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Morton G, McGuffin M, Chung H, Ravi A, Tseng C, Hasan Y, Mendez L, Loblaw D. High Dose-Rate Prostate Brachytherapy as Monotherapy: a Single Fraction May Not be Enough. Int J Radiat Oncol Biol Phys 2019. [DOI: 10.1016/j.ijrobp.2019.06.492] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Martell K, Han K, Mendez L, Barnes E, Taggar A, Ravi A, Leung E. A Multicenter Analysis of the Utility of MRI Based ADC Image Sets in Delineating GTVres Volumes in Cervical Brachytherapy. Int J Radiat Oncol Biol Phys 2019. [DOI: 10.1016/j.ijrobp.2019.06.1724] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Halstead F, Ravi A, Thomson N, Nuur M, Hughes K, Brailey M, Oppenheim B. Whole genome sequencing of toxigenic Clostridium difficile in asymptomatic carriers: insights into possible role in transmission. J Hosp Infect 2019; 102:125-134. [DOI: 10.1016/j.jhin.2018.10.012] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2018] [Accepted: 10/15/2018] [Indexed: 01/05/2023]
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Roy S, Loblaw A, Cheung P, Chu W, Chung HT, Vesprini D, Ong A, Chowdhury A, Panjwani D, Pang G, Korol R, Davidson M, Ravi A, McCurdy B, Helou J, Zhang L, Mamedov A, Deabreu A, Quon HC. Prostate-specific Antigen Bounce After Stereotactic Body Radiotherapy for Prostate Cancer: A Pooled Analysis of Four Prospective Trials. Clin Oncol (R Coll Radiol) 2019; 31:621-629. [PMID: 31126725 DOI: 10.1016/j.clon.2019.05.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2018] [Revised: 03/05/2019] [Accepted: 04/01/2019] [Indexed: 12/21/2022]
Abstract
AIMS We conducted a pooled analysis of four prospective stereotactic body radiotherapy (SBRT) trials of low- and intermediate-risk prostate cancer to evaluate the incidence of prostate-specific antigen (PSA) bounce and its correlation with the time-dose-fraction schedule. The correlation between bounce with PSA response at 4 years (nadir PSA < 0.4 ng/ml) and biochemical failure-free survival (BFFS) was also explored. MATERIALS AND METHODS The study included four treatment groups: 35 Gy/five fractions once per week (QW) (TG-1; n = 84); 40 Gy/five fractions QW (TG-2; n = 100); 40 Gy/five fractions every other day (TG-3; n = 73); and 26 Gy/two fractions QW (TG-4; n = 30). PSA bounce was defined as a rise in PSA by 0.2 ng/ml (nadir + 0.2) or 2 ng/ml (nadir + 2.0) above nadir followed by a decrease back to nadir. Patients with fewer than three follow-up PSA tests were excluded from the pooled analysis. RESULTS In total, 287 patients were included, with a median follow-up of 5.0 years. The pooled 5-year cumulative incidence of bounce by nadir + 2.0 was 8%. The 2-year cumulative incidences of PSA bounce by nadir + 0.2 were 28.9, 21, 19.6 and 16.7% (P = 0.12) and by nadir + 2.0 were 7.2, 8, 2.7 and 6.7% (P = 0.32) for TG-1 to TG-4, respectively. Multivariable analysis revealed that for nadir + 2.0, pre-treatment PSA (odds ratio 0.49; 95% confidence interval 0.26-0.97) correlated with PSA bounce. Although PSA bounce by nadir + 0.2 (odds ratio 0.10; 95% confidence interval 0.04-0.24) and nadir + 2.0 (odds ratio 0.29; 95% confidence interval 0.09-0.93) was associated with a lower probability of PSA response at 4 years, there was no association between bounce by nadir + 0.2 (hazard ratio 0.36; 95% confidence interval 0.08-1.74) or nadir + 2 (hazard ratio 1.77; 95% confidence interval 0.28-11.07) with BFFS. CONCLUSION The incidence of PSA bounce was independent of time-dose-fraction schedule for prostate SBRT. One in 13 patients experienced a bounce high enough to be misinterpreted as biochemical failure, and clinicians should avoid early salvage interventions in these patients. There was no association between PSA bounce and BFFS.
