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Crook J, Moideen N, Arbour G, Castro F, Araujo C, Batchelar D, Halperin R, Hilts M, Kim D, Petrik D, Rose J, Cheng JC, Bachand F. A Randomized Trial Comparing Quality of Life After Low-Dose Rate or High-Dose Rate Prostate Brachytherapy Boost With Pelvic External Beam Radiation Therapy. Int J Radiat Oncol Biol Phys 2024:S0360-3016(24)00381-X. [PMID: 38493901 DOI: 10.1016/j.ijrobp.2024.02.064] [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: 12/06/2023] [Revised: 01/30/2024] [Accepted: 02/10/2024] [Indexed: 03/19/2024]
Abstract
PURPOSE To compare health-related quality of life (QoL) in urinary, bowel, and sexual domains after combined external beam radiation therapy (EBRT) and either low-dose rate (LDR) or high-dose rate (HDR) prostate brachytherapy (BT). METHODS AND MATERIALS Eligible men with intermediate or high-risk prostate cancer treated with combined pelvic EBRT and BT were randomly assigned to either HDR (15 Gy) or LDR (110 Gy) boost. International Prostate Symptom Score, Index of Erectile Function, and Expanded Prostate Cancer Composite were collected at baseline, 1, 3, 6, and 12 months, every 6 months to 3 years and then annually along with prostate-specific antigen/testosterone. Fisher's exact test compared categorical variables and the Mann-Whitney U test Expanded Prostate Cancer Index Composite (EPIC) domain scores. RESULTS From January 2014 to December 2019, a random number generator assigned 195 men: 108 to HDR and 87 to LDR. Median age was 71 years. Risk group was high in 57% and unfavorable intermediate in 43%. Androgen deprivation (used in 74%) began with 3 months neoadjuvant and continued for median 12 months. Baseline EPIC scores were similar for the LDR/HDR cohorts: 89 and 88 respectively for Genito-urinary; 92 and 93 for Gastro-intestinal. EPIC urinary scores decreased at 1 month for HDR but recovered promptly to a steady state by 6 months. LDR scores reached a nadir at 3 months with slow recovery to 18 months, after which urinary QoL was similar for HDR and LDR. Bowel QOL scores fell in both cohorts reaching respective nadirs at 12 months. HDR patients recovered close to baseline and maintained higher scores than LDR patients to 5 years. The decline for LDR patients remained more than the minimum clinically important difference out to 5 years. CONCLUSIONS The patient experience for combined EBRT and prostate BT is improved with HDR BT. Urinary QoL improves over time to be equivalent between the 2 modalities after 18 months, but LDR patients report lasting bowel symptoms.
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Affiliation(s)
- Juanita Crook
- Division of Radiation Oncology, Univeristy of British Columbia, Vancouver, British Columbia, Canada.
| | - Nikitha Moideen
- Radiation Oncology, BCCancer, Kelowna, British Columbia, Canada
| | - Greg Arbour
- Department of Statistics, University of British Columbia, Vancouver, British Columbia, Canada
| | - Felipe Castro
- Radiation Oncology, BCCancer, Kelowna, British Columbia, Canada
| | - Cynthia Araujo
- Medical Physics, BCCancer, Kelowna, British Columbia, Canada
| | | | - Ross Halperin
- Radiation Oncology, BCCancer, Kelowna, British Columbia, Canada
| | - Michelle Hilts
- Medical Physics, BCCancer, Kelowna, British Columbia, Canada
| | - David Kim
- Radiation Oncology, BCCancer, Kelowna, British Columbia, Canada
| | - David Petrik
- Radiation Oncology, BCCancer, Kelowna, British Columbia, Canada
| | - Jim Rose
- Radiation Oncology, BCCancer, Abbottsford, British Columbia, Canada
| | - J C Cheng
- Radiation Oncology, BCCancer, Kelowna, British Columbia, Canada
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Castro F, Crook JM, Arbour G, Araujo CD, Batchelar D, Moideen N, Hilts M, Halperin RM, Kim DJW, Petrik DW, Rose J, Bachand F. Health-Related Quality of Life after Combined External Beam and Either High Dose Rate (HDR) or Low Dose Rate (LDR) Brachytherapy: Does the Rectal Dose from the LDR Brachytherapy Make a Difference? Int J Radiat Oncol Biol Phys 2023; 117:e369. [PMID: 37785260 DOI: 10.1016/j.ijrobp.2023.06.2467] [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) The recently reported randomized Phase III trial comparing health related quality of life (HRQOL) after combined external beam radiation therapy (EBRT) and either HDR or LDR brachytherapy (BT) found a significant decline in the EPIC Bowel domain HRQOL score at 24- 48 months after treatment in the LDR arm of the trial. As all patients in the trial received the same EBRT dose, and HDR rectal dose was strictly controlled to be <9.5 Gy to 1cc of rectal wall (RD1cc), we investigated whether the variable rectal dose from the LDR component of treatment was related to the decline in Bowel HRQOL for these patients. MATERIALS/METHODS A total of 195 men with upper tier intermediate or high-risk prostate cancer were assigned by a random number generator to receive either an HDR (15 Gy, n = 108) or LDR (110Gy, n = 87) brachytherapy boost combined with 46Gy/23 fractions EBRT. All LDR patients had 1 month post implant quality assurance using CT-MRI fusion. The Expanded Prostate Cancer Composite (EPIC) questionnaire was used to evaluate HRQOL at baseline, q3 mo for 1 year, q6mo for 3 yr and then annually. A multivariate linear regression model was used to investigate the dose-response relationship between EPIC bowel domain score at 24- 48 months and RD1cc. RESULTS With a median follow up of 48 months, the previous analysis confirmed the expected time course of acute bowel/urinary symptoms, with LDR showing more prolonged decline in HRQOL bowel domain at 3 and 6 months, but equivalence to HDR by 12 months. HRQOL urinary domain remained equivalent from 12-60 mo. The decline in the HRQOL bowel domain observed for LDR patients from 24-48 mo was analyzed for the 79 patients with sufficient data. The mean baseline HRQOL bowel domain score was 92 and fell on average to 85 at 24-48 mo. Mean RD1cc for the LDR patients was 82Gy (SD 22 Gy), with a maximum value of 129 Gy. In this range of rectal doses, a 20Gy increase in RD1cc, was associated on average with a 1.5-point decrease in EPIC HRQOL bowel domain score (p = 0.21). CONCLUSION The rectal dose received by the LDR patients showed a non-significant dose-response with the EPIC Bowel domain HRQOL score. This confirms the accepted rectal dose constraints for LDR brachytherapy but does not explain the observed decline in bowel scores from 24-48 months.
