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Siva S, Bressel M, Sidhom M, Sridharan S, Vanneste B, Davey R, Ruben J, Foroudi F, Higgs BG, Lin C, Raman A, Hardcastle N, Shaw M, Mancuso P, Lawrentschuk N, Wood S, Brook N, Kron T, Martin JM, Pryor DI. TROG 15.03/ANZUP International Multicenter Phase II Trial of Focal Ablative STereotactic RAdiotherapy for Cancers of the Kidney (FASTRACK II). Int J Radiat Oncol Biol Phys 2023; 117:S3. [PMID: 37784470 DOI: 10.1016/j.ijrobp.2023.06.208] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Stereotactic body radiotherapy (SBRT) is an emerging non-invasive alternative for primary renal cell cancer (RCC) in patients unsuitable for surgery. The objective of the FASTRACK II clinical trial was to investigate the efficacy of SBRT for primary RCC. MATERIALS/METHODS This non-randomized, intergroup multi-institutional phase II study was activated in 7 Australian centers and 1 Dutch center, through the Trans Tasman Radiation Oncology Group (TROG) and the Australian and New Zealand Urogenital and Prostate Cancer Trials Group (ANZUP). Eligible patients had biopsy confirmed diagnosis of primary RCC with a single lesion within a kidney, ECOG performance ≤2 and were medically inoperable, high risk or declined surgery. For tumors ≤4 cm a single fraction of 26 Gy was prescribed, for tumors > 4 cm, 42 Gy in three fractions was prescribed. The primary outcome of the study was to estimate the efficacy of SBRT for primary RCC, defined as local control based on RECIST criteria. The study was powered assuming that 1-year local control would be 90%, with the null hypothesis of ≤80% considered undesirable and not worthy of proceeding to a future randomized controlled trial. RESULTS Between July 2016 and February 2020, 70 patients were enrolled with a median follow-up of 42 months. Median age was 77 years. Forty-nine patients were male (70%), median BMI was 32 and median Charlson comorbidity score was 7. The median [IQR] RENAL complexity score was 8 [7-10]. Biopsy confirmation was 100%. Twenty-three patients (33%) had T1a disease. The median (interquartile range [IQR]) tumor size was 4.6cm [3.7-5.5]; it was 3.3cm [3.0-3.6] in those receiving single fraction (n = 23), and 5.3cm [4.6-6.0] in those receiving 3-fraction SBRT (n = 47). During real-time pre-treatment quality assurance review, 10 cases (14.3%) required resubmission for protocol deviation, 2119 variables were assessed at final review, and final protocol compliance was 99.3%. Seven (10%) patients experienced grade 3 treatment-related adverse events, with no grade 4 or 5 events observed. Eleven (16%) patients reported no adverse events. Local control was 100% throughout the lifetime of the trial (p<0.001). Cancer-specific survival was also 100% throughout the lifetime of the trial. Freedom from distant failure (95% CIs) at 1 and 3 years was 99% (90-100%). Overall survival (95% CIs) at 1 and 3 years was 99% (90-100%) and 82% (70-89%), respectively. Baseline mean eGFR (95% CI) was 61.1 mLs/min (56.6; 65.6) and reduced by -10.8 mLs/min (-13.0; -8.6) by 1-year, by -14.6 mLs/min (-17.0; -12.2) by 2-years and plateaued thereafter. CONCLUSION In the first multicenter prospective trial of a non-surgical primary RCC cohort, enrolling mostly T1b+ disease, SBRT was an effective treatment strategy with no observed local failures. We observed an acceptable side effect profile and renal function after SBRT. These outcomes support the design of a future randomized clinical trial of SBRT versus surgery for primary RCC. The trial was registered with ID: NCT02613819.
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Affiliation(s)
- S Siva
- Peter MacCallum Cancer Centre and Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, Australia
| | - M Bressel
- Peter MacCallum Cancer Centre and Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, VIC, Australia
| | - M Sidhom
- Liverpool Hospital Cancer Therapy Centre, University of New South Wales, School of Medicine, Sydney, NSW, Australia
| | - S Sridharan
- Calvary Mater Newcastle, Waratah & School of Medicine and Public Health, University of Newcastle, Callaghan, NSW, Australia
| | - B Vanneste
- Department of Radiation Oncology (MAASTRO), GROW - School for Oncology and Developmental Biology, Maastricht University Medical Center, Maastricht, Netherlands
| | - R Davey
- TROG Cancer Research, Waratah, NSW, Australia
| | - J Ruben
- The William Buckland Radiotherapy Centre, Alfred Health, Melbourne, VIC, Australia
| | - F Foroudi
- Austin Health, Radiation Oncology, Melbourne, Australia
| | - B G Higgs
- Department of Radiation Oncology, Royal Adelaide Hospital, Adelaide, SA, Australia
| | - C Lin
- Dept of Radiation Oncology, Royal Brisbane and Women's Hospital, Brisbane, QLD, Australia
| | - A Raman
- Royal Newcastle Centre, John Hunter Hospital & School of Medicine and Public Health, University of Newcastle, Newcastle, NSW, Australia
| | - N Hardcastle
- Peter MacCallum Cancer Centre and Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, VIC, Australia
| | - M Shaw
- Peter MacCallum Cancer Centre, Melbourne, VIC, Australia
| | - P Mancuso
- Urology Department, Liverpool Hospital, Sydney, NSW, Australia
| | - N Lawrentschuk
- Peter MacCallum Cancer Centre, Melbourne, VIC, Australia
| | - S Wood
- Princess Alexandra Hospital, Brisbane, QLD, Australia
| | - N Brook
- Department of Surgery, School of Medicine, University of Adelaide, Adelaide, SA, Australia
| | - T Kron
- Peter MacCallum Cancer Centre and Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, VIC, Australia
| | - J M Martin
- Department of Radiation Oncology, Calvary Mater Newcastle & School of Medicine and Public Health, University of Newcastle, Newcastle, NSW, Australia
| | - D I Pryor
- Princess Alexandra Hospital, Brisbane, QLD, Australia
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Siva S, McMahon R, Bressel M, Dsouza C, Castle RG, DiIulio J, Jennens R, Thai A, Tan L, Morris T, Dawson SJ, Shaw M, Plumridge N, Neeson P, Ball DL, Solomon B. SABRSeq: A Randomized Phase Ib Trial of SABR Sequencing with Pembrolizumab in Metastatic Non-Small Cell Lung Cancer (NSCLC). Int J Radiat Oncol Biol Phys 2023; 117:e58. [PMID: 37785761 DOI: 10.1016/j.ijrobp.2023.06.774] [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 optimal sequencing of stereotactic ablative body radiotherapy (SABR) with anti-PD1 checkpoint blockade is unknown. The purpose of SABRseq was to assess the toxicity of the combination of SABR delivered either before or after the commencement of pembrolizumab. The central hypothesis is that the treatment combination will have a safety profile that is clinically acceptable and demonstrate anti-tumor efficacy. Furthermore, we hypothesize that differences in systemic immune activation will be observed between treatment arms. MATERIALS/METHODS This was a single institutional phase Ib randomized clinical trial (Trial ID NCT03307759). Eligible patients had metastatic NSCLC, ECOG performance 0-1, and had not received prior checkpoint immunotherapy, high-dose radiation (>36 Gy) within 6 months, or either systemic or radiation therapy within 4 weeks of randomization. Eligible patients had either TPS≥50% PD-L1 expression in the first-line or TPS≥1% PD-L1 expression with prior chemotherapy exposure. Patients were randomized to SABR before the commencement of pembrolizumab [ARM1] or SABR commencing after pembrolizumab [ARM2]. SABR was delivered in a single fraction of 18-20 Gy to 1-3 lesions. The primary endpoint was treatment-related adverse events (AE's) related to SABR and/or pembrolizumab. Secondary endpoints included best overall response (BOR), overall survival (OS), and progression-free survival (PFS). Translational objectives included the evaluation of longitudinal changes in immunological cellular subsets within peripheral blood to explore changes in systemic immunity and circulating tumor DNA (ctDNA) dynamics. RESULTS Between December 2017 and December 2019, 13 patients were randomized. The median follow-up was 37 months. The study was closed early due to poor accrual. Median age was 66 years, with 11 patients (84%) having adenocarcinoma. Nine (69%) were enrolled in the first-line setting. The median [range] number of lesions was 6 [3-11]. The median [range] cycles of pembrolizumab delivered in ARM 1 was 13 [12-32] and ARM 2 was 9 [3-34]. Grade 3 treatment-related AEs were experienced in 0 of 5 patients in ARM1 and in 1 of 8 patients in ARM 2 (hyperglycemia). There were no grade 4 or 5 adverse events reported. The BOR by both RECIST and iRECIST criteria was CR in one patient, PR in seven patients, SD in five patients. Median (95% Cis) PFS was 12.4 months (6.3-21.0), and median (95% Cis) OS was 47.1 months (12.6-not reached; 2-year point estimate 62% [31-82]). Mass cytometry was used on serial peripheral blood samples to examine changes in the frequency of immune cells, changes in T cell activation, differentiation and functional polarization state. Targeted sequencing was performed to assess ctDNA. Translational outcomes will be presented. CONCLUSION There was no evidence of a concerning safety signal from either SABR before or after start of pembrolizumab. The combination demonstrated activity with promising PFS and OS and is worthy of evaluation in larger randomized trials.
