101
|
Wilkinson J, Shah C, Amin M, Shaitelman S, Chen P, Wallace M, Mitchell C, Grills I, Martinez A, Vicini F. Outcomes by Breast Cancer Subtype in Patients Treated with Accelerated Partial Breast Irradiation. Int J Radiat Oncol Biol Phys 2011. [DOI: 10.1016/j.ijrobp.2011.06.423] [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]
|
102
|
Wallace M, Shah C, Wilkinson J, Mitchell C, Vicini F. Comparison of Five Year Clinical Outcomes between Interstitial, Balloon-Based, and 3-D Conformal Partial Breast Irradiation Techniques in ASTRO Suitable and Cautionary Risk Category Patients. Int J Radiat Oncol Biol Phys 2011. [DOI: 10.1016/j.ijrobp.2011.06.420] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022]
|
103
|
Ye H, Martinez A, Wallace M, Dilworth J, Mitchell C, Marvin K, Krauss D, Chen P, Ghilezan M, Gustafson G. Long-term Outcome Analysis for Low/Intermediate Risk Prostate Cancer Patients Treated with Permanent Interstitial or High-dose-rate Brachytherapy. Int J Radiat Oncol Biol Phys 2011. [DOI: 10.1016/j.ijrobp.2011.06.722] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|
104
|
Vicini F, Shah C, Wilkinson J, Wallace M, Mitchell C. The Impact of Lymph Node Status on Clinical Outcomes following Accelerated Partial Breast Irradiation. Int J Radiat Oncol Biol Phys 2011. [DOI: 10.1016/j.ijrobp.2011.06.1725] [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]
|
105
|
Wilkinson JB, Shah C, Amin M, Shaitelman SF, Nadeau L, Chen P, Wallace M, Mitchell C, Grills IS, Martinez AA, Vicini FA. Outcomes by breast cancer subtype in patients treated with accelerated partial breast irradiation. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.27_suppl.83] [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
83 Background: To determine clinical outcomes for patients treated with accelerated partial breast irradiation (APBI) based on breast cancer subtype. Methods: We evaluated 516 consecutive patients who received APBI with a minimum follow-up of 6 months. Methods of APBI delivery included interstitial brachytherapy (n=221), balloon-based brachytherapy (n=201), and 3D-CRT (n=106). Women were assigned a breast cancer subtype (BCST) based on results of testing for estrogen (ER), progesterone (PR), and human epidermal growth factor (HER2/neu) receptors. Those without test results for all three receptors were excluded. 278 patients were eligible and submitted for analysis. Receptor subtypes were approximated as follows: ER+, PR+/–, and HER-2 negative [luminal A (LA), 164 pts.]; ER+, PR+/–, and HER-2 positive [luminal B (LB), 81 pts.]; ER/PR–, HER-2+ [HER-2 (H2), 5 pts.], and ER/PR/HER-2 negative [basal (B), 28 pts.]. An analysis was then performed to estimate IBTR, RNF, DM, DFS, CSS, and OS. Results: Mean age was 66 years, median follow-up was 4.9 yrs. Basal and H2 subtype patients had higher histologic grades (Gr. 3 = 75% vs. 10% LA/LB, p<0.001), larger tumors (13.0mm vs. 10.7mm LA/LB, p=0.05), and were more likely to receive chemotherapy (68% vs. 15% LA/LB, p<0.001). Basal subtype patients were also more likely to be African American (18% vs. 4% LA/LB, p=0.002). Margin and nodal status were similar between all BCSTs. At five years, IBTR rates were 2.9%, 3.2%, 0%, and 4.8% for LA, LB, H2, and B subtypes, respectively (p=0.75). The IBTR within the B subtype group was due to a single elsewhere failure, the rate of which was not statistically different than that for the LA subtype (2.9%, p=0.30). DM was only seen in LA (2.5%) and LB (1.4%) (p=0.87). Disease-free survival (95-100%), CSS (97%-100%), and OS (80-100%) (Table) were also not statistically different (p=0.98, 0.85, 0.24, respectively) between BCST categories. Conclusions: Five-year local control rates after treatment with APBI are excellent for luminal, HER2, and triple-negative phenotypes of early-stage breast cancer. Further study of BCST is important and may be useful when counseling patients on adjuvant treatment options following breast-conserving surgery.