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Alayed Y, Cheung P, Chu W, Chung H, Davidson M, Ravi A, Helou J, Zhang L, Mamedov A, Commisso A, Commisso K, Loblaw A. PO-0840 Two StereoTactic Ablative Radiotherapy Treatments for Localized Prostate Cancer (2STAR). Radiother Oncol 2019. [DOI: 10.1016/s0167-8140(19)31260-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Mendez L, Martell K, Chung H, Tseng C, Alayed Y, Cheung P, Liu S, Vesprini D, Chu W, Szumacher E, Ravi A, Loblaw A, Morton G. OC-0288 Long-term results of 15Gy HDRBT boost in intermediate risk-prostate cancer:Analysis of 500 + patients. Radiother Oncol 2019. [DOI: 10.1016/s0167-8140(19)30708-x] [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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Martell K, Mendez LC, Chung H, Tseng CL, Zhang L, Alayed Y, Liu S, Vesprini D, Chu W, Paudel M, Cheung P, Szumacher E, Ravi A, Loblaw A, Morton G. Absolute percentage of biopsied tissue positive for Gleason pattern 4 disease (APP4) appears predictive of disease control after high dose rate brachytherapy and external beam radiotherapy in intermediate risk prostate cancer. Radiother Oncol 2019; 135:170-177. [PMID: 31015164 DOI: 10.1016/j.radonc.2019.03.007] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2019] [Revised: 03/06/2019] [Accepted: 03/10/2019] [Indexed: 11/30/2022]
Abstract
BACKGROUND AND PURPOSE To identify if, in intermediate risk prostate cancer (IR-PCa), the absolute percentage of biopsied tissue positive for pattern 4 disease (APP4) may be a predictor of outcome. MATERIALS AND METHODS 411 patients with IR-PCa were retrospectively reviewed. APP4 was calculated based on biopsy reports. Multivariable competing risk analysis was then performed on optimized APP4 cutpoints to predict for biochemical failure (BF), androgen deprivation use for BF (ADT-BF) and development of metastases (MD). RESULTS Median follow-up for the cohort was 5.2 (Inter Quartile Range: 2.9-6.6) years. Median baseline PSA was 7.3 (5.3-9.8) ng/mL. 234 (56.9%) patients had T1 and 177 (43.1%) had T2 disease. Median APP4 was 2.00 (0.75-7.50)%. 38 (9.3%) patients experienced BF. The optimal cutpoint of APP4 for BF was >3.3% with an area under the curve (AUC) of 0.66. 17 (4.1%) received ADT-BF. The ADT-BF cutpoint was >6.6% with an AUC of 0.72. Eight (2.0%) developed MD. The MD cutpoint was >17.5% with an AUC of 0.86. Using APP4 >3.3 vs ≤ 3.3, log-transformed baseline PSA ln(PSA) (HR 2.5, 1.1-6.1; p = 0.037) and APP4 (HR 2.3, 1.1-4.7; p = 0.031) predicted for BF. Using APP4 >6.6 vs ≤ 6.6, ln(PSA) (HR 4.2, 1.4-12.4; p = 0.010) and APP4 (HR 3.7, 1.4-10.0; p = 0.009) were predictive of ADT-BF. APP4 >17.5 vs ≤ 17.5 alone was predictive of MD (HR 25.7, 4.9-135.3; p < 0.001). CONCLUSION APP4 cutpoints of >3.3%, >6.6% and >17.5% were strongly associated with increased risk of BF, ADT-BF and developing MD respectively. These findings may inform future practice when treating IR-PCa but require external validation.
