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Reynolds BD, Nagel HG, Perry E, Whittaker CJ, Caruso KA, Annear MJ, Irving WM, McCarthy PM, Dion A, Yi JMS, Hall E, Smith JS. Ophthalmic findings associated with Australian tick paralysis (holocyclotoxicity) in hospitalized domestic dogs and cats. Vet Ophthalmol 2024. [PMID: 38468143 DOI: 10.1111/vop.13205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2023] [Revised: 02/21/2024] [Accepted: 02/24/2024] [Indexed: 03/13/2024]
Abstract
OBJECTIVE To describe ophthalmic findings in hospitalized canine and feline patients with tick paralysis (TP) and investigate possible predisposing factors. ANIMALS STUDIED Forty-seven dogs and 28 cats hospitalized with TP assessed with an ophthalmic examination performed by an ABVO resident. METHODS Dogs and cats were hospitalized with TP from October 2021 to January 2022 and had an ophthalmic examination performed by an ABVO resident. Patient signalment data, information regarding tick number and location, hospitalization duration, medications used, and patient paralysis grades were recorded. Statistical analysis was performed to correlate findings. RESULTS Corneal ulcers developed in up to 34.8% of dogs and up to 42.9% of cats hospitalized with TP. An absent palpebral reflex ipsilaterally increased the odds of a concurrent corneal ulcer being present by 14.7× in dogs and 20.1× in cats (p < .0001). Palpebral reflexes were absent in 38.3% of dogs and 35.7% of cats hospitalized with TP and were correlated with more severe gait paralysis (p = .01) and respiratory paralysis (p = .005) in dogs, and respiratory paralysis in cats (p = .041). STT-1 findings <10 mm/min were present in 27.7% of dogs and 57.1% of cats examined and were associated with increasing gait paralysis (p = .017) and respiratory paralysis (p = .007) in dogs, and increasing gait paralysis in cats (p = .017). CONCLUSIONS Simple corneal ulcers, loss of a complete palpebral reflex, and reduced STT-1 scores frequently occurred in dogs and cats hospitalized for TP. The frequency of these findings increased as the degree of patient paralysis increased.
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Affiliation(s)
- B D Reynolds
- Eye Clinic for Animals, Sydney, New South Wales, Australia
| | - H G Nagel
- Terrey Hills Animal Hospital, Sydney, New South Wales, Australia
| | - E Perry
- Northside Emergency Veterinary Service, Sydney, New South Wales, Australia
| | - C J Whittaker
- Eye Clinic for Animals, Sydney, New South Wales, Australia
| | - K A Caruso
- Eye Clinic for Animals, Sydney, New South Wales, Australia
| | - M J Annear
- Eye Clinic for Animals, Sydney, New South Wales, Australia
| | - W M Irving
- Eye Clinic for Animals, Sydney, New South Wales, Australia
| | - P M McCarthy
- Eye Clinic for Animals, Sydney, New South Wales, Australia
| | - A Dion
- Northside Emergency Veterinary Service, Sydney, New South Wales, Australia
| | - J M S Yi
- Northside Emergency Veterinary Service, Sydney, New South Wales, Australia
| | - E Hall
- University of Sydney, Sydney, New South Wales, Australia
| | - J S Smith
- Eye Clinic for Animals, Sydney, New South Wales, Australia
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Reynolds BD, Perry E, Nagel HG, Whittaker CJ, Caruso KA, Annear MJ, Irving WM, McCarthy PM, Dion A, Yi JS, Hall E, Smith JS. Retrospective assessment of ophthalmic disease development in domestic dogs and cats when hospitalised with tick paralysis caused by Ixodes holocyclus. Aust Vet J 2024. [PMID: 38369322 DOI: 10.1111/avj.13325] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Revised: 12/19/2023] [Accepted: 01/21/2024] [Indexed: 02/20/2024]
Abstract
OBJECTIVE To investigate the incidence and predisposing factors leading to the development of corneal ulcers and the loss of a palpebral reflex in hospitalised canine and feline patients with tick paralysis (TP). ANIMALS STUDIED A total of 102 dogs and 100 cats retrospectively were assessed from previously hospitalised patients. METHODS A retrospective cohort study was performed on 102 different canine and 100 different feline patients who were hospitalised for TP from October 2020-January 2022. Patient data were collected, and logistic regression was conducted to determine factors affecting the palpebral reflex and the development of corneal ulcers. RESULTS Corneal ulcers occurred in 23/102 (22.5%) dogs during hospitalisation and were strongly associated with an incomplete palpebral reflex ipsilaterally during hospitalisation (P < 0.001), hospitalisation ≥3 days (P = 0.004), mechanical ventilation ≥3 days (P = 0.015) or a tick location cranial to C1 (P = 0.003). An incomplete palpebral reflex during hospitalisation was observed in 29/102 (28.4%) dogs and was significantly associated with decreasing patient weight (P = 0.018), increasing days hospitalised (P = 0.001), having a tick found cranial to C1 (P = 0.004), highest recorded GP grade (P = 0.01), highest recorded RP grade (P = 0.005), use of amoxycillin-clavulanic acid during hospitalisation (P = 0.002) and use of piperacillin/tazobactam during hospitalisation (P = 0.003). There was a significant association between the loss of a complete palpebral reflex and mortality during hospitalisation in dogs (OR = 4.5, P = 0.029). Corneal ulcers occurred in 10/100 (10.0%) cats during hospitalisation, and was significantly more likely to occur to an eye if an incomplete palpebral reflex was observed ipsilaterally during hospitalisation (OR = 20.1, P < 0.0001) and with increasing patient age (P = 0.019). The absence of a complete palpebral reflex during hospitalisation was observed in 18/10 (18.0%) cats and was significantly associated with increasing days hospitalised (P = 0.034). There was no significant association between the loss of a complete palpebral reflex and mortality during hospitalisation in cats. CONCLUSIONS The frequency of corneal ulcers and loss of palpebral reflexes were significant in dogs and cats hospitalised by TP, with many factors contributing to the risk of these developing.
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Affiliation(s)
- B D Reynolds
- Eye Clinic for Animals, Sydney, New South Wales, 2064, Australia
| | - E Perry
- Northside Emergency Veterinary Service, Sydney, New South Wales, 2084, Australia
| | - H G Nagel
- Terrey Hills Animal Hospital, Sydney, New South Wales, 2084, Australia
| | - C J Whittaker
- Eye Clinic for Animals, Sydney, New South Wales, 2064, Australia
| | - K A Caruso
- Eye Clinic for Animals, Sydney, New South Wales, 2064, Australia
| | - M J Annear
- Eye Clinic for Animals, Sydney, New South Wales, 2064, Australia
| | - W M Irving
- Eye Clinic for Animals, Sydney, New South Wales, 2064, Australia
| | - P M McCarthy
- Eye Clinic for Animals, Sydney, New South Wales, 2064, Australia
| | - A Dion
- Northside Emergency Veterinary Service, Sydney, New South Wales, 2084, Australia
| | - Jm-S Yi
- Northside Emergency Veterinary Service, Sydney, New South Wales, 2084, Australia
| | - E Hall
- University of Sydney, Sydney, New South Wales, 2006, Australia
| | - J S Smith
- Eye Clinic for Animals, Sydney, New South Wales, 2064, Australia
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Hudson EM, Slevin F, Biscombe K, Brown SR, Haviland JS, Murray L, Kirby AM, Thomson DJ, Sebag-Montefiore D, Hall E. Hitting the Target: Developing High-quality Evidence for Proton Beam Therapy Through Randomised Controlled Trials. Clin Oncol (R Coll Radiol) 2024; 36:70-79. [PMID: 38042671 DOI: 10.1016/j.clon.2023.11.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Accepted: 11/03/2023] [Indexed: 12/04/2023]
Abstract
The National Health Service strategy for the delivery of proton beam therapy (PBT) in the UK provides a unique opportunity to deliver high-quality evidence for PBT through randomised controlled trials (RCTs). We present a summary of three UK PBT RCTs in progress, including consideration of their key design characteristics and outcome assessments, to inform and support future PBT trial development. The first three UK multicentre phase III PBT RCTs (TORPEdO, PARABLE and APPROACH), will compare PBT with photon radiotherapy for oropharyngeal squamous cell carcinoma, breast cancer and oligodendroglioma, respectively. All three studies were designed by multidisciplinary teams, which combined expertise from clinicians, clinical trialists and scientists with strong patient advocacy and guidance from national radiotherapy research networks and international collaborators. Consistent across all three studies is a focus on the reduction of long-term radiotherapy-related toxicities and an evaluation of patient-reported outcomes and health-related quality of life, which will address key uncertainties regarding the clinical benefits of PBT. Innovative translational components will provide insights into mechanisms of toxicity and help to frame the key future research questions regarding PBT. The UK radiotherapy research community is developing and delivering an internationally impactful PBT research portfolio. The combination of data from RCTs with prospectively collected data from a national PBT outcomes registry will provide an innovative, high-quality repository for PBT research and the platform to design and deliver future trials of PBT.
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Affiliation(s)
- E M Hudson
- Leeds Cancer Research UK Clinical Trials Unit, Leeds Institute of Clinical Trials Research, University of Leeds, Leeds, UK.
| | - F Slevin
- Leeds Institute of Medical Research at St James's, University of Leeds, Leeds, UK; Department of Clinical Oncology, Leeds Cancer Centre, Leeds, UK
| | - K Biscombe
- Clinical Trials and Statistics Unit, The Institute of Cancer Research, London, UK
| | - S R Brown
- Leeds Cancer Research UK Clinical Trials Unit, Leeds Institute of Clinical Trials Research, University of Leeds, Leeds, UK
| | - J S Haviland
- Clinical Trials and Statistics Unit, The Institute of Cancer Research, London, UK; Wolfson Institute of Population Health, Queen Mary University of London, London, UK
| | - L Murray
- Leeds Institute of Medical Research at St James's, University of Leeds, Leeds, UK; Department of Clinical Oncology, Leeds Cancer Centre, Leeds, UK
| | - A M Kirby
- The Royal Marsden NHS Foundation Trust & The Institute of Cancer Research, Sutton, UK
| | - D J Thomson
- The Christie NHS Foundation Trust, Manchester, UK
| | - D Sebag-Montefiore
- Leeds Institute of Medical Research at St James's, University of Leeds, Leeds, UK; Department of Clinical Oncology, Leeds Cancer Centre, Leeds, UK
| | - E Hall
- Clinical Trials and Statistics Unit, The Institute of Cancer Research, London, UK
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Beckett EM, Abelmann A, Roberts B, Lewis RC, Cheatham D, Miller EW, Hall E, Pierce JS. An updated evaluation of reported no-observed adverse effect levels for chrysotile, amosite, and crocidolite asbestos for lung cancer and mesothelioma. Crit Rev Toxicol 2023; 53:611-657. [PMID: 38126124 DOI: 10.1080/10408444.2023.2283169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Accepted: 11/08/2023] [Indexed: 12/23/2023]
Abstract
This analysis updates two previous analyses that evaluated the exposure-response relationships for lung cancer and mesothelioma in chrysotile-exposed cohorts. We reviewed recently published studies, as well as updated information from previous studies. Based on the 16 studies considered for chrysotile (<10% amphibole), we identified the "no-observed adverse effect level" (NOAEL) for lung cancer and/or mesothelioma; it should be noted that smoking or previous or concurrent occupational exposure to amphiboles (if it existed) was not controlled for. NOAEL values ranged from 2.3-<11.5 f/cc-years to 1600-3200 f/cc-years for lung cancer and from 100-<400 f/cc-years to 800-1599 f/cc-years for mesothelioma. The range of best-estimate NOAELs was estimated to be 97-175 f/cc-years for lung cancer and 250-379 f/cc-years for mesothelioma. None of the six cohorts of cement or friction product manufacturing workers exhibited an increased risk at any exposure level, while all but one of the six studies of textile workers reported an increased risk at one or more exposure levels. This is likely because friction and cement workers were exposed to much shorter chrysotile fibers. Only eight cases of peritoneal mesothelioma were reported in all studies on predominantly chrysotile-exposed cohorts combined. This analysis also proposed best-estimate amosite and crocidolite NOAELs for mesothelioma derived by the application of relative potency estimates to the best-estimate chrysotile NOAELs for mesothelioma and validated by epidemiology studies with exposure-response information. The best-estimate amosite and crocidolite NOAELs for mesothelioma were 2-5 f/cc-years and 0.6-1 f/cc-years, respectively. The rate of peritoneal mesothelioma in amosite- and crocidolite-exposed cohorts was between approximately 70- to 100-fold and several-hundred-fold higher than in chrysotile-exposed cohorts, respectively. These findings will help characterize potential worker and consumer health risks associated with historical and current chrysotile, amosite, and crocidolite exposures.
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Affiliation(s)
| | | | | | | | | | | | - Ethan Hall
- Benchmark Risk Group, Grand Rapids, MI, USA
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Jr EMJ, Hall E, Marchant R, Horton B, Jin R, Mistro M, Walker B, Romano K. Impact of Lymphopenia on Definitive Treatment of Locally Advanced Cervical Cancer. Int J Radiat Oncol Biol Phys 2023; 117:e514-e515. [PMID: 37785607 DOI: 10.1016/j.ijrobp.2023.06.1775] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Pre-treatment lymphopenia prior to initiating treatment has been correlated with reduced survival in a number of different cancers. The purpose of this study is to evaluate the association between lymphopenia and survival in women with locally advanced cervical cancer (LACC) treated with primary chemoradiation (CRT). MATERIALS/METHODS We retrospectively reviewed patients with LACC treated at a single institution from 2005 - 2021 with available lymphocyte information. Patient and treatment characteristics were recorded including age, tumor size and stage, EBRT dose/fractionation, and brachytherapy dosimetry data. Absolute lymphocyte counts (ALC) were collected prior to initiating CRT and at 3-month intervals following CRT and graded based on severity of lymphopenia using CTCAE v 5.0. Overall survival (OS), progression free survival (PFS), and local control (LC) were calculated from the start of treatment to date of last follow-up. Kaplan-Meier survival analysis was performed to evaluate whether lymphocyte changes were associated with OS, PFS, or LC. RESULTS A total of 124 patients met study inclusion criteria with stage IB - IV disease (41 stage I, 41 stage II, 36 stage III, 6 stage IV) and a median follow up of 3.6 years (range 0.2-16.5 years). The median age was 49 years (range 26-77). The median EBRT dose was 45 Gy (range: 26-57.5 Gy) and 44.2% of patients received para-aortic (PA) nodal EBRT (28.8% elective and 15.4% with positive PA nodes). 5-year OS, PFS, and LC were 60.3% (95% CI 51.5-70.7), 47.5% (95% CI 39-58), and 75.5% (95% CI 67.3-82.9), respectively. Pre-treatment lymphopenia (ALC <1000 cells/mm3) was present in 11 (9%) patients. When the total cohort was divided into patients with and without pre-treatment lymphopenia, OS was statistically improved in the patients without baseline lymphopenia, with a 5-year OS of 63.2% (95% CI 53.9-73.9) versus 35.3% (95% CI 14.5-86.3) in the lymphopenia group (p = 0.034). LC also trended to being improved in the patients without lymphopenia, though this did not reach statistical significance in our small sample size of lymphopenic patients, with 5-year LC of 76.8% (95% CI 68.4-84.3) versus 67.5% (05% CI 36.6-93.8), p = 0.45. CONCLUSION In this single institution experience of LACC treated with definitive CRT, we found that baseline lymphopenia is associated with inferior OS. Patients with higher pre-CRT ALC may represent a population with more robust immune systems, producing more favorable tumor responses to treatment. Additional studies are warranted to investigate the evolving role of combined EBRT and systemic therapy in LACC.