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Affiliation(s)
- F Castro
- BC Cancer, Kelowna, BC, Canada; University of British Columbia, Kelowna, BC, Canada
| | - J M Crook
- BC Cancer, Kelowna, BC, Canada; University of British Columbia, Kelowna, BC, Canada
| | - G Arbour
- University of British Columbia, Vancouver, BC, Canada
| | - C D Araujo
- BC Cancer, Kelowna, BC, Canada; University of British Columbia, Kelowna, BC, Canada
| | - D Batchelar
- BC Cancer, Kelowna, BC, Canada; University of British Columbia, Kelowna, BC, Canada
| | | | - M Hilts
- BC Cancer, Kelowna, BC, Canada; University of British Columbia, Kelowna, BC, Canada
| | | | | | | | - J Rose
- BC Cancer, Kelowna, BC, Canada
| | - F Bachand
- BC Cancer, Kelowna, BC, Canada; University of British Columbia, Kelowna, BC, Canada
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Kudla M, Bachand F, Moore J, Batchelar D. Patient-specific cylinder templates for hybrid interstitial vaginal brachytherapy: Feasibility of automated 3-D design, 3D printing, and dosimetric outlook. Brachytherapy 2023; 22:468-476. [PMID: 37169607 DOI: 10.1016/j.brachy.2023.03.002] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Revised: 02/24/2023] [Accepted: 03/09/2023] [Indexed: 05/13/2023]
Abstract
PURPOSE Delivering highly conformal treatment plans for high-dose rate vaginal brachytherapy using commercially available applicators can be challenging. A partially automated workflow is presented for the in-house modeling and 3D printing of patient-specific cylindrical templates (PSCTs), which facilitate placement of flexible intracavitary and interstitial needles. To demonstrate feasibility, we compare PSCT treatment plans to retrospective interstitial brachytherapy plans delivered at our center. PSCTs derived from these plans were 3D printed to test the validity of the auto-design process. To facilitate clinical implementation, we validated the steam sterilization compatibility of PSCTs printed using polyetheretherketone (PEEK). METHODS AND MATERIALS Plans for ten patients treated using a combination of vaginal cylinder and interstitial needles were compared to PSCT-based plans created for the same patient. DVH parameters for the HRCTV (V100, V150, V200, D90) and OARs (D2 cm3) were evaluated, as well as the number of needles used and the total interstitial length. Each planned PSCT was printed and compared to the intended needle geometry. 3D printed models were sterilization validated by an independent contractor for an autoclave protocol. RESULTS PSCT plans demonstrated advantages over template based perineal BT in reducing the total interstitial needle length required while preserving or improving HRCTV and OAR dosimetry. All printed PSCTs matched planned geometry. CONCLUSIONS PSCTs stand to be an alternative to current HDR-BT templates/applicators for patients with vaginal and locally recurrent endometrial cancers. Clinically equivalent or improved treatment plans can be created and devices to deliver these plans can be accurately printed and sterilized.
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Affiliation(s)
- Michael Kudla
- Department of Physics, The University of British Columbia - Okanagan, Kelowna, BC, Canada.
| | - Francois Bachand
- Department of Radiation Oncology, BC Cancer - Kelowna, Kelowna, BC, Canada
| | - Jocelyn Moore
- Department of Radiation Oncology, Saskatoon Cancer Center, Saskatoon, SK, Canada
| | - Deidre Batchelar
- Department of Physics, The University of British Columbia - Okanagan, Kelowna, BC, Canada; Department of Medical Physics, BC Cancer - Kelowna, Kelowna, BC, Canada
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Kwiatek L, Landry-Voyer AM, Latour M, Yague-Sanz C, Bachand F. PABPN1 prevents the nuclear export of an unspliced RNA with a constitutive transport element and controls human gene expression via intron retention. RNA 2023; 29:644-662. [PMID: 36754576 PMCID: PMC10158996 DOI: 10.1261/rna.079294.122] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Accepted: 01/12/2023] [Indexed: 05/06/2023]
Abstract
Intron retention is a type of alternative splicing where one or more introns remain unspliced in a polyadenylated transcript. Although many viral systems are known to translate proteins from mRNAs with retained introns, restriction mechanisms generally prevent export and translation of incompletely spliced mRNAs. Here, we provide evidence that the human nuclear poly(A)-binding protein, PABPN1, functions in such restrictions. Using a reporter construct in which nuclear export of an incompletely spliced mRNA is enhanced by a viral constitutive transport element (CTE), we show that PABPN1 depletion results in a significant increase in export and translation from the unspliced CTE-containing transcript. Unexpectedly, we find that inactivation of poly(A)-tail exosome targeting by depletion of PAXT components had no effect on export and translation of the unspliced reporter mRNA, suggesting a mechanism largely independent of nuclear RNA decay. Interestingly, a PABPN1 mutant selectively defective in stimulating poly(A) polymerase elongation strongly enhanced the expression of the unspliced, but not of intronless, reporter transcripts. Analysis of RNA-seq data also revealed that PABPN1 controls the expression of many human genes via intron retention. Notably, PABPN1-dependent intron retention events mostly affected 3'-terminal introns and were insensitive to PAXT and NEXT deficiencies. Our findings thus disclose a role for PABPN1 in restricting nuclear export of intron-retained transcripts and reinforce the interdependence between terminal intron splicing, 3' end processing, and polyadenylation.
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Affiliation(s)
- Lauren Kwiatek
- RNA Group, Department of Biochemistry and Functional Genomics, Université de Sherbrooke, Sherbrooke, Québec, Canada J1E 4K8
| | - Anne-Marie Landry-Voyer
- RNA Group, Department of Biochemistry and Functional Genomics, Université de Sherbrooke, Sherbrooke, Québec, Canada J1E 4K8
| | - Mélodie Latour
- RNA Group, Department of Biochemistry and Functional Genomics, Université de Sherbrooke, Sherbrooke, Québec, Canada J1E 4K8
| | - Carlo Yague-Sanz
- RNA Group, Department of Biochemistry and Functional Genomics, Université de Sherbrooke, Sherbrooke, Québec, Canada J1E 4K8
| | - Francois Bachand
- RNA Group, Department of Biochemistry and Functional Genomics, Université de Sherbrooke, Sherbrooke, Québec, Canada J1E 4K8
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Kamrava M, Leung E, Bachand F, Beriwal S, Chargari C, D'Souza D, Erickson B, Fokdal L, Han K, Harkenrider M, Lin L, Mahantshetty U, Nesvacil N, Ravi A, Schmid M, Vigneault E, Westerveld H, Yashar C, Nout R. GEC-ESTRO (ACROP)-ABS-CBG Consensus Brachytherapy Target Definition Guidelines for Recurrent Endometrial and Cervical Tumors in the Vagina. Int J Radiat Oncol Biol Phys 2023; 115:654-663. [PMID: 36191741 DOI: 10.1016/j.ijrobp.2022.09.072] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Revised: 08/23/2022] [Accepted: 09/13/2022] [Indexed: 02/04/2023]
Abstract
PURPOSE Representatives from the Gynecologic Groupe European de Curietherapie-European Society for Radiation Therapy and Oncology (GYN GEC-ESTRO), the American Brachytherapy Society (ABS), and the Canadian Brachytherapy Group (CBG) met to develop international consensus recommendations for target definitions for image-guided adaptive brachytherapy for vaginal recurrences of endometrial or cervical cancer. METHODS AND MATERIALS Seventeen radiation oncologists and 2 medical physicists participated. Before an in-person meeting each participant anonymously contoured 3 recurrent endometrial/cervical cancer cases. Participants contoured the residual gross primary tumor volume (GTV-Tres), a high-risk clinical target volume (CTV-THR), and an intermediate-risk clinical target volume (CTV-TIR), on T2-weighted magnetic resonance images (MRIs). All contours were drawn using Falcon EduCase. Contours were reviewed at an in-person meeting during which a consensus document was created defining agreed-upon target definitions (Trial 1). After establishing these definitions, the group was sent one of the cases again (recurrent cervical cancer vaginal recurrence) and asked to contour the targets again (Trial 2). The Computerized Environment for Radiation Research (CERR) software (The Mathworks, Natwick, MA) was used to analyze the contours. Kappa statistics were generated to assess level of agreement between contours. A conformity index (CI), defined as the ratio between the intersection and union volume of a given pair of contours, was calculated. A simultaneous truth and performance level estimation (STAPLE) contour was created for the CTV-THR and CTV-TIR for the postmeeting case. RESULTS Consensus definitions for GTV-Tres, CTV-THR, and CTV-TIR were established. Kappa statistics (Trial 1/Trial 2) for GTV-Tres, CTV-THR, and CTV-TIR were 0.536/0.583, 0.575/0.743 and 0.522/0.707. Kappa statistics for Trial 2 for the CTV-THR and CTV-TIR showed "substantial" agreement while the GTV-Tres remained at moderate agreement. CONCLUSIONS This consensus provides recommendations to facilitate future collaborations for MRI-guided adaptive brachytherapy target definitions in endometrial/cervical vaginal recurrences.