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Iyyappan RP, Vasudevan A, Ravi A, Sudhan H. A Study to Compare Transurethral Resection of the Prostate and Inguinal Hernioplasty as Combined and Separate Procedures. J Clin Diagn Res 2019. [DOI: 10.7860/jcdr/2019/41371.12910] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Weiss Y, Mendez L, D'Souza D, Ravi A, Barbera L, Leung E. Three-Dimensional-Guided Perineal-Based Interstitial Brachytherapy in Primary Vaginal Cancer: A Systematic Review of Local Control and Toxicities. Int J Radiat Oncol Biol Phys 2018. [DOI: 10.1016/j.ijrobp.2018.07.1787] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Ravi A. URINARY 2,3-DINOR-11SS-PROSTAGLANDIN F2A – CLINICAL UTILITY IN PEDIATRIC MAST CELL ACTIVATION SYNDROME. Ann Allergy Asthma Immunol 2018. [DOI: 10.1016/j.anai.2018.09.419] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Roy S, Loblaw D, Cheung P, Chu W, Chung H, Vesprini D, Ong A, Chowdhury A, Panjwani D, Pang G, Korol R, Davidson M, Ravi A, McCurdy B, Helou J, Zhang L, Mamedov A, Deabreu A, Quon H. PSA Bounce after Stereotactic Body Radiation Therapy for Prostate Cancer: Pooled Analysis from 4 SBRT Trials Evaluating Different Time-Dose-Fraction Schedules. Int J Radiat Oncol Biol Phys 2018. [DOI: 10.1016/j.ijrobp.2018.07.263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Mendez L, Ravi A, Tseng C, Chung H, Paudel M, Wronski M, Davidson M, Loblaw A, Morton G. PO-1028: Acute urinary retention and hematuria in prostate cancer patients treated with HDR-BT. Radiother Oncol 2018. [DOI: 10.1016/s0167-8140(18)31338-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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Skliarenko J, D'Souza D, Perdrizet J, Ang M, Barbera L, Gutierrez E, Ravi A, Tanderup K, Warde P, Chan K, Isaranuwatchai W, Milosevic M. OC-0076: MR-guided vs CT-guided brachytherapy more effective and less costly in locally advanced cervical cancer. Radiother Oncol 2018. [DOI: 10.1016/s0167-8140(18)30386-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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Ravi A, Butterfield J. P382 Familial hypertryptasemia in children. Ann Allergy Asthma Immunol 2017. [DOI: 10.1016/j.anai.2017.09.015] [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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D'Souza D, Perdrizet J, Skliarenko J, Ang M, Barbera L, Ravi A, Gutierrez E, Tanderup K, Warde P, Chan K, Isaranuwatchai W, Milosevic M. A Cost-Utility Analysis Comparing MR-Guided Brachytherapy to Standard 2D Brachytherapy for Patients With Locally Advanced Cervical Cancer in Ontario, Canada. Int J Radiat Oncol Biol Phys 2017. [DOI: 10.1016/j.ijrobp.2017.06.558] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Mendez L, Weiss Y, D'Souza D, Ravi A, Barbera L, Leung E. Three-Dimensional Guided Perineal-Based Interstitial Brachytherapy in Cervical Cancer: A Systematic Review of Technique, Local Control, and Toxicities. Int J Radiat Oncol Biol Phys 2017. [DOI: 10.1016/j.ijrobp.2017.06.1326] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Leung E, D'Souza D, Alfieri J, Banerjee R, Bachand F, Barbera L, Barkati M, Barnes E, Bowes D, Fortin I, Foster W, Han K, Huang F, Patil N, Velker V, Vigneault E, Wiebe E, Wronski M, Ravi A. Contouring and Target Variability in Vaginal Tumors Treated with MR-Based Interstitial Brachytherapy: A Multi-institutional Contouring Study. Int J Radiat Oncol Biol Phys 2017. [DOI: 10.1016/j.ijrobp.2017.06.263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Sriram R, Sapthagiri R, Ilavarasan L, Ravi A. Retracted
: Microwave Assisted Synthesis of Trifluoro Substituted 2-Aminobenzimidazole Derivatives via