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Affiliation(s)
- E M Janowski Jr
- University of Virginia Department of Radiation Oncology, Charlottesville, VA
| | - E Hall
- University of Virginia, Charlottesville, VA
| | - R Marchant
- University of Virginia, Charlottesville, VA
| | - B Horton
- University of Virginia, Charlottesville, VA
| | - R Jin
- University of Virginia, Charlottesville, VA
| | - M Mistro
- University of Virginia Department of Radiation Oncology, Charlottesville, VA
| | | | - K Romano
- Department of Radiation Oncology, University of Virginia, Charlottesville, VA
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Ratnakumaran R, Hinder V, Brand DH, Staffurth J, Hall E, van As N, Tree A. The Association between Acute and Late Genitourinary and Gastrointestinal Toxicities: An Analysis of the PACE B Study. Int J Radiat Oncol Biol Phys 2023; 117:S27. [PMID: 37784464 DOI: 10.1016/j.ijrobp.2023.06.286] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Acute gastrointestinal (GI) and genitourinary (GU) toxicity after prostate radiotherapy (RT) has been shown to be associated with late toxicity with 3D conformal RT. However, whether this association is present with modern approaches, such as stereotactic body radiotherapy (SBRT), remains unclear. We analyzed patients treated within the international phase III non-inferiority randomized control trial, PACE-B, to assess the association between acute and late toxicity following SBRT and conventional/moderately hypofractionated radiotherapy (CRT). We hypothesize that acute toxicity is significantly associated with equivalent late toxicity following prostate SBRT and CRT. MATERIALS/METHODS We analyzed patients with GI and GU Common Terminology Criteria for Adverse Events (CTCAE) measurements in the acute (≤12 weeks post-RT) and late period (6-24 months post-RT). Using logistic regression, we analyze the association between G2+ acute GI and GU toxicities with equivalent late toxicities. Lasso variable selection was used to determine patient, tumor and treatment variables to include in the multivariable model. The area under the receiver operator characteristics curve (AUC) was used to evaluate the model's predictive performance. RESULTS Of patients included in this analysis (n = 842), 414 were treated with SBRT and 428 with CRT. In univariable analysis (UVA), G2+ acute GU toxicity was significantly associated with developing G2+ late GU toxicity after SBRT (OR 4.63, 95% CI (2.96-7.25), p<0.0001) and CRT (OR 2.83, 95% CI (1.69-4.71), p<0.0001). This association remained significant in multivariable analysis (MVA). The models AUC for predicting G2+ late GU toxicity after SBRT was 0.73 (95% CI, 0.67-0.78) and 0.66 (95% CI, 0.59-0.73) following CRT. In UVA, G2+ acute GI toxicity was associated with developing G2+ late GI toxicity after SBRT (OR 3.67, 95% CI (1.91-7.03), p <0.0001) and CRT (OR 4.4, 95% CI (2.04-9.47), p<0.0001). This association also remained significant in MVA. The models AUC for predicting G2+ late GI toxicity after SBRT was 0.66 (0.95% CI, 0.57-0.75) and 0.64 (95% CI, 0.57-0.72) following CRT. In UVA analysis, G2+ baseline GU symptoms were also associated with developing G2+ late GU toxicity after SBRT (OR 7.59, 95% CI (2.72-21.19, p<0.0001) and CRT (OR 7.98, 95% CI (3.03-20.96), p<0.0001), and this continued to be significant in MVA. Acute toxicity remained associated with persistent late toxicity (≥2 G2+ late events) and late toxicity 12-24 months. CONCLUSION Our study demonstrates an independent association between acute and late GU/GI toxicity in patients treated with SBRT and CRT for localized prostate cancer. Recognizing those at risk of late toxicity can provide an opportunity for early intervention to improve outcomes. G2+ acute toxicity should be considered an essential variable for predicting late GI/GU toxicity after prostate RT.
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Affiliation(s)
- R Ratnakumaran
- The Royal Marsden NHS Foundation Trust, London, United Kingdom; Radiotherapy and Imaging Division, Institute of Cancer Research, London, United Kingdom
| | - V Hinder
- The Institute of Cancer Research, Clinical Trials and Statistics Unit, London, United Kingdom
| | - D H Brand
- Department of Medical Physics and Bioengineering, University College London, London, United Kingdom
| | - J Staffurth
- Division of Cancer and Genetics, School of Medicine, Cardiff University, Cardiff, United Kingdom
| | - E Hall
- The Institute of Cancer Research, Clinical Trials and Statistics Unit, London, United Kingdom
| | - N van As
- The Royal Marsden NHS Foundation Trust, London, United Kingdom; Radiotherapy and Imaging Division, Institute of Cancer Research, London, United Kingdom
| | - A Tree
- The Royal Marsden NHS Foundation Trust, London, United Kingdom; Radiotherapy and Imaging Division, Institute of Cancer Research, London, United Kingdom
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7
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Lee JY, Dess RT, Zelefsky MJ, Davis BJ, Horwitz EM, Cooperberg MR, Zaorsky NG, Jia AY, Sandler HM, Efstathiou JA, Pisansky TM, Hall E, Tree A, Roy S, Bolla M, Nabid A, Zapatero A, Kishan AU, Spratt DE, Sun Y. Individual Patient Data Analysis of 17 Randomized Trials vs. Real-World Data for Men with Localized Prostate Cancer Receiving Radiotherapy. Int J Radiat Oncol Biol Phys 2023; 117:e404-e405. [PMID: 37785347 DOI: 10.1016/j.ijrobp.2023.06.1543] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Prior work has demonstrated poor correlation between the results of randomized controlled trials (RCTs) and real-world evidence (RWD). However, patients enrolled in RCTs are often considered to poorly represent the real-world population. Herein, we utilize multiple large data repositories to determine differences in baseline characteristics and long-term outcomes between patients enrolled in RCTs and RWD that received radiotherapy for localized prostate cancer. MATERIALS/METHODS Meta-Analysis of Randomized trials in Cancer of the Prostate (MARCAP) Consortium was leveraged, and 17 phase III randomized trials were included. RWD were accessed through the Staging Collaboration for Cancer of the Prostate (STAR-CAP) cohort, a cohort that is comprised of >60 centers across the United States and Europe. Additionally, RWD was assessed via the Surveillance, Epidemiology, and End Results (SEER) database. MARCAP and STAR-CAP both contain outcomes for distant metastasis (DM), metastasis-free survival (MFS), prostate cancer-specific mortality (PCSM), and overall survival (OS). SEER only contains PCSM and OS. Wilcoxon signed-rank test and chi-square test were used to compare continuous and categorical variables, respectively. Inverse probability of treatment weighting (IPTW) analysis was conducted, balancing for age, PSA, Gleason score, T stage, and treatment year in the three cohorts. Cox and Fine-Gray regression models were used to compare disease outcomes between RCTs vs. RWD. RESULTS Data from 10,666 patients from RCTs, 6,530 patients in STAR-CAP, and 117,586 patients in SEER were included. SEER patients were slightly younger (p<0.001, median age 68 (IQR 62-73) than those in RCTs (70, IQR 65-74) and in STAR-CAP (70, IQR 64-74). 10-year OS in RCTs was 65.4%, STAR-CAP 70.2%, SEER 64.1%. OS was superior in STAR-CAP (RCTs as reference; HR 0.91, 95% CI 0.85-0.96, p<0.0001), but there was no significant difference between SEER and RCTs (HR 0.96, 95% CI 0.91-1.02, p = 0.22). 10-year PCSM cumulative incidence was 7.4% in RCTs, 8.1% in STAR-CAP, and 11.0% in SEER. There was no significant difference in PCSM between STAR-CAP RWD and RCTs (HR 0.88, 95% CI 0.78-1.01, p = 0.08), whereas PCSM was worse in SEER than RCTs (HR 1.37, 95% CI 1.21-1.55, p<0.0001). There was no significant difference in DM between STAR-CAP RWD and RCTs (HR 0.93, 95% CI 0.83-1.04, p = 0.2). CONCLUSION While baseline differences exist in patients enrolled on localized prostate cancer RCTs and real-world datasets, there were small if any significant relative differences in oncologic outcomes. This provides reassurance that RCT results are generally applicable to patients in routine practice.
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Affiliation(s)
- J Y Lee
- Case Western Reserve University School of Medicine, Cleveland, OH; University Hospitals Cleveland Medical Center, Cleveland, OH
| | - R T Dess
- Department of Radiation Oncology, University of Michigan, Ann Arbor, MI
| | - M J Zelefsky
- Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, NY
| | - B J Davis
- Department of Radiation Oncology, Mayo Clinic, Rochester, MN
| | - E M Horwitz
- Department of Radiation Oncology, Fox Chase Cancer Center, Philadelphia, PA
| | - M R Cooperberg
- University of California, San Francisco, San Francisco, CA
| | - N G Zaorsky
- University Hospitals Seidman Cancer Center, Case Western Reserve University, Cleveland, OH
| | - A Y Jia
- Weill Cornell Medical College/New York Presbyterian Hospital, New York, NY
| | - H M Sandler
- Cedars-Sinai Medical Center, Los Angeles, CA
| | - J A Efstathiou
- Department of Radiation Oncology, Harvard School of Medicine, Boston, MA
| | - T M Pisansky
- Department of Radiation Oncology, Mayo Clinic, Rochester, MN
| | - E Hall
- The Institute of Cancer Research, Clinical Trials and Statistics Unit, London, United Kingdom
| | - A Tree
- Radiotherapy and Imaging Division, Institute of Cancer Research, London, United Kingdom
| | - S Roy
- Rush University Medical Centre, Chicago, IL
| | - M Bolla
- Department of Radiation Oncology. CHU Grenoble, Grenoble, France
| | - A Nabid
- Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, QC, Canada
| | - A Zapatero
- Hospital Universitario de La Princesa, Madrid, Spain
| | - A U Kishan
- Department of Radiation Oncology, University of California, Los Angeles, Los Angeles, CA
| | - D E Spratt
- Department of Radiation Oncology, University Hospitals Seidman Cancer Center and Case Western Reserve University, Cleveland, OH
| | - Y Sun
- University Hospitals Seidman Cancer Center, Case Western Reserve School of Medicine, Cleveland, OH
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8
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Lee JH, Shi DD, Shin KY, Buckley E, Gunasti L, Roldan CS, Hall E, Mann E, Spicer B, Brennan VS, Huynh MA, Spektor A, Chen YH, Krishnan MS, Balboni TA, Hertan LM. A Prospective Study Assessing the Efficacy and Toxicity of Stereotactic Body Radiation Therapy for Oligometastatic Bone Metastases. Int J Radiat Oncol Biol Phys 2023; 117:e126. [PMID: 37784681 DOI: 10.1016/j.ijrobp.2023.06.920] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Stereotactic body radiation therapy (SBRT) is a promising treatment for oligometastatic disease in bone due to its delivery of high dose to target tissue and minimal dose to surrounding tissue. The purpose of this study is to assess efficacy and toxicity of this treatment in patients with previously unirradiated oligometastatic bony disease. MATERIALS/METHODS In this prospective phase II trial, patients with oligometastatic bone disease, defined as ≤3 active sites of disease, were treated with SBRT at one of two academic institutions between December 2016 and May 2019. Local progression-free survival (LPFS), progression-free survival (PFS), prostatic specific antigen (PSA) progression, and overall survival (OS) were reported. Treatment-related toxicity was also reported. RESULTS A total of 98 patients and 131 lesions arising from various tumor histologies were included in this study. The median age of patients enrolled in the study was 72.8 years (80.6% male, 19.4% female). Median follow-up was 26.7 months. The most common histology was prostate cancer (68.4%, 67/98). The most common dose prescriptions were 27/30 Gy in 3 fractions (26.0%, 34/131), 30 Gy in 5 fractions (19.1%, 25/131), or 30/35 Gy in 5 fractions (16.0%, 21/131). Multiple doses per treatment regimen reflect dose painting employing the lower dose to the clinical target volume (CTV) and higher dose to the gross tumor volume (GTV). Four patients (4.1%, 4/98) experienced local progression at one site for each patient (3.1%, 4/131). Among patients who progressed locally, the median time to local recurrence was 25.8 months (31.0 months among prostate cancer patients, N = 2, and 14.5 months among non-prostate cancer patients, N = 2). Among the entire cohort, 2-year LPFS (including death without local progression) was 85.0%, 2-year PFS (including deaths as well as local, distant, and PSA-based progression) was 47.0%, and 2-year OS was 87.5%. Twenty-seven patients (27.6%, 27/98) developed treatment-related toxicities, and most were Grade 1 (19.4%, 19/98) and 2 (4.1%, 4/98). Four patients (4.1%, 4/98) developed Grade 3 toxicities; there were no Grade 4 toxicities. The most common toxicity was fatigue (10.2%, 10/98). Of 68 treated spine metastases, there were four (5.9%, 4/68) vertebral fractures. Among these four patients, median time to fracture was 23.5 months (range 14.2-39.2 months). CONCLUSION Our study supports existing literature in showing that SBRT is effective and tolerable in patients with oligometastatic bone disease. Larger phase III trials are necessary and reasonable to determine long-term efficacy and toxicities.
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Affiliation(s)
- J H Lee
- Department of Medical Oncology, Dana-Farber Cancer Institute and Brigham and Women's Hospital, Harvard Medical School, Boston, MA
| | - D D Shi
- Department of Radiation Oncology, Dana-Farber Cancer Institute/Brigham and Women's Cancer Center, Harvard Medical School, Boston, MA
| | - K Y Shin
- Department of Data Science, Dana-Farber Cancer Institute, Boston, MA
| | - E Buckley
- Department of Radiation Oncology, Dana-Farber Cancer Institute/Brigham and Women's Cancer Center, Harvard Medical School, Boston, MA
| | - L Gunasti
- Department of Radiation Oncology, Dana-Farber Cancer Institute/Brigham and Women's Cancer Center, Harvard Medical School, Boston, MA
| | - C S Roldan
- Northwestern Feinberg School of Medicine, Chicago, IL
| | - E Hall
- Department of Radiation Oncology, Beth Israel Deaconess Medical Center, Boston, MA
| | - E Mann
- Department of Radiation Oncology, Dana-Farber Cancer Institute/Brigham and Women's Cancer Center, Harvard Medical School, Boston, MA
| | - B Spicer
- Department of Radiation Oncology, Dana-Farber Cancer Institute/Brigham and Women's Cancer Center, Harvard Medical School, Boston, MA
| | - V S Brennan
- Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, NY
| | - M A Huynh
- Department of Radiation Oncology, Dana-Farber Cancer Institute/Brigham and Women's Cancer Center, Harvard Medical School, Boston, MA
| | - A Spektor
- Department of Radiation Oncology, Brigham and Women's Hospital/Dana-Farber Cancer Institute, Boston, MA
| | - Y H Chen
- Department of Data Science, Dana-Farber Cancer Institute, Boston, MA
| | - M S Krishnan
- Department of Radiation Oncology, Dana-Farber Cancer Institute/Brigham and Women's Cancer Center, Harvard Medical School, Boston, MA
| | - T A Balboni
- Department of Radiation Oncology, Brigham and Women's Hospital/Dana-Farber Cancer Institute, Boston, MA
| | - L M Hertan
- Department of Radiation Oncology, Beth Israel Deaconess Medical Center, Boston, MA
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Aghdam N, Hall E, Bennett L, Aronovitz JA, Kaplan ID. Transient Radiographic Pseudoprogression Following Fractionated SBRT for Primary Renal Cell Carcinoma. Int J Radiat Oncol Biol Phys 2023; 117:e362-e363. [PMID: 37785246 DOI: 10.1016/j.ijrobp.2023.06.2453] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) SBRT is an emerging treatment for patients with RCC who are not surgical candidates. Pooled analysis of an international consortium suggests promising short term local control. In the event of local failure, other ablative methods may be used to salvage these patients. Trends in radiographic surveillance are not well characterized post SBRT. In this study we observe a common transient increase in the tumor size followed by stability or decline in patients treated with fractionated SBRT on a phase II clinical protocol. MATERIALS/METHODS Radiographic studies of patients enrolled in a phase II clinical trial were reviewed for this report. Primary RCC tumors were treated using SBRT with two fractionation schema (48 Gy in 3 or 4 fractions) based on a 5 cm size threshold. Patients were followed with routine imaging per protocol at 3, 6, 12, 18, and 24 months post-treatment. Percent change in greatest dimension is analyzed over time and subsequently stratified by dose, baseline tumor diameter, and PTV. An increase in tumor size by 10% or greater followed by tumor shrinkage or stability was considered a transient increase. RESULTS From August of 2013 to December of 2022, 40 patients were enrolled in this trial with a median age of 77.5 and follow up of 18 months. 32 patients with at least two follow up images (minimum of 6 months post-SBRT) were included in the analysis. 26 of these patients were treated with 48 Gy in 3 fractions and 6 were treated with 48 Gy in 3 fractions. Median tumor size was 38.4 cc with a median diameter of 3.5 cm. 46.9% of patients experienced a transient increase with a median increase of 19.7% (range = 63.1, IQR = 13.9%-38.6%) of the pretreatment largest dimension. 66.7% of patients with tumors ≥ 5 cm experienced a transient increase vs. 42.3% of patients with tumors < 5cm. 56.3% of patients with PTV ≥ 38.4 cc experienced a transient increase vs. 40% of patients with a PTV < 38.4cc. Patients with PTV < 38.4 cc experienced a median 19% increase compared with the PTV ≥ 38.4 cc median increase of 37.5%. Most common transient increase was observed at 3 months post treatment. Of patients evaluated with CT scans, 50% experienced a transient increase, compared with 37.5% of those evaluated with MRI scans. CONCLUSION SBRT is a promising treatment for primary RCC, however radiographic surveillance of the disease post-treatment is not well characterized. In this study of patients enrolled in a Phase II protocol, there appears to be a transient radiographic increase in the size of primary tumors followed by stability and decline. Further investigations will guide the timing and need for salvage treatment for post- SBRT RCC.
