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Lockwood G. O-221 The concept of ‘family' in the era of assisted conception : a sociolinguistic analysis. Hum Reprod 2022. [DOI: 10.1093/humrep/deac105.140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Study question
Should current societal concerns about how the application of ART has resulted in evolving family structures influence clinical and legislative practice
Summary answer
Concerns about the role of ART in ‘threatening' historical norms need to be addressed as they cause distress and fail to support valid life choices
What is known already
Techniques of assisted conception including gamete donation, cryopreservation and surrogacy have enabled many individuals to access unconventional and different family structures. ART modalities that were initially concerned with achieving a child for a hetero-normative couple are now widely accessed by individuals and couples with alternative family structures. Current societal concerns oscillate between anxieties about inappropriate access and recourse to fertility treatments, demographic evidence of declining fecundity and geo-political pressures to optimize social structures.
Study design, size, duration
A historical review was undertaken of family structures during the historical epoque since records are available of family size, maternal mortality, generational divergence and ‘un-official' family formation. Consideration of literary sources including foundlings, child ‘gifting', adoption and abandonment was involved. Assessment of current cultural norms including Census data information on household composition was accessed. Semi-qualitative interviews with individuals wishing to access fertility treatment with donor gametes..
Participants/materials, setting, methods
On-line access to records, census data, historical reviews etc.
Main results and the role of chance
In the post-industrial era a significant proportion of children lived in families to which they had no genetic link. ‘Excess' children were ‘gifted' to relatives, ‘sent' to live with individuals who offered the opportunity of a ‘better' life or who simply required a servant, or a companion or an heir. Quantitatively this is no different from the current situation in the UK where half of all young children live in a household in which they are not genetically linked to one of the adults who care for them. Deferred marriage or coupledom and age-related subfertility have increased the use of donor eggs. Single women and same sex female partners can now freely access donor sperm. it could be concluded that the current ‘moral panic'about the status of ‘the family' is misguided and historically inaccurate.Contemporary family structures are not so different from what has preceded them, even though the ways in which these longed for children arrive may be nove.l
Limitations, reasons for caution
These data refer to UK sources and may not be universalisable
Wider implications of the findings
Practitioners of ART and allied professionals who support their work need to be aware of the needs and entitlements of individuals who seek to form families by accessing ART.
Trial registration number
Not applicable
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Affiliation(s)
- G Lockwood
- Care Fertility UK, Assisted Conception , Waters Upton , United Kingdom
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2
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Lockwood G. Dishonesty in science. Perfusion 2019; 34:352-353. [DOI: 10.1177/0267659119855597] [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: 11/15/2022]
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Palinska-Rudzka KE, Ghobara T, Parsons N, Milner J, Lockwood G, Hartshorne GM. Five-year study assessing the clinical utility of anti-Müllerian hormone measurements in reproductive-age women with cancer. Reprod Biomed Online 2019; 39:712-720. [PMID: 31471141 DOI: 10.1016/j.rbmo.2019.06.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2019] [Revised: 05/03/2019] [Accepted: 06/04/2019] [Indexed: 11/28/2022]
Abstract
RESEARCH QUESTION An important discussion point before chemotherapy is ovarian toxicity, a side-effect that profoundly affects young women with cancer. Their quality of life after successful treatment, including the ability to conceive, is a major concern. We asked whether serum anti-Müllerian hormone (AMH) measurements before chemotherapy for two most common malignancies are predictive of long-term changes in ovarian reserve? DESIGN A prospective cohort study measured serum AMH in 66 young women with lymphoma and breast cancer, before and at 1 year and 5 years after chemotherapy, compared with 124 healthy volunteers of the same age range (18-43 years). Contemporaneously, patients reported their menses and live births during 5-year follow-up. RESULTS After adjustment for age, serum AMH was 1.4 times higher (95% CI 1.1 to 1.9; P < 0.02) in healthy volunteers than in cancer patients before chemotherapy. A strong correlation was observed between baseline and 5-year AMH in the breast cancer group (P < 0.001, regression coefficient = 0.58, 95% CI 0.29 to 0.89). No significant association was found between presence of menses at 5 years and serum AMH at baseline (likelihood ratio test from logistics regression analysis). CONCLUSIONS Reproductive-age women with malignancy have lower serum AMH than healthy controls even before starting chemotherapy. Pre-chemotherapy AMH was significantly associated with long-term ovarian function in women with breast cancer. At key time points, AMH measurements could be used as a reproductive health advisory tool for young women with cancer. Our results highlight the unsuitability of return of menstruation as a clinical indicator of ovarian reserve after chemotherapy.
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Affiliation(s)
- K E Palinska-Rudzka
- Warwick Medical School, University of Warwick Coventry CV4 7AL, UK; University Hospitals Coventry and Warwickshire NHS Trust, Clifford Bridge Road Coventry CV2 2DX, UK
| | - T Ghobara
- University Hospitals Coventry and Warwickshire NHS Trust, Clifford Bridge Road Coventry CV2 2DX, UK
| | - N Parsons
- Warwick Medical School, University of Warwick Coventry CV4 7AL, UK
| | - J Milner
- CARE Fertility Tamworth House, Ventura Park Road, Tamworth B78 3HL, UK
| | - G Lockwood
- CARE Fertility Tamworth House, Ventura Park Road, Tamworth B78 3HL, UK
| | - G M Hartshorne
- Warwick Medical School, University of Warwick Coventry CV4 7AL, UK; University Hospitals Coventry and Warwickshire NHS Trust, Clifford Bridge Road Coventry CV2 2DX, UK.
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Chadder J, Zomer S, Lockwood G, Moxam RS, Louzado C, Coronado A, Rahal R, Green E. Understanding the Experiences of Cancer Patients as They Transition From Treatment to Primary and Community Care: A Pan-Canadian Study of Over 13,000 Cancer Survivors. J Glob Oncol 2018. [DOI: 10.1200/jgo.18.24900] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Background: Being diagnosed with cancer can be overwhelming, with many physical and emotional challenges. As needs of survivors shift from disease management to recovery, the adjustment is often not seamless. Ideally, a health care system is integrated and responsive to the needs of survivors, however, when cancer treatment is complete, they often face lingering concerns. Limited patient-reported data were available in Canada on experiences and barriers survivors face posttreatment. Aim: The Experiences of Cancer Patients in Transition study is the first national survey gathering data from cancer survivors in Canada as they transition from cancer care to the broader health care system. Methods: A survey was developed in consultation with patients/survivors, health care providers and researchers to address experiences related to physical, emotional, informational and practical needs. Ethics approvals were obtained and 10 provinces participated. Cancer survivors expected to have completed treatment within 1-3 years were identified from provincial cancer registries. Included were those aged 30+ at diagnosis of nonmetastatic breast, colorectal, prostate, melanoma or hematologic cancer; or aged 15-29 at diagnosis of any nonmetastatic cancer or metastatic testicular cancer. Despite the intention of the sampling, the final sample included some survivors diagnosed with a site other than the target sites, and some whose time since treatment was outside 1-3 years. All respondents are included in this analysis. Results are not weighted to represent the true distribution of cancer survivors. Results: From a total survey population of 40,790 Canadian cancer survivors, 33% completed the survey. The respondents were 48% male, 51% female; 2.5% were under 30 years old, 60% were 65+. 68% of respondents reported challenging periods posttreatment, with 48% of these saying that the first 6 months to 1 year were most challenging. Cancer survivors continued to live with side-effects: 87% reported physical challenges; 78% reported emotional challenges; 45% reported practical challenges. The most prevalent concerns were fatigue (68%), anxiety about cancer returning (68%) and returning to work/school (23%). Less than half of those with emotional or practical concerns received useful information (42% and 46%, respectively). 42% of respondents could not get help to address their most difficult concern. Of those who could get help, 10.7% waited a year or more. Conclusion: The results provide insight into the nature of challenges cancer survivors face, as well as needed supports and barriers faced in accessing them. There is a clear need for health systems to ensure a seamless patient experience throughout the cancer journey, for instance, through development and adoption of resources to help health care providers and their patients identify and address challenges from diagnosis through to survivorship.