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Affiliation(s)
- S Siva
- Peter MacCallum Cancer Centre and Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, Australia
| | - R McMahon
- Peter MacCallum Cancer Centre and Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, VIC, Australia
| | - M Bressel
- Peter MacCallum Cancer Centre and Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, VIC, Australia
| | - C Dsouza
- Peter MacCallum Cancer Centre, Melbourne, VIC, Australia
| | - R G Castle
- Peter MacCallum Cancer Centre, Melbourne, Australia
| | - J DiIulio
- Peter MacCallum Cancer Centre, Melbourne, VIC, Australia
| | - R Jennens
- Peter MacCallum Cancer Centre, Melbourne, VIC, Australia
| | - A Thai
- Peter MacCallum Cancer Centre, Melbourne, VIC, Australia
| | - L Tan
- Peter MacCallum Cancer Centre, Melbourne, VIC, Australia
| | - T Morris
- Southern Blood and Cancer Service, Dunedin, New Zealand
| | - S J Dawson
- Peter MacCallum Cancer Centre and Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, VIC, Australia
| | - M Shaw
- Peter MacCallum Cancer Centre, Melbourne, VIC, Australia
| | - N Plumridge
- Peter MacCallum Cancer Centre, Melbourne, VIC, Australia
| | - P Neeson
- Peter MacCallum Cancer Centre and Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, VIC, Australia
| | - D L Ball
- Peter MacCallum Cancer Centre and Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, VIC, Australia
| | - B Solomon
- Peter MacCallum Cancer Centre and Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, VIC, Australia
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Alipour R, Jackson P, Bressel M, Hogg A, Callahan J, Hicks RJ, Kong G. The relationship between tumour dosimetry, response, and overall survival in patients with unresectable Neuroendocrine Neoplasms (NEN) treated with 177Lu DOTATATE (LuTate). Eur J Nucl Med Mol Imaging 2023; 50:2997-3010. [PMID: 37184682 PMCID: PMC10382388 DOI: 10.1007/s00259-023-06257-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [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: 12/03/2022] [Accepted: 04/30/2023] [Indexed: 05/16/2023]
Abstract
Peptide Receptor Radionuclide Therapy (PRRT) delivers targeted radiation to Somatostatin Receptor (SSR) expressing Neuroendocrine Neoplasms (NEN). We sought to assess the predictive and prognostic implications of tumour dosimetry with respect to response by 68 Ga DOTATATE (GaTate) PET/CT molecular imaging tumour volume of SSR (MITVSSR) change and RECIST 1.1, and overall survival (OS). METHODS Patients with gastro-entero-pancreatic (GEP) NEN who received LuTate followed by quantitative SPECT/CT (Q-SPECT/CT) the next day (Jul 2010 to Jan 2019) were retrospectively reviewed. Single time-point (STP) lesional dosimetry was performed for each cycle using population-based pharmacokinetic modelling. MITVSSR and RECIST 1.1 were measured at 3-months post PRRT. RESULTS Median of 4 PRRT cycles were administered to 90 patients (range 2-5 cycles; mean 27.4 GBq cumulative activity; mean 7.6 GBq per cycle). 68% received at least one cycle with radiosensitising chemotherapy (RSC). RECIST 1.1 partial response was 24%, with 70% stable and 7% progressive disease. Cycle 1 radiation dose in measurable lesions was associated with local response (odds ratio 1.5 per 50 Gy [95% CI: 1.1-2.0], p = 0.002) when adjusted by tumour grade and RSC. Median change in MITVSSR was -63% (interquartile range -84 to -29), with no correlation with radiation dose to the most avid lesion on univariable or multivariant analyses (5.6 per 10 Gy [95% CI: -1.6, 12.8], p = 0.133). OS at 5-years was 68% (95% CI: 56-78%). Neither baseline MITVSSR (hazard ratio 1.1 [95% CI: 1.0, 1.2], p = 0.128) nor change in baseline MITVSSR (hazard ratio 1.0 [95% CI: 1.0, 1.1], p = 0.223) were associated with OS when adjusted by tumour grade and RSC but RSC was (95% CI: 0.2, 0.8, p = 0.012). CONCLUSION Radiation dose to tumour during PRRT was predictive of radiologic response but not survival. Survival outcomes may relate to other biological factors. There was no evidence that MITVSSR change was associated with OS, but a larger study is needed.
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Affiliation(s)
- R Alipour
- Department of Cancer Imaging, Peter MacCallum Cancer Centre, Melbourne, Australia.
- The Sir Peter MacCallum Department of Oncology, The University of Melbourne, Melbourne, Australia.
| | - P Jackson
- Department of Cancer Imaging, Peter MacCallum Cancer Centre, Melbourne, Australia
- The Sir Peter MacCallum Department of Oncology, The University of Melbourne, Melbourne, Australia
| | - M Bressel
- The Sir Peter MacCallum Department of Oncology, The University of Melbourne, Melbourne, Australia
- Centre for Biostatistics and Clinical Trials, Peter MacCallum Cancer Centre, Melbourne, Australia
| | - A Hogg
- Department of Cancer Imaging, Peter MacCallum Cancer Centre, Melbourne, Australia
| | - J Callahan
- Department of Cancer Imaging, Peter MacCallum Cancer Centre, Melbourne, Australia
| | - R J Hicks
- Department of Medicine, St Vincent's Medical School, The University of Melbourne, Melbourne, Australia
| | - G Kong
- Department of Cancer Imaging, Peter MacCallum Cancer Centre, Melbourne, Australia
- The Sir Peter MacCallum Department of Oncology, The University of Melbourne, Melbourne, Australia
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Bucknell N, Hardcastle N, Woon B, Bressel M, Byrne K, Selbie L, Callahan J, Hanna G, Hofman M, Ball D, Kron T, Siva S. EP05.01-023 Feasibility of Functional Lung Avoidance using Ga-68 4D Ventilation Perfusion PET/CT: The HI-FIVE Trial. J Thorac Oncol 2022. [DOI: 10.1016/j.jtho.2022.07.470] [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: 12/01/2022]
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Rischin D, Mehanna H, Young RJ, Bressel M, Dunn J, Corry J, Soni P, Fulton-Lieuw T, Iqbal G, Kenny L, Porceddu S, Wratten C, Robinson M, Solomon BJ. Prognostic stratification of HPV-associated oropharyngeal cancer based on CD103 + immune cell abundance in patients treated on TROG 12.01 and De-ESCALaTE randomized trials. Ann Oncol 2022; 33:804-813. [PMID: 35525376 DOI: 10.1016/j.annonc.2022.04.074] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [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: 02/09/2022] [Revised: 04/14/2022] [Accepted: 04/18/2022] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND High CD103+ intratumoral immune cell (ITIC) abundance is associated with better prognosis in unselected patients with human papilloma virus-associated oropharyngeal squamous cell carcinoma (HPV-associated OPSCC) treated with cisplatin and radiotherapy (CIS/RT). Substituting cetuximab (CETUX) for CIS with RT in HPV-associated OPSCC resulted in inferior efficacy. Our aim was to determine whether quantification of CD103 ITIC could be used to identify a population of HPV-associated OPSCC with superior prognosis. PATIENTS AND METHODS We pooled data from the TROG 12.01 and De-ESCALaTE randomized trials that compared CETUX/70GyRT with CIS/70GyRT in low-risk HPV-associated OPSCC: American Joint Committee on Cancer 7 stage III (excluding T1-2N1) or stage IV (excluding N2b-c if smoking history >10 pack-years and/or distant metastases), including all patients with available tumor samples. The primary endpoint was failure-free survival (FFS) in patients receiving CETUX/RT comparing CD103+ ITIC high (≥30%) versus low (<30%). High and low CD103 were compared using Cox regression adjusting for age, stage and trial. RESULTS Tumor samples were available in 159/182 patients on TROG 12.01 and 145/334 on De-ESCALaTE. CD103+ ITIC abundance was high in 27% of patients. The median follow-up was 3.2 years. The 3-year FFS in patients treated with CETUX/RT was 93% [95% confidence interval (CI) 79% to 98%] in high CD103 and 74% (95% CI 63% to 81%) in low CD103 [adjusted hazard ratio = 0.22 (95% CI 0.12-0.41), P < 0.001]. The 3-year overall survival in patients treated with CETUX/RT was 100% in high CD103 and 86% (95% CI 76% to 92%) in low CD103, P < 0.001. In patients treated with CIS/RT, there was no significant difference in FFS. CONCLUSIONS CD103+ ITIC expression separates CETUX/RT-treated low-risk HPV-associated OPSCC into excellent and poor prognosis subgroups. The high CD103 population is a rational target for de-intensification trials.