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Affiliation(s)
- N Aghdam
- Department of Radiation Oncology, Beth Israel Deaconess Medical Center, Boston, MA
| | - E Hall
- Department of Radiation Oncology, Beth Israel Deaconess Medical Center, Boston, MA
| | - L Bennett
- Beth Israel Deaconess Medical Center, Boston, MA
| | | | - I D Kaplan
- Beth Israel Deaconess Medical Center, Boston, MA
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Jerjen CP, Kumaran SJ, Liesegang A, Hall E, Wichert B, Haase B. Melanocortin-4 receptor and proopiomelanocortin: Candidate genes for obesity in domestic shorthair cats. Anim Genet 2023; 54:637-642. [PMID: 37365843 DOI: 10.1111/age.13335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Revised: 05/16/2023] [Accepted: 06/05/2023] [Indexed: 06/28/2023]
Abstract
Obesity is an escalating global health problem affecting both humans and companion animals. In cats it is associated with increased mortality and multiple diseases, including diabetes mellitus. Two genes coding for proteins known to play a critical role in energy homeostasis across species are the proopiomelanocortin (POMC) gene and the melanocortin-4 receptor (MC4R) gene. A missense variant in the coding sequence of the feline MC4R (MC4R:c.92C>T) has been reported to be associated with diabetes and overweight in domestic shorthair cats, and while variants in the POMC gene are known to cause obesity in humans and dogs, variants in POMC and their association with feline obesity and diabetes mellitus have not been investigated to date. The current study aimed to assess the association between the previously described MC4R variant and body condition score (BCS), as well as body fat content (%BF) in 89 non-diabetic domestic shorthair cats. Furthermore, we investigated the feline POMC gene as a potential candidate gene for obesity. Our results indicate that the MC4R:c.92C>T polymorphism is not associated with BCS or %BF in non-diabetic domestic shorthair cats. The mutation analysis of all POMC exons identified two missense variants, with a variant in exon 1 (c.28G>C; p.G10R) predicted to be damaging. The variant was subsequently assessed in all 89 cats, and cats heterozygous for the variant had a significantly increased body condition score (p = 0.03) compared with cats homozygous for the wild-type allele. Results from our study provide additional evidence that the previously described variant in MC4R is not associated with obesity in domestic shorthair cats. More importantly, we have identified a novel variant in the POMC gene, which might play a role in increased body condition score and body fat content in domestic shorthair cats.
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Affiliation(s)
- C P Jerjen
- Faculty of Science, Sydney School of Veterinary Science, University of Sydney, Camperdown, New South Wales, Australia
| | - S J Kumaran
- Faculty of Science, Sydney School of Veterinary Science, University of Sydney, Camperdown, New South Wales, Australia
| | - A Liesegang
- Vetsuisse Faculty, Institute of Animal Nutrition and Dietetics, University of Zurich, Zurich, Switzerland
| | - E Hall
- Faculty of Science, Sydney School of Veterinary Science, University of Sydney, Camperdown, New South Wales, Australia
| | - B Wichert
- Vetsuisse Faculty, Institute of Animal Nutrition and Dietetics, University of Zurich, Zurich, Switzerland
| | - B Haase
- Faculty of Science, Sydney School of Veterinary Science, University of Sydney, Camperdown, New South Wales, Australia
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11
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Westley R, Dunlop A, Alexander S, Mitchell A, Diamantopoulos S, Chick J, Hall E, Mohajer J, Tree A. Is the Motion Causing a Commotion? Two-Fraction Prostate SBRT on the MR-Linac. Int J Radiat Oncol Biol Phys 2023; 117:e449-e450. [PMID: 37785446 DOI: 10.1016/j.ijrobp.2023.06.1634] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) In HERMES (NCT04595019) men with localized prostate cancer are treated on the Unity MR-Linac platform (MRL, Elekta AB, Stockholm) and randomized between stereotactic body radiotherapy (SBRT) with 36.25 Gy in 5 fractions and 24 Gy in 2 fractions. Patients randomized to two fractions receive 24 Gy to the high risk PTV, 20 Gy to the low risk PTV and a boost of 27 Gy to the dominant intraprostatic lesion. This study explores dose received by the target and organs at risk (OARs) when considering intrafraction motion in two fraction SBRT. MATERIALS/METHODS Targets and OARs were delineated and a reference plan generated on Monaco v5.40.01 (Elekta). An Adapt-to-Shape (ATS) workflow was used. Contours were propagated to the session MRI (MRIsession) and edited accordingly. Prior to delivery, a verification MRI (MRIverif) was acquired with baseline shifts corrected for using the Adapt-to-Position (ATP-of-ATS) workflow. A post treatment MRI (MRIpost) was acquired after delivery. Men in the 2-fraction arm received each fraction in 2 sub-fractions sequentially on the same day, to mitigate intrafraction motion. The plans of 5 men receiving 2 fraction SBRT were analyzed. The targets, urethra, bladder and rectum were recontoured on the MRIverif and MRIpost. Delivered plans were recalculated on the corresponding MRIverif and MRIpost. The percentage of optimal and mandatory target dose constraints met were calculated. Accumulated OAR doses were calculated by averaging their respective dose statistics across all sub-fractions, conservatively assuming that the same area of the OAR receives the maximum dose each fraction. Analysis was carried out separately for MRIverif and MRIpost as the true 'delivered dose' most likely lies between these two estimates. RESULTS There was good coverage across all fractions. The mandatory constraints of CTVpsv V24.0 Gy > 95% and CTVsv V20.0 Gy > 95% were met in 100% of fractions and V2700cGy > 95% in 90% on the MRIpost. Table 3 shows OAR dose. CONCLUSION This work demonstrates that target coverage is good, even for the GTV where no margin is applied. With our conservative dose calculation approach, we found dose constraints are exceeded for some patients. However, treatment has been well tolerated, suggesting that that our current dose constraints may be cautious. Once Elekta's True Tracking and automated gating software is implemented at our center we will be able to further improve OAR clinical goal compliance.
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Affiliation(s)
- R Westley
- The Royal Marsden NHS Foundation Trust, London, United Kingdom
| | - A Dunlop
- The Royal Marsden Hospital NHS Foundation Trust, London, United Kingdom
| | - S Alexander
- Institute of Cancer Research, Sutton, United Kingdom
| | - A Mitchell
- The Royal Marsden Hospital NHS Foundation Trust, London, United Kingdom
| | | | - J Chick
- The Royal Marsden, Sutton, United Kingdom
| | - E Hall
- The Institute of Cancer Research, Clinical Trials and Statistics Unit, London, United Kingdom
| | - J Mohajer
- The Royal Marsden NHS Foundation Trust, London, United Kingdom
| | - A Tree
- Radiotherapy and Imaging Division, Institute of Cancer Research, London, United Kingdom
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Huddart R, Hafeez S, Omar A, Alonzi R, Birtle A, Cheung KC, Choudhury A, Foroudi F, Gribble H, Henry A, Hilman S, Hindson B, Lewis R, Muthukumar D, McLaren DB, McNair H, Nikapota A, Olorunfemi A, Parikh O, Philipps L, Rimmer Y, Syndikus I, Tolentino A, Varughese M, Vassallo-Bonner C, Webster A, Griffin C, Hall E. Acute Toxicity of Hypofractionated and Conventionally Fractionated (Chemo)Radiotherapy Regimens for Bladder Cancer: An Exploratory Analysis from the RAIDER Trial. Clin Oncol (R Coll Radiol) 2023; 35:586-597. [PMID: 37225552 DOI: 10.1016/j.clon.2023.05.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Revised: 03/24/2023] [Accepted: 05/04/2023] [Indexed: 05/26/2023]
Abstract
AIMS Adding concurrent (chemo)therapy to radiotherapy improves outcomes for muscle-invasive bladder cancer patients. A recent meta-analysis showed superior invasive locoregional disease control for a hypofractionated 55 Gy in 20 fractions schedule compared with 64 Gy in 32 fractions. In the RAIDER clinical trial, patients undergoing 20 or 32 fractions of radical radiotherapy were randomised (1:1:2) to standard radiotherapy or to standard-dose or escalated-dose adaptive radiotherapy. Neoadjuvant chemotherapy and concomitant therapy were permitted. We report exploratory analyses of acute toxicity by concomitant therapy-fractionation schedule combination. MATERIALS AND METHODS Participants had unifocal bladder urothelial carcinoma staged T2-T4a N0 M0. Acute toxicity was assessed (Common Terminology Criteria for Adverse Events) weekly during radiotherapy and at 10 weeks after the start of treatment. Within each fractionation cohort, non-randomised comparisons of the proportion of patients reporting treatment emergent grade 2 or worse genitourinary, gastrointestinal or other adverse events at any point in the acute period were carried out using Fisher's exact tests. RESULTS Between September 2015 and April 2020, 345 (163 receiving 20 fractions; 182 receiving 32 fractions) patients were recruited from 46 centres. The median age was 73 years; 49% received neoadjuvant chemotherapy; 71% received concomitant therapy, with 5-fluorouracil/mitomycin C most commonly used: 44/114 (39%) receiving 20 fractions; 94/130 (72%) receiving 32 fractions. The acute grade 2+ gastrointestinal toxicity rate was higher in those receiving concomitant therapy compared with radiotherapy alone in the 20-fraction cohort [54/111 (49%) versus 7/49 (14%), P < 0.001] but not in the 32-fraction cohort (P = 0.355). Grade 2+ gastrointestinal toxicity was highest for gemcitabine, with evidence of significant differences across therapies in the 32-fraction cohort (P = 0.006), with a similar pattern but no significant differences in the 20-fraction cohort (P = 0.099). There was no evidence of differences in grade 2+ genitourinary toxicity between concomitant therapies in either the 20- or 32-fraction cohorts. CONCLUSION Grade 2+ acute adverse events are common. The toxicity profile varied by type of concomitant therapy; the gastrointestinal toxicity rate seemed to be higher in patients receiving gemcitabine.
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Affiliation(s)
- R Huddart
- Division of Radiotherapy and Imaging, The Institute of Cancer Research, London, UK; Radiotherapy Department, The Royal Marsden NHS Foundation Trust, London, UK.
| | - S Hafeez
- Division of Radiotherapy and Imaging, The Institute of Cancer Research, London, UK; Radiotherapy Department, The Royal Marsden NHS Foundation Trust, London, UK
| | - A Omar
- Clinical Trials and Statistics Unit at The Institute of Cancer Research, London, UK
| | - R Alonzi
- Clinical Oncology, Mount Vernon Cancer Centre, East and North Hertfordshire NHS Trust, Middlesex, UK
| | - A Birtle
- Cancer Oncology, Lancashire Teaching Hospitals NHS Trust, Lancashire, UK
| | - K C Cheung
- Clinical Trials and Statistics Unit at The Institute of Cancer Research, London, UK
| | - A Choudhury
- Translational Radiobiology, The Christie NHS Foundation Trust, Manchester, UK
| | - F Foroudi
- Radiation Oncology, Austin Health, Heidelberg, Australia
| | - H Gribble
- Clinical Trials and Statistics Unit at The Institute of Cancer Research, London, UK
| | - A Henry
- University of Leeds and the Leeds Teaching Hospital NHS Trust, Leeds, UK
| | - S Hilman
- Clinical Oncology, University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK
| | - B Hindson
- Canterbury Regional Cancer and Haematology Service, Te Whatu Ora, Waitaha Canterbury, Christchurch, New Zealand
| | - R Lewis
- Clinical Trials and Statistics Unit at The Institute of Cancer Research, London, UK
| | - D Muthukumar
- Oncology, East Suffolk and North Essex NHS Foundation Trust, Colchester, UK
| | - D B McLaren
- Department of Clinical Oncology, Edinburgh Cancer Centre, NHS Lothian, Edinburgh, UK
| | - H McNair
- Division of Radiotherapy and Imaging, The Institute of Cancer Research, London, UK; Radiotherapy Department, The Royal Marsden NHS Foundation Trust, London, UK
| | - A Nikapota
- Clinical Oncology, Brighton and Sussex University Hospitals NHS Trust, Brighton, UK
| | - A Olorunfemi
- Clinical Trials and Statistics Unit at The Institute of Cancer Research, London, UK
| | - O Parikh
- Lancashire Teaching Hospitals NHS Trust, Burnley, UK
| | - L Philipps
- Clinical Trials and Statistics Unit at The Institute of Cancer Research, London, UK
| | - Y Rimmer
- Department of Oncology, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - I Syndikus
- Department of Radiotherapy, The Clatterbridge Cancer Centre, Liverpool, UK
| | - A Tolentino
- Clinical Trials and Statistics Unit at The Institute of Cancer Research, London, UK
| | - M Varughese
- Department of Oncology, Royal Devon & Exeter NHS Foundation Trust, Exeter, UK
| | - C Vassallo-Bonner
- Patient Representative, The Institute of Cancer Research, London, UK
| | - A Webster
- National Radiotherapy Trials Quality Assurance Group (RTTQA), University College Hospital, London, UK
| | - C Griffin
- Clinical Trials and Statistics Unit at The Institute of Cancer Research, London, UK
| | - E Hall
- Clinical Trials and Statistics Unit at The Institute of Cancer Research, London, UK
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Philipps L, Porta N, James N, Huddart R, Hafeez S, Hall E. Correlation of Clinician- and Patient-Reported Outcomes in the BC2001 Trial. Clin Oncol (R Coll Radiol) 2023; 35:331-338. [PMID: 36918330 DOI: 10.1016/j.clon.2023.02.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Revised: 01/04/2023] [Accepted: 02/02/2023] [Indexed: 02/11/2023]
Abstract
AIMS To evaluate whether there is sufficient correlation between patient-reported outcomes (PROs) and clinician-reported outcomes (CROs) in bladder cancer follow-up post-radiotherapy to streamline data collection and to reduce trial follow-up burden on patients, clinicians and trial programmes. MATERIALS AND METHODS PROs data were collected within the BC2001 trial using the Functional Assessment of Cancer Therapy specific to bladder cancer (FACT-BL) questionnaire. CROs data were collected by clinicians using Late Effects in Normal Tissues Subjective, Objective and Management (LENT/SOM). Data were collected at baseline, post-treatment, at 6 and 12 months post-randomisation and then annually to 5 years. The percentage agreement between CROs and PROs measures was evaluated at 2 and 5 years post-randomisation. Concordance was tested using the weighted Kappa statistic with 95% confidence intervals. RESULTS Correlation was evaluated between six categories of the FACT-BL and LENT/SOM scores. At 2 years the percentage agreement across these domains ranged from 45 to 78%, with the weighted Kappa statistic between 0.07 and 0.35. Results were similar in year 5 with 48-83% agreement and kappa statistics between -0.02 and 0.21. CONCLUSION The correlation between CROs and PROs in patients treated with radiotherapy for bladder cancer were generally poor. PROs appear to be more sensitive, with higher grade events reported. Further work is needed to evaluate whether PROs alone can be used to evaluate toxicity-related outcomes in randomised controlled trials.
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Affiliation(s)
- L Philipps
- Clinical Trials and Statistics Unit, Institute of Cancer Research, London, UK; The Institute of Cancer Research, London, UK.
| | - N Porta
- The Institute of Cancer Research, London, UK
| | - N James
- The Institute of Cancer Research, London, UK; The Royal Marsden NHS Foundation Trust, Sutton, UK
| | - R Huddart
- The Institute of Cancer Research, London, UK; The Royal Marsden NHS Foundation Trust, Sutton, UK
| | - S Hafeez
- The Institute of Cancer Research, London, UK; The Royal Marsden NHS Foundation Trust, Sutton, UK
| | - E Hall
- The Institute of Cancer Research, London, UK
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Philipps L, Porta N, James N, Huddart R, Hafeez S, Ballas L, Hall E. Differences in Quality of Life and Toxicity for Male and Female Patients following Chemo(radiotherapy) for Bladder Cancer. Clin Oncol (R Coll Radiol) 2023; 35:e336-e343. [PMID: 36906497 DOI: 10.1016/j.clon.2023.02.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Revised: 01/12/2023] [Accepted: 02/07/2023] [Indexed: 02/13/2023]
Abstract
AIMS BC2001, a randomised trial of treatment for muscle-invasive bladder cancer, demonstrated no difference in health-related quality of life (HRQoL) or late toxicity between patients receiving radical radiotherapy with and without chemotherapy. This secondary analysis explored sex-based differences in HRQoL and toxicity. MATERIALS AND METHODS Participants completed the Functional Assessment of Cancer Therapy Bladder (FACT-BL) HRQoL questionnaires at baseline, end of treatment, 6 months and annually until 5 years. Clinicians assessed toxicity with the Radiation Therapy Oncology Group (RTOG) and Late Effects in Normal Tissues Subjective, Objective and Management (LENT/SOM) scoring systems at the same timepoints. The impact of sex on patient-reported HRQoL was evaluated using multivariate analyses of change in FACT-BL subscores from baseline to the timepoints of interest. For clinician-reported toxicity, differences were compared by calculating the proportion of patients with grade 3-4 toxicities occurring over the follow-up period. RESULTS For both males and females, all FACT-BL subscores had a reduction in HRQoL at the end of treatment. For males, the mean bladder cancer subscale (BLCS) score remained stable through to year 5. For females, there was a decline in BLCS from baseline at years 2 and 3 with a return to baseline at year 5. At year 3, females had a statistically significant and clinically meaningful worsening of mean BLCS score (-5.18; 95% confidence interval -8.37 to -1.99), which was not seen in males (0.24; -0.76 to 1.23). RTOG toxicity was more frequent in females than males (27% versus 16%, P = 0.027). CONCLUSION Results suggest that female patients treated with radiotherapy ± chemotherapy for localised bladder cancer report worse treatment-related toxicity in post-treatment years 2 and 3 than males.