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6
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Lockwood G. Blood transfusion: devil and God: co-existing. Perfusion 2018; 33:4-5. [DOI: 10.1177/0267659117748133] [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: 01/28/2023]
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7
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Palinska-Rudzka K, Lockwood G, Milner J, Ghobara T, Hartshorne G. Measuring impact of chemotherapy upon AMH and fertility in breast cancer and lymphoma patients relative to normal controls- 5-year multicentre study. Fertil Steril 2017. [DOI: 10.1016/j.fertnstert.2017.07.108] [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: 10/18/2022]
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8
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Tran K, Rahal R, Fung S, Lockwood G, Louzado C, Xu J, Bryant H. Choosing wisely in cancer control across Canada-a set of baseline indicators. Curr Oncol 2017; 24:201-206. [PMID: 28680281 PMCID: PMC5486386 DOI: 10.3747/co.24.3643] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
Value-based care, which balances high-quality care with the most efficient use of resources, has been considered the next frontier in cancer care and a means to maintain health system sustainability. Created to promote value-based care, Choosing Wisely Canada-modelled after Choosing Wisely in the United States-is a national clinician-driven campaign to identify unnecessary or harmful services that are frequently used in Canada. As part of the campaign, national medical societies have developed recommendations for tests and treatments that clinicians and patients should question. Here, we present baseline indicator findings about current practice patterns associated with 7 cancer-related recommendations from Choosing Wisely Canada and about the effects of those practices on patients and the health care system. Indicator findings point to substantial variations in cancer system performance between Canadian jurisdictions, most notably for breast cancer screening practices, treatment practices for men with low-risk localized prostate cancer, and radiation therapy practices for early-stage breast cancer and bone metastases. Extrapolating indicator findings to the entire country, it was estimated that 740,000 breast and cervical cancer screening tests were performed outside of the recommended age ranges, and within 1 year of diagnosis, 17,000 patients received treatments that could be low-value. A 15% reduction in the use of the 7 screening and treatment practices examined could lead to multiple benefits for patients and the health care system: 9000 false-positive results and 3000 treatments and related side effects could be avoided, and 4500 hours of linear accelerator capacity could be freed up each year. Interjurisdictional performance variations suggest potential differences in clinical practice patterns in the planning and delivery of cancer control services, and in some cases, in disease management outcomes. Although the cancer screening and treatment practices described might be unnecessary for some patients, it is important to realize that they could, in fact, be necessary for other patients. Further research into appropriate rates of use could help to determine how much cancer care represents overuse of practices that are not supported by evidence or underuse of practices that are supported by evidence.
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Affiliation(s)
- K. Tran
- Canadian Partnership Against Cancer, Toronto, ON
| | - R. Rahal
- Canadian Partnership Against Cancer, Toronto, ON
| | - S. Fung
- Canadian Partnership Against Cancer, Toronto, ON
| | - G. Lockwood
- Canadian Partnership Against Cancer, Toronto, ON
| | - C. Louzado
- Canadian Partnership Against Cancer, Toronto, ON
| | - J. Xu
- Canadian Partnership Against Cancer, Toronto, ON
| | - H. Bryant
- Canadian Partnership Against Cancer, Toronto, ON
- Departments of Community Health Sciences and of Oncology, University of Calgary, Calgary, AB
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9
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Rahal R, Chadder J, DeCaria K, Lockwood G, Bryant H. How different is cancer control across Canada? Comparing performance indicators for prevention, screening, diagnosis, and treatment. ACTA ACUST UNITED AC 2017; 24:124-128. [PMID: 28490927 DOI: 10.3747/co.24.3578] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Meaningful performance measures are an important part of the toolkit for health system improvement. The Canadian Partnership Against Cancer has been reporting on pan-Canadian cancer system performance indicators since 2009-work that has led to the availability of standardized measures that can help to shed light on the extent of variation and opportunities for quality improvement across the country. Those measures include a core set of system indicators ranging from prevention and screening, through diagnosis and treatment, to survivorship and end-of-life care. Key indicators were calculated and graphed, showing the range from worst to best result for the provinces and territories included in the data. There were often significant differences in cancer system performance between provinces and territories. For example, smoking prevalence rates ranged from 14% to 62%. The 90th percentile wait times from an abnormal breast screen to resolution (without biopsy) ranged from 4 weeks to 8 weeks. The percentage of breast cancer resections that used breast-conserving surgery rather than mastectomy ranged from 38% to 75%. Clinical trial participation rates for adults ranged from 0.2% to 6.6%. Variations in performance indicators between Canadian jurisdictions suggest potential differences in the planning and delivery of cancer control services and in clinical practice patterns and patient outcomes. Understanding sources of variation can help to identify opportunities for improvements in the quality and outcomes of cancer control service delivery in each province and territory.
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Affiliation(s)
- R Rahal
- Canadian Partnership Against Cancer, Toronto, ON
| | - J Chadder
- Canadian Partnership Against Cancer, Toronto, ON
| | - K DeCaria
- Canadian Partnership Against Cancer, Toronto, ON
| | - G Lockwood
- Canadian Partnership Against Cancer, Toronto, ON
| | - H Bryant
- Canadian Partnership Against Cancer, Toronto, ON.,Departments of Community Health Sciences and of Oncology, University of Calgary, Calgary, AB
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Liu J, Chadder J, Fung S, Lockwood G, Rahal R, Halligan M, Mowat D, Bryant H. Smoking behaviours of current cancer patients in Canada. ACTA ACUST UNITED AC 2016; 23:201-3. [PMID: 27330349 DOI: 10.3747/co.23.3180] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Evidence shows that continued smoking by cancer patients leads to adverse treatment outcomes and affects survival. Smoking diminishes treatment effectiveness, exacerbates side effects, and increases the risk of developing additional complications. Patients who continue to smoke also have a higher risk of developing a second primary cancer or experiencing a cancer recurrence, both of which ultimately contribute to poorer quality of life and poorer survival. Here, we present a snapshot of smoking behaviours of current cancer patients compared with the non-cancer patient population in Canada. Minimal differences in smoking behaviours were noted between current cancer patients and the rest of the population. Based on 2011-2014 data from the Canadian Community Health Survey, 1 in 5 current cancer patients (20.1%) reported daily or occasional smoking. That estimate is comparable to findings in the surveyed non-cancer patient population, of whom 19.3% reported smoking daily or occasionally. Slightly more male cancer patients than female cancer patients identified as current smokers. A similar distribution was observed in the non-cancer patient population. There is an urgent need across Canada to better support cancer patients in quitting smoking. As a result, the quality of patient care will improve, as will cancer treatment and survival outcomes, and quality of life for these patients.
