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Vial N, Nevesny S, Sotton S, Moslemi D, Jmour O, Guillaume E, Rehailia-Blanchard A, Trone JC, Langrand-Escure J, Vallard A, Magne N. Focus on the expected quality of reporting in SBRT/radiosurgery prospective studies: how far have we come in 30 years? Br J Radiol 2021; 94:20200115. [PMID: 33861141 PMCID: PMC8506168 DOI: 10.1259/bjr.20200115] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Objectives: We aimed at describing and assessing the quality of reporting in all published prospective trials about radiosurgery (SRS) and stereotactic body radiotherapy (SBRT). Methods: The Medline database was searched for. The reporting of study design, patients’ and radiotherapy characteristics, previous and concurrent cancer treatments, acute and late toxicities and assessment of quality of life were collected. Results: 114 articles – published between 1989 and 2019 - were analysed. 21 trials were randomised (18.4%). Randomisation information was unavailable in 59.6% of the publications. Data about randomisation, ITT analysis and whether the study was multicentre or not, had been significantly less reported during the 2010–2019 publication period than before (respectively 29.4% vs 57.4% (p < 0.001), 20.6% vs 57.4% (p < 0.001), 48.5% vs 68.1% (p < 0.001). 89.5% of the articles reported the number of included patients. Information about radiation total dose was available in 86% of cases and dose per fraction in 78.1%. Regarding the method of dose prescription, the prescription isodose was the most reported information (58.8%). The reporting of radiotherapy characteristics did not improve during the 2010 s-2019s. Acute and late high-grade toxicity was reported in 37.7 and 30.7%, respectively. Their reporting decreased in recent period, especially for all-grade late toxicities (p = 0.044). Conclusion: It seems necessary to meet stricter specifications to improve the quality of reporting. Advances in knowledge: Our work results in one of the rare analyses of radiosurgery and SBRT publications. Literature must include necessary information to first, ensure treatments can be compared and reproduced and secondly, to permit to decide on new standards of care.
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Affiliation(s)
- Nicolas Vial
- Department of Radiotherapy, Lucien Neuwirth Cancer Institute, Saint-Priest en Jarez, France
| | - Stéphane Nevesny
- Department of Radiotherapy, Lucien Neuwirth Cancer Institute, Saint-Priest en Jarez, France
| | - Sandrine Sotton
- Department of Radiotherapy, Lucien Neuwirth Cancer Institute, Saint-Priest en Jarez, France
| | - Dariush Moslemi
- Department of Radiotherapy, Lucien Neuwirth Cancer Institute, Saint-Priest en Jarez, France.,Department of radiotherapy, Babol University of Medical Sciences, Babol, Mazandaran Province, Iran
| | - Omar Jmour
- Department of Radiotherapy, Lucien Neuwirth Cancer Institute, Saint-Priest en Jarez, France
| | - Elodie Guillaume
- Department of Radiotherapy, Lucien Neuwirth Cancer Institute, Saint-Priest en Jarez, France
| | | | - Jane-Chloé Trone
- Department of Radiotherapy, Lucien Neuwirth Cancer Institute, Saint-Priest en Jarez, France
| | - Julien Langrand-Escure
- Department of Radiotherapy, Lucien Neuwirth Cancer Institute, Saint-Priest en Jarez, France
| | - Alexis Vallard
- Department of Radiotherapy, Lucien Neuwirth Cancer Institute, Saint-Priest en Jarez, France
| | - Nicolas Magne
- Department of Radiotherapy, Lucien Neuwirth Cancer Institute, Saint-Priest en Jarez, France
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Liu X, Zhang Y, Tang LL, Le QT, Chua MLK, Wee JTS, Lee NY, O'Sullivan B, Lee AWM, Sun Y, Ma J. Characteristics of Radiotherapy Trials Compared With Other Oncological Clinical Trials in the Past 10 Years. JAMA Oncol 2019; 4:1073-1079. [PMID: 29799987 DOI: 10.1001/jamaoncol.2018.0887] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Importance Modern precision radiotherapy is an innovative and effective treatment of cancer, yet it is unclear how radiotherapy trials are affected by expanding targeted and immune therapies and declining National Institutes of Health funding. Objective To analyze and compare the characteristics of radiotherapy trials with other oncological trials registered on ClinicalTrials.gov. Design, Setting, and Participants This is a cross-sectional analysis of trials registered on ClinicalTrials.gov between June 1, 2007, and May 8, 2017. Records of all 243 758 clinical studies registered by May 8, 2017, were downloaded, but only 25 907 interventional oncological trials registered between June 1, 2007, and May 8, 2017, and whose primary purpose was "treatment" were included in the final analysis. Trials were categorized according to cancer type and other registration information. Main Outcomes and Measures Characteristics of radiotherapy trials were compared with characteristics of other oncological trials. Chronological shifts in radiotherapy trials were also analyzed. Results Of the 25 907 trials selected, 1378 (5.3%) were radiotherapy trials and 24 529 (94.7%) were other oncological studies. The number of radiotherapy