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Weber J, Scotland R, Wong R, Lau R, Snively J, Garcia M, Targan S. 22 INVITED CTLA-1 and PD-1 abrogation as targets for therapy. EJC Suppl 2006. [DOI: 10.1016/s1359-6349(06)70027-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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252
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McHugh J, Wong R, Keenan J. A Hazard of undiagnosed diabetes with benign prostatic hyperplasia: bilateral endogenous bacterial endophthalmitis. Eye (Lond) 2006; 21:432-3. [PMID: 17024222 DOI: 10.1038/sj.eye.6702586] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
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253
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Grabarz D, Letourneau D, La Macchia N, Wong R, Jaffray D, Gospodarowicz M. 181 A Cone Beam Enabled One Step Scan-to-Treat Process for Palliative Radiotherapy. Radiother Oncol 2006. [DOI: 10.1016/s0167-8140(06)80922-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Christensen E, Maddix K, Scott S, Cops F, Burrows K, Wang L, Grabarz D, Wong R. 240 A prospective cohort study to describe the factors predictive of interruption during fluoroscopic simulation for palliative radio-therapy. Radiother Oncol 2006. [DOI: 10.1016/s0167-8140(06)80981-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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256
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Tsao MN, Lloyd N, Wong R, Chow E, Rakovitch E, Laperriere N. Whole brain radiotherapy for the treatment of multiple brain metastases. Cochrane Database Syst Rev 2006:CD003869. [PMID: 16856022 DOI: 10.1002/14651858.cd003869.pub2] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
BACKGROUND Brain radiotherapy is used to treat cancer patients who have brain metastases resulting from various primary malignancies. OBJECTIVES To assess the effectiveness and adverse effects of whole brain radiotherapy (WBRT) in adult patients with multiple metastases to the brain. SEARCH STRATEGY CENTRAL (The Cochrane Library), MEDLINE, EMBASE, CANCERLIT, and CINAHL were searched. SELECTION CRITERIA Randomized controlled trials (RCTs) in which adult patients with multiple metastases to the brain from any primary cancer and treated with WBRT were included. Trials of prophylactic WBRT were excluded as well as trials that dealt with surgery or WBRT, or both, for the treatment of a single brain metastasis. DATA COLLECTION AND ANALYSIS Two review authors independently abstracted information for each predetermined outcome: overall survival at six months, intracranial progression-free duration, local brain response, local brain control, quality of life, symptom control, neurological function, and the proportion of patients able to reduce the daily dexamethasone dose. Adverse effects were also collected. MAIN RESULTS Eight published reports (nine trials) showed no benefit of altered dose-fractionation schedules as compared to control fractionation (3000 cGy in 10 fractions) of WBRT on the probability of survival at six months. These studies also showed no difference in symptom control nor neurologic improvement among the different dose-fractionation schemes. The addition of radiosensitizers, in five RCTs, did not confer additional benefit to WBRT in either overall median survival times or brain tumor response rates. The addition of the radiosensitizer motexafin gadolinium did not improve quality of life nor time to neurologic progression overall. For the radiosensitizer misonidazole, there was no improvement in Karnofsky performance score outcomes. Three RCTs found no benefit in overall survival with the use of WBRT and a radiosurgery boost as compared to WBRT alone for selected patients with multiple brain metastases (up to four brain metastases). Overall, however, there was a statistically significant improvement in local brain control favoring the whole brain radiotherapy and radiosurgery boost arm. Only one trial of radiosurgery boost with WBRT reported an improved Karnofsky performance score outcome and improved ability to reduce dexamethasone dose. One RCT examined the use of WBRT and prednisone versus prednisone alone and produced inconclusive results. AUTHORS' CONCLUSIONS None of the RCTs with altered dose-fractionation schemes as compared to standard delivery (3000 cGy in ten fractions) found a benefit in terms of overall survival, neurologic function, or symptom control. The use of radiosensitizers or chemotherapy in conjunction with WBRT remains experimental. A radiosurgery boost with WBRT may improve local disease control in selected patients, although survival remains unchanged. The benefit of WBRT as compared to supportive care alone has not been studied in RCTs. It may be that supportive care alone, without WBRT, may be appropriate for some patients, particularly those with advanced disease and poor performance status.