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Affiliation(s)
- L Philipps
- The Institute of Cancer Research, London, UK.
| | - N Porta
- The Institute of Cancer Research, London, UK
| | - N James
- The Institute of Cancer Research, London, UK; The Royal Marsden NHS Foundation Trust, Sutton, UK
| | - R Huddart
- The Institute of Cancer Research, London, UK; The Royal Marsden NHS Foundation Trust, Sutton, UK
| | - S Hafeez
- The Institute of Cancer Research, London, UK; The Royal Marsden NHS Foundation Trust, Sutton, UK
| | - L Ballas
- Cedars-Sinai Medical Center, Los Angeles, California, USA
| | - E Hall
- The Institute of Cancer Research, London, UK
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Nandi D, Wright L, Sublett-Smith J, Brax A, Almond C, Bansal N, Azeka E, Butts R, Conway J, Chen C, Cunningham C, Fisher L, Hall E, Hunter T, Kobayashi R, Patterson D, Peng D, Simpson K, Ryan T, Spinner J, Wisotzkey B, Zangwill S, Gajarski R, O'Connor M. Suboptimal Titration of Heart Failure Medications in Pediatric Patients: Baseline Data from the ACTION Network. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.1627] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2023] Open
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Daly E, Collins G, Hall E, O'Dwyer J, Gallagher D, Kelly J. Telehealth Rehabilitation for the Management of Long Covid Symptoms. Ir Med J 2023; 115:677. [PMID: 36920416] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Subscribe] [Scholar Register] [Indexed: 03/16/2023]
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Murray JR, Sankey P, Tree AC, Hall E. PEARLS: Is Our Use of Prostate-specific Membrane Antigen Positron Emission Tomography-Computed Tomography Meaningful for Our Patients? Clin Oncol (R Coll Radiol) 2022; 34:589-592. [PMID: 35649963 DOI: 10.1016/j.clon.2022.05.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Revised: 04/06/2022] [Accepted: 05/05/2022] [Indexed: 11/15/2022]
Affiliation(s)
- J R Murray
- The Royal Marsden NHS Foundation Trust, Sutton, UK; The Institute of Cancer Research, London, UK.
| | - P Sankey
- University Hospitals Plymouth NHS Trust, Plymouth, UK
| | - A C Tree
- The Royal Marsden NHS Foundation Trust, Sutton, UK; The Institute of Cancer Research, London, UK
| | - E Hall
- The Institute of Cancer Research, London, UK
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Griebsch C, Hall E, Barrs VR. Effectiveness of aspirin vs. clopidogrel in dogs with immune mediated haemolytic anaemia evaluated by serial thromboelastography and platelet mapping. Vet J 2022; 287:105882. [PMID: 35963596 DOI: 10.1016/j.tvjl.2022.105882] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Revised: 08/09/2022] [Accepted: 08/09/2022] [Indexed: 11/27/2022]
Abstract
Most dogs with immune mediated haemolytic anaemia (IMHA) are hypercoagulable, as measured by thromboelastography (TEG). Thromboelastography-platelet mapping (TEG-PM) has been used to assess platelet function in human patients treated with aspirin or clopidogrel. The aim of this study was to compare platelet thromboxane A2-receptor inhibition (TXA2-RI) and platelet adenosine diphosphate (ADP)-receptor inhibition (ADP-RI) as measured by TEG-PM in dogs with primary IMHA receiving aspirin or clopidogrel to determine if TEG-PM might be useful to monitor treatment. Eighteen client-owned dogs with IMHA were enroled in a prospective double blinded study. Dogs were randomised to receive aspirin or clopidogrel in addition to standard therapy. Thromboelastography was measured before, and 1 and 4 days after commencing treatment. Thromboelastography-PM was performed on days 1 and 4. Non-responders were defined as < 50 % platelet thromboxane A2-receptor inhibition (TXA2-RI) in the aspirin group and < 50 % platelet adenosine diphosphate (ADP)-receptor inhibition (ADP-RI) in the clopidogrel group, on day 4. Mean platelet TXA2-RI and platelet ADP-RI were not significantly different between groups at any timepoint (P > 0.05). The overall mean percentage inhibition of TXA2-receptor was 25 % (aspirin 33 %, clopidogrel 15 %), and of ADP-receptor was 82 % (aspirin 83 %, clopidogrel 80 %). On day 4, 6/9 dogs (66 %) in the aspirin group and 2/8 dogs (25 %) in the clopidogrel group were non-responders (P = 0.086). Two dogs defined as responders based on TEG-PM developed thromboembolism. Overall, there was no significant difference in efficacy between aspirin and clopidogrel based on measurement of receptor inhibition using TEG-PM (P > 0.05), and routine TEG was not reliable for monitoring treatment response in dogs with IMHA. In some dogs, there was a discrepancy between TEG-PM results and clinical response. Further investigation of TEG-PM use in dogs, including its usefulness to monitor treatment response and adjust treatment in individual dogs and any effect of anaemia, is warranted.
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Affiliation(s)
- C Griebsch
- Sydney School of Veterinary Science, Faculty of Science, University of Sydney, Sydney, Australia.
| | - E Hall
- Sydney School of Veterinary Science, Faculty of Science, University of Sydney, Sydney, Australia
| | - V R Barrs
- Sydney School of Veterinary Science, Faculty of Science, University of Sydney, Sydney, Australia; Department of Veterinary Clinical Sciences, Jockey Club College of Veterinary Medicine and Life Sciences, City University of Hong Kong, Hong Kong, China
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19
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Bodnarova T, Hall E, Duplan F. Prescribing habits for the use of omeprazole as a gastroprotectant in dogs in a veterinary teaching hospital. J Small Anim Pract 2022; 63:769-775. [PMID: 35840131 DOI: 10.1111/jsap.13531] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Revised: 04/24/2022] [Accepted: 06/14/2022] [Indexed: 11/27/2022]
Abstract
OBJECTIVES To examine the prescribing habits for omeprazole in a veterinary teaching hospital and to evaluate the effect of a clinical audit on omeprazole prescription. MATERIAL AND METHODS Observational study with retrospective clinical audit followed by a prospective study. The evaluated data about omeprazole prescription included the dose, frequency and indication. These were assessed according to published guidelines. A seminar about the audit and current guidelines on the use of omeprazole was organised for all members of clinical staff. Prospective data collection was conducted after the seminar. A comparison of the collected data before and after the clinical audit was made. RESULTS A total of 301 dogs were prescribed omeprazole in the veterinary teaching hospital during the study period (including the retrospective and prospective parts). Complete data were acquired from 240 patients. The prescribed frequency of omeprazole was inappropriate in 23 (16.5%) of the prescriptions in the retrospective section but in only five (5.0%) in the prospective study. Inappropriate indications were reported in 12 (8.6%) patients in the retrospective section and in two patients (2.0%) in the prospective study. Overall inappropriate omeprazole prescription was identified in 34 (24.5%) patients in the retrospective part and in seven (6.9%) patients in the prospective part. There was a statistically significant difference between the two groups in frequency, indication and overall prescription of omeprazole. CLINICAL SIGNIFICANCE This study details the frequency of inappropriate prescription of omeprazole in a veterinary teaching hospital and provides some evidence that dissemination of guidelines based on clinical audit can improve prescribing habits.
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Affiliation(s)
- T Bodnarova
- Veterinary Clinic Podebrady, Podebrady, 29001, Czech Republic
| | - E Hall
- School of Veterinary Sciences, University of Bristol, Bristol, BS40 5DU, UK
| | - F Duplan
- School of Veterinary Sciences, University of Bristol, Bristol, BS40 5DU, UK
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20
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Wilkins A, Hall E, Lewis R, Gribble H, Melcher A, Huddart R. RE-ARMing the Immune Response to Bladder Cancer with Radiotherapy. Clin Oncol (R Coll Radiol) 2022; 34:421-425. [PMID: 34998656 DOI: 10.1016/j.clon.2021.12.019] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Revised: 12/07/2021] [Accepted: 12/22/2021] [Indexed: 12/15/2022]
Affiliation(s)
- A Wilkins
- Division of Radiotherapy and Imaging, The Institute of Cancer Research, London, UK; Royal Marsden Hospital, London, UK.
| | - E Hall
- Division of Clinical Studies, The Institute of Cancer Research, London, UK
| | - R Lewis
- Division of Clinical Studies, The Institute of Cancer Research, London, UK
| | - H Gribble
- Division of Clinical Studies, The Institute of Cancer Research, London, UK
| | - A Melcher
- Division of Radiotherapy and Imaging, The Institute of Cancer Research, London, UK; Royal Marsden Hospital, London, UK
| | - R Huddart
- Division of Radiotherapy and Imaging, The Institute of Cancer Research, London, UK; Royal Marsden Hospital, London, UK
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21
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Westley R, Hall E, Tree A. HERMES: Delivery of a Speedy Prostate Cancer Treatment. Clin Oncol (R Coll Radiol) 2022; 34:426-429. [PMID: 35093251 PMCID: PMC8802653 DOI: 10.1016/j.clon.2022.01.003] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Revised: 12/23/2021] [Accepted: 01/04/2022] [Indexed: 12/27/2022]
Affiliation(s)
- R Westley
- The Royal Marsden NHS Foundation Trust, Sutton, UK; The Institute of Cancer Research, London, UK
| | - E Hall
- The Institute of Cancer Research, London, UK
| | - A Tree
- The Royal Marsden NHS Foundation Trust, Sutton, UK; The Institute of Cancer Research, London, UK.
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22
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Dearnaley D, Hinder V, Hijab A, Horan G, Srihari N, Rich P, Houston G, Henry A, Gibbs S, Venkitaraman R, Cruickshank C, Hassan S, Mason M, Pedley I, Payne H, Brock S, Wade R, Robinson A, Din O, Lees K, Murray J, Parker C, Griffin C, Sohaib A, Hall E. OC-0105 PROMPTS RCT of screening MRI for spinal cord compression in prostate cancer (ISRCTN74112318). Radiother Oncol 2022. [DOI: 10.1016/s0167-8140(22)02481-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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23
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Ross K, Kattakayam F, Hall E, Barker JR. 710 IPC STOCKINGS FOR VTE PREVENTION IN STROKE: BENEFITS OF INTRODUCING ELECTRONIC PRESCRIPTIONS AND WARD ROUND PROMPTS. Age Ageing 2022. [DOI: 10.1093/ageing/afac034.710] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
A fully completed audit cycle, performed by doctors on the Stroke Unit at Royal Lancaster Infirmary (RLI) which is a combined acute and rehabilitation ward in a university teaching hospital.
Introduction
Deep vein thrombosis (DVT) and pulmonary embolism (PE) are common complications of hemiplegic stroke. Evidence shows that IPCs (intermittent pneumatic compression devices) reduce the risk of DVT. Recent data from SSNAP reports that IPCs are only used in 33% of all stroke patients. We aimed to improve our local standards in the prescription of IPCs for stroke patients within 3 days of admission, thus reducing the incidence of VTE (venous thromboembolism).
Methods
Data was collected retrospectively from patient records of all stroke patients discharged over a one-month period for each of 2 audit cycles. Prescribing is electronic based at RLI. After the first cycle we initiated a prompt on the electronic VTE pro forma to initiate prescribing. We also changed the prescribing default to regular instead of when required, requiring staff to document when they were not given and the reasons why.
Results
Between the first and second cycle, completion of VTE proformas improved to 100% and VTE incidence reduced from 7.6% to 0. Overall, there was a large improvement in prescribing IPCs within the first 3 days of admission. 71% of patients reviewed in the second cycle had IPCs prescribed compared to 37% in the first.
Conclusion
Adherence to local standards in prescribing of IPCs within 3 days of admission markedly improved after the Introduction of electronic ward round prompts and prescriptions and the incidence of VTE decreased to zero. The prescribing prompts encouraged increased documentation of administering of IPCs. There are still some issues concerning documentation and prescribing of anticoagulants which will be tackled by implementing teaching sessions and updating our electronic prescribing prompts.
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Affiliation(s)
- K Ross
- Royal Lancaster Infirmary
| | | | - E Hall
- Royal Lancaster Infirmary
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24
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Stevenson K, Brooks M, Moore F, Hall E, Menon A. Employing a patient with lived experience of musculoskeletal disease to assist service transformation. Physiotherapy 2022. [DOI: 10.1016/j.physio.2021.12.199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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25
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Al-Yahyaey F, Shaat I, Hall E, Bush RD. Effect of Spirulina platensis supplementation on growth, performance and body conformation of two Omani goat breeds. Anim Prod Sci 2022. [DOI: 10.1071/an21483] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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26
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Abratenko P, An R, Anthony J, Asaadi J, Ashkenazi A, Balasubramanian S, Baller B, Barnes C, Barr G, Basque V, Bathe-Peters L, Benevides Rodrigues O, Berkman S, Bhanderi A, Bhat A, Bishai M, Blake A, Bolton T, Book JY, Camilleri L, Caratelli D, Caro Terrazas I, Castillo Fernandez R, Cavanna F, Cerati G, Chen Y, Cianci D, Conrad JM, Convery M, Cooper-Troendle L, Crespo-Anadón JI, Del Tutto M, Dennis SR, Devitt D, Diurba R, Dorrill R, Duffy K, Dytman S, Eberly B, Ereditato A, Evans JJ, Fine R, Fiorentini Aguirre GA, Fitzpatrick RS, Fleming BT, Foppiani N, Franco D, Furmanski AP, Garcia-Gamez D, Gardiner S, Ge G, Gollapinni S, Goodwin O, Gramellini E, Green P, Greenlee H, Gu W, Guenette R, Guzowski P, Hagaman L, Hall E, Hen O, Horton-Smith GA, Hourlier A, Itay R, James C, Ji X, Jiang L, Jo JH, Johnson RA, Jwa YJ, Kamp N, Kaneshige N, Karagiorgi G, Ketchum W, Kirby M, Kobilarcik T, Kreslo I, LaZur R, Lepetic I, Li K, Li Y, Lin K, Littlejohn BR, Louis WC, Luo X, Manivannan K, Mariani C, Marsden D, Marshall J, Martinez Caicedo DA, Mason K, Mastbaum A, McConkey N, Meddage V, Mettler T, Miller K, Mills J, Mistry K, Mogan A, Mohayai T, Moon J, Mooney M, Moor AF, Moore CD, Mora Lepin L, Mousseau J, Murphy M, Naples D, Navrer-Agasson A, Neely RK, Nowak J, Nunes M, Palamara O, Paolone V, Papadopoulou A, Papavassiliou V, Pate SF, Paudel A, Pavlovic Z, Piasetzky E, Ponce-Pinto ID, Prince S, Qian X, Raaf JL, Radeka V, Rafique A, Reggiani-Guzzo M, Ren L, Rice LCJ, Rochester L, Rodriguez Rondon J, Rogers HE, Rosenberg M, Ross-Lonergan M, Scanavini G, Schmitz DW, Schukraft A, Seligman W, Shaevitz MH, Sharankova R, Shi J, Siegel H, Sinclair J, Smith A, Snider EL, Soderberg M, Söldner-Rembold S, Spentzouris P, Spitz J, Stancari M, John JS, Strauss T, Sutton K, Sword-Fehlberg S, Szelc AM, Tagg N, Tang W, Terao K, Thorpe C, Totani D, Toups M, Tsai YT, Uchida MA, Usher T, Van De Pontseele W, Viren B, Weber M, Wei H, Williams Z, Wolbers S, Wongjirad T, Wospakrik M, Wresilo K, Wright N, Wu W, Yandel E, Yang T, Yarbrough G, Yates LE, Zeller GP, Zennamo J, Zhang C. Search for a Higgs Portal Scalar Decaying to Electron-Positron Pairs in the MicroBooNE Detector. Phys Rev Lett 2021; 127:151803. [PMID: 34678031 DOI: 10.1103/physrevlett.127.151803] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Revised: 08/11/2021] [Accepted: 09/10/2021] [Indexed: 06/13/2023]
Abstract
We present a search for the decays of a neutral scalar boson produced by kaons decaying at rest, in the context of the Higgs portal model, using the MicroBooNE detector. We analyze data triggered in time with the Fermilab NuMI neutrino beam spill, with an exposure of 1.93×10^{20} protons on target. We look for monoenergetic scalars that come from the direction of the NuMI hadron absorber, at a distance of 100 m from the detector, and decay to electron-positron pairs. We observe one candidate event, with a standard model background prediction of 1.9±0.8. We set an upper limit on the scalar-Higgs mixing angle of θ<(3.3-4.6)×10^{-4} at the 95% confidence level for scalar boson masses in the range (100-200) MeV/c^{2}. We exclude, at the 95% confidence level, the remaining model parameters required to explain the central value of a possible excess of K_{L}^{0}→π^{0}νν[over ¯] decays reported by the KOTO collaboration. We also provide a model-independent limit on a new boson X produced in K→πX decays and decaying to e^{+}e^{-}.