Iodoacetic Acid Mediated One-pot Condensation. J Heterocycl Chem 2017. [DOI: 10.1002/jhet.2841] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Dalimonte L, Helou J, Morton G, Chung H, McGuffin M, Ravi A, Loblaw A. OC-0102: MRI assisted focal boost integrated with HDR monotherapy for low/intermediate risk prostate cancer. Radiother Oncol 2017. [DOI: 10.1016/s0167-8140(17)30546-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Musunuru H, Deabreu A, Davidson M, Ravi A, Hlou J, Ho L, Cheung P, Vesprini D, Liu S, Chu W, Chung H, Zhang L, Loblaw A. EP-1341: Pelvic SABR with HDR boost in intermediate and high risk prostate cancer (spare): early results. Radiother Oncol 2017. [DOI: 10.1016/s0167-8140(17)31776-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Han S, Ravi A. P03.07 The prognostic value of a novel quantitative MGMT promoter methylation score for patients with glioblastoma. Neuro Oncol 2017. [DOI: 10.1093/neuonc/nox036.122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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D'Alimonte L, Morton G, Smith M, Chung H, McGuffin M, Ravi A, Loblaw A. MRI guided Focal Boost Integrated with HDR Brachytherapy for Prostate Cancer Patients: A Dosimetric Analysis. J Med Imaging Radiat Sci 2017. [DOI: 10.1016/j.jmir.2017.02.051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Grek CL, Montgomery J, Sharma M, Ravi A, Rajkumar JS, Moyer KE, Gourdie RG, Ghatnekar GS. A Multicenter Randomized Controlled Trial Evaluating a Cx43-Mimetic Peptide in Cutaneous Scarring. J Invest Dermatol 2016; 137:620-630. [PMID: 27856288 DOI: 10.1016/j.jid.2016.11.006] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2016] [Revised: 10/24/2016] [Accepted: 11/03/2016] [Indexed: 01/06/2023]
Abstract
The transmembrane protein Cx43 has key roles in fibrogenic processes including inflammatory signaling and extracellular matrix composition. aCT1 is a Cx43 mimetic peptide that in preclinical studies accelerated wound closure, decreased inflammation and granulation tissue area, and normalized mechanical properties after cutaneous injury. We evaluated the efficacy and safety of aCT1 in the reduction of scar formation in human incisional wounds. In a prospective, multicenter, within-participant controlled trial, patients with bilateral incisional wounds (≥10 mm) after laparoscopic surgery were randomized to receive acute treatment (immediately after wounding and 24 hours later) with an aCT1 gel formulation plus conventional standard of care protocols, involving moisture-retentive occlusive dressing, or standard of care alone. The primary efficacy endpoint was average scarring score using visual analog scales evaluating incision appearance and healing progress over 9 months. There was no significant difference in scar appearance between aCT1- or control-treated incisions after 1 month. At month 9, aCT1-treated incisions showed a 47% improvement in scar scores over controls (Vancouver Scar Scale; P = 0.0045), a significantly higher Global Assessment Scale score (P = 0.0009), and improvements in scar pigmentation, thickness, surface roughness, and mechanical suppleness. Adverse events were similar in both groups. aCT1 has potential to improve scarring outcome after surgery.
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Jin J, Ravi A. P343 A seasonal skin rash: is this an allergy? Ann Allergy Asthma Immunol 2016. [DOI: 10.1016/j.anai.2016.09.357] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Chen J, Wu X, Christos P, Yan W, Ravi A. The Impact of Adjuvant Radiation Therapy on Survival in T3N0 Breast Cancer Patients Older than Age 75 Years After Mastectomy: A Surveillance, Epidemiology, and End Results Analysis. Int J Radiat Oncol Biol Phys 2016. [DOI: 10.1016/j.ijrobp.2016.06.725] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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