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Affiliation(s)
- J Liu
- Canadian Partnership Against Cancer, Toronto, ON
| | - J Chadder
- Canadian Partnership Against Cancer, Toronto, ON
| | - S Fung
- Canadian Partnership Against Cancer, Toronto, ON
| | - G Lockwood
- Canadian Partnership Against Cancer, Toronto, ON
| | - R Rahal
- Canadian Partnership Against Cancer, Toronto, ON
| | - M Halligan
- Canadian Partnership Against Cancer, Toronto, ON
| | - D Mowat
- Canadian Partnership Against Cancer, Toronto, ON
| | - H Bryant
- Canadian Partnership Against Cancer, Toronto, ON;; Departments of Community Health Sciences and of Oncology, University of Calgary, Calgary, AB
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11
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Popadiuk C, Coldman A, Memon S, Fitzgerald N, Gribble S, Lockwood G, Wolfson M, Miller A. Comparing the health and economic impacts of cervical cancer screening strategies using the Cancer Risk Management Model (CRMM). Gynecol Oncol 2016. [DOI: 10.1016/j.ygyno.2016.04.185] [Citation(s) in RCA: 2] [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: 11/24/2022]
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12
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Chadder J, Dewar R, Shack L, Nishri D, Niu J, Lockwood G. A first look at relative survival by stage for colorectal and lung cancers in Canada. ACTA ACUST UNITED AC 2016; 23:119-24. [PMID: 27122976 DOI: 10.3747/co.23.3096] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Monitoring and reporting on cancer survival provides a mechanism for understanding the effectiveness of Canada's cancer care system. Although 5-year relative survival for colorectal cancer and lung cancer has been previously reported, only recently has pan-Canadian relative survival by stage been analyzed using comprehensive registry data. This article presents a first look at 2-year relative survival by stage for colorectal and lung cancer across 9 provinces. As expected, 2-year age-standardized relative survival ratios (arsrs) for colorectal cancer and lung cancer were higher when the cancer was diagnosed at an earlier stage. The arsrs for stage i colorectal cancer ranged from 92.2% in Nova Scotia [95% confidence interval (ci): 88.6% to 95.1%] to 98.4% in British Columbia (95% ci: 96.2% to 99.3%); for stage iv, they ranged from 24.3% in Prince Edward Island (95% ci: 15.2% to 34.4%) to 38.8% in New Brunswick (95% ci: 33.3% to 44.2%). The arsrs for stage i lung cancer ranged from 66.5% in Prince Edward Island (95% ci: 54.5% to 76.5%) to 84.8% in Ontario (95% ci: 83.5% to 86.0%). By contrast, arsrs for stage iv lung cancer ranged from 7.6% in Manitoba (95% ci: 5.8% to 9.7%) to 13.2% in British Columbia (95% ci: 11.8% to 14.6%). The available stage data are too recent to allow for meaningful comparisons between provinces, but over time, analyzing relative survival by stage can provide further insight into the known differences in 5-year relative survival. As the data mature, they will enable an assessment of the extent to which interprovincial differences in relative survival are influenced by differences in stage distribution or treatment effectiveness (or both), permitting targeted measures to improve population health outcomes to be implemented.
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Affiliation(s)
- J Chadder
- Canadian Partnership Against Cancer, Toronto, ON
| | - R Dewar
- Cancer Care Nova Scotia, Halifax, NS
| | - L Shack
- CancerControl Alberta, Alberta Health Services, Calgary, AB;; Departments of Community Health Sciences and of Oncology, University of Calgary, Calgary, AB
| | - D Nishri
- Cancer Care Ontario, Toronto, ON
| | - J Niu
- Canadian Partnership Against Cancer, Toronto, ON
| | - G Lockwood
- Canadian Partnership Against Cancer, Toronto, ON
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13
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Lockwood G. Adenosine to protect the myocardium. Perfusion 2016; 31:93-4. [PMID: 26903559 DOI: 10.1177/0267659116631688] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Kerner J, Liu J, Wang K, Fung S, Landry C, Lockwood G, Zitzelsberger L, Mai V. Canadian cancer screening disparities: a recent historical perspective. ACTA ACUST UNITED AC 2015; 22:156-63. [PMID: 25908914 DOI: 10.3747/co.22.2539] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
Across Canada, introduction of the Pap test for cervical cancer screening, followed by mammography for breast cancer screening and, more recently, the fecal occult blood test for colorectal cancer screening, has contributed to a reduction in cancer mortality. However, another contribution of screening has been disparities in cancer mortality between certain populations. Here, we explore the disparities associated with breast and cervical cancer screening and preliminary data concerning disparities in colorectal cancer screening. Although some disparities in screening utilization have been successfully reduced over time (for example, mammography and Pap test screening in rural and remote populations), screening utilization data for other populations (for example, low-income groups) clearly indicate that disparities have existed and continue to exist across Canada. Organized screening programs in Canada have been able to successfully engage 80% of women for regular cervical cancer screening and 70% of women for regular mammography screening, but of the women who remain to be reached or engaged in regular screening, those with the least resources, those who are the most isolated, and those who are least culturally integrated into Canadian society as a whole are over-represented. Population differences are also observed for utilization of colorectal cancer screening services. The research literature on interventions to promote screening utilization provides some evidence about what can be done to increase participation in organized screening by vulnerable populations. Adaption and adoption of evidence-based screening promotion interventions can increase the utilization of available screening services by populations that have experienced the greatest burden of disease with the least access to screening services.
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Affiliation(s)
- J Kerner
- Canadian Partnership Against Cancer, Toronto, ON
| | - J Liu
- Canadian Partnership Against Cancer, Toronto, ON
| | - K Wang
- Canadian Partnership Against Cancer, Toronto, ON
| | - S Fung
- Canadian Partnership Against Cancer, Toronto, ON
| | - C Landry
- Canadian Partnership Against Cancer, Toronto, ON
| | - G Lockwood
- Canadian Partnership Against Cancer, Toronto, ON
| | | | - V Mai
- Canadian Partnership Against Cancer, Toronto, ON
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Lockwood G. Double Whammy: best or worst of two worlds. Perfusion 2015; 30:180-1. [PMID: 25784165 DOI: 10.1177/0267659115577031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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DeCaria K, Rahal R, Niu J, Lockwood G, Bryant H. Rectal cancer resection and circumferential margin rates in Canada: a population-based study. Curr Oncol 2015; 22:60-3. [PMID: 25684989 PMCID: PMC4324344 DOI: 10.3747/co.22.2391] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
INTRODUCTION [...]
