky, NG, Deng, L, Yuan, ZY, Lu, Y & Wang, P 2016, 'Necroptosis in tumorigenesis, activation of anti-tumor immunity, and cancer therapy', Oncotarget, vol. 7, no. 35, pp. 57391-57413.
Johnson, ME, Zaorsky, NG, Martin, JM, Ruth, K, Greenberg, RE, Uzzo, RG, Hayes, SB, Smaldone, MC, Kutikov, A, Viterbo, R, Chen, DYT, Hallman, MA, Sobczak, ML & Horwitz, EM 2016, 'Patient reported outcomes among treatment modalities for prostate cancer', Canadian Journal of Urology, vol. 23, no. 6, pp. 8535-8545.
Wang, HH, Zaorsky, NG, Meng, MB, Zeng, XL, Deng, L, Song, YC, Zhuang, HQ, Li, FT, Zhao, LJ, Yuan, ZY, Wang, P & Hao, XS 2016, 'Stereotactic radiation therapy for oligometastases or oligorecurrence within mediastinal lymph nodes', Oncotarget, vol. 7, no. 14, pp. 18135-18145.
Guo, J, Zinner, R, Zaorsky, NG, Guo, W & Lu, B 2016, 'Systemic therapy for echinoderm microtubule-associated proteinlike 4 anaplastic lymphoma kinase non-small cell lung cancer brain metastases', Journal of Thoracic Disease, vol. 8, no. 9, pp. E1028-E1031.
Zaorsky, N, Egleston, BL, Horwitz, EM, Dicker, AP, Nguyen, PL, Showalter, TN & Den, RB 2016, 'The Missing Pieces in Reporting of Randomized Controlled Trials of External Beam Radiation Therapy Dose Escalation for Prostate Cancer', American Journal of Clinical Oncology: Cancer Clinical Trials, vol. 39, no. 4, pp. 321-326.
Hawkey, NM, Zaorsky, NG & Galloway, TJ 2016, 'The role of radiation therapy in the management of sialorrhea: A systematic review', Laryngoscope, vol. 126, no. 1, pp. 80-85.
Zaorsky, NG, Shaikh, T, Handorf, E, Eastwick, G, Hesney, A, Scher, ED, Jones, RT, Showalter, TN, Avkshtol, V, Rice, SR, Horwitz, EM & Meyer, JE 2016, 'What Are Medical Students in the United States Learning about Radiation Oncology? Results of a Multi-Institutional Survey', International Journal of Radiation Oncology Biology Physics, vol. 94, no. 2, pp. 235-242.

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