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Maswikiti EP, Yu Y, Li H, Wang C, Ma H, Xu B, He P, Ma Y, Wang B, Ma B, Yang J, Ma Z, Zhu J, Chen H. Application of intraoperative photodynamic therapy in patients suspected of recurrence post radical surgery: A single center experience. Photodiagnosis Photodyn Ther 2022; 40:103047. [PMID: 35931356 DOI: 10.1016/j.pdpdt.2022.103047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2021] [Revised: 07/30/2022] [Accepted: 08/01/2022] [Indexed: 12/14/2022]
Abstract
BACKGROUND Difficult to resect tumors may be treated with a combination of radical surgery and photodynamic therapy to try to reduce recurrence. The aim of this single center study is to present results from a combined application of radical surgery with intraoperative PDT for patients with various cancers suspected of high risk for post-operative local recurrence. METHODS Radical surgery combined with intraoperative PDT was performed in each and every patient under study at different time points from June 2020 to July 2021, and the PDT irradiation time ranged from 10, 20, 25 and 30 min. Hematoporphyrin, as a photo synthesizer, was administered intravenously 48 h before surgery and during the operative period respectively, at a 3 mg/kg dose. In addition, the mean and median survival times for each of these patients were also evaluated. Patient's overall disease-Free Survival (DFS) and survival (OS) were immensely evaluated. RESULTS 12 patients (33.3% female and 66.7 % male) underwent radical surgery and PDT simultaneously. No photosensitivity events were reported in the included patients, except for one case with a moderate to severe erythema. Intraoperative PDT was tolerated in all included patients without serious liver and kidney damages. As from the time these patients underwent radical surgery and PDT, three mortalities were recorded and the remaining 9 patients had some remarkable outcomes with less or no recurrences. CONCLUSIONS Intraoperative PDT is a potentially safe therapeutic strategy for various tumor patients who undergo operation. Intraoperative PDT combined with surgery may improve local tumor control but this needs to be tested in a larger patient population.
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Affiliation(s)
| | - Yang Yu
- The Second Clinical Medical College, Lanzhou University, Lanzhou 730030, China
| | - Huixia Li
- The Department of Tumor Surgery, Lanzhou University Second Hospital, Lanzhou 730030, China
| | - Caijuan Wang
- The Department of Tumor Surgery, Lanzhou University Second Hospital, Lanzhou 730030, China
| | - Huanhuan Ma
- The Second Clinical Medical College, Lanzhou University, Lanzhou 730030, China
| | - Bo Xu
- The Second Clinical Medical College, Lanzhou University, Lanzhou 730030, China
| | - Puyi He
- The Second Clinical Medical College, Lanzhou University, Lanzhou 730030, China
| | - Yanling Ma
- The Second Clinical Medical College, Lanzhou University, Lanzhou 730030, China
| | - Bofang Wang
- The Second Clinical Medical College, Lanzhou University, Lanzhou 730030, China
| | - Bin Ma
- The Department of Tumor Surgery, Lanzhou University Second Hospital, Lanzhou 730030, China
| | - Jinwei Yang
- The Department of Tumor Surgery, Lanzhou University Second Hospital, Lanzhou 730030, China
| | - Zhen Ma
- The Second Clinical Medical College, Lanzhou University, Lanzhou 730030, China
| | - Jingyu Zhu
- The Second Clinical Medical College, Lanzhou University, Lanzhou 730030, China
| | - Hao Chen
- The Second Clinical Medical College, Lanzhou University, Lanzhou 730030, China; The Department of Tumor Surgery, Lanzhou University Second Hospital, Lanzhou 730030, China.