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Affiliation(s)
| | - Eric Leung
- Sunnybrook Odette Cancer Center, Ontario
| | | | - Sushil Beriwal
- Allegheny Health Network, Pittsburgh, Pennsylvania and Varian Medical Systems, Palo Alto, California
| | - Cyrus Chargari
- Gustave Roussy Comprehensive Cancer Center, Villejuif, France
| | | | | | | | - Kathy Han
- Princess Margaret Cancer Centre, University Health Network, University of Toronto, Ontario, Canada
| | | | - Lilie Lin
- MD Anderson Cancer Center, Houston, Texas
| | | | - Nicole Nesvacil
- Department of Radiation Oncology, Comprehensive Cancer Center, Medical University of Vienna, Austria
| | | | - Max Schmid
- Department of Radiation Oncology, Comprehensive Cancer Center, Medical University of Vienna, Austria
| | - Eric Vigneault
- Centre Hospitalier Universitaire de Québec, Quebec, Canada
| | | | | | - Remi Nout
- Erasmus MC Cancer Institute, University Medical Center Rotterdam, the Netherlands
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Moideen N, Crook J, Araujo C, Batchelar D, Castro F, Halperin R, Hilts M, Kim D, Petrik D, Rose J, Bachand F. PL04 Presentation Time: 2:45 PM. Brachytherapy 2022. [DOI: 10.1016/j.brachy.2022.09.052] [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: 12/05/2022]
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Moideen N, Crook J, Araujo C, Batchelar D, Castro F, Hilts M, Halperin R, Kim D, Petrik D, Rose J, Bachand F. A Randomized Phase III Trial Comparing Health-Related Quality of Life after Low Dose Rate (LDR) or High Dose Rate (HDR) Prostate Brachytherapy Boost Combined with External Beam Pelvic Radiotherapy (EBRT). Int J Radiat Oncol Biol Phys 2022. [DOI: 10.1016/j.ijrobp.2022.07.2324] [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: 10/31/2022]
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Michaelson D, Dignam J, Hamstra D, Bachand F, Master V, Bruner D, Torres M, Saylor P, Wallace R, Vapiwala N, Efstathiou J, Roach M, Rosenthal S, Raben A, Morgan S, Kavadi V, Spratt D, Michalski J, Rodgers J, Sandler H. Phase III Trial of Dose Escalated Radiation Therapy and Standard Androgen Deprivation Therapy (ADT) vs. Dose Escalated Radiation Therapy and Enhanced ADT with TAK-700 for Men with High-Risk Prostate Cancer (NRG Oncology/RTOG 1115). Int J Radiat Oncol Biol Phys 2022. [DOI: 10.1016/j.ijrobp.2022.07.458] [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: 11/30/2022]
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Bruner D, Pugh S, Michaelson D, Hamstra D, Bachand F, Master V, Torres M, Kaplan I, Rosenthal S, Roach M, Raben A, Michalski J, Kavadi V, Ferguson M, Morgan S, D'Souza D, DeMora L, Sandler H, Movsas B. RTOG/NRG 1115 Quality of Life of Phase III Dose Escalated Radiation Therapy (RT) and Standard Androgen Deprivation Therapy (ADT) with GnRH Agonist vs. Dose Escalated RT and ADT with GnRH Agonist and Orteronel (TAK-700) for Men with High-Risk Prostate. Int J Radiat Oncol Biol Phys 2022. [DOI: 10.1016/j.ijrobp.2022.07.1151] [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: 10/31/2022]
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Dang A, Zehnder S, Sunderland K, Urban R, Lim P, Lester B, Holloway C, Bachand F, Hamilton S. 161: Organ Perforation and Clinical, Dosimetric, and Treatment Outcomes During Image Guided Cervix Brachytherapy. Radiother Oncol 2022. [DOI: 10.1016/s0167-8140(22)04441-3] [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: 10/14/2022]
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Urban R, Wong J, Lim P, Zhang S, Spadinger I, Olson R, Bachand F, Ho C, Tinker AV, Gondara L, Hamilton SN. Cervical cancer patient reported gastrointestinal outcomes: intensity/volumetric modulated vs. 3D conformal radiation therapy. J Gynecol Oncol 2022; 33:e70. [PMID: 35882607 PMCID: PMC9428301 DOI: 10.3802/jgo.2022.33.e70] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Revised: 06/12/2022] [Accepted: 06/21/2022] [Indexed: 12/24/2022] Open
Abstract
OBJECTIVE To evaluate gastrointestinal (GI) patient reported outcomes (PROs) in cervical cancer patients treated with definitive radiotherapy (RT), comparing 3D conformal RT (3DCRT) vs. intensity modulated/volumetric modulated arc therapy (IMRT/VMAT). METHODS An analysis of patients treated with definitive RT between 2015-2018 was performed. GI PROs were prospectively collected at baseline, during RT (acute), ≤12 weeks after RT (subacute), and >12 weeks after RT (late). GI PROs evaluated three symptom domains: bowel problems (BPs), bowel bother (BB), and abdominal problems (APs). Multiple linear regression analysis was performed to investigate associations between mean changes of symptom scores with clinical and dosimetric variables. RESULTS The cohort included 167 patients. A total of 100 (60%) patients were treated with IMRT/VMAT and 67 (40%) with 3DCRT. In the subacute phase, the mean change of symptom scores from baseline in 3DCRT vs. IMRT/VMAT were +0.9 vs. -1.15 (p=0.004) for BP, +2.18 vs. -0.10 (p=0.019) for BB, and +1.41 vs. -0.38 (p=0.021) for AP. Likewise, in the late phase, mean changes were +0.72 vs. -0.82 (p=0.014) for BP, +1.98 vs. -0.03 (p=0.008) for BB, and +1.29 vs. -0.31 (p<0.001) for AP. On multiple linear regression, use of 3DCRT vs. IMRT/VMAT was associated with greater mean changes in subacute BP (p=0.023) and late phase AP (p=0.019). A higher small bowel V50Gy was associated increased symptom scores in late AP (p=0.012). CONCLUSION 3DCRT was associated with significantly greater worsening of GI PRO symptom scores in the subacute and late phase. These data support the ongoing use of IMRT/VMAT in routine practice.
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Affiliation(s)
- Ryan Urban
- Department of Medicine, The University of British Columbia, Vancouver, BC, Canada.,Department of Radiation Oncology, BC Cancer - Vancouver, Vancouver, BC, Canada
| | - Justin Wong
- Department of Medicine, The University of British Columbia, Vancouver, BC, Canada
| | - Peter Lim
- Department of Medicine, The University of British Columbia, Vancouver, BC, Canada.,Department of Radiation Oncology, BC Cancer - Vancouver, Vancouver, BC, Canada
| | - Susan Zhang
- Department of Medicine, The University of British Columbia, Vancouver, BC, Canada.,Department of Medical Physics, BC Cancer - Vancouver, Vancouver, BC, Canada
| | - Ingrid Spadinger
- Department of Medicine, The University of British Columbia, Vancouver, BC, Canada.,Department of Medical Physics, BC Cancer - Vancouver, Vancouver, BC, Canada
| | - Robert Olson
- Department of Medicine, The University of British Columbia, Vancouver, BC, Canada.,Department of Radiation Oncology, BC Cancer - Prince George, Prince George, BC, Canada
| | - Francois Bachand
- Department of Medicine, The University of British Columbia, Vancouver, BC, Canada.,Department of Radiation Oncology, BC Cancer - Kelowna, Kelowna, BC, Canada
| | - Clement Ho
- Department of Medicine, The University of British Columbia, Vancouver, BC, Canada.,Department of Radiation Oncology, BC Cancer - Surrey, Surrey, BC, Canada
| | - Anna V Tinker
- Department of Medicine, The University of British Columbia, Vancouver, BC, Canada.,Department of Medical Oncology, BC Cancer - Vancouver, Vancouver, BC, Canada
| | - Lovedeep Gondara
- Department of Population Oncology, BC Cancer - Vancouver, Vancouver, BC, Canada
| | - Sarah Nicole Hamilton
- Department of Medicine, The University of British Columbia, Vancouver, BC, Canada.,Department of Radiation Oncology, BC Cancer - Vancouver, Vancouver, BC, Canada.
