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Vasiliadou I, Mikhaeel G, Brady J, Poetter V, Benjamin R, Patten P, Cuadrado M, Evans R, Alexander E, Gillham C, Summers J, Ajithkumar T, Bates A, Kuhnl A, Sanderson R. Factors Affecting Outcome of Bridging Radiotherapy (RT) Before CAR-T for High Grade Lymphoma. Int J Radiat Oncol Biol Phys 2021. [DOI: 10.1016/j.ijrobp.2021.07.962] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Gunther J, Yang J, Hajj C, Ng A, Brady J, Cheng S, Levis M, Qi S, Mikhaeel G, Ricardi U, Illidge T, Turin A, Knafl M, Specht L, Dabaja B, Yahalom J. Efficacy and Toxicity of Alternative Radiation Treatment Schemes for Patients With Hematologic Malignancies: A Collaborative ILROG COVID Era Report. Int J Radiat Oncol Biol Phys 2021. [PMCID: PMC8536223 DOI: 10.1016/j.ijrobp.2021.07.961] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Purpose/Objective(s) The COVID19 pandemic required radiation oncologists (ROs) to consider shorter treatment courses to minimize patient and staff exposure and conserve healthcare resources. Hematologic ROs adopted hypofractionated radiation therapy (hRT) regimens according to guidelines published by the International Lymphoma Radiation Oncology Group (ILROG). We report for the first time the preliminary efficacy and toxicity of these novel hypofractionated regimens in the treatment of hematologic malignancies. Materials/Methods We conducted a multicenter, multinational retrospective study under the direction of the ILROG. All patients receiving hRT according to ILROG guidelines from 1/1/2020 to 8/31/2020 were included. Patient and treatment details were abstracted from separate institutional databases. Toxicity was graded using CTCAE v5.0. Results Ninety-three patients from 4 institutions treated with 114 RT courses were included. Patient and treatment details are displayed in Table 1. Median follow up for the cohort was 179 days, and 77 patients (82%) were alive at last follow up. Maximal toxicity experienced by patients included Grade 1 (n = 16), Grade 2 (n = 1) and Grade 3 (n = 1) toxicities. Of 80 sites with response assessment within the RT field, 69% of patients achieved a complete response (n = 55), 20% partial response (n = 16), 9% stable disease (n = 7), and 2% progressive disease (n = 2). No COVID19 infections during or after RT have been documented in this patient cohort. Conclusion HRT according to ILROG guidelines resulted in low rates of acute toxicity and reasonable short-term treatment efficacy. Longer follow up and comparison with control groups is needed to draw more definitive conclusions and will be presented at the Annual Meeting.
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Kuhnl A, Mikhaeel G, Kirkwood A, Menne T, Frew J, Tholouli E, Patel A, Besley C, Beasley M, Latif A, O'Rourke N, Nicholson E, Alexander E, Chaganti S, Stevens A, Marzolini M, Johnson R, Sanderson R, Sivabalasingham S, Roddie C. Radiotherapy Bridging in Patients With R/R High-Grade Lymphoma Receiving CD19 CAR-T in the UK. Int J Radiat Oncol Biol Phys 2021. [DOI: 10.1016/j.ijrobp.2021.07.296] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Martelli M, Zucca E, Botto B, Kryachok I, Ceriani L, Balzarotti M, Tucci A, Cabras MG, Zilioli VR, Rusconi C, Angrilli F, Arcaini L, Iwanicka AD, Ferreri A, Merli F, Zhao W, Hodgson D, Ionescu C, Fosså A, Cwynarski K, Mikhaeel G, Jerkeman M, Janikova A, Hüttmann A, Ciccone G, Metser U, Barrington S, Malkowski B, Versari A, Esposito F, Cozens K, Ielmini N, Ricardi R, Cavalli F, Johnson P, Davies A. IMPACT OF DIFFERENT INDUCTION REGIMENS ON THE OUTCOME OF PRIMARY MEDIASTINAL B CELL LYMPHOMA IN THE PROSPECTIVE IELSG 37 TRIAL. Hematol Oncol 2021. [DOI: 10.1002/hon.49_2879] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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Shelley C, Brady J, Rahman F, Mikhaeel G. PO-0919: Low vs intermediate dose radiotherapy in head & neck MALT lymphoma with and without Sjogren syndrome. Radiother Oncol 2020. [DOI: 10.1016/s0167-8140(21)00936-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Barber J, Mikhaeel G, Brady J, Mistry A. An Investigation of the Possible Advantages of Treating Lymphoma Stomach Patients in DIBH or EEBH to Reduce Heart Dose. Int J Radiat Oncol Biol Phys 2019. [DOI: 10.1016/j.ijrobp.2019.06.1463] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Brady J, Mikhaeel G. Is Radiotherapy Adequate Treatment for Patients not in Complete Metabolic Response after First-Line Chemotherapy for DLBCL? Int J Radiat Oncol Biol Phys 2019. [DOI: 10.1016/j.ijrobp.2019.06.518] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Mikhaeel G. SP-0023 Aggressive Lymphoma (DLBCL); when does addition of RT make a difference? Radiother Oncol 2019. [DOI: 10.1016/s0167-8140(19)30443-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Binkley M, Brady J, Mikhaeel G, Hoppe R. Definitive and Immediate Salvage Treatment Achieves Durable Response for Relapse Following