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257
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Visbal AL, Darling G, Wong R, Guindi M, Hornby J, Feld R, Ringash J, Keshavjee S, Chen E, Brierly J, Knox J. Phase II trial of preoperative (POP) irinotecan (I) + cisplatin (C) and radiotherapy for esophageal cancer. J Clin Oncol 2006. [DOI: 10.1200/jco.2006.24.18_suppl.4056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
4056 Background: Esophagectomy (E) for locally advanced esophageal cancer (LAEC) yields limited survival; this phase II trial assess feasibility and efficacy of induction chemo-radiotherapy followed by E. Methods: Patients (pts) with LAEC of the thoracic esophagus (TE) or gastroesophageal junction (GEJ), ECOG PS ≤ 2 and surgical candidates underwent POP I (65mg/m2) + C (30mg/m2) on weeks 1,2,4,5,7,8 + concurrent conformal radiotherapy (40Gy/20 fractions (F) during wk 4–7) and external beam boost (10Gy/5F on wk 8); E was performed on wk 12–16 after restaging. Pts receiving 75% of POP chemotherapy were eligible for pathologic (p) evaluation; planned sample size 36 nonM1A pts. Results: 52 pts enrolled from 11/02 to 12/05, mean age 60 yr (33–79), male:40, GEJ:TE/15:37; 37 adenocarcinoma, 13 SCC, 2 other; 13 pts were stage IIA, 7 IIB, 22 III, and 10 IVA. Toxicity during POP treatment included ANC (G3/4:36%), febrile neutropenia (9%), diarrhea (G3:9%), nausea (G3:6%), esophagitis (G3:2%) and anorexia (G3/4:15%); 3 pts stopped treatment due to toxicity, 2 withdrew, 2 progressed becoming non-operable, 1 died of a stroke and 1 from central line sepsis. Clinical response by RECIST was CR:2%, PR:30%, SD:62% and PD in 6%. Dysphagia improved or resolved in 34/47 pts (72%) during POP treatment. Of 43 evaluable pts, 41 underwent E, achieving R0 resection in 98% (1 refused E, 1 pending). Perioperative complications included anastomotic leak (23%), Afib (21%), pneumonia (21%), delirium (10%) and aspiration (10%); 1 pt died from aspiration. 7 pts (17%) achieved pCR, 2 of whom were pretreatment clinical stage IIA, 1 IIb and 4 III; downstaging occurred in 3/7 pts; 15 pts (36.6%) achieved minimal residual disease, 15 (36.6%) pPR, and 4 (9.8%) pSD. At a median (med) follow-up of 15.2 months (1.3–34.5m), 16/52 patients died (med & 2yr overall survival (OS) of 29 m & 66%). Of 41 resected pts, 17 recurred (med & 2yr disease free survival (DFS) of 20m & 46%) of whom 10 died of progression (med & 2-yr OS of 29m & 68.4%). 2yr DFS & OS was 83% & 86% in pCR vs 41% & 76% in non-pCR. Conclusion: In LAEC, induction I/C and radiotherapy followed by E is associated with 72% dysphagia improvement, a significant but manageable toxicity profile, and encouraging survival compared to historical controls. [Table: see text]
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Maroun J, Kocha W, Kvols L, Bjarnason G, Chen E, Germond C, Hanna S, Poitras P, Rayson D, Reid R, Rivera J, Roy A, Shah A, Sideris L, Siu L, Wong R. Guidelines for the diagnosis and management of carcinoid tumours. Part 1: the gastrointestinal tract. A statement from a Canadian National Carcinoid Expert Group. Curr Oncol 2006; 13:67-76. [PMID: 17576444 PMCID: PMC1891174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Carcinoid tumours are relatively rare and, in general, slow growing. They can be "non-functioning" tumours, presenting as a tumour mass, or "functioning" tumours secondary to the production of several biopeptides leading to the carcinoid syndrome. Though these tumours represent 0.25% of an oncology practice, a proper understanding of the clinical course of the disease and of the importance of appropriate diagnostic and therapeutic measures is very important. Proper patient management can lead to cure, particularly if the tumour can be fully resected, or to long-term palliation with medical treatment or cytoreductive surgery, or both, with significant prolongation of survival. A good understanding of the use of somatostatin analogues to achieve effective symptomatic control and of the importance of adequate follow-up and cardiac monitoring to prevent or effectively treat cardiac complications can contribute significantly to optimal control of this complex disease, ultimately improving the quality of life of affected patients. This article, developed by a group of Canadian experts, provides a framework that will assist clinicians in taking an optimal approach to managing their patients with carcinoid tumour.