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Affiliation(s)
- K. DeCaria
- Canadian Partnership Against Cancer, Toronto, ON
| | - R. Rahal
- Canadian Partnership Against Cancer, Toronto, ON
| | - J. Niu
- Canadian Partnership Against Cancer, Toronto, ON
| | - G. Lockwood
- Canadian Partnership Against Cancer, Toronto, ON
| | - H. Bryant
- Canadian Partnership Against Cancer, Toronto, ON
- Departments of Community Health Sciences and of Oncology, University of Calgary, Calgary, AB
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Vorauer E, Louzado C, DeCaria K, Hernandez J, Rahal R, Niu J, Lockwood G, Bryant H. Use of pet in the management of non-small-cell lung cancer in Canada. Curr Oncol 2014; 21:337-9. [PMID: 25489261 DOI: 10.3747/co.21.2271] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Positron-emission tomography (pet) has emerged as an effective imaging method for diagnosing, staging, [...]
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Affiliation(s)
- E Vorauer
- Canadian Partnership Against Cancer, Toronto, ON. ; Department of Physics, Ryerson University, Toronto, ON
| | - C Louzado
- Canadian Partnership Against Cancer, Toronto, ON
| | - K DeCaria
- Canadian Partnership Against Cancer, Toronto, ON
| | - J Hernandez
- Canadian Partnership Against Cancer, Toronto, ON
| | - R Rahal
- Canadian Partnership Against Cancer, Toronto, ON
| | - J Niu
- Canadian Partnership Against Cancer, Toronto, ON
| | - G Lockwood
- Canadian Partnership Against Cancer, Toronto, ON. ; Dalla Lana School of Public Health, University of Toronto, Toronto, ON
| | - H Bryant
- Canadian Partnership Against Cancer, Toronto, ON. ; Departments of Community Health Sciences and of Oncology, University of Calgary, Calgary, AB
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18
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Forbes LJL, Simon AE, Warburton F, Boniface D, Brain KE, Dessaix A, Donnelly C, Haynes K, Hvidberg L, Lagerlund M, Lockwood G, Tishelman C, Vedsted P, Vigmostad MN, Ramirez AJ, Wardle J. Erratum: Differences in cancer awareness and beliefs between Australia, Canada, Denmark, Norway, Sweden and the UK (the International Cancer Benchmarking Partnership): do they contribute to differences in cancer survival? Br J Cancer 2014. [PMCID: PMC4264454 DOI: 10.1038/bjc.2014.562] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
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DeCaria K, Rahal R, Forte T, Lockwood G, Xu J, Bryant H. Examining Cancer-Risk Profiles for the Largest Metropolitan Areas across Canada. Curr Oncol 2014; 21:51-3. [DOI: 10.3747/co.21.1853] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Because health behaviours can be influenced at many different levels, there is value in examining differences in risk factors and health behaviours between the largest cities in Canada. [...]
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Palinska-Rudzka K, Hartshorne G, Lockwood G, Ghobara T, Eapen A. Before chemotherapy, cancer patients have lower serum AMH than age-matched healthy controls. Fertil Steril 2013. [DOI: 10.1016/j.fertnstert.2013.07.1679] [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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21
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Datta A, Eapen A, Kurinchi-Selvan A, Lockwood G. Improved clinical outcomes and lower OHSS risk with GnRH agonist trigger and hCG incorporated luteal support, compared to hCG trigger in GnRH-antagonist protocol for anticipated high responders. Fertil Steril 2013. [DOI: 10.1016/j.fertnstert.2013.07.243] [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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Rahal R, Klein-Geltink J, Forte T, Lockwood G, Bryant H. Measuring concordance with guidelines for the diagnosis and treatment of colon cancer. ACTA ACUST UNITED AC 2013; 20:227-9. [PMID: 23904764 DOI: 10.3747/co.20.1436] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Colorectal cancer is the second leading cause of cancer death and the third most commonly diagnosed cancer in Canada, with an estimated 9200 deaths and 23,300 new cases in 2012. [...]
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Affiliation(s)
- R Rahal
- Canadian Partnership Against Cancer, Toronto, ON
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Abstract
Hypertonic Saline (HS) has been a proven and effective therapy and a safe alternative to mannitol in patients with increase intracranial pressure (ICP). We hereby present a case of 25-year-old women with intracranial bleed secondary to right parietal arteriovenous malformation. Patient underwent surgery for evacuation of hematoma and resection of arteriovenous malformation. Post- operative course was complicated by recurrent episodes of elevated ICP. She received total of 17 doses of 23.4% HS and 30 doses of mannitol with good outcome. Despite reluctance from some clinicians to use HS, hypertonic saline seems to be a safe and effective therapy.
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Affiliation(s)
- Salim Surani
- Division of Pulmonary and Critical Care Medicine, Texas A&M University, TX, USA
| | | | | | | | - Joseph Varon
- The University of Texas Health Science Center at Houston, TX, USA The University of Texas Medical Branch at Galveston, TX, USA University General Hospital, Houston, TX, USA
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Klein-Geltink J, Forte T, Rahal R, Darling G, Cheung W, Alvi R, Noonan G, Russell C, Vriends K, Niu J, Lockwood G, Bryant H. New chart review data validate administrative data-based indicator for guideline-recommended treatment of locally advanced non-small-cell lung cancer and shed light on reasons for non-referral and non-treatment. ACTA ACUST UNITED AC 2013; 20:118-20. [PMID: 23559875 DOI: 10.3747/co.20.1351] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The 2012 Cancer System Performance Report is the 4th annual report on the Canadian cancer control system produced by the System Performance initiative at the Canadian Partnership Against Cancer, in collaboration with its provincial and national partners. [...]