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Affiliation(s)
- D Rischin
- Department of Medical Oncology, Peter MacCallum Cancer Centre, Melbourne; Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, Australia.
| | - H Mehanna
- Institute of Head and Neck Studies and Education (InHANSE), University of Birmingham, Birmingham, UK
| | - R J Young
- Research Division, Peter MacCallum Cancer Centre, Melbourne, Australia
| | - M Bressel
- Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, Australia; Centre for Biostatistics and Clinical Trials, Peter MacCallum Cancer Centre, Melbourne, Australia
| | - J Dunn
- Warwick Clinical Trials Unit, University of Warwick, Coventry, UK
| | - J Corry
- Genesiscare St Vincent's Hospital, Melbourne, Australia; Department of Medicine, University of Melbourne, Melbourne, Australia
| | - P Soni
- Department of Pathology, Peter MacCallum Cancer Centre, Melbourne, Australia
| | - T Fulton-Lieuw
- Institute of Head and Neck Studies and Education (InHANSE), University of Birmingham, Birmingham, UK
| | - G Iqbal
- Warwick Clinical Trials Unit, University of Warwick, Coventry, UK
| | - L Kenny
- Department of Radiation Oncology, Royal Brisbane & Women's Hospital, Brisbane, Australia; Faculty of Medicine, University of Queensland, Brisbane, Australia
| | - S Porceddu
- Faculty of Medicine, University of Queensland, Brisbane, Australia; Department of Radiation Oncology, Princess Alexandra Hospital, Brisbane, Australia
| | - C Wratten
- Department of Radiation Oncology, Calvary Mater Hospital and University of Newcastle, Newcastle, Australia
| | - M Robinson
- Cellular Pathology, Newcastle upon Tyne Hospitals, Newcastle, UK
| | - B J Solomon
- Department of Medical Oncology, Peter MacCallum Cancer Centre, Melbourne; Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, Australia; Research Division, Peter MacCallum Cancer Centre, Melbourne, Australia
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Xu M, Lasocki A, Bressel M, Goroncy N, Seymour J, Wheeler G, Dwyer M, Wiltshire K, Haghighi N, Mason K, Tange D, Campbell B. OC-0760 Active surveillance is safe for asymptomatic radiation-induced meningiomas in cancer survivors. Radiother Oncol 2022. [DOI: 10.1016/s0167-8140(22)02666-4] [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: 11/26/2022]
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McDowell L, Rischin D, King M, Kenny L, Porceddu S, Wratten C, Macann A, Jackson J, Bressel M, Fua T, Lin C, Liu C, Corry J. PD-0822 Impact of radiotherapy laterality on patient-reported outcomes in T1-2 HPV tonsillar carcinoma. Radiother Oncol 2022. [DOI: 10.1016/s0167-8140(22)02963-2] [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: 11/28/2022]
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Siva S, Bressel M, Sogono P, Shaw M, Chander S, Chu J, Plumridge N, Byrne K, Kothari G, Bucknell N, Hardcastle N, Kron T, Wheeler G, MacManus M, Hanna G, Ball D, David S. MO-0711 Impact of operability and total metastatic ablation on outcomes after SABR for oligometastases. Radiother Oncol 2022. [DOI: 10.1016/s0167-8140(22)02409-4] [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: 10/18/2022]
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Tran K, Tsang R, Suh C, Yoon H, Taguchi S, Oguchi M, Gunther J, Dabaja B, Wright C, Plastaras J, Elsayad K, Ng A, Binkley M, Brady J, Wang X, Levis M, Harris M, Bressel M, MacManus M, Wirth A. An International, Multi-Centre Study of Radiotherapy for Bilateral Indolent Orbital Adnexal Lymphomas (IOAL). Int J Radiat Oncol Biol Phys 2021. [DOI: 10.1016/j.ijrobp.2021.07.242] [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: 10/20/2022]
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Sandhu S, Joshua A, Emmett L, Spain L, Horvath L, Crumbaker M, Anton A, Wallace R, Pasam A, Bressel M, Cassidy E, Banks P, Kumar A, Alipour R, Akhurst T, Kong G, Davis I, Williams S, Hicks R, Hofman M. 577O PRINCE: Interim analysis of the phase Ib study of 177Lu-PSMA-617 in combination with pembrolizumab for metastatic castration resistant prostate cancer (mCRPC). Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.1090] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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Campbell B, Lasocki A, Bressel M, Oon S, Goroncy N, Seymour J, Dwyer M, Wiltshire K, Mason K, Tange D, Xu M, Wheeler G. OC-0209 Radiation-induced cavernomas: investigating the role of MRI-SWI for screening and surveillance in long-term cancer survivors. Radiother Oncol 2021. [DOI: 10.1016/s0167-8140(21)06824-9] [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: 10/20/2022]
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Siva S, Bressel M, Mai T, Le H, Vinod S, de Silva H, Macdonald S, Skala M, Hardcastle N, Rezo A, Pryor D, Gill S, Higgs B, Wagenfuehr K, Montgomery R, Awad R, Chesson B, Eade T, Wong W, Sasso G, De Abreu Lourenco R, Kron T, Ball D, Neeson P. OC-0335 Final results of TROG 13.01 SAFRON II: Single vs multi-fraction SABR for pulmonary oligometastases. Radiother Oncol 2021. [DOI: 10.1016/s0167-8140(21)06868-7] [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: 10/20/2022]
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Kron T, Bressel M, Lonski P, Hill C, Mercieca-Bebber R, Ahern V, Lehman M, Johnson C, Latty D, Ward R, Miller D, Banjade D, Moriss D, De Abreu Lourenco R, Woodcock J, Montgomery R, Lehmann J, Chua B. PH-0225 TROG 14.04: Multicentre study of feasibility and impact on anxiety of DIBH in breast cancer patients. Radiother Oncol 2021. [DOI: 10.1016/s0167-8140(21)07277-7] [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: 10/20/2022]
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Yeh J, Foroudi F, Tai K, Bressel M, Kron T. PD-0851 Clinical outcomes of online adaptive RT and conventional RT for muscle invasive bladder cancer. Radiother Oncol 2021. [DOI: 10.1016/s0167-8140(21)07130-9] [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: 10/20/2022]
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Campbell BA, Lasocki A, Oon SF, Bressel M, Goroncy N, Dwyer M, Wiltshire K, Seymour JF, Mason K, Tange D, Xu M, Wheeler G. Evaluation of the Impact of Magnetic Resonance Imaging with Susceptibility-weighted Imaging for Screening and Surveillance of Radiation-induced Cavernomas in Long-term Survivors of Malignancy. Clin Oncol (R Coll Radiol) 2021; 33:e425-e432. [PMID: 34024699 DOI: 10.1016/j.clon.2021.04.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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: 12/28/2020] [Revised: 03/25/2021] [Accepted: 04/21/2021] [Indexed: 11/26/2022]
Abstract
AIMS Radiation-induced cavernomas (RIC) are common late toxicities in long-term survivors of malignancy following cerebral irradiation. However, the natural history of RIC is poorly described. We report the first series of long-term surveillance of RIC using modern magnetic resonance imaging (MRI) including highly sensitive susceptibility-weighted imaging (SWI). The aims of this research were to better characterise the natural history of RIC and investigate the utility of MRI-SWI for screening and surveillance. MATERIALS AND METHODS Eligibility required long-term survivors of malignancy with previous exposure to cerebral irradiation and RIC identified on MRI-SWI surveillance. The number and size of RIC were reported on Baseline MRI-SWI and last Follow-up MRI-SWI. RESULTS In total, 113 long-term survivors with RIC underwent MRI-SWI surveillance; 109 (96%) were asymptomatic at the time of RIC diagnosis. The median age at cerebral irradiation was 9.3 years; the median radiotherapy dose was 50.4 Gy. The median time from cerebral irradiation to Baseline MRI-SWI was 17.9 years. On Baseline MRI-SWI, RIC multiplicity was present in 89% of patients; 34% had >10 RIC; 65% had RIC ≥4 mm. The median follow-up from Baseline MRI-SWI was 7.3 years. On Follow-up MRI-SWI, 96% of patients had multiple RIC; 62% had >10 RIC; 72% had RIC ≥4 mm. Of the 109 asymptomatic patients at RIC diagnosis, 96% remained free from RIC-related symptoms at 10 years. Only two required neurosurgical intervention for RIC; there was no RIC-related mortality. CONCLUSIONS RIC are commonly multiple, asymptomatic and typically increase in size and number over time. Our findings suggest that MRI-SWI for screening of RIC is unlikely to influence longer term intervention in asymptomatic cancer survivors. In the absence of neurological symptoms, assessment or monitoring of RIC are insufficient indications for MRI-SWI surveillance for long-term survivors of malignancy with past exposure to cerebral irradiation.