Collapse
|
106
|
Chen PY, Vicini FA, Mitchell C, Wallace M, Benitez P, Dekhne N, Shah C, Wilkinson JB, Martinez A. Efficacy analysis of high-risk breast cancer patients treated with accelerated partial breast irradiation from a single institution. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.27_suppl.111] [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
111 Background: We present the results of an analysis of high-risk breast cancer patients as defined by the NSABP B-39/RTOG 0413 phase III trial, all treated with accelerated partial breast irradiation (APBI) from a single institution. Methods: Between July 1993 and August 2010, 130 patients with any combination of at least one of the high-risk features of estrogen receptor (ER) negativity, age < 50, and/or axillary nodal positivity were treated with 1 of 3 forms of APBI. Sixty-seven patients were treated with interstitial needle-catheter brachytherapy, 44 balloon-based brachytherapy and 19 with 3D conformal external beam radiation therapy. Aside from the high-risk features, general eligibility criteria included infiltrating ductal carcinoma, with inclusion of invasive lobular and DCIS since 2003, margins > 2 mm, and surgically staged axilla. One-hundred eighteen patients had one high-risk factor, 11 had two, and 1 had all three factors. The median tumor size was 12.0 mm with margins > 2 mm in 80% of patients. Greater than 75% had T1 tumors and 50% were ER negative. Thirty-one percent of patients were node positive. Based upon the ASTRO Consensus Guidelines for use of APBI (2009) none of these patients were suitable, 38% cautionary and 62% were unsuitable. Results: Median age was 56.5 yrs (range 40-90). With a median follow-up of 5.3 yrs (0.02-16.9) the 5-yr actuarial local recurrence rate (LR) was 4.2%; regional recurrence (RR) was 2.1%. Median time to LR and RR were 1.2 and 2.8 yrs, respectively. On univariate analysis, the only factor significant for LR was a close/positive margin (p=0.031), as ER/PR, age, nodal status, tumor size, histology, grade, hormonal or chemotherapy were all NS. The 5-yr actuarial cause specific, disease-free, and overall survivals as well as distant metastasis were 94%, 91%, 90%, and 6.4%, respectively. Conclusions: This cohort of NSABP B-39/RTOG 0413 identified high-risk patients who have undergone APBI has yielded local-regional control rates and survival outcomes comparable to standard risk patients undergoing partial breast irradiation. Continued follow-up will be needed to assess the long-term efficacy of such high-risk breast cancer patients treated with APBI.
Collapse
|
107
|
Jones G, Haddrill R, Mitchell C, Anumba D. Why do women attend late for antenatal booking? A qualitative interview study exploring the perspectives of service users and stakeholders. J Epidemiol Community Health 2011. [DOI: 10.1136/jech.2011.143586.9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
|
108
|
Galante J, Mitchell C, Renfigo A, Burton P, Lyons R, Gallacher J. O1-2.1 The use of remote methods in the conduct of gene-environment interaction studies. Br J Soc Med 2011. [DOI: 10.1136/jech.2011.142976a.19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
|
109
|
Mitchell C, Cowburn G, Foster C. Assessing the options for local government to use legal approaches to combat obesity in the UK: putting theory into practice. Obes Rev 2011; 12:660-7. [PMID: 21426480 DOI: 10.1111/j.1467-789x.2011.00872.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
The law is recognized as a powerful tool to address some of the structural determinants of chronic disease, including 'obesogenic' environments which are a major factor in the increasing prevalence of obesity worldwide. However, it is often local - as opposed to national - government that has responsibility for an environment, including the built environment, and their role in reducing obesity using law remains relatively unexplored. With the English government shifting emphasis for improvement of public health from central to local government, this paper reviews the potential for regulatory action by local government to reduce obesity. We took a novel approach to assess the evidence and to identify legal options for implementation by local government: conducting reviews of literature, media reports and case law. Our results provide a clear rational for regulatory intervention that encourages a real choice of behaviour. They highlight strategic legal areas for reduction of obesity through restriction of traffic and promotion of active travel, promotion of access to healthy food and construction of a sustainable and active environment. Importantly, we identify current legal mechanisms for adoption by UK local government including the use of planning, licensing and transport legislation to develop local obesity prevention policy.