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Forbes LJL, Simon AE, Warburton F, Boniface D, Brain KE, Dessaix A, Donnelly C, Haynes K, Hvidberg L, Lagerlund M, Lockwood G, Tishelman C, Vedsted P, Vigmostad MN, Ramirez AJ, Wardle J. Differences in cancer awareness and beliefs between Australia, Canada, Denmark, Norway, Sweden and the UK (the International Cancer Benchmarking Partnership): do they contribute to differences in cancer survival? Br J Cancer 2013; 108:292-300. [PMID: 23370208 PMCID: PMC3566814 DOI: 10.1038/bjc.2012.542] [Citation(s) in RCA: 164] [Impact Index Per Article: 14.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2012] [Revised: 10/30/2012] [Accepted: 11/01/2012] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND There are wide international differences in 1-year cancer survival. The UK and Denmark perform poorly compared with other high-income countries with similar health care systems: Australia, Canada and Sweden have good cancer survival rates, Norway intermediate survival rates. The objective of this study was to examine the pattern of differences in cancer awareness and beliefs across these countries to identify where these might contribute to the pattern of survival. METHODS We carried out a population-based telephone interview survey of 19079 men and women aged ≥ 50 years in Australia, Canada, Denmark, Norway, Sweden and the UK using the Awareness and Beliefs about Cancer measure. RESULTS Awareness that the risk of cancer increased with age was lower in the UK (14%), Canada (13%) and Australia (16%) but was higher in Denmark (25%), Norway (29%) and Sweden (38%). Symptom awareness was no lower in the UK and Denmark than other countries. Perceived barriers to symptomatic presentation were highest in the UK, in particular being worried about wasting the doctor's time (UK 34%; Canada 21%; Australia 14%; Denmark 12%; Norway 11%; Sweden 9%). CONCLUSION The UK had low awareness of age-related risk and the highest perceived barriers to symptomatic presentation, but symptom awareness in the UK did not differ from other countries. Denmark had higher awareness of age-related risk and few perceived barriers to symptomatic presentation. This suggests that other factors must be involved in explaining Denmark's poor survival rates. In the UK, interventions that address barriers to prompt presentation in primary care should be developed and evaluated.
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Affiliation(s)
- L J L Forbes
- King's College London Promoting Early Presentation Group, Capital House, 42 Weston Street, London SE1 3QD, UK.
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26
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Klein-Geltink J, Forte T, Rahal R, Niu J, He D, Lockwood G, Cheung W, Darling G, Bryant H. A retrospective chart review validates indicator results and provides insight into reasons for non-concordance with evidence-based guidelines. Curr Oncol 2013; 19:329-31. [PMID: 23300359 DOI: 10.3747/co.19.1224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
As part of the system performance initiative of the Canadian Partnership Against Cancer, indicators measuring treatment practice patterns across the country relative to evidence-based guidelines were first published in 2010 and are updated annually. Among the treatment indicators examined is the percentage of resected stage ii and iii rectal cancer patients receiving neoadjuvant (preoperative) radiation therapy (RT), the treatment approach recommended for locally advanced rectal cancer
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27
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Rahal R, Forte T, Lockwood G, Klein-Geltink J, Bryant H. Recently published indicators allow for comparison of radiation treatment rates relative to evidence-based guidelines for rectal cancer. ACTA ACUST UNITED AC 2012; 19:175-6. [PMID: 22670097 DOI: 10.3747/co.19.1065] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
The system performance initiative of the Canadian Partnership Against Cancer is the first pan-Canadian report to offer indicators for measuring treatment practice patterns by province and for comparing practice with current guidelines [...]
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Affiliation(s)
- R Rahal
- Canadian Partnership Against Cancer, Toronto, ON
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28
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Abstract
Five-year relative survival statistics are often used to measure cancer control across jurisdictions, and international comparisons such as the CONCORD or EUROCARE studies often point to substantial survival differences across participating countries [...]
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Affiliation(s)
- H Bryant
- Canadian Partnership Against Cancer, Toronto, ON
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Hu JCY, Seo BK, Neri QV, Rozenwaks Z, Palermo GD, Fields T, Neri QV, Monahan D, Rosenwaks Z, Palermo GD, Szkodziak P, Plewka K, Wozniak S, Czuczwar P, Mroczkowski A, Lorenzo Leon C, Hernandez J, Chinea Mendez E, Concepcion Lorenzo C, Sanabria Perez V, Puopolo M, Palumbo A, Toth B, Franz C, Montag M, Boing A, Strowitzki T, Nieuwland R, Griesinger G, Schultze-Mosgau A, Cordes T, Depenbusch M, Diedrich K, Vloeberghs V, Verheyen G, Camus M, Van de Velde H, Goossens A, Tournaye H, Coppola G, Di Caprio G, Wilding M, Ferraro P, Esposito G, Di Matteo L, Dale R, Coppola G, Dale B, Daoud S, Auger J, Wolf JP, Dulioust E, Lafuente R, Lopez G, Brassesco M, Hamad M, Montenarh M, Hammadeh M, Robles F, Magli MC, Crippa A, Pescatori E, Ferraretti AP, Gianaroli L, Zahiri M, Movahedin M, Mowla SJ, Noruzinia M, Crippa A, Ferraretti AP, Magli MC, Crivello AM, Robles F, Gianaroli L, Sermondade N, Dupont C, Hafhouf E, Cedrin-Durnerin I, Poncelet