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Peters GW, Tao W, Wei W, Miccio JA, Jethwa KR, Cecchini M, Johung KL. Publication Bias in Gastrointestinal Oncology Trials Performed over the Past Decade. Oncologist 2021; 26:660-667. [PMID: 33728733 DOI: 10.1002/onco.13759] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Accepted: 02/26/2021] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Randomized controlled trials (RCTs) are the gold standard for evidence-based practice, but their development and implementation is resource intensive. We aimed to describe modern RCTs in gastrointestinal (GI) cancer and identify predictors of successful accrual and publication. MATERIALS AND METHODS ClinicalTrials.gov was queried for phase III GI cancer RCTs opened between 2010 and 2019 and divided into two cohorts: past and recruiting. Past trials were analyzed for predictors of successful accrual and the subset with ≥3 years follow-up were analyzed for predictors of publication. Univariate and multivariable (MVA) logistic regression were used to identify covariates associated with complete accrual and publication status. RESULTS A total of 533 GI RCTs were opened from 2010 to 2019, 244 of which are still recruiting. In the "past" trials cohort (235/533) MVA, Asian continent of enrollment was a predictor for successful accrual, whereas trials with prolonged enrollment (duration longer than median of 960 days) trended to failed accrual. Predictors for publication on MVA included international enrollment and accrual completion. Sponsorship was not associated with accrual or publication. Notably, 33% of past trials remain unpublished, and 60% of trials that were closed early remain unpublished. CONCLUSION Accrual rate and the primary continent of enrollment drive both trial completion and publication in GI oncology. Accrual must be streamlined to enhance the impact of RCTs on clinical management. A large portion of trials remain unpublished, underscoring the need to encourage dissemination of all trials to, at a minimum, inform future trial design. IMPLICATIONS FOR PRACTICE Two-thirds of gastrointestinal (GI) oncology phase III randomized controlled trials successfully accrue; however, one third of these trials are unpublished and more than half of trials that close early are unpublished. The strongest predictors for publication are successful accrual and international collaborations. Initiatives to optimize the trial enrollment process need to be explored to maximize the potential for trials to engender progress in clinical practice. Moreover, this study identified a significant publication bias in the realm of GI oncology, and the field should promote reporting of all trials in order to better inform future trial questions and design.
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Affiliation(s)
- Gabrielle W Peters
- Department of Therapeutic Radiology, Yale School of Medicine, New Haven, Connecticut, USA
| | - Weiwei Tao
- Department of Mechanical Engineering, Boston University, Boston, Massachusetts, USA
| | - Wei Wei
- Yale School of Public Health, New Haven, Connecticut, USA
| | - Joseph A Miccio
- Department of Therapeutic Radiology, Yale School of Medicine, New Haven, Connecticut, USA
| | - Krishan R Jethwa
- Department of Therapeutic Radiology, Yale School of Medicine, New Haven, Connecticut, USA
| | - Michael Cecchini
- Department of Internal Medicine (Medical Oncology), Yale School of Medicine, New Haven, Connecticut, USA
| | - Kimberly L Johung
- Department of Therapeutic Radiology, Yale School of Medicine, New Haven, Connecticut, USA
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Carey M, Boyes AW, Smits R, Bryant J, Waller A, Olver I. Access to clinical trials among oncology patients: results of a cross sectional survey. BMC Cancer 2017; 17:653. [PMID: 28923028 PMCID: PMC5604159 DOI: 10.1186/s12885-017-3644-3] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2016] [Accepted: 09/11/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Clinical trials are necessary for the advancement of cancer treatment and care, however low rates of participation in such trials limit the generalisability of findings. The objective of this study was to examine the proportion of medical oncology outpatients in Australia who are invited and consent to participate in clinical trials and the factors associated with this. METHODS A sample of adult medical oncology patients was recruited from three Australian cancer treatment centres. Consenting patients completed two paper-and-pencil surveys; one at the time of consent and another approximately 1 month later. A multivariate logistic regression was conducted to explore factors associated with invitation and participation in a trial. RESULTS Thirty-eight percent (n = 146) of the 383 participants reported they had been invited to take part in a clinical trial. Of those invited, 93% reported consenting to participate in the trial, with the majority indicating that they did not regret their decision (89%). Treatment centre and time since diagnosis were significantly associated with being invited to take part in a clinical trial. None of the factors examined were associated with clinical trial consent rates. CONCLUSIONS The main barrier to clinical trial participation is not being invited to do so, with the centre the patient attends being a modifiable determinant of whether or not they are invited. Increasing the resources available to treatment centres to ensure all patients are offered participation in trials they are eligible for may help to improve rates of trial participation.