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Affiliation(s)
- P Abratenko
- Tufts University, Medford, Massachusetts 02155, USA
| | - R An
- Illinois Institute of Technology (IIT), Chicago, Illinois 60616, USA
| | - J Anthony
- University of Cambridge, Cambridge CB3 0HE, United Kingdom
| | - J Asaadi
- University of Texas, Arlington, Texas 76019, USA
| | - A Ashkenazi
- Massachusetts Institute of Technology (MIT), Cambridge, Massachusetts 02139, USA
- Tel Aviv University, Tel Aviv 69978, Israel
| | - S Balasubramanian
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - B Baller
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - C Barnes
- University of Michigan, Ann Arbor, Michigan 48109, USA
| | - G Barr
- University of Oxford, Oxford OX1 3RH, United Kingdom
| | - V Basque
- The University of Manchester, Manchester M13 9PL, United Kingdom
| | | | | | - S Berkman
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - A Bhanderi
- The University of Manchester, Manchester M13 9PL, United Kingdom
| | - A Bhat
- Syracuse University, Syracuse, New York 13244, USA
| | - M Bishai
- Brookhaven National Laboratory (BNL), Upton, New York 11973, USA
| | - A Blake
- Lancaster University, Lancaster LA1 4YW, United Kingdom
| | - T Bolton
- Kansas State University (KSU), Manhattan, Kansas 66506, USA
| | - J Y Book
- Harvard University, Cambridge, Massachusetts 02138, USA
| | - L Camilleri
- Columbia University, New York, New York 10027, USA
| | - D Caratelli
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - I Caro Terrazas
- Colorado State University, Fort Collins, Colorado 80523, USA
| | | | - F Cavanna
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - G Cerati
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - Y Chen
- Universität Bern, Bern CH-3012, Switzerland
| | - D Cianci
- Columbia University, New York, New York 10027, USA
| | - J M Conrad
- Massachusetts Institute of Technology (MIT), Cambridge, Massachusetts 02139, USA
| | - M Convery
- SLAC National Accelerator Laboratory, Menlo Park, California 94025, USA
| | - L Cooper-Troendle
- Wright Laboratory, Department of Physics, Yale University, New Haven, Connecticut 06520, USA
| | - J I Crespo-Anadón
- Centro de Investigaciones Energéticas, Medioambientales y Tecnológicas (CIEMAT), Madrid E-28040, Spain
| | - M Del Tutto
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - S R Dennis
- University of Cambridge, Cambridge CB3 0HE, United Kingdom
| | - D Devitt
- Lancaster University, Lancaster LA1 4YW, United Kingdom
| | - R Diurba
- University of Minnesota, Minneapolis, Minnesota 55455, USA
| | - R Dorrill
- Illinois Institute of Technology (IIT), Chicago, Illinois 60616, USA
| | - K Duffy
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - S Dytman
- University of Pittsburgh, Pittsburgh, Pennsylvania 15260, USA
| | - B Eberly
- University of Southern Maine, Portland, Maine 04104, USA
| | | | - J J Evans
- The University of Manchester, Manchester M13 9PL, United Kingdom
| | - R Fine
- Los Alamos National Laboratory (LANL), Los Alamos, New Mexico 87545, USA
| | - G A Fiorentini Aguirre
- South Dakota School of Mines and Technology (SDSMT), Rapid City, South Dakota 57701, USA
| | | | - B T Fleming
- Wright Laboratory, Department of Physics, Yale University, New Haven, Connecticut 06520, USA
| | - N Foppiani
- Harvard University, Cambridge, Massachusetts 02138, USA
| | - D Franco
- Wright Laboratory, Department of Physics, Yale University, New Haven, Connecticut 06520, USA
| | - A P Furmanski
- University of Minnesota, Minneapolis, Minnesota 55455, USA
| | | | - S Gardiner
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - G Ge
- Columbia University, New York, New York 10027, USA
| | - S Gollapinni
- Los Alamos National Laboratory (LANL), Los Alamos, New Mexico 87545, USA
- University of Tennessee, Knoxville, Tennessee 37996, USA
| | - O Goodwin
- The University of Manchester, Manchester M13 9PL, United Kingdom
| | - E Gramellini
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - P Green
- The University of Manchester, Manchester M13 9PL, United Kingdom
| | - H Greenlee
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - W Gu
- Brookhaven National Laboratory (BNL), Upton, New York 11973, USA
| | - R Guenette
- Harvard University, Cambridge, Massachusetts 02138, USA
| | - P Guzowski
- The University of Manchester, Manchester M13 9PL, United Kingdom
| | - L Hagaman
- Wright Laboratory, Department of Physics, Yale University, New Haven, Connecticut 06520, USA
| | - E Hall
- Massachusetts Institute of Technology (MIT), Cambridge, Massachusetts 02139, USA
| | - O Hen
- Massachusetts Institute of Technology (MIT), Cambridge, Massachusetts 02139, USA
| | | | - A Hourlier
- Massachusetts Institute of Technology (MIT), Cambridge, Massachusetts 02139, USA
| | - R Itay
- SLAC National Accelerator Laboratory, Menlo Park, California 94025, USA
| | - C James
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - X Ji
- Brookhaven National Laboratory (BNL), Upton, New York 11973, USA
| | - L Jiang
- Center for Neutrino Physics, Virginia Tech, Blacksburg, Virginia 24061, USA
| | - J H Jo
- Wright Laboratory, Department of Physics, Yale University, New Haven, Connecticut 06520, USA
| | - R A Johnson
- University of Cincinnati, Cincinnati, Ohio 45221, USA
| | - Y-J Jwa
- Columbia University, New York, New York 10027, USA
| | - N Kamp
- Massachusetts Institute of Technology (MIT), Cambridge, Massachusetts 02139, USA
| | - N Kaneshige
- University of California, Santa Barbara, California 93106, USA
| | - G Karagiorgi
- Columbia University, New York, New York 10027, USA
| | - W Ketchum
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - M Kirby
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - T Kobilarcik
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - I Kreslo
- Universität Bern, Bern CH-3012, Switzerland
| | - R LaZur
- Colorado State University, Fort Collins, Colorado 80523, USA
| | - I Lepetic
- Rutgers University, Piscataway, New Jersey 08854, USA
| | - K Li
- Wright Laboratory, Department of Physics, Yale University, New Haven, Connecticut 06520, USA
| | - Y Li
- Brookhaven National Laboratory (BNL), Upton, New York 11973, USA
| | - K Lin
- Los Alamos National Laboratory (LANL), Los Alamos, New Mexico 87545, USA
| | - B R Littlejohn
- Illinois Institute of Technology (IIT), Chicago, Illinois 60616, USA
| | - W C Louis
- Los Alamos National Laboratory (LANL), Los Alamos, New Mexico 87545, USA
| | - X Luo
- University of California, Santa Barbara, California 93106, USA
| | - K Manivannan
- Syracuse University, Syracuse, New York 13244, USA
| | - C Mariani
- Center for Neutrino Physics, Virginia Tech, Blacksburg, Virginia 24061, USA
| | - D Marsden
- The University of Manchester, Manchester M13 9PL, United Kingdom
| | - J Marshall
- University of Warwick, Coventry CV4 7AL, United Kingdom
| | - D A Martinez Caicedo
- South Dakota School of Mines and Technology (SDSMT), Rapid City, South Dakota 57701, USA
| | - K Mason
- Tufts University, Medford, Massachusetts 02155, USA
| | - A Mastbaum
- Rutgers University, Piscataway, New Jersey 08854, USA
| | - N McConkey
- The University of Manchester, Manchester M13 9PL, United Kingdom
| | - V Meddage
- Kansas State University (KSU), Manhattan, Kansas 66506, USA
| | - T Mettler
- Universität Bern, Bern CH-3012, Switzerland
| | - K Miller
- University of Chicago, Chicago, Illinois 60637, USA
| | - J Mills
- Tufts University, Medford, Massachusetts 02155, USA
| | - K Mistry
- The University of Manchester, Manchester M13 9PL, United Kingdom
| | - A Mogan
- University of Tennessee, Knoxville, Tennessee 37996, USA
| | - T Mohayai
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - J Moon
- Massachusetts Institute of Technology (MIT), Cambridge, Massachusetts 02139, USA
| | - M Mooney
- Colorado State University, Fort Collins, Colorado 80523, USA
| | - A F Moor
- University of Cambridge, Cambridge CB3 0HE, United Kingdom
| | - C D Moore
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - L Mora Lepin
- The University of Manchester, Manchester M13 9PL, United Kingdom
| | - J Mousseau
- University of Michigan, Ann Arbor, Michigan 48109, USA
| | - M Murphy
- Center for Neutrino Physics, Virginia Tech, Blacksburg, Virginia 24061, USA
| | - D Naples
- University of Pittsburgh, Pittsburgh, Pennsylvania 15260, USA
| | - A Navrer-Agasson
- The University of Manchester, Manchester M13 9PL, United Kingdom
| | - R K Neely
- Kansas State University (KSU), Manhattan, Kansas 66506, USA
| | - J Nowak
- Lancaster University, Lancaster LA1 4YW, United Kingdom
| | - M Nunes
- Syracuse University, Syracuse, New York 13244, USA
| | - O Palamara
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - V Paolone
- University of Pittsburgh, Pittsburgh, Pennsylvania 15260, USA
| | - A Papadopoulou
- Massachusetts Institute of Technology (MIT), Cambridge, Massachusetts 02139, USA
| | - V Papavassiliou
- New Mexico State University (NMSU), Las Cruces, New Mexico 88003, USA
| | - S F Pate
- New Mexico State University (NMSU), Las Cruces, New Mexico 88003, USA
| | - A Paudel
- Kansas State University (KSU), Manhattan, Kansas 66506, USA
| | - Z Pavlovic
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | | | - I D Ponce-Pinto
- Columbia University, New York, New York 10027, USA
- Wright Laboratory, Department of Physics, Yale University, New Haven, Connecticut 06520, USA
| | - S Prince
- Harvard University, Cambridge, Massachusetts 02138, USA
| | - X Qian
- Brookhaven National Laboratory (BNL), Upton, New York 11973, USA
| | - J L Raaf
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - V Radeka
- Brookhaven National Laboratory (BNL), Upton, New York 11973, USA
| | - A Rafique
- Kansas State University (KSU), Manhattan, Kansas 66506, USA
| | - M Reggiani-Guzzo
- The University of Manchester, Manchester M13 9PL, United Kingdom
| | - L Ren
- New Mexico State University (NMSU), Las Cruces, New Mexico 88003, USA
| | - L C J Rice
- University of Pittsburgh, Pittsburgh, Pennsylvania 15260, USA
| | - L Rochester
- SLAC National Accelerator Laboratory, Menlo Park, California 94025, USA
| | - J Rodriguez Rondon
- South Dakota School of Mines and Technology (SDSMT), Rapid City, South Dakota 57701, USA
| | - H E Rogers
- St. Catherine University, Saint Paul, Minnesota 55105, USA
| | - M Rosenberg
- University of Pittsburgh, Pittsburgh, Pennsylvania 15260, USA
| | | | - G Scanavini
- Wright Laboratory, Department of Physics, Yale University, New Haven, Connecticut 06520, USA
| | - D W Schmitz
- University of Chicago, Chicago, Illinois 60637, USA
| | - A Schukraft
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - W Seligman
- Columbia University, New York, New York 10027, USA
| | - M H Shaevitz
- Columbia University, New York, New York 10027, USA
| | - R Sharankova
- Tufts University, Medford, Massachusetts 02155, USA
| | - J Shi
- University of Cambridge, Cambridge CB3 0HE, United Kingdom
| | - H Siegel
- Columbia University, New York, New York 10027, USA
| | - J Sinclair
- Universität Bern, Bern CH-3012, Switzerland
| | - A Smith
- University of Cambridge, Cambridge CB3 0HE, United Kingdom
| | - E L Snider
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - M Soderberg
- Syracuse University, Syracuse, New York 13244, USA
| | | | - P Spentzouris
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - J Spitz
- University of Michigan, Ann Arbor, Michigan 48109, USA
| | - M Stancari
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - J St John
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - T Strauss
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - K Sutton
- Columbia University, New York, New York 10027, USA
| | - S Sword-Fehlberg
- New Mexico State University (NMSU), Las Cruces, New Mexico 88003, USA
| | - A M Szelc
- University of Edinburgh, Edinburgh EH9 3FD, United Kingdom
- The University of Manchester, Manchester M13 9PL, United Kingdom
| | - N Tagg
- Otterbein University, Westerville, Ohio 43081, USA
| | - W Tang
- University of Tennessee, Knoxville, Tennessee 37996, USA
| | - K Terao
- SLAC National Accelerator Laboratory, Menlo Park, California 94025, USA
| | - C Thorpe
- Lancaster University, Lancaster LA1 4YW, United Kingdom
| | - D Totani
- University of California, Santa Barbara, California 93106, USA
| | - M Toups
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - Y-T Tsai
- SLAC National Accelerator Laboratory, Menlo Park, California 94025, USA
| | - M A Uchida
- University of Cambridge, Cambridge CB3 0HE, United Kingdom
| | - T Usher
- SLAC National Accelerator Laboratory, Menlo Park, California 94025, USA
| | - W Van De Pontseele
- Harvard University, Cambridge, Massachusetts 02138, USA
- University of Oxford, Oxford OX1 3RH, United Kingdom
| | - B Viren
- Brookhaven National Laboratory (BNL), Upton, New York 11973, USA
| | - M Weber
- Universität Bern, Bern CH-3012, Switzerland
| | - H Wei
- Brookhaven National Laboratory (BNL), Upton, New York 11973, USA
| | - Z Williams
- University of Texas, Arlington, Texas 76019, USA
| | - S Wolbers
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - T Wongjirad
- Tufts University, Medford, Massachusetts 02155, USA
| | - M Wospakrik
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - K Wresilo
- University of Cambridge, Cambridge CB3 0HE, United Kingdom
| | - N Wright
- Massachusetts Institute of Technology (MIT), Cambridge, Massachusetts 02139, USA
| | - W Wu
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - E Yandel
- University of California, Santa Barbara, California 93106, USA
| | - T Yang
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - G Yarbrough
- University of Tennessee, Knoxville, Tennessee 37996, USA
| | - L E Yates
- Massachusetts Institute of Technology (MIT), Cambridge, Massachusetts 02139, USA
| | - G P Zeller
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - J Zennamo
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - C Zhang
- Brookhaven National Laboratory (BNL), Upton, New York 11973, USA
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Abratenko P, Alrashed M, An R, Anthony J, Asaadi J, Ashkenazi A, Balasubramanian S, Baller B, Barnes C, Barr G, Basque V, Bathe-Peters L, Benevides Rodrigues O, Berkman S, Bhanderi A, Bhat A, Bishai M, Blake A, Bolton T, Camilleri L, Caratelli D, Caro Terrazas I, Castillo Fernandez R, Cavanna F, Cerati G, Chen Y, Church E, Cianci D, Conrad J, Convery M, Cooper-Troendle L, Crespo-Anadón J, Del Tutto M, Dennis S, Devitt D, Diurba R, Domine L, Dorrill R, Duffy K, Dytman S, Eberly B, Ereditato A, Escudero Sanchez L, Evans J, Fiorentini Aguirre G, Fitzpatrick R, Fleming B, Foppiani N, Franco D, Furmanski A, Garcia-Gamez D, Gardiner S, Ge G, Gollapinni S, Goodwin O, Gramellini E, Green P, Greenlee H, Gu W, Guenette R, Guzowski P, Hagaman L, Hall E, Hamilton P, Hen O, Hill C, Horton-Smith G, Hourlier A, Itay R, James C, Jan de Vries J, Ji X, Jiang L, Jo J, Johnson R, Jwa YJ, Kamp N, Kaneshige N, Karagiorgi G, Ketchum W, Kirby B, Kirby M, Kobilarcik T, Kreslo I, LaZur R, Lepetic I, Li K, Li Y, Littlejohn B, Lorca D, Louis W, Luo X, Marchionni A, Mariani C, Marsden D, Marshall J, Martin-Albo J, Martinez Caicedo D, Mason K, Mastbaum A, McConkey N, Meddage V, Mettler T, Miller K, Mills J, Mistry K, Mogan A, Mohayai T, Moon J, Mooney M, Moor A, Moore C, Mora Lepin L, Mousseau J, Murphy M, Naples D, Navrer-Agasson A, Neely R, Nienaber P, Nowak J, Palamara O, Paolone V, Papadopoulou A, Papavassiliou V, Pate S, Paudel A, Pavlovic Z, Piasetzky E, Ponce-Pinto I, Porzio D, Prince S, Qian X, Raaf J, Radeka V, Rafique A, Reggiani-Guzzo M, Ren L, Rochester L, Rodriguez Rondon J, Rogers H, Rosenberg M, Ross-Lonergan M, Russell B, Scanavini G, Schmitz D, Schukraft A, Seligman W, Shaevitz M, Sharankova R, Sinclair J, Smith A, Snider E, Soderberg M, Söldner-Rembold S, Soleti S, Spentzouris P, Spitz J, Stancari M, John J, Strauss T, Sutton K, Sword-Fehlberg S, Szelc A, Tagg N, Tang W, Terao K, Thorpe C, Toups M, Tsai YT, Uchida M, Usher T, Van De Pontseele W, Viren B, Weber M, Wei H, Williams Z, Wolbers S, Wongjirad T, Wospakrik M, Wu W, Yandel E, Yang T, Yarbrough G, Yates L, Zeller G, Zennamo J, Zhang C. Measurement of the flux-averaged inclusive charged-current electron neutrino and antineutrino cross section on argon using the NuMI beam and the MicroBooNE detector. Int J Clin Exp Med 2021. [DOI: 10.1103/physrevd.104.052002] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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Tree A, Hall E, Ostler P, van der Voet H, Loblaw A, Chu W, Ford D, Tolan S, Jain S, Martin A, Staffurth J, Camilleri P, Kancherla K, Frew J, Brand D, Chan A, Dayes I, Brown S, Pugh J, Burnett S, Dufton A, Griffin C, Mahmud M, Naismith O, van As N, of the O. OC-0289 Comparison of side effects at 2 years in the randomised PACE-B trial (SBRT vs standard radiotherapy). Radiother Oncol 2021. [DOI: 10.1016/s0167-8140(21)06839-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Huddart R, Hafeez S, Omar A, Choudhury A, Birtle A, Syndikus I, Hindson B, Varughese M, Henry A, McLaren D, Foroud F, Webster A, McNair H, Tolentino A, Webster L, Gribble H, Philipps L, Nikapota A, Parikh O, Alonzi R, Mahmood R, Hilman S, Rimmer Y, Griffin C, Hall E. OC-0513 Acute toxicity of hypo- and conventionally-fractionated radiosensitised bladder radiotherapy. Radiother Oncol 2021. [DOI: 10.1016/s0167-8140(21)06939-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Webster A, Hafeez S, Lewis R, Griffins C, Warren-Oseni K, Patel E, Hansen VN, Hall E, Huddart R, Miles E, McNair HA. The Development of Therapeutic Radiographers in Imaging and Adaptive Radiotherapy Through Clinical Trial Quality Assurance. Clin Oncol (R Coll Radiol) 2021; 33:461-467. [PMID: 33766503 DOI: 10.1016/j.clon.2021.02.009] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Revised: 01/29/2021] [Accepted: 02/17/2021] [Indexed: 02/06/2023]
Abstract
AIMS Adaptive radiotherapy (ART) is an emerging advanced treatment option for bladder cancer patients. Therapeutic radiographers (RTTs) are central to the successful delivery of this treatment. The purpose of this work was to evaluate the image-guided radiotherapy (IGRT) and ART experience of RTTs before participating in the RAIDER trial. A plan of the day (PoD) quality assurance programme was then implemented. Finally, the post-trial experience of RTTs was evaluated, together with the impact of trial quality assurance participation on their routine practice. MATERIALS AND METHODS A pre-trial questionnaire to assess the experience of the RTT staff group in IGRT and ART in bladder cancer was sent to each centre. Responses were grouped according to experience. The PoD quality assurance programme was implemented, and the RAIDER trial commenced. During stage 1 of the trial, RTTs reported difficulties in delivering PoD and the quality assurance programme was updated accordingly. A follow-up questionnaire was sent assessing experience in IGRT and ART post-trial. Any changes in routine practice were also recorded. RESULTS The experience of RTTs in IGRT and ART pre-trial varied. For centres deemed to have RTTs with more experience, the initial PoD quality assurance programme was streamlined. For RTTs without ART experience, the full quality assurance programme was implemented, of which 508 RTTs completed. The quality assurance programme was updated (as the trial recruited) and it was mandated that at least one representative RTT (regardless of pre-trial experience) participated in the update in real-time. The purpose of the updated quality assurance programme was to provide further support to RTTs in delivering a complex treatment. Engagement with the updated quality assurance programme was high, with RTTs in 24/33 centres participating in the real-time online workshop. All 33 UK centres reported all RTTs reviewed the updated training offline. Post-trial, the RTTs' experience in IGRT and ART was increased. CONCLUSION Overall, 508 RTTs undertook the PoD quality assurance programme. There was a high engagement of RTTs in the PoD quality assurance programme and trial. RTTs increased their experience in IGRT and ART and subsequently updated their practice for bladder cancer and other treatment sites.