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Affiliation(s)
- B A Campbell
- Department of Radiation Oncology, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia; Sir Peter MacCallum Department of Oncology, The University of Melbourne, Melbourne, Victoria, Australia.
| | - A Lasocki
- Department of Cancer Imaging, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia; Sir Peter MacCallum Department of Oncology, The University of Melbourne, Melbourne, Victoria, Australia
| | - S F Oon
- Sir Peter MacCallum Department of Oncology, The University of Melbourne, Melbourne, Victoria, Australia
| | - M Bressel
- Centre for Biostatistics and Clinical Trials, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
| | - N Goroncy
- Department of Cancer Nursing, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
| | - M Dwyer
- Department of Radiation Oncology, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
| | - K Wiltshire
- Department of Radiation Oncology, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
| | - J F Seymour
- Centre for Biostatistics and Clinical Trials, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia; Department of Haematology, Peter MacCallum Cancer Centre and Royal Melbourne Hospital, Melbourne, Victoria, Australia
| | - K Mason
- Sir Peter MacCallum Department of Oncology, The University of Melbourne, Melbourne, Victoria, Australia; Department of Haematology, Peter MacCallum Cancer Centre and Royal Melbourne Hospital, Melbourne, Victoria, Australia
| | - D Tange
- Department of Cancer Surgery, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
| | - M Xu
- Department of Radiation Oncology, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
| | - G Wheeler
- Department of Radiation Oncology, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
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16
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Newman S, Bucknell N, Bressel M, Tran P, Campbell BA, David S, Haghighi N, Hanna GG, Kok D, MacManus M, Phillips C, Plumridge N, Shaw M, Wirth A, Wheeler G, Ball D, Siva S. Long-term Survival with 18-Fluorodeoxyglucose Positron Emission Tomography-directed Therapy in Non-small Cell Lung Cancer with Synchronous Solitary Brain Metastasis. Clin Oncol (R Coll Radiol) 2020; 33:163-171. [PMID: 33129655 DOI: 10.1016/j.clon.2020.10.010] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Revised: 07/28/2020] [Accepted: 10/13/2020] [Indexed: 11/27/2022]
Abstract
AIMS At diagnosis, <1% of patients with non-small cell lung cancer (NSCLC) have synchronous solitary brain metastasis (SSBM). In prior cohorts without 18-fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) staging, definitive treatment to intracranial and intrathoracic disease showed a 5-year overall survival (OS) of 11-21%. We investigated the long-term survival outcomes for patients with SSBM NSCLC, diagnosed in the FDG-PET/CT era and treated definitively with local therapies to both intracranial and intrathoracic sites of disease. MATERIALS AND METHODS This retrospective study assessed patients staged with FDG-PET/CT who received definitive lung and SSBM treatment from February 1999 to December 2017. A lung-molecular graded prognostic assessment (lung-molGPA) score was assigned for each patient using age, performance status score, and, where carried out, molecular status. Overall survival and progression-free survival (PFS) were calculated using Kaplan-Meier methods. Cox proportional hazard models determined OS and PFS prognostic factors. RESULTS Forty-nine patients newly diagnosed with NSCLC and SSBM had a median age of 63 years (range 34-76). The median follow-up of all patients was 3.9 years. Thirty-three patients (67%) had ≥T2 disease, 23 (47%) had ≥N2. At 2 years, 45% of first failures were intracranial only (95% confidence interval 30-59). At 3 and 5 years, OS was 45% (95% confidence interval 32-63) and 30% (95% confidence interval 18-51), respectively. In ≥N1 disease, 5-year OS was 34% (95% confidence interval 18-63). The 3- and 5-year PFS was 8% (95% confidence interval 3-22) and 0%, respectively. Higher lung-molGPA was associated with longer OS (hazard ratio 0.26, 95% confidence interval 0.11-0.61, P = 0.002). Higher lung-molGPA (hazard ratio 0.33, 95% confidence interval 0.15-0.71, P = 0.005) and lower N-stage (hazard ratio 1.56, 95% confidence interval 1.13-2.15, P = 0.007) were associated with longer PFS. CONCLUSIONS Definitive treatment of patients with NSCLC and SSBM staged with FDG-PET/CT can result in 5-year survivors, including those with ≥N1 disease.
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Affiliation(s)
- S Newman
- Peter MacCallum Cancer Centre, Radiation Oncology, Parkville, Victoria, Australia
| | - N Bucknell
- Peter MacCallum Cancer Centre, Radiation Oncology, Parkville, Victoria, Australia; Sir Peter MacCallum Department of Oncology, Melbourne University, Parkville, Victoria, Australia
| | - M Bressel
- Peter MacCallum Cancer Centre, Radiation Oncology, Parkville, Victoria, Australia
| | - P Tran
- Peter MacCallum Cancer Centre, Radiation Oncology, Parkville, Victoria, Australia
| | - B A Campbell
- Peter MacCallum Cancer Centre, Radiation Oncology, Parkville, Victoria, Australia; Sir Peter MacCallum Department of Oncology, Melbourne University, Parkville, Victoria, Australia
| | - S David
- Peter MacCallum Cancer Centre, Radiation Oncology, Parkville, Victoria, Australia
| | - N Haghighi
- Peter MacCallum Cancer Centre, Radiation Oncology, Parkville, Victoria, Australia
| | - G G Hanna
- Peter MacCallum Cancer Centre, Radiation Oncology, Parkville, Victoria, Australia; Sir Peter MacCallum Department of Oncology, Melbourne University, Parkville, Victoria, Australia
| | - D Kok
- Peter MacCallum Cancer Centre, Radiation Oncology, Parkville, Victoria, Australia
| | - M MacManus
- Peter MacCallum Cancer Centre, Radiation Oncology, Parkville, Victoria, Australia; Sir Peter MacCallum Department of Oncology, Melbourne University, Parkville, Victoria, Australia
| | - C Phillips
- Peter MacCallum Cancer Centre, Radiation Oncology, Parkville, Victoria, Australia
| | - N Plumridge
- Peter MacCallum Cancer Centre, Radiation Oncology, Parkville, Victoria, Australia
| | - M Shaw
- Peter MacCallum Cancer Centre, Radiation Oncology, Parkville, Victoria, Australia
| | - A Wirth
- Peter MacCallum Cancer Centre, Radiation Oncology, Parkville, Victoria, Australia
| | - G Wheeler
- Peter MacCallum Cancer Centre, Radiation Oncology, Parkville, Victoria, Australia
| | - D Ball
- Sir Peter MacCallum Department of Oncology, Melbourne University, Parkville, Victoria, Australia
| | - S Siva
- Peter MacCallum Cancer Centre, Radiation Oncology, Parkville, Victoria, Australia; Sir Peter MacCallum Department of Oncology, Melbourne University, Parkville, Victoria, Australia.
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17
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Siva S, Bressel M, Kron T, Mai T, Le H, Montgomery R, Hardcastle N, Rezo A, Gill S, Higgs B, Pryor D, De Abreu Lourenco R, Awad R, Chesson B, Eade T, Skala M, Sasso G, Wong W, Vinod S, Ball D. Stereotactic Ablative Fractionated Radiotherapy versus Radiosurgery for Oligometastatic Neoplasia to the Lung: A Randomized Phase II Trial. Int J Radiat Oncol Biol Phys 2020. [DOI: 10.1016/j.ijrobp.2020.07.2072] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
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18
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Siva S, Bressel M, Loi S, Sandhu S, Tran B, Mooi J, Lewin J, Azad A, Colyer D, Shaw M, Chander S, Cuff K, Wood S, Lawrentschuk N, Murphy D, Pryor D. MA01.01 Safety of Pembrolizumab Combined with Stereotactic Ablative Body Radiotherapy (SABR) for Pulmonary Oligometastases. J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.08.493] [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: 11/25/2022]
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Solomon B, Young RJ, Bressel M, Cernelc J, Savas P, Liu H, Urban D, Thai A, Cooper C, Fua T, Neeson P, Loi S, Porceddu SV, Rischin D. Identification of an excellent prognosis subset of human papillomavirus-associated oropharyngeal cancer patients by quantification of intratumoral CD103+ immune cell abundance. Ann Oncol 2019; 30:1638-1646. [PMID: 31400196 DOI: 10.1093/annonc/mdz271] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [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: 12/14/2022] Open
Abstract
BACKGROUND Accurate prognostic stratification of human papillomavirus-associated oropharyngeal cancers (HPV+OPSCC) is required to identify patients potentially suitable for treatment deintensification. We evaluated the prognostic significance of CD103, a surface marker associated with tissue-resident memory T cells (TRMs), in two independent cohorts of patients with HPV+OPSCC. PATIENTS AND METHODS The abundance and distribution of CD103+ immune cells were quantified using immunohistochemistry in a cohort of 189 HPV+OPSCC patients treated with curative intent and correlated with outcome. Findings were then validated in an independent cohort comprising 177 HPV+OPSCCs using univariable and multivariable analysis. Intratumoral CD103+ immune cells were characterized by multispectral fluorescence immunohistochemistry and gene expression analysis. RESULTS High intratumoral abundance of CD103+ immune cells using a ≥30% cut-off was found in 19.8% of tumors in the training cohort of HPV+OPSCC patients and associated with excellent prognosis for overall survival (OS) with adjusted hazard ratio (HR) of 0.13 [95% confidence interval (CI) 0.02-0.94, P = 0.004]. In the independent cohort of HPV+OPSCCs, 20.4% had high intratumoral CD103+ abundance and an adjusted HR for OS of 0.16 (95% CI 0.02-1.22, P = 0.02). Five year OS of patients with high intratumoral CD103 was 100% across both cohorts. The C-statistic for the multivariate prognostic model with stage and age was significantly improved in both cohorts with the addition of intratumoral CD103+ cell abundance. On the basis of spatial location, co-expression of CD8 and CD69, and gene expression profiles, intratumoral CD103+ cells were consistent with TRMs. CONCLUSION Quantification of intratumoral CD103+ immune cell abundance provides prognostic information beyond that provided by clinical parameters such as TNM-staging, identifying a population of low risk HPV+OPSCC patients who are good candidates for trials of deintensification strategies.