Collapse
|
110
|
Bélanger SA, Warren AE, Hamilton RM, Gray C, Gow RM, Sanatani S, Côté JM, Frcpc JL, Leblanc J, Martin S, Miles B, Mitchell C, Gorman DA, Weiss M, Schachar R. Cardiac risk assessment before the use of stimulant medications in children and youth. Paediatr Child Health 2011; 14:579-92. [PMID: 21037835 DOI: 10.1093/pch/14.9.579] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Regulatory decisions and scientific statements regarding the management of attention-deficit hyperactivity disorder (ADHD) raise questions about the safety of medications and the appropriate pretreatment evaluation to determine suitability for treatment with medication. This is particularly true in the setting of known structural or functional heart disease. The present paper reviews the available data, including peer-reviewed literature, data from the United States Food and Drug Administration Web site on reported adverse reactions in children using stimulant medication, and Health Canada data on the same problem. A consensus-based guideline on appropriate assessment is provided, based on input from members of the Canadian Paediatric Society, the Canadian Cardiovascular Society and the Canadian Academy of Child and Adolescent Psychiatry, with specific expertise and knowledge in the areas of both ADHD and paediatric cardiology. The present statement advocates a thorough history and physical examination before starting stimulant medications, with an emphasis on the identification of risk factors for sudden death, but does not routinely recommend electrocardiographic screening or cardiac sub-specialist consultation unless indicated by history or physical examination findings. A checklist for identifying children who are potentially at risk of sudden death (independent of ADHD or medications used to treat it) is provided. Although recommendations are based on the best evidence currently available, the committee further agrees that more research on this subject is necessary to optimize the approach to this common clinical scenario.
Collapse
|
111
|
Wallace M, Shah C, Mitchell C, John W, Vicini F. 75 oral TWELVE YEAR CLINICAL OUTCOMES WITH INTERSTITIAL ACCELERATED PARTIAL BREAST IRRADIATION. Radiother Oncol 2011. [DOI: 10.1016/s0167-8140(11)70198-0] [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]
|
112
|
Vicini F, Arthur D, Wazer D, Chen P, Mitchell C, Wallace M, Kestin L, Martinez A, Ye H. Limitations of the American Society of Therapeutic Radiology and Oncology (ASTRO) Consensus Panel Guidelines on the Use of Accelerated Partial Breast Irradiation. Int J Radiat Oncol Biol Phys 2010. [DOI: 10.1016/j.ijrobp.2010.07.386] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
|
113
|
Ghilezan M, Yan D, Kestin L, Brabbins D, Wallace M, Mitchell C, Casey A, Krauss D, Vicini F, Martinez A. Hypofractionated Online Cone-beam CT-guided Intensity Modulated Radiation Therapy (hypoCBCT-IMRT) for Localized Prostate Cancer: Acute Toxicity Profile Compared to Adaptive Offline Image-guided IMRT (ART-IMRT). Int J Radiat Oncol Biol Phys 2010. [DOI: 10.1016/j.ijrobp.2010.07.872] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
|
114
|
Wilkinson J, Wallace M, Chen P, Mitchell C, Shaitelman S, Marvin K, Grills I, Vicini F. Outcomes of Breast Cancer Patients with Triple Negative Receptor Status Treated with Accelerated Partial Breast Irradiation. Int J Radiat Oncol Biol Phys 2010. [DOI: 10.1016/j.ijrobp.2010.07.561] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
|
115
|
Flynn C, Mitchell C, Limbacher A, Vicini F, Martinez A. A Comparison of Quality of Life for Early Stage Breast Cancer Examining Whole Breast IMRT versus Accelerated Partial Breast Irradiation. Int J Radiat Oncol Biol Phys 2010. [DOI: 10.1016/j.ijrobp.2010.07.1419] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