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Affiliation(s)
- A Webster
- National Radiotherapy Trials Quality Assurance Group, Mount Vernon Cancer Centre, London, UK.
| | - S Hafeez
- Division of Radiotherapy and Imaging, The Institute of Cancer Research, London, UK; The Royal Marsden NHS Foundation Trust, London, UK
| | - R Lewis
- Clinical Trials and Statistics Unit, The Institute of Cancer Research, London, UK
| | - C Griffins
- Clinical Trials and Statistics Unit, The Institute of Cancer Research, London, UK
| | | | - E Patel
- University College Hospital, London, UK
| | - V N Hansen
- Odense University Hospital, Odense, Denmark
| | - E Hall
- Clinical Trials and Statistics Unit, The Institute of Cancer Research, London, UK
| | - R Huddart
- Division of Radiotherapy and Imaging, The Institute of Cancer Research, London, UK; The Royal Marsden NHS Foundation Trust, London, UK
| | - E Miles
- National Radiotherapy Trials Quality Assurance Group, Mount Vernon Cancer Centre, London, UK
| | - H A McNair
- Division of Radiotherapy and Imaging, The Institute of Cancer Research, London, UK; The Royal Marsden NHS Foundation Trust, London, UK
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Hafeez S, Lewis R, Hall E, Huddart R. Advancing Radiotherapy for Bladder Cancer: Randomised Phase II Trial of Adaptive Image-guided Standard or Dose-escalated Tumour Boost Radiotherapy (RAIDER). Clin Oncol (R Coll Radiol) 2021; 33:e251-e256. [PMID: 33766502 DOI: 10.1016/j.clon.2021.02.012] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Revised: 01/18/2021] [Accepted: 02/19/2021] [Indexed: 11/21/2022]
Affiliation(s)
- S Hafeez
- Division of Radiotherapy and Imaging, The Institute of Cancer Research, London, UK; Department of Radiotherapy, The Royal Marsden NHS Foundation Trust, London, UK.
| | - R Lewis
- Clinical Trials and Statistics Unit, The Institute of Cancer Research, London, UKS
| | - E Hall
- Clinical Trials and Statistics Unit, The Institute of Cancer Research, London, UKS
| | - R Huddart
- Division of Radiotherapy and Imaging, The Institute of Cancer Research, London, UK; Department of Radiotherapy, The Royal Marsden NHS Foundation Trust, London, UK
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Brandon C, Stewart L, Hall E, Siddique M, Wohlrab K. 37 The latzko procedure: A classic approach to vesicovaginal fistula repair. Am J Obstet Gynecol 2021. [DOI: 10.1016/j.ajog.2021.04.181] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Abratenko P, Alrashed M, An R, Anthony J, Asaadi J, Ashkenazi A, Balasubramanian S, Baller B, Barnes C, Barr G, Basque V, Bathe-Peters L, Benevides Rodrigues O, Berkman S, Bhanderi A, Bhat A, Bishai M, Blake A, Bolton T, Camilleri L, Caratelli D, Caro Terrazas I, Castillo Fernandez R, Cavanna F, Cerati G, Chen Y, Church E, Cianci D, Conrad J, Convery M, Cooper-Troendle L, Crespo-Anadón J, Del Tutto M, Devitt D, Diurba R, Domine L, Dorrill R, Duffy K, Dytman S, Eberly B, Ereditato A, Escudero Sanchez L, Evans J, Fiorentini Aguirre G, Fitzpatrick R, Fleming B, Foppiani N, Franco D, Furmanski A, Garcia-Gamez D, Gardiner S, Ge G, Gollapinni S, Goodwin O, Gramellini E, Green P, Greenlee H, Gu W, Guenette R, Guzowski P, Hall E, Hamilton P, Hen O, Horton-Smith G, Hourlier A, Huang EC, Itay R, James C, Jan de Vries J, Ji X, Jiang L, Jo J, Johnson R, Jwa YJ, Kamp N, Karagiorgi G, Ketchum W, Kirby B, Kirby M, Kobilarcik T, Kreslo I, LaZur R, Lepetic I, Li K, Li Y, Littlejohn B, Lorca D, Louis W, Luo X, Marchionni A, Marcocci S, Mariani C, Marsden D, Marshall J, Martin-Albo J, Martinez Caicedo D, Mason K, Mastbaum A, McConkey N, Meddage V, Mettler T, Miller K, Mills J, Mistry K, Mogan A, Mohayai T, Moon J, Mooney M, Moor A, Moore C, Mousseau J, Murphy M, Naples D, Navrer-Agasson A, Neely R, Nienaber P, Nowak J, Palamara O, Paolone V, Papadopoulou A, Papavassiliou V, Pate S, Paudel A, Pavlovic Z, Piasetzky E, Ponce-Pinto I, Porzio D, Prince S, Qian X, Raaf J, Radeka V, Rafique A, Reggiani-Guzzo M, Ren L, Rochester L, Rodriguez Rondon J, Rogers H, Rosenberg M, Ross-Lonergan M, Russell B, Scanavini G, Schmitz D, Schukraft A, Shaevitz M, Sharankova R, Sinclair J, Smith A, Snider E, Soderberg M, Söldner-Rembold S, Soleti S, Spentzouris P, Spitz J, Stancari M, John J, Strauss T, Sutton K, Sword-Fehlberg S, Szelc A, Tagg N, Tang W, Terao K, Thorpe C, Toups M, Tsai YT, Tufanli S, Uchida M, Usher T, Van De Pontseele W, Viren B, Weber M, Wei H, Williams Z, Wolbers S, Wongjirad T, Wospakrik M, Wu W, Yang T, Yarbrough G, Yates L, Zeller G, Zennamo J, Zhang C. Convolutional neural network for multiple particle identification in the MicroBooNE liquid argon time projection chamber. Int J Clin Exp Med 2021. [DOI: 10.1103/physrevd.103.092003] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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Akaike T, Doolittle-Amieva C, Lachance K, Fonseca A, Church C, Hall E, Nghiem P, Zaba L. 675 Utility of circulating tumor DNA testing in Merkel cell carcinoma patients. J Invest Dermatol 2021. [DOI: 10.1016/j.jid.2021.02.705] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Hafeez S, Lewis R, Griffin C, Hall E, Huddart R. Failing to Close the Gap Between Evidence and Clinical Practice in Radical Bladder Cancer Radiotherapy. Clin Oncol (R Coll Radiol) 2021; 33:46-49. [PMID: 32762980 DOI: 10.1016/j.clon.2020.07.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2020] [Revised: 06/12/2020] [Accepted: 07/01/2020] [Indexed: 12/18/2022]
Affiliation(s)
- S Hafeez
- Department of Radiotherapy and Imaging, The Institute of Cancer Research, London, UK; The Royal Marsden NHS Foundation Trust, London, UK.
| | - R Lewis
- Clinical Trials and Statistics Unit, The Institute of Cancer Research, London, UK
| | - C Griffin
- Clinical Trials and Statistics Unit, The Institute of Cancer Research, London, UK
| | - E Hall
- Clinical Trials and Statistics Unit, The Institute of Cancer Research, London, UK
| | - R Huddart
- Department of Radiotherapy and Imaging, The Institute of Cancer Research, London, UK; The Royal Marsden NHS Foundation Trust, London, UK
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Abratenko P, Alrashed M, An R, Anthony J, Asaadi J, Ashkenazi A, Balasubramanian S, Baller B, Barnes C, Barr G, Basque V, Bathe-Peters L, Benevides Rodrigues O, Berkman S, Bhanderi A, Bhat A, Bishai M, Blake A, Bolton T, Camilleri L, Caratelli D, Caro Terrazas I, Castillo Fernandez R, Cavanna F, Cerati G, Chen Y, Church E, Cianci D, Cohen EO, Conrad JM, Convery M, Cooper-Troendle L, Crespo-Anadón JI, Del Tutto M, Devitt D, Diurba R, Domine L, Dorrill R, Duffy K, Dytman S, Eberly B, Ereditato A, Escudero Sanchez L, Evans JJ, Fiorentini Aguirre GA, Fitzpatrick RS, Fleming BT, Foppiani N, Franco D, Furmanski AP, Garcia-Gamez D, Gardiner S, Gollapinni S, Goodwin O, Gramellini E, Green P, Greenlee H, Gu L, Gu W, Guenette R, Guzowski P, Hall E, Hamilton P, Hen O, Horton-Smith GA, Hourlier A, Huang EC, Itay R, James C, Jan de Vries J, Ji X, Jiang L, Jo JH, Johnson RA, Jwa YJ, Kamp N, Karagiorgi G, Ketchum W, Kirby B, Kirby M, Kobilarcik T, Kreslo I, LaZur R, Lepetic I, Li K, Li Y, Littlejohn BR, Lorca D, Louis WC, Luo X, Marchionni A, Marcocci S, Mariani C, Marsden D, Marshall J, Martin-Albo J, Martinez Caicedo DA, Mason K, Mastbaum A, McConkey N, Meddage V, Mettler T, Miller K, Mills J, Mistry K, Mogan A, Mohayai T, Moon J, Mooney M, Moor AF, Moore CD, Mousseau J, Murphy M, Naples D, Navrer-Agasson A, Neely RK, Nienaber P, Nowak J, Palamara O, Paolone V, Papadopoulou A, Papavassiliou V, Pate SF, Paudel A, Pavlovic Z, Piasetzky E, Ponce-Pinto ID, Porzio D, Prince S, Qian X, Raaf JL, Radeka V, Rafique A, Reggiani-Guzzo M, Ren L, Rochester L, Rodriguez Rondon J, Rogers HE, Rosenberg M, Ross-Lonergan M, Russell B, Scanavini G, Schmitz DW, Schukraft A, Shaevitz MH, Sharankova R, Sinclair J, Smith A, Snider EL, Soderberg M, Söldner-Rembold S, Soleti SR, Spentzouris P, Spitz J, Stancari M, John JS, Strauss T, Sutton K, Sword-Fehlberg S, Szelc AM, Tagg N, Tang W, Terao K, Thornton RT, Thorpe C, Toups M, Tsai YT, Tufanli S, Uchida MA, Usher T, Van De Pontseele W, Van de Water RG, Viren B, Weber M, Wei H, Williams Z, Wolbers S, Wongjirad T, Wospakrik M, Wu W, Yang T, Yarbrough G, Yates LE, Zeller GP, Zennamo J, Zhang C. First Measurement of Differential Charged Current Quasielasticlike ν_{μ}-Argon Scattering Cross Sections with the MicroBooNE Detector. Phys Rev Lett 2020; 125:201803. [PMID: 33258649 DOI: 10.1103/physrevlett.125.201803] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Revised: 09/11/2020] [Accepted: 10/02/2020] [Indexed: 06/12/2023]
Abstract
We report on the first measurement of flux-integrated single differential cross sections for charged-current (CC) muon neutrino (ν_{μ}) scattering on argon with a muon and a proton in the final state, ^{40}Ar (ν_{μ},μp)X. The measurement was carried out using the Booster Neutrino Beam at Fermi National Accelerator Laboratory and the MicroBooNE liquid argon time projection chamber detector with an exposure of 4.59×10^{19} protons on target. Events are selected to enhance the contribution of CC quasielastic (CCQE) interactions. The data are reported in terms of a total cross section as well as single differential cross sections in final state muon and proton kinematics. We measure the integrated per-nucleus CCQE-like cross section (i.e., for interactions leading to a muon, one proton, and no pions above detection threshold) of (4.93±0.76_{stat}±1.29_{sys})×10^{-38} cm^{2}, in good agreement with theoretical calculations. The single differential cross sections are also in overall good agreement with theoretical predictions, except at very forward muon scattering angles that correspond to low-momentum-transfer events.