C, Benzacken B, Levy R, Sifer C, Ferfouri F, Boitrelle F, Clement P, Molina Gomes D, Bailly M, Selva J, Vialard F, Yaprak E, Basar M, Guzel E, Arda O, Irez T, Norambuena P, Krenkova P, Tuettelmann F, Kliesch S, Paulasova P, Stambergova A, Macek M, Macek M, Rivera R, Garrido-Gomez T, Galletero S, Meseguer M, Dominguez F, Garrido N, Mallidis C, Sanchez V, Weigeng L, Redmann K, Wistuba J, Gross P, Wuebbelling F, Fallnich C, Burger M, Kliesch S, Schlatt S, San Celestino Carchenilla M, Pacheco Castro A, Simon Sanjurjo P, Molinero Ballesteros A, Rubio Garcia S, Garcia Velasco JA, Macanovic B, Otasevic V, Korac A, Vucetic M, Garalejic E, Ivanovic Burmazovic I, Filipovic MR, Buzadzic B, Stancic A, Jankovic A, Velickovic K, Golic I, Markelic M, Korac B, Gosalvez J, Ruiz-Jorro M, Garcia-Ochoa C, Sachez-Martin P, Martinez-Moya M, Caballero P, Hasegawa N, Fukunaga N, Nagai R, Kitasaka H, Yoshimura T, Tamura F, Kato M, Nakayama K, Oono H, Kojima E, Yasue K, Watanabe H, Asano E, Hashiba Y, Asada Y, Das M, Al-Hathal N, San-Gabriel M, Phillips S, Kadoch IJ, Bissonnette F, Holzer H, Zini A, Zebitay AG, Irez T, Ocal P, Sahmay S, Karahuseyinoglu S, Usta T, Repping S, Silber S, Van Wely M, Datta A, Nayini K, Eapen A, Barlow S, Lockwood G, Tavares R, Baptista M, Publicover SJ, Ramalho-Santos J, Vaamonde D, Rodriguez I, Diaz A, Darr C, Chow V, Ma S, Smith R, Jeria F, Rivera J, Gabler F, Nicolai H, Cunha M, Viana P, Goncalves A, Silva J, Oliveira C, Teixeira da Silva J, Ferraz L, Madureira C, Doria S, Sousa M, Barros A, Herrero MB, Delbes G, Troueng E, Holzer H, Chan PTK, Vingris L, Setti AS, Braga DPAF, Figueira RCS, Iaconelli A, Borges E, Sargin Oruc A, Gulerman C, Zeyrek T, Yilmaz N, Tuzcuoglu D, Cicek N, Scarselli F, Terribile M, Franco G, Zavaglia D, Dente D, Zazzaro V, Riccio T, Minasi MG, Greco E, Cejudo-Roman A, Ravina CG, Candenas L, Gallardo-Castro M, Martin-Lozano D, Fernandez-Sanchez M, Pinto FM, Balasuriya A, Serhal P, Doshi A, Harper J, Romany L, Garrido N, Fernandez JL, Pellicer A, Meseguer M, Ribas-Maynou J, Garcia-Peiro A, Fernandez-Encinas A, Prada E, Jorda I, Cortes P, Llagostera M, Navarro J, Benet J, Kesici H, Cayli S, Erdemir F, Karaca Z, Aslan H, Karaca Z, Cayli S, Ocakli S, Kesici H, Erdemir F, Aslan H, Tas U, Ozdemir AA, Aktas RG, Tok OE, Ocakli S, Cayli S, Karaca Z, Erdemir F, Aslan H, Li S, Lu C, Hwu Y, Lee RK, Landaburu I, Gonzalvo MC, Clavero A, Ramirez JP, Pedrinaci S, Serrano M, Montero L, Carrillo S, Weiss J, Ortiz AP, Castilla JA, Sahin O, Bakircioglu E, Serdarogullari M, Bayram A, Yayla S, Ulug U, Tosun SB, Bahceci M, Aktas RG, Ozdemir AA, Tok OE, Yoon SY, Shin DH, Shin TE, Park EA, Won HJ, Kim YS, Lee WS, Yoon TK, Lee DR, Hattori H, Nakajo Y, Kyoya T, Kuchiki M, Kanto S, Kyono K, Park M, Park MR, Lim EJ, Lee WS, Yoon TK, Lee DR, Choi Y, Mitra A, Bhattacharya J, Kundu A, Mukhopadhaya D, Pal M, Enciso M, Alfarawati S, Wells D, Fernandez-Encinas A, Garcia-Peiro A, Ribas-Maynou J, Abad C, Amengual MJ, Navarro J, Benet J, Esmaeili V, Safiri M, Shahverdi AH, Alizadeh AR, Ebrahimi B, Brucculeri AM, Ruvolo G, Giovannelli L, Schillaci R, Cittadini E, Scaravelli G, Perino A, Cortes Gallego S, Gabriel Segovia A, Nunez Calonge R, Guijarro Ponce A, Ortega Lopez L, Caballero Peregrin P, Heindryckx B, Kashir J, Jones C, Mounce G, Ramadan WM, Lemmon B, De Sutter P, Parrington J, Turner K, Child T, McVeigh E, Coward K, Bakircioglu E, Ulug U, Tosun S, Serdarogullari M, Bayram A, Ciray N, Bahceci M, Saeidi S, Shapouri F, Hoseinifar H, Sabbaghian M, Pacey A, Aflatoonian R, Bosco L, Ruvolo G, Carrillo L, Pane A, Manno M, Roccheri MC, Cittadini E, Selles E, Garcia-Herrero S, Martinez JA, Munoz M, Meseguer M, Garrido N, Durmaz A, Dikmen N, Gunduz C, Tavmergen Goker E, Tavmergen E, Gozuacik D, Vatansever HS, Kara B, Calimlioglu N, Yasar P, Tavmergen E, Tavmergen Goker E, Semerci B, Baka M, Ozbilgin K, Karabulut A, Tekin A, Sabah B, Cottin V, Kottelat D, Fellmann M, Halm S, Rosenthaler E, Kisida T, Kojima F, Sakamoto T, Makutina VA, Balezin SL, Rosly OF, Slishkina TV, Hatzi E, Lazaros L, Xita N, Makrydimas G, Sofikitis N, Kaponis A, Stefos T, Zikopoulos K, Georgiou I, Zikopoulos K, Lazaros L, Xita N, Makrydimas G, Sofikitis N, Kaponis A, Stefos T, Hatzi E, Georgiou I, Georgiou I, Lazaros L, Xita N, Makrydimas G, Sofikitis N, Kaponis A, Stefos T, Hatzi E, Zikopoulos K, Hibi H, Ohori T, Sumitomo M, Asada Y, Anarte C, Calvo I, Domingo A, Presilla N, Aleman M, Bou R, Guardiola F, Agirregoikoa JA, De Pablo JL, Barrenetxea G, Zhylkova I, Feskov O, Feskova I, Zozulina O, Somova O, Nabi A, Khalili MA, Roudbari F, Parmegiani L, Cognigni GE, Bernardi S, Taraborrelli S, Troilo E, Ciampaglia W, Pocognoli P, Infante FE, Tabarelli de fatis C, Arnone A, Maccarini AM, Filicori M, Silva L, Oliveira JBA, Petersen CG, Mauri AL, Massaro FC, Cavagna M, Baruffi RLR, Franco JG, Fujii Y, Endou Y, Mtoyama H, Shokri S, Aitken RJ. ANDROLOGY. Hum Reprod 2012. [DOI: 10.1093/humrep/27.s2.73] [Citation(s) in RCA: 4] [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: 11/13/2022] Open
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Asghar Nawaz M, Patni R, Chan KMJ, Lockwood G, Punjabi P. Hyperinflation of lungs during redo-sternotomy, a safer technique. Heart Lung Circ 2011; 20:722-3. [PMID: 21855410 DOI: 10.1016/j.hlc.2011.07.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2011] [Accepted: 07/22/2011] [Indexed: 11/18/2022]
Abstract
Increasing numbers of patients are being referred for repeat cardiac procedures and redo-sternotomy is technically more arduous as well as time consuming. We describe our unique technique to overcome this challenging task by hyperinflating the lungs as a useful manoeuvre.
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Affiliation(s)
- Muhammad Asghar Nawaz
- Cardiothoracic Surgery, Imperial College Healthcare NHS, Hammersmith Hospital, DuCane Road, London, UK.