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Urban R, Wong J, Lim P, Zhang S, Spadinger I, Olson R, Bachand F, Ho C, Tinker A, Lovedeep G, Hamilton S. Cervical Cancer Patient Reported Gastrointestinal Outcomes: Intensity/Volumetric Modulated vs. 3D Conformal Radiation Therapy. Int J Radiat Oncol Biol Phys 2021. [DOI: 10.1016/j.ijrobp.2021.07.641] [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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Zheng J, Bachand F, Halperin R, Kim D, Petrik D, Crook J. 70: After ASCENDE-RT: Outcomes of Androgen Deprivation, External Beam Radiation and LDR Brachytherapy Boost for High-Tier Intermediate and High Risk Prostate Cancer Treated at BC Cancer Kelowna. Radiother Oncol 2021. [DOI: 10.1016/s0167-8140(21)08948-9] [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: 11/29/2022]
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14
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Urban R, Wong J, Lim P, Zhang S, Spadinger I, Olson R, Bachand F, Ho C, Tinker A, Gondara L, Hamilton S. 44: Cervical Cancer Patient Reported Gastrointestinal Outcomes: Intensity/ Volumetric Modulated Versus 3D Conformal Radiation Therapy. Radiother Oncol 2021. [DOI: 10.1016/s0167-8140(21)08922-2] [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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Zheng J, Bachand F, Halperin R, Kim D, Petrik D, Crook J. PRSOR06 Presentation Time: 12:25 PM. Brachytherapy 2021. [DOI: 10.1016/j.brachy.2021.06.070] [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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Ding J, Tissaverasinghe S, Batchelar D, Hilts M, Araujo C, Bachand F, Crook J. PP-0161 mpMRI-guided dose escalation to DIL with US-planned HDR prostate brachytherapy: a phase II study. Radiother Oncol 2021. [DOI: 10.1016/s0167-8140(21)06453-7] [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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Landry-Voyer AM, Bergeron D, Yague-Sanz C, Baker B, Bachand F. PDCD2 functions as an evolutionarily conserved chaperone dedicated for the 40S ribosomal protein uS5 (RPS2). Nucleic Acids Res 2020; 48:12900-12916. [PMID: 33245768 PMCID: PMC7736825 DOI: 10.1093/nar/gkaa1108] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Revised: 10/23/2020] [Accepted: 10/28/2020] [Indexed: 11/12/2022] Open
Abstract
PDCD2 is an evolutionarily conserved protein with previously characterized homologs in Drosophila (zfrp8) and budding yeast (Tsr4). Although mammalian PDCD2 is essential for cell proliferation and embryonic development, the function of PDCD2 that underlies its fundamental cellular role has remained unclear. Here, we used quantitative proteomics approaches to define the protein-protein interaction network of human PDCD2. Our data revealed that PDCD2 specifically interacts with the 40S ribosomal protein uS5 (RPS2) and that the PDCD2-uS5 complex is assembled co-translationally. Loss of PDCD2 expression leads to defects in the synthesis of the small ribosomal subunit that phenocopy a uS5 deficiency. Notably, we show that PDCD2 is important for the accumulation of soluble uS5 protein as well as its incorporation into 40S ribosomal subunit. Our findings support that the essential molecular function of PDCD2 is to act as a dedicated ribosomal protein chaperone that recognizes uS5 co-translationally in the cytoplasm and accompanies uS5 to ribosome assembly sites in the nucleus. As most dedicated ribosomal protein chaperones have been identified in yeast, our study reveals that similar mechanisms exist in human cells to assist ribosomal proteins coordinate their folding, nuclear import and assembly in pre-ribosomal particles.
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Affiliation(s)
- Anne-Marie Landry-Voyer
- Department of Biochemistry & Functional Genomics, Université de Sherbrooke, Sherbrooke, QC J1E 4K8, Canada
| | - Danny Bergeron
- Department of Biochemistry & Functional Genomics, Université de Sherbrooke, Sherbrooke, QC J1E 4K8, Canada
| | - Carlo Yague-Sanz
- Department of Biochemistry & Functional Genomics, Université de Sherbrooke, Sherbrooke, QC J1E 4K8, Canada
| | - Breac Baker
- Department of Biochemistry & Functional Genomics, Université de Sherbrooke, Sherbrooke, QC J1E 4K8, Canada
| | - Francois Bachand
- Department of Biochemistry & Functional Genomics, Université de Sherbrooke, Sherbrooke, QC J1E 4K8, Canada
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Parimi S, Bondy S, Aparicio M, Sunderland K, Cho J, Bachand F, Nguyen Chi K, Pickles T, Tyldesley S. Presenting stage and risk group in men dying of prostate cancer. Curr Oncol 2020; 27:e547-e551. [PMID: 33380869 PMCID: PMC7755438 DOI: 10.3747/co.27.6385] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
Introduction Prostate cancer remains the 3rd leading cause of cancer-related mortality in Canadian men, and yet screening for prostate cancer continues to be controversial because the majority of men diagnosed with prostate cancer do not die of the disease. It also remains uncertain whether treatment of cases that can be treated with curative intent alters the mortality rate. There are very few studies describing the presenting stage, risk groups, and survival after diagnosis for men dying of prostate cancer in the literature. In this study, we explored these characteristics for all men who died of prostate cancer in British Columbia between 2013 and 2015. Methods The population-based BC Cancer databases were used to identify all patients diagnosed between January 2013 and December 2015 who died of prostate cancer. Patient, tumour, and treatment characteristics were collected, and the risk grouping for each tumour was determined. The proportion of cases in each risk group at the time of diagnosis was determined. Survival time from diagnosis to death was calculated for all patients and for each risk group using the Kaplan-Meier method. Results A total of 1256 patients died of prostate cancer. Of patients who presented with metastatic disease, 57.2% presented with a Gleason score of 8 or more, compared with only 35.7% of patients who presented with nonmetastatic disease (p < 0.0001). The presenting stage and risk group of those dying of prostate cancer were as follows: 32% metastatic disease, 3% regional (defined as node-positive), 39% localized high risk, 9% localized intermediate risk, 4% localized low risk, 6% localized not otherwise specified, and 7% unknown. Therefore, 80.3% of those with a known risk group presented with either localized high-risk, regional, or metastatic disease at diagnosis. The median survival times from diagnosis to death were 12 years for localized low-risk, 10 years for localized intermediate-risk, 6.5 years for localized high-risk, 4 years for regional, and 1.7 years for metastatic disease at diagnosis. Conclusions This population-based analysis demonstrates that patients with localized high-risk, regional, or metastatic disease at diagnosis constitute the overwhelming majority of patients who die of prostate cancer in British Columbia. Unless these disease states can reliably be identified at an earlier low- or intermediate-risk localized state in the future, it is unlikely that treatment of localized low- and intermediate-risk cancer will have an impact on survival. Furthermore, patients with de novo metastatic disease had identifiable risk factors of a higher prostate-specific antigen and Gleason score. Further studies are required to confirm these results.