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Affiliation(s)
- P Abratenko
- Tufts University, Medford, Massachusetts 02155, USA
| | - M Alrashed
- Kansas State University (KSU), Manhattan, Kansas 66506, USA
| | - R An
- Illinois Institute of Technology (IIT), Chicago, Illinois 60616, USA
| | - J Anthony
- University of Cambridge, Cambridge CB3 0HE, United Kingdom
| | - J Asaadi
- University of Texas, Arlington, Texas 76019, USA
| | - A Ashkenazi
- Massachusetts Institute of Technology (MIT), Cambridge, Massachusetts 02139, USA
| | - S Balasubramanian
- Department of Physics, Wright Laboratory, Yale University, New Haven, Connecticut 06520, USA
| | - B Baller
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - C Barnes
- University of Michigan, Ann Arbor, Michigan 48109, USA
| | - G Barr
- University of Oxford, Oxford OX1 3RH, United Kingdom
| | - V Basque
- The University of Manchester, Manchester M13 9PL, United Kingdom
| | | | | | - S Berkman
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - A Bhanderi
- The University of Manchester, Manchester M13 9PL, United Kingdom
| | - A Bhat
- Syracuse University, Syracuse, New York 13244, USA
| | - M Bishai
- Brookhaven National Laboratory (BNL), Upton, New York 11973, USA
| | - A Blake
- Lancaster University, Lancaster LA1 4YW, United Kingdom
| | - T Bolton
- Kansas State University (KSU), Manhattan, Kansas 66506, USA
| | - L Camilleri
- Columbia University, New York, New York 10027, USA
| | - D Caratelli
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - I Caro Terrazas
- Colorado State University, Fort Collins, Colorado 80523, USA
| | | | - F Cavanna
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - G Cerati
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - Y Chen
- Universität Bern, Bern CH-3012, Switzerland
| | - E Church
- Pacific Northwest National Laboratory (PNNL), Richland, Washington 99352, USA
| | - D Cianci
- Columbia University, New York, New York 10027, USA
| | - E O Cohen
- Tel Aviv University, Tel Aviv, Israel 69978
| | - J M Conrad
- Massachusetts Institute of Technology (MIT), Cambridge, Massachusetts 02139, USA
| | - M Convery
- SLAC National Accelerator Laboratory, Menlo Park, California 94025, USA
| | - L Cooper-Troendle
- Department of Physics, Wright Laboratory, Yale University, New Haven, Connecticut 06520, USA
| | | | - M Del Tutto
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - D Devitt
- Lancaster University, Lancaster LA1 4YW, United Kingdom
| | - R Diurba
- University of Minnesota, Minneapolis, Minnesota 55455, USA
| | - L Domine
- SLAC National Accelerator Laboratory, Menlo Park, California 94025, USA
| | - R Dorrill
- Illinois Institute of Technology (IIT), Chicago, Illinois 60616, USA
| | - K Duffy
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - S Dytman
- University of Pittsburgh, Pittsburgh, Pennsylvania 15260, USA
| | - B Eberly
- Davidson College, Davidson, North Carolina 28035, USA
| | | | | | - J J Evans
- The University of Manchester, Manchester M13 9PL, United Kingdom
| | - G A Fiorentini Aguirre
- South Dakota School of Mines and Technology (SDSMT), Rapid City, South Dakota 57701, USA
| | | | - B T Fleming
- Department of Physics, Wright Laboratory, Yale University, New Haven, Connecticut 06520, USA
| | - N Foppiani
- Harvard University, Cambridge, Massachusetts 02138, USA
| | - D Franco
- Department of Physics, Wright Laboratory, Yale University, New Haven, Connecticut 06520, USA
| | - A P Furmanski
- University of Minnesota, Minneapolis, Minnesota 55455, USA
| | | | - S Gardiner
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - S Gollapinni
- Los Alamos National Laboratory (LANL), Los Alamos, New Mexico 87545, USA
- University of Tennessee, Knoxville, Tennessee 37996, USA
| | - O Goodwin
- The University of Manchester, Manchester M13 9PL, United Kingdom
| | - E Gramellini
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - P Green
- The University of Manchester, Manchester M13 9PL, United Kingdom
| | - H Greenlee
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - L Gu
- Center for Neutrino Physics, Virginia Tech, Blacksburg, Virginia 24061, USA
| | - W Gu
- Brookhaven National Laboratory (BNL), Upton, New York 11973, USA
| | - R Guenette
- Harvard University, Cambridge, Massachusetts 02138, USA
| | - P Guzowski
- The University of Manchester, Manchester M13 9PL, United Kingdom
| | - E Hall
- Massachusetts Institute of Technology (MIT), Cambridge, Massachusetts 02139, USA
| | - P Hamilton
- Syracuse University, Syracuse, New York 13244, USA
| | - O Hen
- Massachusetts Institute of Technology (MIT), Cambridge, Massachusetts 02139, USA
| | | | - A Hourlier
- Massachusetts Institute of Technology (MIT), Cambridge, Massachusetts 02139, USA
| | - E-C Huang
- Los Alamos National Laboratory (LANL), Los Alamos, New Mexico 87545, USA
| | - R Itay
- SLAC National Accelerator Laboratory, Menlo Park, California 94025, USA
| | - C James
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - J Jan de Vries
- University of Cambridge, Cambridge CB3 0HE, United Kingdom
| | - X Ji
- Brookhaven National Laboratory (BNL), Upton, New York 11973, USA
| | - L Jiang
- Center for Neutrino Physics, Virginia Tech, Blacksburg, Virginia 24061, USA
| | - J H Jo
- Department of Physics, Wright Laboratory, Yale University, New Haven, Connecticut 06520, USA
| | - R A Johnson
- University of Cincinnati, Cincinnati, Ohio 45221, USA
| | - Y-J Jwa
- Columbia University, New York, New York 10027, USA
| | - N Kamp
- Massachusetts Institute of Technology (MIT), Cambridge, Massachusetts 02139, USA
| | - G Karagiorgi
- Columbia University, New York, New York 10027, USA
| | - W Ketchum
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - B Kirby
- Brookhaven National Laboratory (BNL), Upton, New York 11973, USA
| | - M Kirby
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - T Kobilarcik
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - I Kreslo
- Universität Bern, Bern CH-3012, Switzerland
| | - R LaZur
- Colorado State University, Fort Collins, Colorado 80523, USA
| | - I Lepetic
- Illinois Institute of Technology (IIT), Chicago, Illinois 60616, USA
| | - K Li
- Department of Physics, Wright Laboratory, Yale University, New Haven, Connecticut 06520, USA
| | - Y Li
- Brookhaven National Laboratory (BNL), Upton, New York 11973, USA
| | - B R Littlejohn
- Illinois Institute of Technology (IIT), Chicago, Illinois 60616, USA
| | - D Lorca
- Universität Bern, Bern CH-3012, Switzerland
| | - W C Louis
- Los Alamos National Laboratory (LANL), Los Alamos, New Mexico 87545, USA
| | - X Luo
- University of California, Santa Barbara, California 93106, USA
| | - A Marchionni
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - S Marcocci
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - C Mariani
- Center for Neutrino Physics, Virginia Tech, Blacksburg, Virginia 24061, USA
| | - D Marsden
- The University of Manchester, Manchester M13 9PL, United Kingdom
| | - J Marshall
- University of Warwick, Coventry CV4 7AL, United Kingdom
| | - J Martin-Albo
- Harvard University, Cambridge, Massachusetts 02138, USA
| | - D A Martinez Caicedo
- South Dakota School of Mines and Technology (SDSMT), Rapid City, South Dakota 57701, USA
| | - K Mason
- Tufts University, Medford, Massachusetts 02155, USA
| | - A Mastbaum
- Rutgers University, Piscataway, New Jersey 08854, USA
| | - N McConkey
- The University of Manchester, Manchester M13 9PL, United Kingdom
| | - V Meddage
- Kansas State University (KSU), Manhattan, Kansas 66506, USA
| | - T Mettler
- Universität Bern, Bern CH-3012, Switzerland
| | - K Miller
- University of Chicago, Chicago, Illinois 60637, USA
| | - J Mills
- Tufts University, Medford, Massachusetts 02155, USA
| | - K Mistry
- The University of Manchester, Manchester M13 9PL, United Kingdom
| | - A Mogan
- University of Tennessee, Knoxville, Tennessee 37996, USA
| | - T Mohayai
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - J Moon
- Massachusetts Institute of Technology (MIT), Cambridge, Massachusetts 02139, USA
| | - M Mooney
- Colorado State University, Fort Collins, Colorado 80523, USA
| | - A F Moor
- University of Cambridge, Cambridge CB3 0HE, United Kingdom
| | - C D Moore
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - J Mousseau
- University of Michigan, Ann Arbor, Michigan 48109, USA
| | - M Murphy
- Center for Neutrino Physics, Virginia Tech, Blacksburg, Virginia 24061, USA
| | - D Naples
- University of Pittsburgh, Pittsburgh, Pennsylvania 15260, USA
| | - A Navrer-Agasson
- The University of Manchester, Manchester M13 9PL, United Kingdom
| | - R K Neely
- Kansas State University (KSU), Manhattan, Kansas 66506, USA
| | - P Nienaber
- Saint Mary's University of Minnesota, Winona, Minnesota 55987, USA
| | - J Nowak
- Lancaster University, Lancaster LA1 4YW, United Kingdom
| | - O Palamara
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - V Paolone
- University of Pittsburgh, Pittsburgh, Pennsylvania 15260, USA
| | - A Papadopoulou
- Massachusetts Institute of Technology (MIT), Cambridge, Massachusetts 02139, USA
| | - V Papavassiliou
- New Mexico State University (NMSU), Las Cruces, New Mexico 88003, USA
| | - S F Pate
- New Mexico State University (NMSU), Las Cruces, New Mexico 88003, USA
| | - A Paudel
- Kansas State University (KSU), Manhattan, Kansas 66506, USA
| | - Z Pavlovic
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | | | | | - D Porzio
- The University of Manchester, Manchester M13 9PL, United Kingdom
| | - S Prince
- Harvard University, Cambridge, Massachusetts 02138, USA
| | - X Qian
- Brookhaven National Laboratory (BNL), Upton, New York 11973, USA
| | - J L Raaf
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - V Radeka
- Brookhaven National Laboratory (BNL), Upton, New York 11973, USA
| | - A Rafique
- Kansas State University (KSU), Manhattan, Kansas 66506, USA
| | - M Reggiani-Guzzo
- The University of Manchester, Manchester M13 9PL, United Kingdom
| | - L Ren
- New Mexico State University (NMSU), Las Cruces, New Mexico 88003, USA
| | - L Rochester
- SLAC National Accelerator Laboratory, Menlo Park, California 94025, USA
| | - J Rodriguez Rondon
- South Dakota School of Mines and Technology (SDSMT), Rapid City, South Dakota 57701, USA
| | - H E Rogers
- St. Catherine University, Saint Paul, Minnesota 55105, USA
| | - M Rosenberg
- University of Pittsburgh, Pittsburgh, Pennsylvania 15260, USA
| | | | - B Russell
- Department of Physics, Wright Laboratory, Yale University, New Haven, Connecticut 06520, USA
| | - G Scanavini
- Department of Physics, Wright Laboratory, Yale University, New Haven, Connecticut 06520, USA
| | - D W Schmitz
- University of Chicago, Chicago, Illinois 60637, USA
| | - A Schukraft
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - M H Shaevitz
- Columbia University, New York, New York 10027, USA
| | - R Sharankova
- Tufts University, Medford, Massachusetts 02155, USA
| | - J Sinclair
- Universität Bern, Bern CH-3012, Switzerland
| | - A Smith
- University of Cambridge, Cambridge CB3 0HE, United Kingdom
| | - E L Snider
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - M Soderberg
- Syracuse University, Syracuse, New York 13244, USA
| | | | - S R Soleti
- Harvard University, Cambridge, Massachusetts 02138, USA
- University of Oxford, Oxford OX1 3RH, United Kingdom
| | - P Spentzouris
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - J Spitz
- University of Michigan, Ann Arbor, Michigan 48109, USA
| | - M Stancari
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - J St John
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - T Strauss
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - K Sutton
- Columbia University, New York, New York 10027, USA
| | - S Sword-Fehlberg
- New Mexico State University (NMSU), Las Cruces, New Mexico 88003, USA
| | - A M Szelc
- The University of Manchester, Manchester M13 9PL, United Kingdom
| | - N Tagg
- Otterbein University, Westerville, Ohio 43081, USA
| | - W Tang
- University of Tennessee, Knoxville, Tennessee 37996, USA
| | - K Terao
- SLAC National Accelerator Laboratory, Menlo Park, California 94025, USA
| | - R T Thornton
- Los Alamos National Laboratory (LANL), Los Alamos, New Mexico 87545, USA
| | - C Thorpe
- Lancaster University, Lancaster LA1 4YW, United Kingdom
| | - M Toups
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - Y-T Tsai
- SLAC National Accelerator Laboratory, Menlo Park, California 94025, USA
| | - S Tufanli
- Department of Physics, Wright Laboratory, Yale University, New Haven, Connecticut 06520, USA
| | - M A Uchida
- University of Cambridge, Cambridge CB3 0HE, United Kingdom
| | - T Usher
- SLAC National Accelerator Laboratory, Menlo Park, California 94025, USA
| | - W Van De Pontseele
- Harvard University, Cambridge, Massachusetts 02138, USA
- University of Oxford, Oxford OX1 3RH, United Kingdom
| | - R G Van de Water
- Los Alamos National Laboratory (LANL), Los Alamos, New Mexico 87545, USA
| | - B Viren
- Brookhaven National Laboratory (BNL), Upton, New York 11973, USA
| | - M Weber
- Universität Bern, Bern CH-3012, Switzerland
| | - H Wei
- Brookhaven National Laboratory (BNL), Upton, New York 11973, USA
| | - Z Williams
- University of Texas, Arlington, Texas 76019, USA
| | - S Wolbers
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - T Wongjirad
- Tufts University, Medford, Massachusetts 02155, USA
| | - M Wospakrik
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - W Wu
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - T Yang
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - G Yarbrough
- University of Tennessee, Knoxville, Tennessee 37996, USA
| | - L E Yates
- Massachusetts Institute of Technology (MIT), Cambridge, Massachusetts 02139, USA
| | - G P Zeller
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - J Zennamo
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - C Zhang
- Brookhaven National Laboratory (BNL), Upton, New York 11973, USA
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Hunt A, Hanson I, Dunlop A, Barnes H, Bower L, Chick J, Cruickshank C, Hall E, Herbert T, Lawes R, McQuaid D, McNair H, Mitchell A, Mohajer J, Morgan T, Oelfke U, Smith G, Nill S, Huddart R, Hafeez S. Feasibility of magnetic resonance guided radiotherapy for the treatment of bladder cancer. Clin Transl Radiat Oncol 2020; 25:46-51. [PMID: 33015380 PMCID: PMC7522378 DOI: 10.1016/j.ctro.2020.09.002] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Revised: 09/03/2020] [Accepted: 09/06/2020] [Indexed: 12/15/2022] Open
Abstract
Whole bladder magnetic resonance image-guided radiotherapy using the 1.5 Telsa MR-linac is feasible. Full online adaptive planning workflow based on the anatomy seen at each fraction was performed. This was delivered within 45 min. Intra-fraction bladder filling did not compromise target coverage. Patients reported acceptable tolerance of treatment.
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Affiliation(s)
- A. Hunt
- The Institute of Cancer Research, London, UK
- The Royal Marsden NHS Foundation Trust, London, UK
| | - I. Hanson
- The Joint Department of Physics at The Institute of Cancer Research and The Royal Marsden NHS Foundation Trust, London, UK
| | - A. Dunlop
- The Joint Department of Physics at The Institute of Cancer Research and The Royal Marsden NHS Foundation Trust, London, UK
| | - H. Barnes
- The Royal Marsden NHS Foundation Trust, London, UK
| | - L. Bower
- The Institute of Cancer Research, London, UK
- The Royal Marsden NHS Foundation Trust, London, UK
| | - J. Chick
- The Joint Department of Physics at The Institute of Cancer Research and The Royal Marsden NHS Foundation Trust, London, UK
| | - C. Cruickshank
- Clinical Trials and Statistics Unit, The Institute of Cancer Research, London, UK
| | - E. Hall
- Clinical Trials and Statistics Unit, The Institute of Cancer Research, London, UK
| | - T. Herbert
- The Royal Marsden NHS Foundation Trust, London, UK
| | - R. Lawes
- The Royal Marsden NHS Foundation Trust, London, UK
| | - D. McQuaid
- The Joint Department of Physics at The Institute of Cancer Research and The Royal Marsden NHS Foundation Trust, London, UK
| | - H. McNair
- The Institute of Cancer Research, London, UK
- The Royal Marsden NHS Foundation Trust, London, UK
| | - A. Mitchell
- The Joint Department of Physics at The Institute of Cancer Research and The Royal Marsden NHS Foundation Trust, London, UK
| | - J. Mohajer
- The Joint Department of Physics at The Institute of Cancer Research and The Royal Marsden NHS Foundation Trust, London, UK
| | - T. Morgan
- The Institute of Cancer Research, London, UK
- The Royal Marsden NHS Foundation Trust, London, UK
| | - U. Oelfke
- The Joint Department of Physics at The Institute of Cancer Research and The Royal Marsden NHS Foundation Trust, London, UK
| | - G. Smith
- The Royal Marsden NHS Foundation Trust, London, UK
| | - S. Nill
- The Joint Department of Physics at The Institute of Cancer Research and The Royal Marsden NHS Foundation Trust, London, UK
| | - R. Huddart
- The Institute of Cancer Research, London, UK
- The Royal Marsden NHS Foundation Trust, London, UK
| | - S. Hafeez
- The Institute of Cancer Research, London, UK
- The Royal Marsden NHS Foundation Trust, London, UK
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38
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Webster A, McNair H, Hansen V, Hafeez S, Lewis R, Griffin C, Hall E, Huddart R. OC-0590: Multicentre dual-trial implementation of plan of the day (PoD) adaptive radiotherapy: lessons learnt. Radiother Oncol 2020. [DOI: 10.1016/s0167-8140(21)00612-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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39
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Kolinsky MP, Rescigno P, Bianchini D, Zafeiriou Z, Mehra N, Mateo J, Michalarea V, Riisnaes R, Crespo M, Figueiredo I, Miranda S, Nava Rodrigues D, Flohr P, Tunariu N, Banerji U, Ruddle R, Sharp A, Welti J, Lambros M, Carreira S, Raynaud FI, Swales KE, Plymate S, Luo J, Tovey H, Porta N, Slade R, Leonard L, Hall E, de Bono JS. A phase I dose-escalation study of enzalutamide in combination with the AKT inhibitor AZD5363 (capivasertib) in patients with metastatic castration-resistant prostate cancer. Ann Oncol 2020; 31:619-625. [PMID: 32205016 PMCID: PMC7217345 DOI: 10.1016/j.annonc.2020.01.074] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2019] [Revised: 01/16/2020] [Accepted: 01/29/2020] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Activation of the PI3K/AKT/mTOR pathway through loss of phosphatase and tensin homolog (PTEN) occurs in approximately 50% of patients with metastatic castration-resistant prostate cancer (mCRPC). Recent evidence suggests that combined inhibition of the androgen receptor (AR) and AKT may be beneficial in mCRPC with PTEN loss. PATIENTS AND METHODS mCRPC patients who previously failed abiraterone and/or enzalutamide, received escalating doses of AZD5363 (capivasertib) starting at 320 mg twice daily (b.i.d.) given 4 days on and 3 days off, in combination with enzalutamide 160 mg daily. The co-primary endpoints were safety/tolerability and determining the maximum tolerated dose and recommended phase II dose; pharmacokinetics, antitumour activity, and exploratory biomarker analysis were also evaluated. RESULTS Sixteen patients were enrolled, 15 received study treatment and 13 were assessable for dose-limiting toxicities (DLTs). Patients were treated at 320, 400, and 480 mg b.i.d. dose levels of capivasertib. The recommended phase II dose identified for capivasertib was 400 mg b.i.d. with 1/6 patients experiencing a DLT (maculopapular rash) at this level. The most common grade ≥3 adverse events were hyperglycemia (26.7%) and rash (20%). Concomitant administration of enzalutamide significantly decreased plasma exposure of capivasertib, though this did not appear to impact pharmacodynamics. Three patients met the criteria for response (defined as prostate-specific antigen decline ≥50%, circulating tumour cell conversion, and/or radiological response). Responses were seen in patients with PTEN loss or activating mutations in AKT, low or absent AR-V7 expression, as well as those with an increase in phosphorylated extracellular signal-regulated kinase (pERK) in post-exposure samples. CONCLUSIONS The combination of capivasertib and enzalutamide is tolerable and has antitumour activity, with all responding patients harbouring aberrations in the PI3K/AKT/mTOR pathway. CLINICAL TRIAL NUMBER NCT02525068.