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Affiliation(s)
- Mariko Carey
- Priority Research Centre for Health Behaviour, School of Medicine & Public Health, Faculty of Health, University of Newcastle, W4, HMRI Building, Callaghan, NSW 2308 Australia
- Hunter Medical Research Institute, New Lambton, NSW Australia
| | - Allison W. Boyes
- Priority Research Centre for Health Behaviour, School of Medicine & Public Health, Faculty of Health, University of Newcastle, W4, HMRI Building, Callaghan, NSW 2308 Australia
- Hunter Medical Research Institute, New Lambton, NSW Australia
| | - Rochelle Smits
- Priority Research Centre for Health Behaviour, School of Medicine & Public Health, Faculty of Health, University of Newcastle, W4, HMRI Building, Callaghan, NSW 2308 Australia
- Hunter Medical Research Institute, New Lambton, NSW Australia
| | - Jamie Bryant
- Priority Research Centre for Health Behaviour, School of Medicine & Public Health, Faculty of Health, University of Newcastle, W4, HMRI Building, Callaghan, NSW 2308 Australia
- Hunter Medical Research Institute, New Lambton, NSW Australia
| | - Amy Waller
- Priority Research Centre for Health Behaviour, School of Medicine & Public Health, Faculty of Health, University of Newcastle, W4, HMRI Building, Callaghan, NSW 2308 Australia
- Hunter Medical Research Institute, New Lambton, NSW Australia
| | - Ian Olver
- Samson Institute for Health Research, University of South Australia, Adelaide, South Australia Australia
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The Perspectives of Haematological Cancer Patients on Tissue Banking. Oncol Ther 2016; 4:91-102. [PMID: 28261642 PMCID: PMC5315074 DOI: 10.1007/s40487-016-0019-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2016] [Indexed: 12/02/2022] Open
Abstract
Background A high level of support for tissue banking has been identified amongst both the general public and patients. However, much debate remains about the regulatory framework of tissue banks. Objective
This study explored the views of haematological cancer patients regarding tissue banking and how tissue banks should operate. Methods Haematological cancer patients from three outpatient clinics in Australia completed a questionnaire examining their preferences for tissue banking as well as items about their sociodemographic characteristics, disease and treatment history. Results The majority of participants (95%) reported being willing to allow their leftover tissue to be used for medical research. Three quarters (76%) supported the idea of their medical record being linked to their tissue sample, and 77% preferred a blanket (one-off) consent model for future research use of their tissue sample. Only 57 (27%) participants had been asked to give a tissue sample for research, 98% of whom gave permission. Conclusion The majority of haematological cancer patients are willing to donate their leftover tissue to a tissue bank and have their medical records linked to tissue samples and prefer a one-off consent process. These novel data from potential donors inform the debate about how tissue banks might operate. Funding Strategic Research Partnership Grant from the Cancer Council NSW to the Newcastle Cancer Control Collaborative (New-3C) and infrastructure funding from the Hunter Medical Research Institute (HMRI). A.W. is supported by an Australian Research Council DECRA fellowship (DE150101262). T.C.M. was supported by a Leukaemia Foundation of Queensland Post-Doctoral Fellowship. A.B. is supported by National Health and Medical Research Council (APP1073317) and Cancer Institute NSW (13/ECF/1–37) Early Career Fellowships. Electronic supplementary material The online version of this article (doi:10.1007/s40487-016-0019-x) contains supplementary material, which is available to authorized users.
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Morrissey CO, Chen SCA, Sorrell TC, Milliken S, Bardy PG, Bradstock KF, Szer J, Halliday CL, Gilroy NM, Moore J, Schwarer AP, Guy S, Bajel A, Tramontana AR, Spelman T, Slavin MA. Galactomannan and PCR versus culture and histology for directing use of antifungal treatment for invasive aspergillosis in high-risk haematology patients: a randomised controlled trial. THE LANCET. INFECTIOUS DISEASES 2013; 13:519-28. [DOI: 10.1016/s1473-3099(13)70076-8] [Citation(s) in RCA: 189] [Impact Index Per Article: 17.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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