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259
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Qureshi MA, Wong R, Robbie SJ, Qureshi KM, Rowe C, Leach J. Contamination of single-use Minims eye drops by multiple use in clinics. J Hosp Infect 2006; 62:245-7. [PMID: 16289460 DOI: 10.1016/j.jhin.2005.08.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2005] [Accepted: 08/15/2005] [Indexed: 11/19/2022]
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260
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Wong R, Malthaner R. Combined chemotherapy and radiotherapy (without surgery) compared with radiotherapy alone in localized carcinoma of the esophagus. Cochrane Database Syst Rev 2006:CD002092. [PMID: 16437440 DOI: 10.1002/14651858.cd002092.pub2] [Citation(s) in RCA: 73] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
BACKGROUND Esophageal carcinoma can be managed primarily with either a surgical or non-surgical radiotherapeutic approach. Combination chemotherapy (CT) and radiotherapy (RT) has been incorporated into clinical practice and applied increasingly, especially in North America. OBJECTIVES To evaluate combined CT and RT (CTRT) versus RT alone in patients with localized esophageal carcinoma. Outcomes included overall survival, cause-specific survival, local recurrence, dysphagia relief, quality of life, acute and chronic toxicities. SEARCH STRATEGY The Cochrane strategy for identifying randomized trials was combined with relevant MeSH headings. The Cochrane Library, MEDLINE, CancerLIT and EMBASE were last searched in April 2005. References from relevant articles and personal files were included. SELECTION CRITERIA Randomized controlled trials in patients with localized esophageal cancer comparing RT alone with combined CTRT were included. Studies comparing non-chemotherapy agents such as pure radiotherapy sensitisers, immunostimulants, planned esophagectomy, were excluded. DATA COLLECTION AND ANALYSIS Two reviewers extracted data independently. Trial quality was assessed using the Jadad scale and Detsky checklist. Sensitivity analyses were planned to examine the effect of concomitant versus sequential treatment, study quality, radiotherapy dose, and whether the drug regimen contained cisplatin or 5-fluorouracil were performed. MAIN RESULTS Nineteen randomized trials were included, with eleven concomitant and eight sequential RTCT studies. Concomitant RTCT provided significant reduction in mortality with a harms ratio (HR) of 0.73 (95% confidence interval (CI) 0.64 to 0.84). Using an estimated mortality rate for the control group of 62% at year one and 83% at year two, the absolute survival benefit for RTCT was 9% (95% CI 5 to 12%) and 4% (95% CI 3 to 6%]) respectively. There was an absolute reduction of local recurrence rate of 12% (95% CI 3 to 22%), number needed to treat (NNT) of 9, when the local recurrence rate for the RT alone arm was 68%. This was associated with a significant risk of severe and life-threatening toxicities (number needed to harm (NNH)of 6). Sensitivity analyses did not identify any factors that interacted with the results. The results from sequential RTCT studies showed no significant benefit in survival or local control but significant toxicities. AUTHORS' CONCLUSIONS Based on the available data, when a non-operative approach is selected then concomitant RTCT is superior to RT alone for patients with localized esophageal cancer but with significant toxicities. In patients who are in good general condition, and the risk benefit has been thoroughly discussed with the patient, concomitant RTCT should be considered for the management of esophageal cancer compared with radiotherapy alone.
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Barrett K, Medlam G, Ditomasso A, Price J, Kelly V, Wong R, Warde P, Brierley J, Bissonnette JP. 439 DEVELOPMENT OF AN INTEGRATED PATIENT-SPECIFIC QUALITY ASSURANCE PROGRAM IN RADIATION THERAPY: A PILOT PROJECT BY THE GASTROINTESTINAL SITE GROUP. J Investig Med 2006. [DOI: 10.2310/6650.2005.x0004.438] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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Letourneau D, Sharpe M, Moseley D, Wong R, Elder C, Bissonnette J, Jaffray D, Gospodarowicz M. Online Strategy for Palliative Treatment of Patients with Bone Metastases of the Spine: A Feasibility Study. Int J Radiat Oncol Biol Phys 2005. [DOI: 10.1016/j.ijrobp.2005.07.155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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263
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Wang Z, Wong R. Bessel-type asymptotic expansions via the Riemann–Hilbert approach. Proc Math Phys Eng Sci 2005. [DOI: 10.1098/rspa.2005.1467] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
A Bessel-type asymptotic expansion is established for the monic polynomials
π
n
(
x
) that are orthogonal with respect to the modified Jacobi weight
,
x
∈(−1,1), where
α
,
β
>−1 and
h
(
x
) is real analytic and strictly positive on [−1,1]. This expansion holds uniformly in a region containing the neighbourhood of the critical value
x
=1. This result complements the two recent results obtained by Kuijlaars and his co-workers, one for
x
bounded away from (−1,1) and the other for
x
in (−1+
δ
,1−
δ
),
δ
>0. Our method is also based on the Riemann–Hilbert approach.