Primary RT for Follicular Lymphoma: An International Collaborative Study on Behalf of ILROG. Int J Radiat Oncol Biol Phys 2018. [DOI: 10.1016/j.ijrobp.2018.06.305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Pinnix C, Wirth A, Milgrom S, Andraos T, Aristophanous M, Pham M, Hancock D, Ludmir E, Fanale M, Oki Y, Nastoupil L, Mikhaeel G, Dabaja B. Omission of Cardiophrenic Lymph Nodes in the Treatment of Patients with Hodgkin Lymphoma Using Modified Involved Site Radiation Therapy: Lower Toxicity with No Added Failure. Int J Radiat Oncol Biol Phys 2017. [DOI: 10.1016/j.ijrobp.2017.06.452] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Bowden J, Starke A, Hall K, Hudson K, Rato A, Aldridge E, Robb D, Mikhaeel G. Non-coplanar Butterfly VMAT and Deep Inspiration Breath Hold for Mediastinal Lymphoma: Do We Need Both? Int J Radiat Oncol Biol Phys 2017. [DOI: 10.1016/j.ijrobp.2017.06.153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Mikhaeel G. SP-0498: Modern imaging and radiotherapy in lymphoma. Radiother Oncol 2016. [DOI: 10.1016/s0167-8140(16)31748-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Mikhaeel G, Dunn J, Smith D, Barrington S. What Is the Optimal Definition of Bulk in Diffuse Large B-cell Lymphoma Patients Treated With RCHOP? Int J Radiat Oncol Biol Phys 2015. [DOI: 10.1016/j.ijrobp.2015.07.154] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Mikhaeel G, Moller H, Warbey V. Patterns of Mediastinal Lymph Node (MLN) Involvement by Lymphoma Using International Association for the Study of Lung Cancer (IASLC) Classification. Int J Radiat Oncol Biol Phys 2014. [DOI: 10.1016/j.ijrobp.2014.05.1975] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Chalkidou A, Mikhaeel G, O’Doherty MJ, Marsden PK. Letter to the Editor re: Positron Emission Tomography with [18F]-3′-Deoxy-3′fluorothymidine (FLT) as a Predictor of Outcome in Patients with Locally Advanced Resectable Rectal Cancer: a Pilot Study. Mol Imaging Biol 2013; 15:521-2. [DOI: 10.1007/s11307-013-0628-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2013] [Accepted: 03/06/2013] [Indexed: 10/27/2022]
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Partridge S, Timothy A, O'Doherty MJ, Hain SF, Rankin S, Mikhaeel G. 2-Fluorine-18-fluoro-2-deoxy-D glucose positron emission tomography in the pretreatment staging of Hodgkin's disease: influence on patient management in a single institution. Ann Oncol 2000; 11:1273-9. [PMID: 11106116 DOI: 10.1023/a:1008368330519] [Citation(s) in RCA: 137] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
PURPOSE Optimum therapy for patients with Hodgkin's disease (HD) is determined by a number of prognostic factors, one of which is an accurate definition of extent of disease (stage). Computerised tomography is widely used in staging but cannot reliably evaluate normal sized lymph nodes and some extranodal sites, e.g., liver, spleen and bone marrow. 2-Fluorine-18-fluoro-2-deoxy-D glucose (FDG) has been shown to concentrate preferentially in lymphoma sites (whether in nodal or extranodal tissue) and therefore may have a useful role in staging patients with HD. This study compares concurrent computerized tomography (CT) and FDG positron emission tomography (PET) in the staging of Hodgkin's disease and assesses the frequency of stage migration and possible changes in therapy related to the use of PET scanning. PATIENTS AND METHODS This was a single centre retrospective study of 44 patients with Hodgkin's disease who underwent both staging CT and PET prior to treatment between September 1993 and August 1998 at St. Thomas' Hospital. The number and sites of disease were assessed for each patient, documenting any stage and therapy modification prompted by PET findings. RESULTS One hundred fifty-nine sites of disease were demonstrated in forty-four patients by FDG-PET compared with eighty-four by CT. As a result, 18 (40.9%) patients were upstaged, nine of these by FDG-uptake in splenic or extranodal sites not visualised on CT. Only three patients were downstaged by PET results. Eleven patients (25%) had treatment modified by PET scan findings. CONCLUSIONS Significantly more sites of disease were identified by PET than CT resulting in stage changes and a modification of therapy in 25% of patients. This has important implications not only for current patient management but also for the design of future clinical trials.
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Affiliation(s)
- S Partridge
- Department of Clinical Oncology, St. Thomas' Hospital, London, UK
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Partridge S, Timothy A, O'Doherty MJ, Hain SF, Rankin S, Mikhaeel G. 2-Fluorine-18-fluoro-2-deoxy-D-glucose Positron Emission Tomography in the Pretreatment Staging of Hodgkin's Disease. ACTA ACUST UNITED AC 1999; 2:323. [PMID: 14516620 DOI: 10.1016/s1095-0397(99)00083-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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