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31
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Colakoglu M, Toy H, Icen MS, Vural M, Mahmoud AS, Yazici F, Buendgen N, Cordes T, Schultze-Mosgau A, Diedrich K, Beyer D, Griesinger G, Oude Loohuis EJ, Nahuis MJ, Bayram N, Hompes PGA, Oosterhuis GJE, Bossuyt PM, van der Veen F, Mol BWJ, van Wely M, Nahuis MJ, Oude Loohuis EJ, Kose N, Bayram N, Hompes PGA, Oosterhuis GJE, Bossuyt PM, van der Veen F, Mol BWJ, van Wely M, Yaba A, Demir N, Allegra A, Pane A, Marino A, Scaglione P, Ruvolo G, Manno M, Volpes A, Lunger F, Wildt L, Seeber B, Kolibianakis EM, Venetis CA, Bosdou J, Toulis K, Goulis DG, Tarlatzi TB, Tarlatzis BC, Franz M, Keck C, Daube S, Pietrowski D, Demir N, Yaba A, Iannetta R, Santos RDS, Lima TP, Giolo F, Iannetta O, Martins WP, Paula FJ, Ferriani RA, Rosa e Silva ACJS, Martinelli CE, Reis RM, Devesa M, Rodriguez I, Coroleu B, Tur R, Gonzalez C, Barri PN, Nardo LG, Mohiyiddeen L, Mulugeta B, McBurney H, Roberts SA, Newman WG, Grynberg M, Lamazou F, Even M, Gallot V, Frydman R, Fanchin R, Abdalla H, Nicopoullos J, Leader A, Pang S, Witjes H, Gordon K, Devroey P, Arrivi C, Ferraretti AP, Magli MC, Tartaglia ML, Fasolino MC, Gianaroli L, Macek sr. M, Feldmar P, Kluckova H, Hrehorcak M, Diblik J, Cernikova J, Paulasova P, Turnovec M, Macek jr. M, Hillensjo T, Yeko T, Witjes H, Elbers J, Devroey P, Mardesic T, Abuzeid M, Witjes H, Mannaerts B, Okubo T, Matsuo R, Kuwayama M, Teramoto S, Chakraborty P, Goswami SK, Chakravarty BN, Nandi SS, Kabir SN, Ramos Vidal J, Prados N, Caligara C, Garcia J, Carranza FJ, Gonzalez-Ravina A, Salazar A, Tocino A, Rodriguez I, Fernandez-Sanchez M, Ito H, Iwasa T, Hasegawa E, Hatano K, Nakayama D, Kazuka M, Usuda S, Isaka K, Ventura V, Doria S, Fernandes S, Barros A, Valkenburg O, Lao O, Schipper I, Louwers YV, Uitterlinden AG, Kayser M, Laven JSE, Sharma S, Goswami S, Goswami SK, Ghosh S, Chattopadhyay R, Sarkar A, Chakravarty BN, Louwers YV, Valkenburg O, Lie Fong S, van Dorp W, de Jong FH, Laven JSE, Ghosh S, Chattopadhyay R, Goswami SK, Radhika KL, Chakravarty BN, Benkhalifa M, Demirol A, Montjeant D, Delagrange P, Gentien D, Giakoumakis G, Menezo Y, Dattilo M, Gurgan T, Engels S, Blockeel C, Haentjens P, De Vos M, Camus M, Devroey P, Dimitraki M, Koutlaki N, Gioka T, Messini CI, Dafopoulos K, Messinis IE, Gurlek B, Batioglu S, Ozyer S, Nafiye Y, Kale I, Karayalcin R, Uncu G, Kasapoglu I, Uncu Y, Celik N, Ozerkan K, Ata B, Ferrero H, Gomez R, Delgado F, Simon C, Gaytan F, Pellicer A, Osborn JC, Fien L, Wolyncevic J, Esler JH, Choi D, Kim N, Choi J, Jo M, Lee E, Lee D, Fujii R, Neyatani N, Waseda T, Oka Y, Takagi H, Tomizawa H, Sasagawa T, Makinoda S, Ajina M, Zorgati H, Ben Salem A, Ben Ali H, Mehri S, Touhami M, Saad A, Piouka A, Karkanaki A, Katsikis I, Delkos D, Mousatat T, Daskalopoulos G, Panidis D, Pantos K, Stavrou D, Sfakianoudis K, Angeli E, Chronopoulou M, Vaxevanoglou T, Jones R GMJ, Lee WD, Kim SD, Jee BC, Kim KC, Kim KH, Kim SH, Kim YJ, Park KA, Chae SJ, Lim KS, Hur CY, Kang YJ, Lee WD, Lim JH, Tomizawa H, Makinoda S, Fujita S, Waseda T, Fujii R, Utsunomiya R T, Vieira C, Martins WP, Fernandes JBF, Soares GM, Reis RM, Silva de Sa MF, Ferriani R RA, Yoo JH, Kim HO, Cha SH, Koong MK, Song IO, Kang IS, Hatakeyama N, Jinno M, Watanabe A, Hirohama J, Hiura R, Konig TE, Beemsterboer SN, Overbeek A, Hendriks ML, Heymans MW, Hompes P, Homburg R, Schats R, Lambalk CB, van der Houwen L, Konig TE, Overbeek A, Hendriks ML, Beemsterboer SN, Kuchenbecker WK, Renckens CNM, Bernardus RE, Schats R, Homburg R, Hompes P, Lambalk CB, Potdar N, Gelbaya TA, Nardo LG, de Groot PCM, Dekkers OM, Romijn JA, Dieben SWM, Helmerhorst FM, Guivarch Leveque A, Homer L, Broux PL, Moy L, Priou G, Vialard J, Colleu D, Arvis P, Dewailly D, Aghahosseini M, Aleyasin A, Sarvi F, Safdarian L, Rahmanpour H, Akhtar MA, Navaratnam K, Ankers D, Sharma SD, Son WY, Chung JT, Reinblatt S, Dahan M, Demirtas M, Holzer H, Aspichueta F, Exposito A, Crisol L, Prieto B, Mendoza R, Matorras R, Kim K, Lee J, Jee B, Lee W, Suh C, Moon J, Kim S, Sarapik A, Velthut A, Haller-Kikkatalo K, Faure GC, Bene MC, de Carvalho M, Massin F, Uibo R, Salumets A, Alhalabi M, Samawi S, Taha A, Kafri N, Modi S, Khatib A, Sharif J, Othman A, Hamamah S, Assou S, Anahory T, Loup V, Dechaud H, Dewailly D, Mousavi Fatemi H, Doody K, Witjes H, Mannaerts B, Basconi V, Jungblut L, Young E, Van Thillo G, Paz D, Pustovrh MC, Fabbri R, Pasquinelli G, Magnani V, Macciocca M, Parazza I, Battaglia C, Paradisi R, Venturoli S, Ono M, Teranisi A, Fumino T, Ohama N, Hamai H, Chikawa A, Takata R, Teramura S, Iwahasi K, Shigeta M, Heidari M, Farahpour M, Talebi S, Edalatkhah H, Zarnani AH, Ardekani AM, Pietrowski D, Szabo L, Sator M, Just A, Franz M, Egarter C, Hope N, Motteram C, Rombauts LJ, Lee W, Chang E, Han J, Won H, Yoon T, Seok H, Diao FY, Mao YD, Wang W, Ding W, Liu JY, Chang E, Yoon T, Lee W, Cho J, Kwak I, Kim Y, Afshan I, Cartwright R, Trew G, Lavery S, Lockwood G, Niyani K, Banerjee S, Chambers A, Pados G, Tsolakidis D, Billi H, Athanatos D, Tarlatzis B, Salumets A, Laanpere M, Altmae S, Kaart T, Stavreus-Evers A, Nilsson TK, van Dulmen-den Broeder E, van der Stroom E, Konig TE, van Montfrans J, Overbeek A, van den Berg MH, van Leeuwen FE, Lambalk CB, Taketani T, Tamura H, Tamura I, Asada H, Sugino N, Al - Azemi M, Kyrou D, Papanikolaou EG, Polyzos NP, Devroey P, Fatemi HM, Qiu Z, Yang L, Yan G, Sun H, Hu Y, Mohiyiddeen L, Higgs J, Roberts S, Newman W, Nardo LG, Ho C, Guijarro JA, Nunez R, Alonso J, Garcia A, Cordeo C, Cortes S, Caballero P, Soliman S, Baydoun R, Wang B, Shreeve N, Cagampang F, Sadek K, Hill CM, Brook N, Macklon N, Cheong Y, Santana R, Setti AS, Maldonado LG, Valente FM, Iaconelli C, Braga