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Affiliation(s)
- B Solomon
- Research Division, Peter MacCallum Cancer Centre, Melbourne, Australia; Department of Medical Oncology, Peter MacCallum Cancer Centre, Melbourne, Australia; The Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, Australia.
| | - R J Young
- Research Division, Peter MacCallum Cancer Centre, Melbourne, Australia; The Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, Australia
| | - M Bressel
- Centre for Biostatistics and Clinical Trials, Peter MacCallum Cancer Centre, Melbourne, Australia
| | - J Cernelc
- Department of Pathology, Peter MacCallum Cancer Centre, Melbourne, Australia
| | - P Savas
- Research Division, Peter MacCallum Cancer Centre, Melbourne, Australia; The Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, Australia
| | - H Liu
- Department of Radiation Oncology, Princess Alexandra Hospital, Brisbane, Australia; Faculty of Medicine, University of Queensland, Brisbane, Australia
| | - D Urban
- Department of Medical Oncology, Sheba Medical Centre, Ramat Gan, Israel
| | - A Thai
- Research Division, Peter MacCallum Cancer Centre, Melbourne, Australia; Department of Medical Oncology, Peter MacCallum Cancer Centre, Melbourne, Australia
| | - C Cooper
- Faculty of Medicine, University of Queensland, Brisbane, Australia; Department of Anatomical Pathology, Pathology Queensland, Princess Alexandra Hospital, Brisbane, Australia
| | - T Fua
- Department of Radiation Oncology, Peter MacCallum Cancer Centre, Melbourne, Australia
| | - P Neeson
- Research Division, Peter MacCallum Cancer Centre, Melbourne, Australia; The Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, Australia
| | - S Loi
- Research Division, Peter MacCallum Cancer Centre, Melbourne, Australia; Department of Medical Oncology, Peter MacCallum Cancer Centre, Melbourne, Australia; The Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, Australia
| | - S V Porceddu
- Department of Radiation Oncology, Princess Alexandra Hospital, Brisbane, Australia; Faculty of Medicine, University of Queensland, Brisbane, Australia
| | - D Rischin
- Department of Medical Oncology, Peter MacCallum Cancer Centre, Melbourne, Australia; The Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, Australia
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Casswell G, Gough K, Drosdowsky A, Bressel M, Shrestha S, Coleman A, Rischin D, D'Costa I, Fua T, Tiong A, Liu C, Solomon B, McDowell L. Sexual Satisfaction and Relationship Status in Long-term Survivors of Human Papillomavirus-Associated Oropharyngeal Carcinoma. Int J Radiat Oncol Biol Phys 2019. [DOI: 10.1016/j.ijrobp.2019.06.1614] [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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21
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Peacock O, Waters PS, Bressel M, Lynch AC, Wakeman C, Eglinton T, Koh CE, Lee PJ, Austin KK, Warrier SK, Solomon MJ, Frizelle FA, Heriot AG. Prognostic factors and patterns of failure after surgery for T4 rectal cancer in the beyond total mesorectal excision era. Br J Surg 2019; 106:1685-1696. [PMID: 31339561 DOI: 10.1002/bjs.11242] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2019] [Revised: 03/31/2019] [Accepted: 04/26/2019] [Indexed: 12/24/2022]
Abstract
BACKGROUND Despite advances in the rates of total mesorectal excision (TME) for rectal cancer surgery, decreased local recurrence rates and increased 5-year survival, there still exists large variation in the quality of treatment received. Up to 30 per cent of rectal cancers are locally advanced at presentation and approximately 5-10 per cent still breach the mesorectal plane and invade adjacent structures despite neoadjuvant therapy. With the evolution of extended resections for rectal cancers beyond the TME plane, proponents advocate that these resections should be performed only in specialist centres. The aim was to assess the prognostic factors and patterns of failure after beyond TME surgery for T4 rectal cancers. METHODS Data were collected from prospective databases at three high-volume institutions specializing in beyond TME surgery for T4 rectal cancers between 1990 and 2013. The primary outcome measures were overall survival, local recurrence and patterns of first failure. RESULTS Three hundred and sixty patients were identified. The negative resection margin (R0) rate was 82·8 per cent (298 patients) and the local recurrence rate was 12·5 per cent (45 patients). The type of surgical procedure (Hartmann's: hazard ratio (HR) 4·49, 95 per cent c.i. 1·99 to 10·14; P = 0·002) and lymphovascular invasion (HR 2·02, 1·08 to 3·77; P = 0·032) were independent predictors of local recurrence. The 5-year overall survival rate for all patients was 61 (95 per cent c.i. 55 to 67) per cent. The 5-year cumulative incidence of first failure was 8 per cent for local recurrence, 6 per cent for local and distant disease, and 18 per cent for distant disease. CONCLUSION This study has demonstrated that a coordinated approach in specialist centres for beyond TME surgery can offer good oncological and long-term survival in patients with T4 rectal cancers.
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Affiliation(s)
- O Peacock
- Colorectal Surgery Unit, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
| | - P S Waters
- Colorectal Surgery Unit, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
| | - M Bressel
- Centre for Biostatistics and Clinical Trials, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
| | - A C Lynch
- Colorectal Surgery Unit, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
| | - C Wakeman
- Colorectal Surgery Unit, Christchurch Hospital, Christchurch, New Zealand
| | - T Eglinton
- Colorectal Surgery Unit, Christchurch Hospital, Christchurch, New Zealand
| | - C E Koh
- Department of Colorectal Surgery and Royal Prince Alfred Institute of Academic Surgery, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia
| | - P J Lee
- Department of Colorectal Surgery and Royal Prince Alfred Institute of Academic Surgery, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia
| | - K K Austin
- Department of Colorectal Surgery and Royal Prince Alfred Institute of Academic Surgery, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia
| | - S K Warrier
- Colorectal Surgery Unit, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
| | - M J Solomon
- Department of Colorectal Surgery and Royal Prince Alfred Institute of Academic Surgery, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia.,Surgical Outcomes Research Unit, University of Sydney, Sydney, New South Wales, Australia
| | - F A Frizelle
- Colorectal Surgery Unit, Christchurch Hospital, Christchurch, New Zealand
| | - A G Heriot
- Colorectal Surgery Unit, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
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22
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MacManus M, Roos D, O'Brien P, Tsang R, Wirth A, Capp A, Bressel M, Seymour J. RESULTS OF A MULTICENTER PHASE2 TRIAL OF INVOLVED FIELD RADIOTHERAPY ALONE FOR LOCALIZED NON-GASTRIC MARGINAL ZONE LYMPHOMA: TROG 05.02. Hematol Oncol 2019. [DOI: 10.1002/hon.36_2630] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- M.P. MacManus
- Radiation Oncology; Peter MacCallum cancer Centre; Melbourne Australia
| | - D. Roos
- Radiation Oncology; Royal Adelaide Hospital; Adelaide Australia
| | - P. O'Brien
- Radiation Oncology; Genesis Care Lake Macquarie Private Hospital; Gateshead Australia
| | - R. Tsang
- Radiation Oncology; Princess Margaret Hospital; Totonto Canada
| | - A. Wirth
- Radiation Oncology; Peter MacCallum cancer Centre; Melbourne Australia
| | - A. Capp
- Radiation Oncology; Calvary Mater Hospital; Waratah Australia
| | - M. Bressel
- Radiation Oncology; Peter MacCallum cancer Centre; Melbourne Australia
| | - J. Seymour
- Haematology; Peter MacCallum Cancer Centre; Melbourne Australia
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23
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Newman S, Bucknell N, Bressel M, Tran P, Campbell B, Haghighi N, Kok D, MacManus M, Phillips C, Shaw M, Wirth A, Wheeler G, Ball D, Siva S. EP-1351 Long-term survival with FDG-PET directed therapy in NSCLC with synchronous solitary brain metastasis. Radiother Oncol 2019. [DOI: 10.1016/s0167-8140(19)31771-2] [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: 10/26/2022]
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24
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Bucknell N, Bressel M, Webb A, Gyorki D, Henderson M, Estall V, Tiong A. EP-1623: Overall survival of patients with cutaneous SCC metastasis to the axilla or groin. Radiother Oncol 2018. [DOI: 10.1016/s0167-8140(18)31932-7] [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: 10/14/2022]
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25
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Phillips KA, Lo L, Bressel M, Collins IM, Emery J, Weideman P, Keogh L, Steel E, Bickerstaffe A, Mann GB, Trainer A, Hopper JL, Antoniou AC, Cuzick J, Butow P. Abstract P4-11-02: Acceptability and usability of iPrevent, a web-based decision support tool for assessment and management of breast cancer risk. Cancer Res 2018. [DOI: 10.1158/1538-7445.sabcs17-p4-11-02] [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: 11/16/2022]
Abstract
Abstract
Background: iPrevent estimates an individual's personal BC risk, using either the IBIS or BOADICEA algorithms, and provides tailored risk management information on screening, lifestyle modifications, risk-reducing surgery and risk-reducing medication. It is designed to be used collaboratively by women and their clinicians. The purpose of this pre-implementation pilot study was to assess the clinical usability and acceptability of the iPrevent prototype, and to identify barriers to clinical implementation. Exploratory aims investigated patients' BC worry, anxiety, risk perception and knowledge before and after using iPrevent. Methods: Eligible clinicians worked in primary care (PC), breast surgical (BS) or genetics clinics (GC). Their female patients were eligible if aged 18-70 years with no personal cancer history. Clinicians were familiarized with iPrevent using hypothetical cases, then actor scenarios, and lastly iPrevent was trialed with patients. All participants completed the System Usability Scale (SUS) and an acceptability questionnaire 2 weeks after using iPrevent. Patients also completed the Lerman BC Worry Scale, Spielberger State-Trait Anxiety Inventory, and BC risk perception and prevention knowledge questionnaires before and 2 weeks after using the tool. Data were summarized using descriptive statistics. Results: 63 participants comprising 20 clinicians (median age 47 years, 8 PC, 6 BS, 6 GC) and 43 patients (median age 38 years, 16% high risk, 51% moderate risk, 33% average risk) were recruited. Usability was rated above average (SUS score >68) by most clinicians (68%) and patients (76%). Most (79% of clinicians, 81% of patients) agreed iPrevent was 'easy to use', although 10 (53%) clinicians and 10 (27%) patients reported that it was too long. Most clinicians (84%) and patients (86%) found iPrevent 'very' or 'somewhat' helpful. 89% of participants reported that iPrevent provided the right amount of information. 5% reported to 'rarely' or 'not at all' worry about BC before iPrevent, and 29% after use. 25% of patients reported less impact of worrying about BC after iPrevent, 47% were unchanged and 28% reported more impact of worrying about BC after iPrevent use. State anxiety remained the same. 87% of patients correctly reported their risk category after using iPrevent® compared with 40% before. BC prevention knowledge improved for most questions. Conclusions: iPrevent has high usability and acceptability. Exploratory analyses suggest that iPrevent may also improve patients' BC risk perception and knowledge without adversely affecting anxiety or BC worry. Because concerns about length could be a barrier to implementation, data entry has been abbreviated in the modified version of iPrevent that will be publically available.