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Affiliation(s)
- S Parimi
- Medical Oncology, BC Cancer, Vancouver, BC
| | - S Bondy
- Genitourinary Cancer Outcomes Unit, BC Cancer, Vancouver, BC
| | - M Aparicio
- Genitourinary Cancer Outcomes Unit, BC Cancer, Vancouver, BC
| | - K Sunderland
- Genitourinary Cancer Outcomes Unit, BC Cancer, Vancouver, BC
| | - J Cho
- Radiation Oncology, BC Cancer, Vancouver, BC
| | - F Bachand
- Radiation Oncology, BC Cancer, Vancouver, BC
| | | | - T Pickles
- Radiation Oncology, BC Cancer, Vancouver, BC
| | - S Tyldesley
- Radiation Oncology, BC Cancer, Vancouver, BC
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19
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Todor D, Fields E, Allen A, Batchelar D, Brouillard E, Ding J, Kudla M, Bachand F, Hajdok G, D'Souza D. PD-0659: Looking Beyond D90: Correlating EUBED, gBEUD with Outcome in Cervical Cancer Brachytherapy. Radiother Oncol 2020. [DOI: 10.1016/s0167-8140(21)00681-2] [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: 10/22/2022]
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20
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Todor D, Fields E, D'Souza D, Hajdok G, Bachand F, Batchelar D, Allen A, Brouillard E, Ding J, Kudla M. Looking Beyond D90: A Novel Way of Correlating Brachytherapy Quality With Local Control in Cervix Cancer. Int J Radiat Oncol Biol Phys 2020. [DOI: 10.1016/j.ijrobp.2020.07.2604] [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: 10/23/2022]
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21
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Awotwi-Pratt J, Pastuch A, Bachand F. A Retrospective Study Investigating the Use of the First Fraction CT-Based Treatment Planning to Deliver Subsequent Fractions for High-Dose-Rate (HDR) Brachytherapy of the Cervix. Int J Radiat Oncol Biol Phys 2019. [DOI: 10.1016/j.ijrobp.2019.06.1794] [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: 11/25/2022]
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22
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Leung E, D'Souza D, Bachand F, Han K, Alfieri J, Huang F, Vigneault E, Barkati M, Wiebe EM, Foster W, Fortin I, Velker V, Bowes D, Barnes E, Patil N, Banerjee R, Barbera L, Ravi A. MRI-based interstitial brachytherapy for vaginal tumors: A multi-institutional study on practice patterns, contouring, and consensus definitions of target volumes. Brachytherapy 2019; 18:598-605. [PMID: 31230941 DOI: 10.1016/j.brachy.2019.05.007] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [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: 12/21/2018] [Revised: 05/10/2019] [Accepted: 05/20/2019] [Indexed: 12/31/2022]
Abstract
PURPOSE Interstitial brachytherapy (ISBT) can be effective for vaginal tumors due to its ability to deliver conformal treatment with 3D planning. As there is no consensus for 3D vaginal brachytherapy (BT) contouring, the goals of this study are to evaluate the variability in practices and contouring, and to develop consensus concepts on target definitions. METHODS A survey/contouring study was conducted with 16 radiation oncologists from 10 Canadian academic centers. The study included three vaginal ISBT cases. Participants were provided staging, prebrachytherapy (pre-BT), and BT MRIs. Participants responded to a questionnaire and contoured on the provided images. Agreement between contours was analyzed. A meeting was held to develop consensus definitions of targets. RESULTS Median ISBT experience was 3.5 years. All 16 participants regularly contour with MRI, whereas three also plan on MRI. For the three cases, there was variation into how CTVHR and CTVIR was defined. Kappa statistics showed higher agreement with bulky tumors (mean 0.59) as compared with small residual tumors (mean 0.29). For all cases, kappa was highest in pre-BT GTVres as compared with BT GTVres (mean 0.58, 0.46). Consensus concepts to define targets were developed. CONCLUSIONS Variations exist in how ISBT targets are defined for vaginal tumors. Highest contouring variability was seen with small residual at BT. Contouring is more consistent on pre-BT MRI as compared with BT MRI suggesting a needle distortion effect. Consensus CTVHR and CTVIR definitions have been developed and further work is warranted to establish international standards.
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Affiliation(s)
- Eric Leung
- Department of Radiation Oncology, Sunnybrook Health Sciences Centre, Odette Cancer Centre, Toronto, Ontario, Canada.
| | - David D'Souza
- Department of Oncology, London Health Sciences Centre, London, Ontario, Canada
| | - Francois Bachand
- Department of Radiation Oncology, BC Cancer, Kelowna, British Columbia, Canada
| | - Kathy Han
- Radiation Medicine Program, Princess Margaret Cancer Centre, Toronto, Ontario, Canada
| | - Joanne Alfieri
- Department of Radiation Oncology, McGill University Health Centre, Montreal, Quebec, Canada
| | - Fleur Huang
- Department of Oncology, Cross Cancer Institute, Edmonton, Alberta, Canada
| | - Eric Vigneault
- Department of Radiation Oncology, CHU de Québec Université Laval, Québec, Québec, Ontario, Canada
| | - Maroie Barkati
- Department of Radiation Oncology, Centre Hospitalier de l'Université de Montréal, Québec, Canada
| | - Ericka M Wiebe
- Department of Oncology, Cross Cancer Institute, Edmonton, Alberta, Canada
| | - William Foster
- Department of Radiation Oncology, CHU de Québec Université Laval, Québec, Québec, Ontario, Canada
| | - Israel Fortin
- Department of Radiation Oncology, Centre Hospitalier de l'Université de Montréal, Québec, Canada
| | - Vikram Velker
- Department of Oncology, London Health Sciences Centre, London, Ontario, Canada
| | - David Bowes
- Department of Radiation Oncology, Nova Scotia Cancer Centre, Halifax, Nova Scotia, Canada
| | - Elizabeth Barnes
- Department of Radiation Oncology, Sunnybrook Health Sciences Centre, Odette Cancer Centre, Toronto, Ontario, Canada
| | - Nikhilesh Patil
- Department of Radiation Oncology, Nova Scotia Cancer Centre, Halifax, Nova Scotia, Canada
| | - Robyn Banerjee
- Division of Radiation Oncology, Tom Baker Cancer Centre, Calgary, Alberta, Canada
| | - Lisa Barbera
- Division of Radiation Oncology, Tom Baker Cancer Centre, Calgary, Alberta, Canada
| | - Ananth Ravi
- Department of Radiation Oncology, Sunnybrook Health Sciences Centre, Odette Cancer Centre, Toronto, Ontario, Canada
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Lombe DC, Crook JM, Bachand F, Batchelar D, Moore J, Rose T, Sherin D. Comparative benefit of interstitial needles in addition to intracavitary applicators in the treatment of locally advanced cervical cancer. J Clin Oncol 2019. [DOI: 10.1200/jco.2019.37.15_suppl.5528] [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: 11/20/2022] Open
Abstract
5528 Background: Cervical cancer is the leading cause of cancer mortality of women in Low and Middle Income Countries (LMIC). Interstitial needles (IN) have improved outcomes but the resources required in comparison to intracavitary brachytherapy (IC) alone has impeded uptake in endemic regions. We conducted a retrospective review of the utilisation of IN in the management of locally advanced cervical cancer and simulated 2D planning by loading the applicators using standard Manchester loading (ML) to explore the magnitude of benefit that interstitial needles provide. Methods: 72 brachytherapy plans of 18 patients who had undergone treatment using tandem and ring and had interstitial brachytherapy between 04/2016 and 10/2018 were reviewed. ML plans prescribed to point A were generated to represent a 2D scenario but the known HR-CTV was taken into consideration and its dosimetric outcomes were compared to those of the 3D based plans. Results: The median tumour volume was 23 cm3. IN was used in 82 % of the insertions. The median number of IN was 2 (range 0 – 6) with median percentage of IN dwell time 6.6 % (range 0.68 – 38.5). V100 was excellent 98.2% for ML 97.3% for 3D IN and 98.7% for 3D non-IN plans. The median HRCTV D90 was 8.5 Gy/fraction (cumulative EQD210101.4 Gy) for ML plans and 8.0 Gy/fraction (cumulative EQD210 91.4 Gy) for 3D plans. The ML plans failed to meet the OAR goals except for the rectum, which was optimally distanced by the rectal paddle. The median bladder, sigmoid and small bowel doses were 24% above the recommended constraint in the individual plans and 15% cumulative EQD2. A statistically significant relationship was found between the number of needles utilised, tumour volume (p < 0.001) and coverage (p = 0.006) but not delivered dose (p < 0.068). Conclusions: 2D brachytherapy can provide adequate dose coverage for most tumours but IN provide a benefit in reducing the doses to OARs in a significant number of patients. This justifies investment in resources for uptake of interstitial needles to increase access to optimal treatment of cervical cancer for women in LMIC. This research was made possible an ASCO Conquer Cancer Foundation grant.