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Affiliation(s)
- M P Kolinsky
- The Royal Marsden NHS Foundation Trust, London, UK; The Institute of Cancer Research, London, UK; Cross Cancer Institute, Edmonton, Canada
| | - P Rescigno
- The Royal Marsden NHS Foundation Trust, London, UK; The Institute of Cancer Research, London, UK; Department of Clinical Medicine and Surgery, Department of Translational Medical Sciences, AOU Federico II, Naples, Italy
| | - D Bianchini
- The Royal Marsden NHS Foundation Trust, London, UK; The Institute of Cancer Research, London, UK
| | - Z Zafeiriou
- The Royal Marsden NHS Foundation Trust, London, UK; The Institute of Cancer Research, London, UK
| | - N Mehra
- The Royal Marsden NHS Foundation Trust, London, UK; The Institute of Cancer Research, London, UK
| | - J Mateo
- The Royal Marsden NHS Foundation Trust, London, UK; The Institute of Cancer Research, London, UK
| | - V Michalarea
- The Royal Marsden NHS Foundation Trust, London, UK; The Institute of Cancer Research, London, UK
| | - R Riisnaes
- The Institute of Cancer Research, London, UK
| | - M Crespo
- The Institute of Cancer Research, London, UK
| | | | - S Miranda
- The Institute of Cancer Research, London, UK
| | | | - P Flohr
- The Institute of Cancer Research, London, UK
| | - N Tunariu
- The Royal Marsden NHS Foundation Trust, London, UK; The Institute of Cancer Research, London, UK
| | - U Banerji
- The Royal Marsden NHS Foundation Trust, London, UK; The Institute of Cancer Research, London, UK
| | - R Ruddle
- The Institute of Cancer Research, London, UK
| | - A Sharp
- The Royal Marsden NHS Foundation Trust, London, UK; The Institute of Cancer Research, London, UK
| | - J Welti
- The Institute of Cancer Research, London, UK
| | - M Lambros
- The Institute of Cancer Research, London, UK
| | - S Carreira
- The Institute of Cancer Research, London, UK
| | - F I Raynaud
- The Institute of Cancer Research, London, UK
| | - K E Swales
- The Institute of Cancer Research, London, UK
| | - S Plymate
- University of Washington School of Medicine, Seattle, USA
| | - J Luo
- Brady Urological Institute, Johns Hopkins Medical Institutions, Baltimore, USA
| | - H Tovey
- The Institute of Cancer Research, London, UK
| | - N Porta
- The Institute of Cancer Research, London, UK
| | - R Slade
- The Institute of Cancer Research, London, UK
| | - L Leonard
- The Institute of Cancer Research, London, UK
| | - E Hall
- The Institute of Cancer Research, London, UK
| | - J S de Bono
- The Royal Marsden NHS Foundation Trust, London, UK; The Institute of Cancer Research, London, UK.
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40
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Hanna CR, Lynskey DM, Wadsley J, Appleyard SE, Anwar S, Miles E, Gower J, Hall E, Coles CE, Hanna GG. Radiotherapy Trial Set-up in the UK: Identifying Inefficiencies and Potential Solutions. Clin Oncol (R Coll Radiol) 2020; 32:266-275. [PMID: 31685377 DOI: 10.1016/j.clon.2019.10.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2019] [Revised: 09/04/2019] [Accepted: 09/26/2019] [Indexed: 11/17/2022]
Abstract
AIMS Radiotherapy clinical trials are integral to the development of new treatments to improve the outcomes of patients with cancer. A collaborative study by the National Cancer Research Institute Clinical and Translational Radiotherapy Research Working Group and the National Institute for Health Research was carried out to understand better if and why inefficiencies occur in the set-up of radiotherapy trials in the UK. MATERIALS AND METHODS Two online surveys collected information on the time taken for UK radiotherapy trials to reach key milestones during set-up and the research support currently being provided to radiotherapy centres to enable efficient clinical trial set-up. Semi-structured interviews with project managers and chief investigators identified better ways of working to improve trial set-up in the future. RESULTS The timelines for the set-up of 39 UK radiotherapy trials were captured in an online survey showing that the median time from grant approval to trial opening was 600 days (range 169-1172). There were 38 responses from radiotherapy centres to a survey asking about the current support provided for radiotherapy research. Most of these centres have more than one type of staff member dedicated to supporting radiotherapy research. The most frequent barrier to radiotherapy trial set-up identified was lack of physicists' time and lack of time for clinical oncologists to carry out research activities. Four main themes around trial set-up were identified from semi-structured interviews: the importance of communication and building relationships, the previous experience of the chief investigator and clinical trials units, a lack of resources and having the time and personnel required to produce trial documentation and to process trial approval requests. CONCLUSIONS This unique, collaborative project has provided up to date information about the current landscape of trial set-up and research support in the UK and identified several avenues on which to focus future efforts in order to support the excellent radiotherapy trial work carried out across the UK.
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Affiliation(s)
- C R Hanna
- CRUK Clinical Trials Unit, University of Glasgow, Glasgow, UK.
| | - D M Lynskey
- Department of Oncology, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - J Wadsley
- Weston Park Cancer Centre, Sheffield, UK
| | | | - S Anwar
- National Institute for Health Research, Leeds, UK
| | - E Miles
- RTTQA Group, Mount Vernon Cancer Centre, Northwood, UK
| | - J Gower
- National Institute for Health Research, Leeds, UK
| | - E Hall
- The Institute of Cancer Research, London, UK
| | - C E Coles
- University of Cambridge, Cambridge, UK
| | - G G Hanna
- Division of Radiation Oncology, Peter MacCallum Cancer Centre, Melbourne, Australia
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41
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Price J, Hall E, West C, Thomson D. TORPEdO - A Phase III Trial of Intensity-modulated Proton Beam Therapy Versus Intensity-modulated Radiotherapy for Multi-toxicity Reduction in Oropharyngeal Cancer. Clin Oncol (R Coll Radiol) 2020; 32:84-88. [PMID: 31604604 DOI: 10.1016/j.clon.2019.09.052] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2019] [Accepted: 08/14/2019] [Indexed: 11/26/2022]
Affiliation(s)
- J Price
- The Christie NHS Foundation Trust, Manchester, UK
| | - E Hall
- Clinical Trials and Statistics Unit, The Institute of Cancer Research, London, UK
| | - C West
- Division of Cancer Science, School of Medical Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
| | - D Thomson
- The Christie NHS Foundation Trust, Manchester, UK; Division of Cancer Science, School of Medical Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK.
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42
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Kang J, Strawderman R, Dearnaley D, Hall E, Burnet N, West C, Kerns S. Predicting Prostate Radiotherapy Toxicity in a Phase III Trial Using Clinical/Dosimetric Variables in Logistic Regression and Random Forest Models. Int J Radiat Oncol Biol Phys 2019. [DOI: 10.1016/j.ijrobp.2019.06.1820] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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43
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Naismith O, Mayles H, Bidmead M, Clark CH, Gulliford S, Hassan S, Khoo V, Roberts K, South C, Hall E, Dearnaley D. Radiotherapy Quality Assurance for the CHHiP Trial: Conventional Versus Hypofractionated High-Dose Intensity-Modulated Radiotherapy in Prostate Cancer. Clin Oncol (R Coll Radiol) 2019; 31:611-620. [PMID: 31201110 DOI: 10.1016/j.clon.2019.05.009] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2019] [Revised: 04/01/2019] [Accepted: 04/12/2019] [Indexed: 10/26/2022]
Abstract
AIMS The CHHiP trial investigated the use of moderate hypofractionation for the treatment of localised prostate cancer using intensity-modulated radiotherapy (IMRT). A radiotherapy quality assurance programme was developed to assess compliance with treatment protocol and to audit treatment planning and dosimetry of IMRT. This paper considers the outcome and effectiveness of the programme. MATERIALS AND METHODS Quality assurance exercises included a pre-trial process document and planning benchmark cases, prospective case reviews and a dosimetry site visit on-trial and a post-trial feedback questionnaire. RESULTS In total, 41 centres completed the quality assurance programme (37 UK, four international) between 2005 and 2010. Centres used either forward-planned (field-in-field single phase) or inverse-planned IMRT (25 versus 17). For pre-trial quality assurance exercises, 7/41 (17%) centres had minor deviations in their radiotherapy processes; 45/82 (55%) benchmark plans had minor variations and 17/82 (21%) had major variations. One hundred prospective case reviews were completed for 38 centres. Seventy-one per cent required changes to clinical outlining pre-treatment (primarily prostate apex and base, seminal vesicles and penile bulb). Errors in treatment planning were reduced relative to pre-trial quality assurance results (49% minor and 6% major variations). Dosimetry audits were conducted for 32 centres. Ion chamber dose point measurements were within ±2.5% in the planning target volume and ±8% in the rectum. 28/36 films for combined fields passed gamma criterion 3%/3 mm and 11/15 of IMRT fluence film sets passed gamma criterion 4%/4 mm using a 98% tolerance. Post-trial feedback showed that trial participation was beneficial in evolving clinical practice and that the quality assurance programme helped some centres to implement and audit prostate IMRT. CONCLUSION Overall, quality assurance results were satisfactory and the CHHiP quality assurance programme contributed to the success of the trial by auditing radiotherapy treatment planning and protocol compliance. Quality assurance supported the introduction of IMRT in UK centres, giving additional confidence and external review of IMRT where it was a newly adopted technique.
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Affiliation(s)
- O Naismith
- Royal Marsden NHS Foundation Trust, London, UK.
| | - H Mayles
- Clatterbridge Cancer Centre, Bebington, Wirral, UK
| | - M Bidmead
- Royal Marsden NHS Foundation Trust, London, UK
| | - C H Clark
- Royal Surrey County Hospital, Guildford, UK
| | - S Gulliford
- The Institute of Cancer Research, London, UK
| | - S Hassan
- The Institute of Cancer Research, London, UK
| | - V Khoo
- Royal Marsden NHS Foundation Trust, London, UK; The Institute of Cancer Research, London, UK
| | - K Roberts
- Royal Marsden NHS Foundation Trust, London, UK
| | - C South
- Royal Surrey County Hospital, Guildford, UK
| | - E Hall
- The Institute of Cancer Research, London, UK
| | - D Dearnaley
- Royal Marsden NHS Foundation Trust, London, UK; The Institute of Cancer Research, London, UK
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Wenzel RG, Major D, Hesp KF, Hall E, Doble P. Cobalt accumulation in horses following repeated administration of cobalt chloride. Aust Vet J 2019; 97:465-472. [PMID: 31418855 DOI: 10.1111/avj.12872] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2018] [Revised: 06/10/2019] [Accepted: 07/13/2019] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To monitor cobalt concentrations in urine, red blood cells and plasma after chronic parenteral administration of cobalt chloride evaluate these results against the current International Federation of Horseracing Authorities thresholds for detecting cobalt misuse. DESIGN Eight mares were randomly assigned to four treatment groups, with two mares in each group: Group 1 - control group, Group 2 - 25 milligrams cobalt intravenously as CoCl2 weekly, Group 3 - 50 milligrams cobalt intravenously as CoCl2 weekly, and Group 4 - 25 milligrams cobalt intravenously mid-week and at the end of the week. Urine and blood samples were collected before each weekly administration so that trough levels were assessed. In the group receiving two doses per week, urine and blood were collected prior to the dose given at the end of each week. Samples were initially collected at time zero then weekly for 10 weeks. Three further collections of urine and blood were made at days 81, 106 and 127. METHODS Urine creatinine measurements to assess horse hydration status were performed by the Jaffe reaction method. Cobalt determinations in plasma, blood and urine were by inductively coupled plasma-mass spectrometry. Haematocrit concentrations, used to calculate red cell cobalt levels, were performed using a microhematocrit centrifuge. Statistical analyses were conducted in Genstat (v17, VSNi). RESULTS Marked cobalt accumulation was evident with increasing cobalt concentrations for all sample matrices in specimens collected immediately prior to cobalt administration. Correlation between the sample matrices improved when urine cobalt concentration was adjusted for creatinine level. Red cell cobalt levels remained elevated for at least 12 weeks after cessation of administration, consistent with the lifespan of the red cell. There was no significant change in haematocrit concentrations for the duration of the study. CONCLUSION The current urine cobalt threshold was only effective at detecting acute cobalt exposure while the plasma cobalt threshold was able to consistently identify chronic high-level cobalt exposure and potential cobalt misuse. The threshold values legislated for urine cobalt do not correlate with those set for plasma. The acute nature of urinary cobalt excretion provides a relatively small window through which cobalt administration is detected. Plasma and red cell cobalt concentrations can provide a clearer picture of potential cobalt misuse.
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Affiliation(s)
- R G Wenzel
- NSW Health Pathology, Trace Elements Laboratory, Royal North Shore Hospital, Level 5, Acute Services Building, Pacific Highway, St Leonards, New South Wales, 2065, Australia.,Centre for Forensic Science, University of Technology Sydney, Broadway, New South Wales, 2001, Australia
| | - D Major
- Derek Major Consulting Pty Ltd, Richmond, New South Wales, 2753, Australia
| | - K F Hesp
- NSW Health Pathology, Trace Elements Laboratory, Royal North Shore Hospital, Level 5, Acute Services Building, Pacific Highway, St Leonards, New South Wales, 2065, Australia
| | - E Hall
- Veterinary Biostatistics, University of Sydney, Camden, New South Wales, 2570, Australia
| | - P Doble
- Centre for Forensic Science, University of Technology Sydney, Broadway, New South Wales, 2001, Australia
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Newson T, Hall E, Carden E, Petulla H. P038 Changing pattern of sweat testing in the post-newborn cystic fibrosis screening era within a regional service 2007–2018. J Cyst Fibros 2019. [DOI: 10.1016/s1569-1993(19)30333-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Webster A, Hafeez S, Hall E, Hansen V, McNair H, Lewis R, Robert H. OC-0634 Implementation of plan of the day adaptive radiotherapy: Compliance to guidelines. Radiother Oncol 2019. [DOI: 10.1016/s0167-8140(19)31054-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Pathmanathan A, Bower L, Creasey H, Dunlop A, Hall E, Hanson I, Herbert T, Lawes R, McQuaid D, McNair H, Mitchell A, Smith G, Huddart R, Oelfke U, Nill S, Tree A. EP-1566 MR-guided online adaptive radiotherapy: First experience in the UK. Radiother Oncol 2019. [DOI: 10.1016/s0167-8140(19)31986-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Hall E, Raker C, Hampton B. 12: Variability in gynecologic case volume of graduating obstetrics and gynecology residents from 2009 to 2017. Am J Obstet Gynecol 2019. [DOI: 10.1016/j.ajog.2019.01.041] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Jeeves B, Ali A, Stevenson K, Menon A, Hall E. An audit to explore the efficient and effective use of MRI scans and referral pathways in a musculoskeletal interface service. Physiotherapy 2019. [DOI: 10.1016/j.physio.2018.11.158] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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