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Kassam Z, Ringash J, Brierley J, Swallow C, Lockwood G, Moore M, Knox J, Siu L, Wong R, Kim J, Cummings B, Oza A. 154 Toxicity and survival in adjuvant chemoradiotherapy in patients with resected gastric adenocarcinoma. Radiother Oncol 2005. [DOI: 10.1016/s0167-8140(05)80315-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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265
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Kassam Z, Ringash J, O'Brien C, Lockwood G, Brierley J, Swallow C, Moore M, Knox J, Siu L, Wong R, Oza A, Kim J, Cummings B. 155 Impact of surgical and pathological features on outcome in patients receiving adjuvant chemoradiation for gastric adenocarcinoma. Radiother Oncol 2005. [DOI: 10.1016/s0167-8140(05)80316-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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266
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Abuzallouf S, Wong R, Mintz AP, Provias J. Hemangioendothelioma of the spinal cord with intramedullary extension. Med Princ Pract 2005; 14:354-7. [PMID: 16103703 DOI: 10.1159/000086935] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2003] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE Hemangioendotheliomas (HE) are vascular neoplasms that rarely involve the neuraxis. We report a rare case in the literature of intradural HE of the spinal cord with intramedullary extension. CLINICAL PRESENTATION AND INTERVENTIONS A 41-year-old gentleman presented with low back pain, numbness and urinary retention. Imaging revealed a spinal tumor causing complete blockage at the level of T12. The tumor was resected and postoperative radiotherapy was delivered for residual disease. No disease was seen on MRI after 48 months of clinical and radiological follow-up. CONCLUSION Complete excision of HE is the treatment of choice. Radiotherapy may play a role in the management of this lesion.
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Wong R, Ringash J, Kim J, Cummings B, Darling G, Knox J, Haider M, Guindi M, Cheung F, Brierley J. 43 A Phase II Study of Preoperative Conformal Radiotherapy and Chemotherapy (CPTII/Cisplatin) for EsophagealCancer. Radiother Oncol 2005. [DOI: 10.1016/s0167-8140(05)80204-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Wiltshire K, Wong R, Alasti H, Abbas A, Cheung F, Ringash J, Brierley J. 57 GTV motion in oesophageal cancer. Radiother Oncol 2005. [DOI: 10.1016/s0167-8140(05)80218-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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269
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Wilson B, Miller K, Wong R, Emmons R, Kupferschmidt G, Foran K. Using six sigma methodology to improve hand hygiene compliance. Am J Infect Control 2005. [DOI: 10.1016/j.ajic.2005.04.197] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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270
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Kassam Z, Ringash J, Brierley J, Swallow C, Moore M, Knox JJ, Siu L, Wong R, Cummings B, Oza A. Toxicity and outcomes of adjuvant chemoradiotherapy in patients with resected gastric adenocarcinoma. J Clin Oncol 2005. [DOI: 10.1200/jco.2005.23.16_suppl.4157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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271
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Arai S, Negrin R, Blume K, Johnston L, Laport G, Lowsky R, Shizuru J, Stockerl-Goldstein K, Letsinger R, Wong R, Horning S. A phase I trial with extended cohort of gemcitabine and vinorelbine followed by autologous peripheral blood stem cell transplantation for recurrent or refractory Hodgkin’s lymphoma. J Clin Oncol 2005. [DOI: 10.1200/jco.2005.23.16_suppl.6651] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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272
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Ringash J, Khaksart SJ, Oza A, Couture J, Japp B, Moore M, Siu LL, Hedley D, Swallow C, Wong S, Cummings B, Kim J, Wong R, Brierley J. Post-operative radiochemotherapy for gastric cancer: adoption and adaptation. Clin Oncol (R Coll Radiol) 2005; 17:91-5. [PMID: 15830570 DOI: 10.1016/j.clon.2004.09.017] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