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Marban Orejas M, Crook J, Keyes M, Batchelar D, Dubash R, Bachand F. OC-0436 13 SCC penis treated with HDR brachytherapy, results and dosimetric analysis. Radiother Oncol 2019. [DOI: 10.1016/s0167-8140(19)30856-4] [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: 11/29/2022]
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25
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Tissaverasinghe S, Crook J, Bachand F, Batchelar D, Hilts M, Araujo C, Anderson D, Bainbridge T, Farnquist B. Dose to the dominant intraprostatic lesion using HDR vs. LDR monotherapy: A Phase II randomized trial. Brachytherapy 2019; 18:299-305. [PMID: 30795889 DOI: 10.1016/j.brachy.2019.01.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [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: 11/11/2018] [Revised: 01/12/2019] [Accepted: 01/17/2019] [Indexed: 12/30/2022]
Abstract
PURPOSE To present the dosimetric results of a Phase II randomized trial comparing dose escalation to the MRI-defined dominant intraprostatic lesion (DIL) using either low-dose-rate (LDR) or high-dose-rate (HDR) prostate brachytherapy. MATERIAL AND METHODS Patients receiving prostate brachytherapy as monotherapy were randomized to LDR or HDR brachytherapy. Prostate and DILs were contoured on preoperative multiparametric MRI. These images were registered with transrectal ultrasound for treatment planning. LDR brachytherapy was preplanned using I-125 seeds. HDR brachytherapy used intraoperative transrectal ultrasound-based planning to deliver 27 Gy/2 fractions in separate implants. DIL location was classified as peripheral, central, or anterior. A student t-test compared DIL D90 between modalities and DIL locations. RESULTS Of 60 patients, 31 underwent LDR and 29 HDR brachytherapy. Up to three DILs were identified per patient (100 total) with 74 peripheral, six central, and 20 anterior DILs. Mean DIL volume was 1.9 cc (SD: 1.7 cc) for LDR and 1.6 cc (SD 1.3 cc) for HDR (p = 0.279). Mean DIL D90 was 151% (SD 30%) for LDR and 132% (SD 13%) for HDR. For LDR, mean peripheral DIL D90 was 159% (SD 27%) and central or anterior 127% (SD 13%). HDR peripheral DILs received 137% (SD 12%) and central or anterior 119% (SD 7%). DIL D90 for peripheral lesions was higher than anterior and central (p < 0.001). CONCLUSIONS DIL location affects dose escalation, particularly because of urethral proximity, such as for anterior and central DILs. HDR brachytherapy may dose escalate better when target DIL is close to critical organs.
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Affiliation(s)
- Steven Tissaverasinghe
- Radiation Oncology, BC Cancer and University of British Columbia, Vancouver, British Columbia, Canada
| | - Juanita Crook
- Radiation Oncology, BC Cancer and University of British Columbia, Vancouver, British Columbia, Canada.
| | - Francois Bachand
- Radiation Oncology, BC Cancer and University of British Columbia, Vancouver, British Columbia, Canada
| | - Deidre Batchelar
- Medical Physics, BC Cancer and University of British Columbia, Vancouver, British Columbia, Canada
| | - Michelle Hilts
- Medical Physics, BC Cancer and University of British Columbia, Vancouver, British Columbia, Canada
| | - Cynthia Araujo
- Medical Physics, BC Cancer and University of British Columbia, Vancouver, British Columbia, Canada
| | - Danielle Anderson
- Medical Physics, BC Cancer and University of British Columbia, Vancouver, British Columbia, Canada
| | - Terry Bainbridge
- Department of Pathology, Kelowna General Hospital, Kelowna, British Columbia, Canada
| | - Brenda Farnquist
- Department of Radiology, Kelowna General Hospital, Kelowna, British Columbia, Canada
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26
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Cho CKJ, Sunderland K, Pickles T, Bachand F, Chi KN, Tyldesley S. A Population-Based Study of Palliative Radiation Therapy for Bone Metastases in Patients Dying of Prostate Cancer. Pract Radiat Oncol 2019; 9:e274-e282. [PMID: 30641243 DOI: 10.1016/j.prro.2019.01.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2018] [Revised: 12/17/2018] [Accepted: 01/02/2019] [Indexed: 12/25/2022]
Abstract
PURPOSE Increasing the survival of patients with metastatic prostate cancer (PCa) may affect the demand for palliative radiation to bone (PRTB). Our aim was to characterize the use of PRTB in patients who died of PCa in British Columbia between 2003 and 2015. METHODS AND MATERIALS All patients with a diagnosis of PCa who died during the study period (n = 23,260) were identified from a population-based provincial registry. Patient and treatment characteristics were analyzed. PRTB utilization rate was calculated by year and location. Survival was calculated from the first and the last course of PRTB. RESULTS A total of 5701 patients died of PCa, with a median survival from diagnosis of 5.2 years. The overall PRTB utilization rate was 38.6%, with an increasing trend over time. Multiple courses of PRTB were frequent, with 51% of patients receiving ≥2 courses of PRTB. Of the patients who died of PCa (15.2% of the PRTB cohort), 5.4% received PRTB within the last 4 weeks of life, 60% of whom received multiple fractions. Rural areas had a lower referral rate and lower use of PRTB. Patients with longer survival tended to receive multiple courses of treatment. The median survival after the first course of PRTB increased from 8.2 months in 2003 to 2004 to 9.4 months in 2013 to 2014 (P = .04). CONCLUSIONS PRTB is only used in a minority of patients dying of PCa. The majority who die of PCa after PRTB do so within a year of their first course. The use of multifractionation was common in the last 4 weeks of life. Survival after first PRTB increased minimally over time, and additional research is required to identify its association with recent changes in practice. The referral rate and PRTB utilization rate differ between rural and nonrural locations, underlying the importance of accessibility and referral for utilization of PRTB. Investigating other barriers and ensuring equitable access to radiation are needed.
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Affiliation(s)
| | | | - Tom Pickles
- University of British Columbia, BC Cancer - Vancouver, Vancouver, Canada
| | - Francois Bachand
- University of British Columbia, BC Cancer - Vancouver, Vancouver, Canada
| | - Kim N Chi
- University of British Columbia, BC Cancer - Vancouver, Vancouver, Canada
| | - Scott Tyldesley
- University of British Columbia, BC Cancer - Vancouver, Vancouver, Canada.