116
|
Wallace M, Ghilezan M, Mitchell C, Kestin L, Shah C, Marvin K, Brabbins D, Gustafson G, Ye H, Martinez A. Five-year Clinical Outcome in Intermediate Risk Gleason 7 Cancer Patients Treated with Image-guided Adaptive Radiation Therapy vs. Image-guided Brachytherapy as Monotherapy. Int J Radiat Oncol Biol Phys 2010. [DOI: 10.1016/j.ijrobp.2010.07.865] [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]
|
117
|
Wares K, Grant J, Hendry A, Mitchell C. P09.04 Challenging cleanliness champions – inspiration, information, instigation. J Hosp Infect 2010. [DOI: 10.1016/s0195-6701(10)60095-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|
118
|
Hemandas A, Mitchell C, Aikoye A. Small bowel evisceration following removal of an abdominal drain. Ir J Med Sci 2010; 181:265-7. [PMID: 20878258 DOI: 10.1007/s11845-010-0589-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2010] [Accepted: 09/15/2010] [Indexed: 02/06/2023]
Abstract
Drain site small bowel evisceration represents a small but potentially serious risk following abdominal drain removal. We present the case of a patient in whom removal of an abdominal drain was complicated by small bowel evisceration requiring surgical intervention. Strategies for management, consequences and potential preventive measures are discussed.
Collapse
|
119
|
Kim N, Boone KB, Victor T, Lu P, Keatinge C, Mitchell C. Sensitivity and Specificity of a Digit Symbol Recognition Trial in the Identification of Response Bias. Arch Clin Neuropsychol 2010; 25:420-8. [DOI: 10.1093/arclin/acq040] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
|
120
|
Mitchell C. The importance of skin cancer prevention in organ transplant patients an editorial to paper by Salgo: 'switch to sirolimus in long-term renal transplant recipients: reduced premalignancies and nonmelanoma skin cancer in a controlled, prospective, randomized, blinded study'. Am J Transplant 2010; 10:1343-4. [PMID: 20553445 DOI: 10.1111/j.1600-6143.2010.03133.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
|
121
|
Mitchell C, Richards S, Harrison CJ, Eden T. Long-term follow-up of the United Kingdom medical research council protocols for childhood acute lymphoblastic leukaemia, 1980-2001. Leukemia 2009; 24:406-18. [PMID: 20010621 PMCID: PMC2820452 DOI: 10.1038/leu.2009.256] [Citation(s) in RCA: 80] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Between 1980 and 2001, the United Kingdom Medical Research Council Childhood Leukemia Working Party has conducted 4 clinical trial in acute lymphoblastic leukemia, which have recruited a total of 6516 patients. UKALL VIII examined the role of daunorubicin in induction chemotherapy, and UKALL X examined the role of post-induction intensification. Both resulted in major improvement in the outcomes. UKALL XI examined the efficacy of different methods of CNS-directed therapy and the effects of an additional intensification. ALL97, which was initially based on the UKALL X D template (two intensification phases), examined the role of different steroids in induction and different thiopurines through continuing chemotherapy. A reappraisal of results from UKALL XI compared to other cooperative group results led to a redesign in 1999, which subsequently resulted in a major improvement in outcomes. Additionally, ALL97 and 97/99 demonstrated a significant advantage for the use of dexamethasone rather than prednisolone; although the use of 6-thioguanine resulted in fewer relapses, this advantage was offset by an increased incidence of deaths in remission. Over the era encompassed by these four trials there has been a major improvement in both event-free and overall survival for children in the UK with ALL.