AIMS Intergroup study 0116 (INT-0116) showed an 11% absolute improvement in 3-year survival with post-operative radiochemotherapy for gastric cancer, but reported 33% severe acute GI toxicity using conventional simulation with large fields. We adapted the treatment using conformal radiotherapy techniques and assessed toxicity and outcome in 20 consecutive patients. METHODS A conformal radiotherapy technique previously developed for gastric lymphoma was adapted to treat the target volume defined in INT-0116. The five-field plan used a large anterior field, plus asymmetrically matched upper AP:PA fields and lower lateral fields. Consecutive patients with ECOG PS 0-2 and stage IB-IV non-metastatic gastric cancer were treated with 5-FU (425 mg/m2 daily x 5 days) and leucovorin (20 mg/m2 daily x 5 days) for one cycle prior to and two cycles following concurrent radiation (45 Gy/25 fractions) with identical drug dosages on the first 4 and last 3 days of radiation. Acute toxicity was prospectively recorded weekly using RTOG and NCI common toxicity criteria. Patient charts were reviewed in November 2003 and late toxicity and outcome were recorded. RESULTS Nineteen of 20 patients completed radiotherapy and 14 completed all chemotherapy cycles. One patient died of neutropenic sepsis. Maximum acute toxicity [grade (number)] was: 5(1), 4(0), 3(4), 2(10), 1(4), 0(1). There were two grade 1 late toxicities. Two-year overall survival is 70% (95% confidence interval: 50-90). CONCLUSIONS Conformal radiotherapy may improve acute toxicity (25% grade 3 or greater toxicity as compared with 41% reported in INT-0116). Survival is comparable to that achieved in the INT-0116 treatment arm (approximately 60% at 2 years). INT-0116 results can be achieved outside a study setting; however, further efforts to improve treatment efficacy and minimize toxicity are warranted.
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Cheng Y, Wong R, Soo YOY, Wong WS, Lee CK, Ng MHL, Chan P, Wong KC, Leung CB, Cheng G. Use of convalescent plasma therapy in SARS patients in Hong Kong. Eur J Clin Microbiol Infect Dis 2005; 24:44-6. [PMID: 15616839 PMCID: PMC7088355 DOI: 10.1007/s10096-004-1271-9] [Citation(s) in RCA: 668] [Impact Index Per Article: 35.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
In order to evaluate the efficacy of convalescent plasma therapy in the treatment of patients with severe acute respiratory syndrome (SARS), 80 SARS patients were given convalescent plasma at Prince of Wales Hospital, Hong Kong, between 20 March and 26 May 2003. Good outcome was defined as discharge by day 22 following the onset of SARS symptoms. Poor outcome was defined as death or hospitalization beyond 22 days. A higher day-22 discharge rate was observed among patients who were given convalescent plasma before day 14 of illness (58.3% vs 15.6%; P<0.001) and among those who were PCR positive and seronegative for coronavirus at the time of plasma infusion (66.7% vs 20%; P=0.001).
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Soo YOY, Cheng Y, Wong R, Hui DS, Lee CK, Tsang KKS, Ng MHL, Chan P, Cheng G, Sung JJY. Retrospective comparison of convalescent plasma with continuing high-dose methylprednisolone treatment in SARS patients. Clin Microbiol Infect 2004; 10:676-8. [PMID: 15214887 PMCID: PMC7129386 DOI: 10.1111/j.1469-0691.2004.00956.x] [Citation(s) in RCA: 274] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Treatment of severe acute respiratory syndrome (SARS) is experimental, and the effectiveness of ribavirin–steroid therapy is unclear. Forty SARS patients with progressive disease after ribavirin treatment and 1.5 g of pulsed methylprednisolone were given either convalescent plasma (n = 19) or further pulsed methylprednisolone (n = 21) in a retrospective non‐randomised study. Good clinical outcome was defined as discharge by day 22 following the onset of symptoms. Convalescent plasma was obtained from recovered patients after informed consent. Patients in the plasma group had a shorter hospital stay (p 0.001) and lower mortality (p 0.049) than the comparator group. No immediate adverse effects were observed following plasma infusion.
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275
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Wong R, Zhao YQ. Uniform asymptotic expansion of the Jacobi polynomials in a complex domain. Proc Math Phys Eng Sci 2004. [DOI: 10.1098/rspa.2004.1296] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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