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Parimi S, Bondy S, Tsang E, McKenzie MR, Bachand F, Aparicio M, Duncan G, Sunderland K, Olson RA, Pai HH, Alexander AS, LaPointe V, Chi KN, Tyldesley S. Pain response in a population-based study of radium-223 (Ra223) for metastatic castration-resistant prostate cancer. Can Urol Assoc J 2018; 13:E311-E316. [PMID: 31364977 DOI: 10.5489/cuaj.5685] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Clinical trials have shown that radium-223 (Ra223) can prolong survival and improve quality of life in patients with metastatic castration-resistant prostate cancer (mCRPC). The objectives of this study were to evaluate pain responses with Ra223 at a population-based level and to determine if there is an association between pain response and alkaline phosphatase (ALP) response. METHODS All patients from the Vancouver and Kelowna Cancer Centers (CC) in British Columbia who were treated with Ra223 between June 2015 and December 2016 were identified. Patients completed the Brief Pain Inventory (BPI) just prior to each Ra223 injection. Pain response was defined as a two or more point improvement in worst pain relative to baseline, without an increase in pain medication level. ALP was determined at each visit, with a response threshold defined as a 30% decrease from baseline, consistent with the definition of response used in the ALSYMPCA trial. RESULTS A total of 65 patients in Vancouver and Kelowna CC received Ra223 during the study period and 56 patients had at least one BPI record, of which 44 (79%) patients were assessable for change in worst pain. Of the assessable patients, 23 (52%, 95% confidence interval [CI] 38-67) had a pain response, although the use of concurrent external beam radiotherapy was a confounder in four cases. Of the 44 patients assessable for change in worst pain, 59% had ALP responses greater than 30%. An ALP response was seen in 56% of pain-responders vs. 43% of non-pain-responders. There was no association between pain response and ALP response (Phi =-0.05; p=0.77). CONCLUSIONS Ra223 administration was associated with a meaningful pain response rate in this cohort. There was no correlation between pain response and ALP response.
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Affiliation(s)
- Sunil Parimi
- Medical Oncology, British Columbia Cancer Agency, BC, Canada
| | - Suraya Bondy
- Genitourinary Cancer Outcomes Unit, British Columbia Cancer Agency, BC, Canada
| | - Erica Tsang
- Medical Oncology, British Columbia Cancer Agency, BC, Canada
| | | | | | - Maria Aparicio
- Genitourinary Cancer Outcomes Unit, British Columbia Cancer Agency, BC, Canada
| | - Graeme Duncan
- Radiation Oncology, British Columbia Cancer Agency, BC, Canada
| | | | | | | | | | | | - Kim N Chi
- Medical Oncology, British Columbia Cancer Agency, BC, Canada
| | - Scott Tyldesley
- Radiation Oncology, British Columbia Cancer Agency, BC, Canada
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Halperin H, Hilts M, Batchelar D, Tisseverasinghe S, Crook J, Bachand F. Development of a Surrogate Urethra for Real-Time Planning of High-Dose-Rate Prostate Brachytherapy. Brachytherapy 2018. [DOI: 10.1016/j.brachy.2018.04.144] [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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29
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Tisseverasinghe S, Crook J, Farnquist B, Araujo C, Batchelar D, Hilts M, Bachand F. Phase II Randomized Pilot Comparing HDR and LDR Monotherapy for Intermediate Risk Prostate Cancer: Report of Dose Escalation to Dominant Intraprostatic Lesions. Brachytherapy 2018. [DOI: 10.1016/j.brachy.2018.04.021] [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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Tetreault-Laflamme A, Crook J, Hamm J, Pickles T, Keyes M, McKenzie M, Pai H, Bachand F, Morris J. Long-Term Prostate Specific Antigen Stability and Predictive Factors of Failure after Permanent Seed Prostate Brachytherapy. J Urol 2018; 199:120-125. [PMID: 28827105 DOI: 10.1016/j.juro.2017.07.089] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/18/2017] [Indexed: 10/19/2022]
Affiliation(s)
- Audrey Tetreault-Laflamme
- Centre intégré universitaire de santé et de services sociaux de l’Estrie-Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, Quebec, Canada
| | - Juanita Crook
- British Columbia Cancer Agency, Kelowna, British Columbia, Canada
| | - Jeremy Hamm
- Cancer Surveillance and Outcomes, British Columbia Cancer Agency, Vancouver, British Columbia, Canada
| | - Tom Pickles
- British Columbia Cancer Agency, Vancouver, British Columbia, Canada
| | - Mira Keyes
- British Columbia Cancer Agency, Vancouver, British Columbia, Canada
| | - Michael McKenzie
- British Columbia Cancer Agency, Vancouver, British Columbia, Canada
| | - Howard Pai
- British Columbia Cancer Agency, Victoria, British Columbia, Canada
| | - Francois Bachand
- British Columbia Cancer Agency, Kelowna, British Columbia, Canada
| | - James Morris
- British Columbia Cancer Agency, Vancouver, British Columbia, Canada
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Parimi S, Tsang E, Alexander A, Mckenzie M, Bachand F, Sunderland K, Chi KN, Aparicio M, Worsley D, Tyldesley S. A population-based study of the use of radium 223 in metastatic castration-resistant prostate cancer: Factors associated with treatment completion. Can Urol Assoc J 2017; 11:350-355. [PMID: 29382449 DOI: 10.5489/cuaj.4415] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Radium 223 (Ra223) given for six cycles has proven efficacy in clinical trials, but its population-level generalizability has not been well-described. The objectives of this study were to describe population-based Ra223 use in the abiraterone and enzalutamide era and identify factors associated with completion. METHODS All Ra223 patients at the British Columbia Cancer Agency between September 2013 and February 2016 were identified. Patients who completed <5 vs. ≥5 cycles were compared on patient characteristics, lines of prior therapy, prostate-specific antigen (PSA) and alkaline phosphatase (ALP) decline >30% from baseline (R30%), and survival, to identify factors associated with therapy completion. RESULTS Ninety-one patients were identified; 48 (52.7%) completed >5 cycles. Median overall survival (mOS) was 10.7 months, PSA and ALP R30% were 21% and 52%, respectively. Completion of <5 cycles was associated with higher baseline ALP (p=0.05) and lower baseline hemoglobin (Hb) levels (p=0.03). Patients in the ≥5 cycles group had longer mOS than those in the <5 cycles group (16.2 vs. 5.9 months; p<0.0001), as well as higher PSA R30% (33.3% vs. 7.0%; p=0.002) and ALP R30% (66.7% vs. 34.9%; p=0.03). Patients with ALP ≥220 and Hb ≤118 had 3.85 times the odds of not completing ≥5 cycles vs. ALP <220 and Hb >118. CONCLUSIONS Compared to clinical trials, patients in a population-based setting had more lines of therapy and shorter survival. Lower ALP and higher hemoglobin were associated with completion of >5 cycles, longer mOS, and greater incidence of PSA and ALP response.