Collapse
|
122
|
Warren AE, Hamilton RM, Bélanger SA, Gray C, Gow RM, Sanatani S, Côté JM, Lougheed J, LeBlanc J, Martin S, Miles B, Mitchell C, Gorman DA, Weiss M, Schachar R. Cardiac risk assessment before the use of stimulant medications in children and youth: A joint position statement by the Canadian Paediatric Society, the Canadian Cardiovascular Society, and the Canadian Academy of Child and Adolescent Psychiatry. Can J Cardiol 2009; 25:625-30. [PMID: 19898693 DOI: 10.1016/s0828-282x(09)70157-6] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
Regulatory decisions and scientific statements regarding the management of attention-deficit hyperactivity disorder (ADHD) raise questions about the safety of medications and the appropriate pretreatment evaluation to determine suitability for treatment with medication. This is particularly true in the setting of known structural or functional heart disease. The present paper reviews the available data, including peer-reviewed literature, data from the United States Food and Drug Administration Web site on reported adverse reactions in children using stimulant medication, and Health Canada data on the same problem. A consensus-based guideline on appropriate assessment is provided, based on input from members of the Canadian Paediatric Society, the Canadian Cardiovascular Society and the Canadian Academy of Child and Adolescent Psychiatry, with specific expertise and knowledge in the areas of both ADHD and pediatric cardiology. The present statement advocates a thorough history and physical examination before starting stimulant medications, with an emphasis on the identification of risk factors for sudden death, but does not routinely recommend electrocardiographic screening or cardiac subspecialist consultation unless indicated by history or physical examination findings. A checklist for identifying children who are potentially at risk of sudden death (independent of ADHD or medications used to treat it) is provided. Although recommendations are based on the best evidence currently available, the committee further agrees that more research on this subject is necessary to optimize the approach to this common clinical scenario.
Collapse
|
123
|
Bélanger SA, Warren AE, Hamilton RM, Gray C, Gow RM, Sanatani S, Côté JM, Lougheed J, LeBlanc J, Martin S, Miles B, Mitchell C, Gorman DA, Weiss M, Schachar R. L'évaluation du risque cardiaque avant l'utilisation de stimulants chez les enfants et les adolescents. Paediatr Child Health 2009. [DOI: 10.1093/pch/14.9.586] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
|
124
|
Hamilton R, Gray C, Bélanger SA, Warren AE, Gow RM, Sanatani S, Côté JM, Lougheed J, LeBlanc J, Martin S, Miles B, Mitchell C, Gorman DA, Weiss M, Schachar R. Cardiac risk assessment before the use of stimulant medications in children and youth: A joint position statement by the Canadian Paediatric Society, the Canadian Cardiovascular Society and the Canadian Academy of Child and Adolescent Psychiatry. JOURNAL OF THE CANADIAN ACADEMY OF CHILD AND ADOLESCENT PSYCHIATRY = JOURNAL DE L'ACADEMIE CANADIENNE DE PSYCHIATRIE DE L'ENFANT ET DE L'ADOLESCENT 2009; 18:349-355. [PMID: 19881947 PMCID: PMC2765391] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
|
125
|
Wallace M, Krauss D, Martinez A, Weiner S, Mitchell C, Chen P, Cook E, Brabbins D. Long-term Outcome of Adjuvant High-dose Whole Abdominopelvic Irradiation for Patients with Stage I/II Endometrial Cancer with High-risk Pathologic Features Including Serous Papillary/Clear Cell. Int J Radiat Oncol Biol Phys 2009. [DOI: 10.1016/j.ijrobp.2009.07.820] [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]
|