Citation Format: Phillips K-A, Lo L, Bressel M, Collins IM, Emery J, Weideman P, Keogh L, Steel E, Bickerstaffe A, Mann GB, Trainer A, Hopper JL, Antoniou AC, Cuzick J, Butow P. Acceptability and usability of iPrevent, a web-based decision support tool for assessment and management of breast cancer risk [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2018;78(4 Suppl):Abstract nr P4-11-02.
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Affiliation(s)
- K-A Phillips
- Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia; Deakin University, Geelong, Victoria, Australia; The University of Melbourne, Parkville, Victoria, Australia; Victorian Comprehensive Cancer Centre, Melbourne, Victoria, Australia; University of Cambridge; Queen Mary University of London; University of Sydney
| | - L Lo
- Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia; Deakin University, Geelong, Victoria, Australia; The University of Melbourne, Parkville, Victoria, Australia; Victorian Comprehensive Cancer Centre, Melbourne, Victoria, Australia; University of Cambridge; Queen Mary University of London; University of Sydney
| | - M Bressel
- Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia; Deakin University, Geelong, Victoria, Australia; The University of Melbourne, Parkville, Victoria, Australia; Victorian Comprehensive Cancer Centre, Melbourne, Victoria, Australia; University of Cambridge; Queen Mary University of London; University of Sydney
| | - IM Collins
- Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia; Deakin University, Geelong, Victoria, Australia; The University of Melbourne, Parkville, Victoria, Australia; Victorian Comprehensive Cancer Centre, Melbourne, Victoria, Australia; University of Cambridge; Queen Mary University of London; University of Sydney
| | - J Emery
- Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia; Deakin University, Geelong, Victoria, Australia; The University of Melbourne, Parkville, Victoria, Australia; Victorian Comprehensive Cancer Centre, Melbourne, Victoria, Australia; University of Cambridge; Queen Mary University of London; University of Sydney
| | - P Weideman
- Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia; Deakin University, Geelong, Victoria, Australia; The University of Melbourne, Parkville, Victoria, Australia; Victorian Comprehensive Cancer Centre, Melbourne, Victoria, Australia; University of Cambridge; Queen Mary University of London; University of Sydney
| | - L Keogh
- Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia; Deakin University, Geelong, Victoria, Australia; The University of Melbourne, Parkville, Victoria, Australia; Victorian Comprehensive Cancer Centre, Melbourne, Victoria, Australia; University of Cambridge; Queen Mary University of London; University of Sydney
| | - E Steel
- Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia; Deakin University, Geelong, Victoria, Australia; The University of Melbourne, Parkville, Victoria, Australia; Victorian Comprehensive Cancer Centre, Melbourne, Victoria, Australia; University of Cambridge; Queen Mary University of London; University of Sydney
| | - A Bickerstaffe
- Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia; Deakin University, Geelong, Victoria, Australia; The University of Melbourne, Parkville, Victoria, Australia; Victorian Comprehensive Cancer Centre, Melbourne, Victoria, Australia; University of Cambridge; Queen Mary University of London; University of Sydney
| | - GB Mann
- Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia; Deakin University, Geelong, Victoria, Australia; The University of Melbourne, Parkville, Victoria, Australia; Victorian Comprehensive Cancer Centre, Melbourne, Victoria, Australia; University of Cambridge; Queen Mary University of London; University of Sydney
| | - A Trainer
- Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia; Deakin University, Geelong, Victoria, Australia; The University of Melbourne, Parkville, Victoria, Australia; Victorian Comprehensive Cancer Centre, Melbourne, Victoria, Australia; University of Cambridge; Queen Mary University of London; University of Sydney
| | - JL Hopper
- Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia; Deakin University, Geelong, Victoria, Australia; The University of Melbourne, Parkville, Victoria, Australia; Victorian Comprehensive Cancer Centre, Melbourne, Victoria, Australia; University of Cambridge; Queen Mary University of London; University of Sydney
| | - AC Antoniou
- Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia; Deakin University, Geelong, Victoria, Australia; The University of Melbourne, Parkville, Victoria, Australia; Victorian Comprehensive Cancer Centre, Melbourne, Victoria, Australia; University of Cambridge; Queen Mary University of London; University of Sydney
| | - J Cuzick
- Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia; Deakin University, Geelong, Victoria, Australia; The University of Melbourne, Parkville, Victoria, Australia; Victorian Comprehensive Cancer Centre, Melbourne, Victoria, Australia; University of Cambridge; Queen Mary University of London; University of Sydney
| | - P Butow
- Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia; Deakin University, Geelong, Victoria, Australia; The University of Melbourne, Parkville, Victoria, Australia; Victorian Comprehensive Cancer Centre, Melbourne, Victoria, Australia; University of Cambridge; Queen Mary University of London; University of Sydney
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Gill S, Gandhidasan S, Kron T, Ball D, Shaw M, Chander S, Bressel M, Chesson B, David S, Siva S. Ablation of oligometastasis cancer with stereotactic ablative body radiotherapy exploiting the stepwise theory of metastasis: A retrospective review of a single institution series. Respir Med 2017. [DOI: 10.1016/j.rmed.2017.07.037] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Thomas R, Turgeon G, Hofman M, Callahan J, Anderson N, Hardcastle N, Kron T, Bressel M, Steinfort D, Shaw M, Plumridge N, Macmanus M, Hicks R, Ball D, Siva S. P2.14-001 Mid-Treatment Perfusion PET/CT Is More Effective Than Ventilation PET/CT in Functionally-Adapted Radiotherapy for NSCLC. J Thorac Oncol 2017. [DOI: 10.1016/j.jtho.2017.09.1373] [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: 11/26/2022]
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Bird T, Michael M, Bressel M, Chu J, Chander S, Cooray P, McKendrick J, Jefford M, Heriot A, Steel M, Leong T, Ngan S. FOLFOX and intensified split-course chemoradiation as initial treatment for rectal cancer with synchronous metastases. Acta Oncol 2017; 56:646-652. [PMID: 28301974 DOI: 10.1080/0284186x.2017.1296584] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
BACKGROUND Optimal initial management of rectal carcinoma with synchronous metastases (RCSM) is controversial - both for patients being treated with curative and palliative intent. This study aims to evaluate the use of an upfront treatment strategy combining FOLFOX chemotherapy with split-course pelvic chemoradiation (FOLFOX + CRT) for patients with RCSM. MATERIAL AND METHODS An analysis of all patients who commenced treatment with FOLFOX + CRT at our institutions between January 2009 and June 2014 was performed. The regimen consisted of a total of 12 weeks of treatment with split-course pelvic chemoradiation (50.4Gy with concurrent oxaliplatin and 5-FU) alternating with FOLFOX chemotherapy. Restaging imaging was performed following treatment, with subsequent management as per local standard of care. RESULTS 78 patients (15 with resectable liver-only metastases) were identified. 77 (99%) completed at least 45Gy of radiation and 87% completed ≥75% of planned dose intensity of both oxaliplatin and 5FU. Two (2.6%) patients died within 30 days of treatment. Rates of radiological complete or partial response for local and metastatic disease were 90% and 66%, respectively. 24% patients had radiological disease progression of metastatic disease. Median overall survival for patients with unresectable metastatic disease at baseline was 23 months (95%CI: 19-28). 12 patients underwent radical surgery to both the rectum and liver and had an estimated 3-year overall survival rate of 62% (95%CI: 37-100). For those patients who did not proceed to rectal surgery, only 7% required palliative re-irradiation or surgery at a later date and all >20months from initial treatment. CONCLUSIONS In patients with unresectable metastatic disease, FOLFOX + CRT provides durable pelvic control for the majority without the need for additional local treatment. For patients with an advanced primary tumor and synchronous resectable liver-only metastases, FOLFOX + CRT can be considered a feasible and tolerable upfront treatment option.