trials increased gradually from 94 (June 1, 2007, through May 31, 2008) to 192 (June 1, 2015, through May 31, 2016). Radiotherapy trials were less likely than other oncological studies to be registered before participant enrollment (763 of 1370 [55.7%] vs 16 105 of 24 434 [65.9%]; P < .001), to be blinded (45 of 1378 [3.3%] vs 2784 of 24 529 [11.3%]; P < .001), or to involve multiple geographic regions (2.4% vs 9.5%; P < .001), but they were more likely to be phase 2 to 3 (773 of 1124 [68.8%] vs 12 910 of 22 300 [57.9%]; P < .001) and to have a data-monitoring committee (839 of 1264 [66.4%] vs 11 728 of 21 060 [55.7%]; P < .001). Only a minority of radiotherapy trials were industry sponsored, which was significantly lower than for other oncological trials (80 of 1378 [5.8%] vs 10 651 of 24 529 [43.4%]; P < .001; adjusted odds ratio, 0.08; 95% CI, 0.06-0.10). The number of National Institutes of Health-sponsored radiotherapy trials decreased from 80 of 544 trials (14.7%) from 2007 to 2012 to 72 of 834 trials (8.6%) from 2012 to 2017 (P < .001). Radiotherapy trials with a sample size of more than 100 patients decreased from 155 of 543 trials (28.5%) from 2007 to 2012 to 157 of 833 trials (18.8%) from 2012 to 2017 (P < .001). Conclusions and Relevance The limited number of and the scarcity of funding for radiotherapy trials is concerning given the integral role of radiotherapy in the clinical management of patients with cancer worldwide. A multidisciplinary collaboration to promote and fund more radiotherapy research is warranted.
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Affiliation(s)
- Xu Liu
- Department of Radiation Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center of Cancer Medicine, Guangzhou, Guangdong, China
| | - Yuan Zhang
- Department of Radiation Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center of Cancer Medicine, Guangzhou, Guangdong, China
| | - Ling-Long Tang
- Department of Radiation Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center of Cancer Medicine, Guangzhou, Guangdong, China
| | - Quynh Thu Le
- Department of Radiation Oncology, Stanford University, Stanford, California
| | - Melvin L K Chua
- Division of Radiation Oncology, National Cancer Centre Singapore, Singapore
| | - Joseph T S Wee
- Division of Radiation Oncology, National Cancer Centre Singapore, Singapore
| | - Nancy Y Lee
- Department of Radiation Oncology, Memorial Sloan-Kettering Cancer Center, New York, New York
| | - Brian O'Sullivan
- Department of Radiation Oncology, University of Toronto, Princess Margaret Cancer Center, Toronto, Ontario, Canada
| | - Anne W M Lee
- Department of Clinical Oncology, The University of Hong Kong and The University of Hong Kong-Shenzhen Hospital, Shenzhen, Guangdong, China
| | - Ying Sun
- Department of Radiation Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center of Cancer Medicine, Guangzhou, Guangdong, China
| | - Jun Ma
- Department of Radiation Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center of Cancer Medicine, Guangzhou, Guangdong, China
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Le QT, Colevas AD, O’Sullivan B, Lee AWM, Lee N, Ma B, Siu LL, Waldron J, Lim CM, Riaz N, Lynn J, Malik S. Current Treatment Landscape of Nasopharyngeal Carcinoma and Potential Trials Evaluating the Value of Immunotherapy. J Natl Cancer Inst 2019; 111:655-663. [PMID: 30912808 PMCID: PMC7962891 DOI: 10.1093/jnci/djz044] [Citation(s) in RCA: 47] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2018] [Revised: 02/27/2019] [Accepted: 03/22/2019] [Indexed: 12/24/2022] Open
Abstract
Nasopharyngeal carcinoma (NPC) is a type of head and neck cancer with a distinctive regional and racial prevalence. It is associated with Epstein-Barr virus infection and has a high propensity for regional and distant metastases, while it is very sensitive to radiation and chemotherapy. A common feature of Epstein-Barr virus-positive NPC is the dense infiltration of lymphocytes in the tumor stroma and positive programmed death-ligand 1 expression in tumor cells, making it an attractive target for immunotherapy, especially immune checkpoint inhibitors. As new immunotherapeutic agents are being rapidly adopted in many cancers, including head and neck cancer, the National Cancer Institute sponsored a clinical trial planning meeting to identify opportunities for developing phase II and III trials testing immunotherapy in different stages of NPC. The meeting started with the summary of the biology of the disease, current standards of care, and evidence of immunotherapy in this cancer. Three subcommittees were tasked to develop clinical trials: loco regionally advanced, nonmetastatic NPC; widely metastatic NPC; and either local recurrence after initial treatment or presenting with oligometastatic disease. This article summarizes the proceedings of this clinical trial planning meeting and provides a road map for future trials incorporating immune checkpoint inhibitors for therapeutic management of NPC. This road map, though specific for NPC, may also be applicable to other virally driven cancers that have similar ability to evade the host's immune system.