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Affiliation(s)
- Sunil Parimi
- Medical Oncology, British Columbia Cancer Agency, Vancouver, BC, Canada
| | - Erica Tsang
- Internal Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Abraham Alexander
- Radiation Oncology, British Columbia Cancer Agency, Vancouver, BC, Canada
| | - Michael Mckenzie
- Radiation Oncology, British Columbia Cancer Agency, Vancouver, BC, Canada
| | - Francois Bachand
- Radiation Oncology, British Columbia Cancer Agency, Vancouver, BC, Canada
| | - Katherine Sunderland
- Genitourinary Cancer Outcomes Unit, British Columbia Cancer Agency, Vancouver, BC, Canada
| | - Kim N Chi
- Medical Oncology, British Columbia Cancer Agency, Vancouver, BC, Canada
| | - Maria Aparicio
- Genitourinary Cancer Outcomes Unit, British Columbia Cancer Agency, Vancouver, BC, Canada
| | - Daniel Worsley
- Nuclear Medicine, Vancouver General Hospital, Vancouver, BC, Canada
| | - Scott Tyldesley
- Radiation Oncology, British Columbia Cancer Agency, Vancouver, BC, Canada
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Pilote L, Crook J, Gastanega M, Ots A, Rose J, Jaswal J, Tetreault-Laflamme A, Batchelar D, Schmid M, Araujo C, Milette M, Korzeniowski M, Bachand F. US-Planned HDR Prostate Brachytherapy Boost: Acute and Late Toxicity. Int J Radiat Oncol Biol Phys 2017. [DOI: 10.1016/j.ijrobp.2017.06.1225] [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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Leung E, D'Souza D, Alfieri J, Banerjee R, Bachand F, Barbera L, Barkati M, Barnes E, Bowes D, Fortin I, Foster W, Han K, Huang F, Patil N, Velker V, Vigneault E, Wiebe E, Wronski M, Ravi A. Contouring and Target Variability in Vaginal Tumors Treated with MR-Based Interstitial Brachytherapy: A Multi-institutional Contouring Study. Int J Radiat Oncol Biol Phys 2017. [DOI: 10.1016/j.ijrobp.2017.06.263] [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: 11/25/2022]
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Tyldesley S, Parimi S, Tsang E, Bachand F, Aparicio M, Duncan G, Sunderland K, Olson R, Pai H, Alexander A, Lapointe V, Chi K. EP-1359: Pain response in a Population-based study of Radium-223 for Metastatic Prostate Cancer. Radiother Oncol 2017. [DOI: 10.1016/s0167-8140(17)31794-2] [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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Pilote L, Crook J, Boronat MG, Ots A, Jaswal J, Rose J, Tétreault-Laflamme A, Batchelar D, Shmid M, Araujo C, Millette MP, Bachand F. US-Planned HDR Prostate Brachytherapy Boost: Acute and Late Toxicity. Brachytherapy 2017. [DOI: 10.1016/j.brachy.2017.04.226] [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: 11/24/2022]
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Korzeniowski M, Crook J, Bowes D, Gaztañaga M, Ots A, Rose J, Tétreault-Laflamme A, Halperin R, Kim D, Petrik D, Araujo C, Bachand F. Prostate Downsizing with Degarelix Prior to Brachytherapy: Results of a Phase II Trial. Brachytherapy 2017. [DOI: 10.1016/j.brachy.2017.04.111] [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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Tetreault-Laflamme A, Araujo C, Bachand F, Schmid M, Batchelar D, Crook J. 38: Is Foley Catheter an Adequate Surrogate for Urethra when Planning High-Dose Rate Prostate Brachytherapy? Radiother Oncol 2016. [DOI: 10.1016/s0167-8140(16)33437-5] [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: 11/15/2022]
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38
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Crook J, Bachand F, Chang S, Batchelar D, Schmid M. 52: Correlation of Multiparametric MRI (MPMRI) with PSA in Assessment of Response to Combined HDR Prostate Brachytherapy and External Beam Radiotherapy for Upper Tier Intermediate and High-Risk Prostate Cancer. Radiother Oncol 2016. [DOI: 10.1016/s0167-8140(16)33451-x] [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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Cho J, Pickles T, Bachand F, Chi K, Tyldesley S, Cho K. 246: Palliative Radiotherapy for Bone Metastases in Patients Dying of Prostate Cancer: The British Columbia Experience. Radiother Oncol 2016. [DOI: 10.1016/s0167-8140(16)33645-3] [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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Tetreault-Laflamme A, Araujo C, Bachand F, Schmid M, Batchelar D, Crook J. Is Foley Catheter an Adequate Surrogate for Urethra when Planning High-Dose-Rate Prostate Brachytherapy? Brachytherapy 2016. [DOI: 10.1016/j.brachy.2016.04.348] [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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Tetreault-Laflamme A, Crook J, Hamm J, Pickles T, Keyes M, McKenzie M, Pai H, Bachand F, Morris J. Long Term PSA Stability and Predictive Factors of Failure after Permanent Seed Prostate Brachytherapy. Brachytherapy 2016. [DOI: 10.1016/j.brachy.2016.04.020] [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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Crook J, Bachand F, Chang S, Batchelar D, Schmid M. Correlation of Multi-Parametric MRI (mpMRI) with PSA in the Assessment of Response to Combined HDR Prostate Brachytherapy and External Beam Radiotherapy for Upper Tier Intermediate and High Risk Prostate Cancer. Brachytherapy 2016. [DOI: 10.1016/j.brachy.2016.04.326] [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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Hilts M, Halperin H, Morton D, Batchelar D, Bachand F, Chowdhury R, Crook J. Skin dose in breast brachytherapy: Defining a robust metric. Brachytherapy 2015; 14:970-8. [DOI: 10.1016/j.brachy.2015.08.002] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2015] [Revised: 07/27/2015] [Accepted: 08/11/2015] [Indexed: 11/27/2022]
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Tetreault-Laflamme A, Bachand F. Grade 3 Radiation Recall Sigmoiditis after Treatment for Locally Advanced Cervical Cancer: A Case Report. Cureus 2015; 7:e353. [PMID: 26623208 PMCID: PMC4652921 DOI: 10.7759/cureus.353] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
We report a case of Grade 3 radiation recall sigmoiditis after administration of a combination of carboplatin, paclitaxel, and bevacizumab, following irradiation for a locally advanced cervical cancer. A 50-year-old woman was diagnosed with an FIGO Stage IIIb squamous cell carcinoma of the cervix with bilateral pelvic and para-aortic lymph nodes. She underwent concurrent chemoradiation followed by high dose rate (HDR) intracavitary brachytherapy. She had a complete loco-regional response. A supraclavicular recurrence was diagnosed three months after completing treatment and two cycles of carboplatin, docetaxel, and bevacizumab were given in April 2014. Shortly after the second cycle, she was admitted to the hospital for significant abdominal pain, diarrhea followed by symptoms of bowel subocclusion. The CT scan and endoscopic images revealed thickening of the sigmoid wall with important edema and telangiectasia. The biopsy was consistent with acute radiation-induced colitis. Because of persistent digestive symptoms, a diverting ileostomy was done few months later. The location, timing, pathology, and its association with a high-dose region are analyzed in this case report.
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Affiliation(s)
| | - Francois Bachand
- Radiation Oncology, BC Cancer Agency, Sindi Ahluwalia Hawkins Centre for the Southern Interior
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Bachand F, Phillips D, Crook J, Petrik D, Batchelar D. The Role of Deformable Image Registration Looking at Small Bowel and Sigmoid During Multi-Fraction Adaptive Image-Guided HDR Brachytherapy for Cervix Cancer. Brachytherapy 2015. [DOI: 10.1016/j.brachy.2015.02.296] [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: 11/30/2022]
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Rose T, Garcia E, Bachand F, Kim D, Petrik D, Halperin R, Crook J. QOL Comparison of Acute Side Effects From a High Dose Rate Vs. Low Dose Rate Prostate Brachytherapy Boost Combined With External Beam Radiotherapy. Brachytherapy 2015. [DOI: 10.1016/j.brachy.2015.02.245] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [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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Rose T, Batchelar D, Robertson B, Crook J, Petrik D, Bachand F. Planning CT Scans for the Treatment of HDR Vaginal Vault Brachytherapy: An Evaluation of Its Role to Determine the Dose to the Organs at Risk. Brachytherapy 2015. [DOI: 10.1016/j.brachy.2015.02.340] [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: 10/23/2022]
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Batchelar D, Collins A, Jaswal J, Schmid M, Bachand F, Crook J. A Comparison of Rigid to Deformable Registration for Dose Escalation to the Dominant Lesion in HDR Prostate Brachytherapy. Brachytherapy 2015. [DOI: 10.1016/j.brachy.2015.02.279] [Citation(s) in RCA: 2] [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: 10/23/2022]
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Rose J, Bachand F, Petrik D, Batchelar D, Schmid M, Crook J. Transvaginal Ultrasound-Guided Interstitial Brachytherapy for Vaginal Tumors: A Fixed Template Technique. Int J Radiat Oncol Biol Phys 2014. [DOI: 10.1016/j.ijrobp.2014.05.1544] [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: 11/24/2022]
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Rose JN, Bachand F, Petrik D, Batchelar D, Schmid M, Crook JM. Transvaginal Ultrasound-Guided Transperineal Interstitial Brachytherapy for Vaginal Tumors: A Fixed Template Technique. Brachytherapy 2014. [DOI: 10.1016/j.brachy.2014.02.335] [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: 11/29/2022]
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