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Affiliation(s)
- T. Bird
- Department of Radiation Oncology, Peter MacCallum Cancer Centre, Melbourne, Australia
| | - M. Michael
- Department of Medicine, Peter MacCallum Cancer Centre, Melbourne, Australia
| | - M. Bressel
- Centre for Biostatistics and Clinical Trials, Peter MacCallum Cancer Centre, Melbourne, Australia
| | - J. Chu
- Department of Radiation Oncology, Peter MacCallum Cancer Centre, Melbourne, Australia
| | - S. Chander
- Department of Radiation Oncology, Peter MacCallum Cancer Centre, Melbourne, Australia
| | - P. Cooray
- Department of Medical Oncology, Eastern Health, Box Hill, Melbourne, Australia
| | - J. McKendrick
- Department of Medical Oncology, Eastern Health, Box Hill, Melbourne, Australia
| | - M. Jefford
- Department of Medicine, Peter MacCallum Cancer Centre, Melbourne, Australia
| | - A. Heriot
- Department of Surgery, Peter MacCallum Cancer Centre, Melbourne, Australia
| | - M. Steel
- Department of Surgical Oncology, Eastern Health, Box Hill, Melbourne, Australia
| | - T. Leong
- Department of Radiation Oncology, Peter MacCallum Cancer Centre, Melbourne, Australia
| | - S. Ngan
- Department of Radiation Oncology, Peter MacCallum Cancer Centre, Melbourne, Australia
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Siva S, Udovicich C, Shaw M, Violet J, Chander S, Bressel M, Goad J, Lawrentschuck N, Foroudi F, Murphy D. Stereotactic radiotherapy for bone and nodal oligometastases: Patterns of relapse in a prospective clinical trial. ACTA ACUST UNITED AC 2017. [DOI: 10.1016/s1569-9056(17)31012-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [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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Ngan S, Bressel M, Chu J, McKendrick J, Chander S, Cooray P, Jefford M, Wong R, Steel M, Leong T, Heriot A, Michael M. A 12-week regimen with interdigitating FOLFOX/bevacizumab and pelvic chemoradiation for synchronous primary and metastatic rectal cancer. The CHROME B trial. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw370.51] [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: 11/13/2022] Open
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Siva S, Pham D, Tan T, Lam J, Bressel M, Price J, Gill S, Shaw M, Tai K, Violet J, Lau E, Parameswaran B, Chesson B, Lawrentschuck N, Goad J, Murphy D, Kron T, Foroudi F. Principal Analysis of a Phase Ib Trial of Stereotactic Body Radiation Therapy (SBRT) for Primary Kidney Cancer. Int J Radiat Oncol Biol Phys 2016. [DOI: 10.1016/j.ijrobp.2016.06.240] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Gandhidasan S, Bressel M, Kron T, Shaw M, Chu J, Chander S, Wheeler G, Plumridge N, Chesson B, Haworth A, David S, Ball D, Siva S. Single-Fraction Stereotactic Ablative Body Radiation Therapy as an Effective Management of Oligometastasis: Results From 133 Consecutive Patients. Int J Radiat Oncol Biol Phys 2016. [DOI: 10.1016/j.ijrobp.2016.06.1901] [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: 10/20/2022]
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Kanjanapan Y, Deb S, Young R, Bressel M, Mileshkin L, Rischin D, Hofman M, Narayan K, Siva S. Prognostic biomarkers in locally advanced cervical cancer (Cx Ca) treated with chemoradiation (CRT). Ann Oncol 2016. [DOI: 10.1093/annonc/mdw363.62] [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: 11/12/2022] Open
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Campbell B, Callahan J, Bressel M, Simeons N, Everitt S, Hofman M, Hicks R, Burbury K, MacManus M. Age and Gender Differences in the Distribution of Proliferating Bone Marrow in Adults Measured by FLT-PET/CT Imaging With Potential Application for Radiation Therapy Planning. Int J Radiat Oncol Biol Phys 2015. [DOI: 10.1016/j.ijrobp.2015.07.153] [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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Ng S, Khor R, Bressel M, MacManus M, Seymour J, Hicks R, Wirth A. Impact of 18-Fluorodeoxyglucose (FDG) Positron Emission Tomography (PET) Stage on Outcomes Among Patients With Early-Stage Follicular Lymphoma. Int J Radiat Oncol Biol Phys 2015. [DOI: 10.1016/j.ijrobp.2015.07.1705] [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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Memon S, Lynch AC, Bressel M, Wise AG, Heriot AG. Systematic review and meta-analysis of the accuracy of MRI and endorectal ultrasound in the restaging and response assessment of rectal cancer following neoadjuvant therapy. Colorectal Dis 2015; 17:748-61. [PMID: 25891148 DOI: 10.1111/codi.12976] [Citation(s) in RCA: 58] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2014] [Accepted: 02/26/2015] [Indexed: 12/14/2022]
Abstract
AIM Restaging imaging by MRI or endorectal ultrasound (ERUS) following neoadjuvant chemoradiotherapy is not routinely performed, but the assessment of response is becoming increasingly important to facilitate individualization of management. METHOD A search of the MEDLINE and Scopus databases was performed for studies that evaluated the accuracy of restaging of rectal cancer following neoadjuvant chemoradiotherapy with MRI or ERUS against the histopathological outcome. A systematic review of selected studies was performed. The methodological quality of studies that qualified for meta-analysis was critically assessed to identify studies suitable for inclusion in the meta-analysis. RESULTS Sixty-three articles were included in the systematic review. Twelve restaging MRI studies and 18 restaging ERUS studies were eligible for meta-analysis of T-stage restaging accuracy. Overall, ERUS T-stage restaging accuracy (mean [95% CI]: 65% [56-72%]) was nonsignificantly higher than MRI T-stage accuracy (52% [44-59%]). Restaging MRI is accurate at excluding circumferential resection margin involvement. Restaging MRI and ERUS were equivalent for prediction of nodal status: the accuracy of both investigations was 72% with over-staging and under-staging occurring in 10-15%. CONCLUSION The heterogeneity amongst restaging studies is high, limiting conclusive findings regarding their accuracies. The accuracy of restaging imaging is different for different pathological T stages and highest for T3 tumours. Morphological assessment of T- or N-stage by MRI or ERUS is currently not accurate or consistent enough for clinical application. Restaging MRI appears to have a role in excluding circumferential resection margin involvement.
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Affiliation(s)
- S Memon
- Division of Cancer Surgery, Colorectal Surgery Department, Peter MacCallum Cancer Centre, East Melbourne, Victoria, Australia.,Department of Surgery, St Vincent's Hospital, University of Melbourne, Melbourne, Victoria, Australia
| | - A C Lynch
- Division of Cancer Surgery, Colorectal Surgery Department, Peter MacCallum Cancer Centre, East Melbourne, Victoria, Australia.,Department of Surgery, St Vincent's Hospital, University of Melbourne, Melbourne, Victoria, Australia
| | - M Bressel
- Department of Biostatistics and Clinical Trials, Peter MacCallum Cancer Centre, East Melbourne, Victoria, Australia
| | - A G Wise
- Department of Cancer Imaging, Peter MacCallum Cancer Centre, East Melbourne, Victoria, Australia
| | - A G Heriot
- Division of Cancer Surgery, Colorectal Surgery Department, Peter MacCallum Cancer Centre, East Melbourne, Victoria, Australia.,Department of Surgery, St Vincent's Hospital, University of Melbourne, Melbourne, Victoria, Australia
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Tan K, Thomas R, Hardcastle N, Pham D, Kron T, Foroudi F, Ball D, te Marvelde L, Bressel M, Siva S. Predictors of Respiratory-induced Lung Tumour Motion Measured on Four-dimensional Computed Tomography. Clin Oncol (R Coll Radiol) 2015; 27:197-204. [DOI: 10.1016/j.clon.2014.12.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2014] [Revised: 11/05/2014] [Accepted: 12/03/2014] [Indexed: 12/25/2022]
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Michael M, Chander S, McKendrick J, MacKay JR, Steel M, Hicks R, Heriot A, Leong T, Cooray P, Jefford M, Zalcberg J, Bressel M, McClure B, Ngan SY. Phase II trial evaluating the feasibility of interdigitating folfox with chemoradiotherapy in locally advanced and metastatic rectal cancer. Br J Cancer 2014; 111:1924-31. [PMID: 25211659 PMCID: PMC4229632 DOI: 10.1038/bjc.2014.487] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2014] [Revised: 07/29/2014] [Accepted: 08/13/2014] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Patients (pts) with metastatic rectal cancer and symptomatic primary, require local and systemic control. Chemotherapy used during chemoradiotherapy (CRT) is adequate for radiosensitisation, but suboptimal for systemic control. The aim of this phase II study was to assess tolerability, local/systemic benefits, of a novel regimen delivering interdigitating intensive chemotherapy with radical CRT. METHODS Eligible pts had untreated synchronous symptomatic primary/metastatic rectal cancer. A total of 12 weeks of treatment with split-course pelvic CRT (total 50.4 Gy with concurrent oxaliplatin and 5-FU infusion) alternating with FOLFOX chemotherapy. All pts staged with CT, MRI and FDG-PET pre and post treatment. RESULTS Twenty-six pts were treated. Rectal primary MRI stage: T3 81% and T4 15%. Liver metastases in 81%. Twenty-four pts (92%) completed the 12-week regimen. All patients received planned RT dose, and for both agents over 88% of patients achieved a relative dose intensity of >75%. Grade 3 toxicities: neutropenia 23%, diarrhoea 15%, and radiation skin reaction 12%. Grade 4 toxicity: neutropenia 15%. FDG-PET metabolic response rate for rectal primary 96%, and for metastatic disease 60%. CONCLUSIONS Delivery of interdigitating chemotherapy with radical CRT was feasible to treat both primary and metastatic rectal cancer. High completion and response rates were encouraging.