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Affiliation(s)
- Quynh Thu Le
- Department of Radiation Oncology, Stanford University, Stanford, CA
| | | | - Brian O’Sullivan
- Department of Radiation Oncology, Princess Margaret Cancer Centre, University of Toronto, Toronto, Canada
| | | | - Nancy Lee
- Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Brigette Ma
- Department of Clinical Oncology, The Chinese University of Hong Kong, State Key Laboratory of Translational Oncology, Hong Kong SAR, China
| | - Lillian L Siu
- Department of Clinical Oncology, Department of Medicine, Cancer Clinical Research Unit, Princess Margaret Cancer Centre, University of Toronto, Toronto, Canada
| | - John Waldron
- Department of Radiation Oncology, Princess Margaret Cancer Centre, University of Toronto, Toronto, Canada
| | - Chwee-Ming Lim
- Department of Otolaryngology, National University of Singapore, Singapore
| | - Nadeem Riaz
- Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Jean Lynn
- Clinical Investigative Branch, Cancer Therapy Evaluation Program, National Institute of Health, Bethesda, MD
| | - Shakun Malik
- Department of Thoracic Oncology Therapeutics
- Clinical Investigative Branch, Cancer Therapy Evaluation Program, National Institute of Health, Bethesda, MD
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Le QT, Yom SS, Wee JTS, Lee AWM, Grau C, Grégoire V, Porceddu S, Welch JJ, Mehanna H. In Regard to Beadle and Anderson. Int J Radiat Oncol Biol Phys 2018; 102:229-230. [PMID: 30102198 DOI: 10.1016/j.ijrobp.2018.05.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2018] [Accepted: 05/02/2018] [Indexed: 10/28/2022]
Affiliation(s)
- Quynh-Thu Le
- Department of Radiation Oncology, Stanford University School of Medicine, Stanford, California
| | - Sue S Yom
- Department of Radiation Oncology, University of California San Francisco, San Francisco, California
| | - Joseph T S Wee
- Division of Radiation Oncology, National Cancer Centre Singapore, Singapore
| | - Anne W M Lee
- Department of Clinical Oncology, The University of Hong Kong, Hong Kong, China
| | - Cai Grau
- Department of Oncology, Aarhus University Hospital, Aarhus, Denmark
| | - Vincent Grégoire
- Center for Molecular Imaging, Oncology and Radiotherapy, Université Catholique de Louvain, Brussels, Belgium; Department of Radiation Oncology, Centre Léon Bérard, Lyon, France
| | - Sandro Porceddu
- Department of Radiation Oncology, Princess Alexandra Hospital, University of Queensland, Queensland, Australia
| | - John J Welch
- Center for Global Health, National Cancer Institute, National Institutes of Health, Bethesda, Maryland
| | - Hisham Mehanna
- Institute of Head and Neck Studies and Education, Department of Head and Neck Surgery, University of Birmingham, Birmingham, United Kingdom
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Thai AA, Rischin D. High-Dose Cisplatin for Head and Neck Cancer Lives On. J Clin Oncol 2018; 36:1055-1057. [PMID: 29394123 DOI: 10.1200/jco.2017.76.8614] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- Alesha A Thai
- Alesha A. Thai, Peter MacCallum Cancer Centre, Melbourne, Australia; and Danny Rischin, Peter MacCallum Cancer Centre; University of Melbourne, Melbourne, Australia
| | - Danny Rischin
- Alesha A. Thai, Peter MacCallum Cancer Centre, Melbourne, Australia; and Danny Rischin, Peter MacCallum Cancer Centre; University of Melbourne, Melbourne, Australia
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