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Affiliation(s)
- M Michael
- Division of Cancer Medicine, Lower Gastrointestinal Tumour Service, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
- The Sir Peter MacCallum Department of Oncology, The University of Melbourne, Parkville, Melbourne, Victoria, Australia
| | - S Chander
- Division of Radiation Oncology, Lower Gastrointestinal Tumour Service, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
| | - J McKendrick
- Department of Medical Oncology, Box Hill Hospital, Melbourne, Victoria, Australia
| | - J R MacKay
- Division of Surgical Oncology, Lower Gastrointestinal Tumour Service, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
| | - M Steel
- Department of Surgery, Box Hill Hospital, Melbourne, Victoria, Australia
| | - R Hicks
- The Sir Peter MacCallum Department of Oncology, The University of Melbourne, Parkville, Melbourne, Victoria, Australia
- Cancer Imaging, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
| | - A Heriot
- Division of Surgical Oncology, Lower Gastrointestinal Tumour Service, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
| | - T Leong
- Division of Radiation Oncology, Lower Gastrointestinal Tumour Service, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
| | - P Cooray
- Department of Medical Oncology, Box Hill Hospital, Melbourne, Victoria, Australia
| | - M Jefford
- Division of Cancer Medicine, Lower Gastrointestinal Tumour Service, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
- The Sir Peter MacCallum Department of Oncology, The University of Melbourne, Parkville, Melbourne, Victoria, Australia
| | - J Zalcberg
- Division of Cancer Medicine, Lower Gastrointestinal Tumour Service, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
| | - M Bressel
- Centre for Biostatistics and Clinical Trials, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
| | - B McClure
- Centre for Biostatistics and Clinical Trials, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
| | - S Y Ngan
- Division of Radiation Oncology, Lower Gastrointestinal Tumour Service, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
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Siva S, Devereux T, Hardcastle N, Callahan J, Pham D, Eu P, Steinfort D, Bressel M, MacManus M, Kron T, Hicks R, Ball D, Hofman M. Feasibility of IMRT Planning to Reduce Dose to Functional Lung Using Respiratory Gated (4D) Gallium-68 Perfusion PET/CT. Int J Radiat Oncol Biol Phys 2014. [DOI: 10.1016/j.ijrobp.2014.05.1844] [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: 11/30/2022]
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Foroudi F, Pham D, Bressel M, Hardcastle N, Gill S, Kron T. Comparison of Margins, Integral Dose and Interfraction Target Coverage with Image-guided Radiotherapy Compared with Non-image-guided Radiotherapy for Bladder Cancer. Clin Oncol (R Coll Radiol) 2014; 26:497-505. [DOI: 10.1016/j.clon.2014.03.007] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2013] [Revised: 02/12/2014] [Accepted: 02/25/2014] [Indexed: 11/15/2022]
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Wirth A, Gospodarowicz M, Aleman B, Bressel M, Ng A, Chao M, Hoppe R, Thieblemont C, Tsang R, Moser L, Specht L, Szpytma T, Lennard A, Seymour J, Zucca E. Long-term outcome for gastric marginal zone lymphoma treated with radiotherapy: a retrospective, multi-centre, International Extranodal Lymphoma Study Group study. Ann Oncol 2013; 24:1344-51. [DOI: 10.1093/annonc/mds623] [Citation(s) in RCA: 65] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
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Foroudi F, Pham D, Bressel M, Wong J, Rolfo A, Roxby P, Kron T. Bladder Cancer Radiotherapy Margins: A Comparison of Daily Alignment using Skin, Bone or Soft Tissue. Clin Oncol (R Coll Radiol) 2012; 24:673-81. [DOI: 10.1016/j.clon.2012.06.012] [Citation(s) in RCA: 26] [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: 06/27/2011] [Revised: 04/04/2012] [Accepted: 06/27/2012] [Indexed: 11/30/2022]
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Siva S, Byrne K, Seel M, Bressel M, Jacobs D, Callahan J, Laing J, MacManus M, Hicks R. FDG-PET Scanning has a High Impact on the Management of Patients With Merkel Cell Carcinoma. Int J Radiat Oncol Biol Phys 2012. [DOI: 10.1016/j.ijrobp.2012.07.152] [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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Siva S, Deb S, Bressel M, Gill S, Fox S, Hicks R, Narayan K. OC-0125 LONG-TERM OUTCOMES OF A PROSPECTIVE STUDY OF POST-THERAPY PET AFTER CHEMORADIATION OF CERVICAL CANCER. Radiother Oncol 2012. [DOI: 10.1016/s0167-8140(12)70464-4] [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: 11/16/2022]
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Gill S, Li J, Thomas J, Bressel M, Thursky K, Styles C, Tai KH, Duchesne GM, Foroudi F. Patient-reported complications from fiducial marker implantation for prostate image-guided radiotherapy. Br J Radiol 2012; 85:1011-7. [PMID: 22253345 DOI: 10.1259/bjr/68127917] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
OBJECTIVES To report on complications from transrectal ultrasound-guided insertion of fiducial markers for prostate image-guided radiotherapy. METHODS 234 patients who underwent transrectal fiducial marker insertion for prostate cancer image-guided radiotherapy were assessed retrospectively by questionnaire with regard to the duration and severity of eight symptoms experienced following the procedure. Pain during the implantation procedure was assessed according to the Wong-Baker faces pain scale. RESULTS Of 234 patients, 32% had at least one new symptom after the procedure. The commonest new symptom following the procedure was urinary frequency affecting 16% of patients who had not been troubled by frequency beforehand. Haematuria, rectal bleeding, dysuria and haematospermia affected 9-13% of patients, mostly at Grade 1 or 2. Pain, obstruction, and fever and shivers affected 3-4% of patients. Grade 3 rectal bleeding, haematuria, fever and shivers, and urinary frequency affected 0.5-1.5% of patients. Only one patient had a Grade 4 complication (i.e. fever and shivers). Overall, 9% of patients had symptoms lasting more than 2 weeks. The commonest symptoms that lasted more than 2 weeks were frequency, dysuria, obstructive symptoms and rectal bleeding. Mean pain score during the procedure was 1.1 (range 0-5). CONCLUSION Transrectal ultrasound-guided fiducial marker insertion for image-guided radiotherapy is well tolerated in the majority of prostate cancer patients. Most symptoms were Grade 1 or 2 in severity. Symptoms in the majority of patients last under 2 weeks. The most serious complication was sepsis in our study.
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Affiliation(s)
- S Gill
- Department of Radiation Oncology, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia.
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Nqan S, McKendrick J, Bressel M, Leong T, Cooray P, Heriot A, Steel M, Chander S, McClure B, Michael M. 6050 POSTER A 12-week Regimen With Interdigitating FOLFOX Chemotherapy and Pelvic Chemoradiation for Simultaneous Primary and Metastatic Rectal Cancer. Eur J Cancer 2011. [DOI: 10.1016/s0959-8049(11)71695-1] [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: 11/24/2022]
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Trinkaus ME, Hicks RJ, Young RJ, Peters LJ, Solomon BJ, Bressel M, Corry J, Fisher R, Binns D, McArthur GA, Rischin D. Correlation of HPV status and hypoxic imaging using [18F]-misonidazole (FMISO) PET in head and neck squamous cell carcinoma (HNSCC). J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.5527] [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: 11/20/2022] Open
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Wiegel T, Bressel M, Schmidt R. Stage D1 Prostatic Cancer – Equivalent Results with Radiotherapy and Hormonal Therapy versus Radical Prostatectomy, Radiotherapy and Hormonal Therapy(?). Oncol Res Treat 2009. [DOI: 10.1159/000218482] [Citation(s) in RCA: 5] [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: 11/19/2022]
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Kühne H, Bressel M, Heitz M, Küppers F, Loch T, Stöckle M. Langzeitheilung eines ossär metastasierten Prostatakarzinoms. Aktuelle Urol 2008. [DOI: 10.1055/s-2008-1065297] [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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