DPAF, Iaconelli Jr. A, Borges Jr. E, Yoon JS, Won MY, Kim SD, Jung JH, Yang SH, Lim JH, Kavrut M, Kahraman S, Sadek KH, Bruce KB, Macklon N, Cagampang FR, Cheong YC, Cota AMM, Oliveira JBA, Petersen CG, Mauri AL, Massaro FC, Silva LFI, Vagnini LD, Nicoletti A, Pontes A, Cavagna M, Baruffi RLR, Franco Jr. JG, Won MY, Kim SD, Yoon JS, Jung JH, Yang SH, Lim JH, Kim SD, Kim JW, Yoon TK, Lee WS, Han JE, Lyu SW, Shim SH, Kuwabara Y, Katayama A, Tomiyama R, Piao H, Ono S, Shibui Y, Abe T, Ichikawa T, Mine K, Akira S, Takeshita T, Hatzi E, Lazaros L, Xita N, Kaponis A, Makrydimas G, Sofikitis N, Stefos T, Zikopoulos K, Georgiou I, Guimera M, Casals G, Fabregues F, Estanyol JM, Balasch J, Mochtar MH, Van den Wijngaard L, Van Voorst S, Koks CAM, Van Mello NM, Mol BWJ, Van der Veen F, Van Wely M, Fabregues F, Iraola A, Casals G, Creus M, Carmona F, Balasch J, Villarroel C, Lopez P, Merino P, Iniguez G, Codner E, Xu B, Cui Y, Gao L, Xue KAI, Li MEI, Zhang YUAN, Diao F, Ma X, Liu J, Leonhardt H, Gull B, Kishimoto K, Kataoka M, Stener-Victorin E, Hellstrom M, Cui Y, Wang X, Zhang Z, Ding G, HU X, Sha J, Zhou Z, Liu J, Liu J, Kyrou D, Kolibianakis EM, Fatemi HM, Camus M, Tournaye H, Tarlatzis BC, Devroey P, Davari F, Rashidi B, Rahmanpour Zanjani H, Al-Inany H, Youssef M, Aboulghar M, Broekmans F, Sterrenburg M, Smit J, Abousetta A, Van Dessel H, Van Leeuwen J, McGee EA, Bodri D, Guillen JJ, Rodriguez A, Trullenque M, Coll O, Vernaeve V, Snajderova M, Keslova P, Sedlacek P, Formankova R, Kotaska K, Stary J, Weghofer A, Dietrich W, Barad DH, Gleicher N, Rustamov O, Pemberton P, Roberts S, Smith A, Yates A, Patchava S, Nardo L, Toulis KA, Mintziori G, Goulis DG, Kintiraki E, Eukarpidis E, Mouratoglou SA, Pavlaki A, Stergianos S, Poulasouhidou M, Tzellos TG, Tarlatzis BC, Nasiri R, Ramezanzadeh F, Sarafraz Yazdi M, Baghrei M, Lee RKK, Wu FS, Lin S, Lin MH, Hwu YM. POSTER VIEWING SESSION - REPRODUCTIVE ENDOCRINOLOGY. Hum Reprod 2011. [DOI: 10.1093/humrep/26.s1.90] [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: 11/13/2022] Open
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Evans WK, Wolfson M, Flanagan W, Oderkirk J, Goffin JR, Shin J, Lockwood G. Canadian cancer risk management model: A new health policy tool useful in policy decisions related to lung cancer. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.e16541] [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: 11/20/2022] Open
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Gladwish A, Koh E, Lockwood G, Hoisak J, Yu E, Laperriere N, Ménard C. Evaluation of Early Response Criteria in Glioblastoma Multiforme. Int J Radiat Oncol Biol Phys 2009. [DOI: 10.1016/j.ijrobp.2009.07.578] [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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35
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Gomez-Iturriaga A, Crook J, Lockwood G, Fleshner N. Median 5 Year Follow-up of Iodine 125 Brachytherapy as Monotherapy in Men Aged ≤55 Years with Favorable Prostate Cancer. Int J Radiat Oncol Biol Phys 2009. [DOI: 10.1016/j.ijrobp.2009.07.745] [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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Huang S, O'Sullivan B, Waldron J, Bayley A, Kim J, Cummings B, Dawson L, Hope A, Cho B, Lockwood G, Ringash J. 28 PATTERNS OF CARE IN ELDERLY HEAD AND NECK CANCER PATIENTS: A SINGLE INSTITUTION RECENT EXPERIENCE. Radiother Oncol 2009. [DOI: 10.1016/s0167-8140(12)72415-5] [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: 10/27/2022]
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37
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Gomez-Iturriaga A, Crook J, Lockwood G, Fleshner N. 1 125-IODINE PROSTATE BRACHYTHERAPY (BT) AS MONOTHERAPY IN PATIENTS AGED 55 YEARS OR LESS WITH LOCALIZED PROSTATE CANCER. Radiother Oncol 2009. [DOI: 10.1016/s0167-8140(09)00359-4] [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: 11/30/2022]
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Crook J, Yeung I, Borg J, McLean M, Lockwood G. 8 10-YEAR EXPERIENCE WITH IODINE-125 PROSTATE BRACHYTHERAPY AT PRINCESS MARGARET HOSPITAL. Radiother Oncol 2009. [DOI: 10.1016/s0167-8140(12)72395-2] [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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40
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Keller H, Tsang R, Goda J, Vines D, Breen S, Lockwood G. Quantification of Early, Intermediate and Late Volumetric and Metabolic Response during Fractionated Radiation Therapy for non-Hodgkin's Lymphoma. Int J Radiat Oncol Biol Phys 2008. [DOI: 10.1016/j.ijrobp.2008.06.471] [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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41
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Crook J, Ludgate C, Malone S, Eapen L, Perry G, Bowen J, Robertson S, Lockwood G. Final Report of a Canadian Phase III Trial of 3 vs 8 months Neoadjuvant Androgen Deprivation Prior to 66 Gray External Beam Radiotherapy for Clinically Localized Prostate Cancer. Int J Radiat Oncol Biol Phys 2008. [DOI: 10.1016/j.ijrobp.2008.06.936] [Citation(s) in RCA: 2] [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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42
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Eccles C, Patel R, Lockwood G, Purdie T, Kirilova A, Haider M, Dawson L. Comparison of Liver Tumor Motion with and without Abdominal Compression using Cine-MRI. Int J Radiat Oncol Biol Phys 2008. [DOI: 10.1016/j.ijrobp.2008.06.879] [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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Huang S, Lockwood G, Irish J, Ringash J, Kim J, Waldron J, Dawson L, Bayley A, Cummings B, O'Sullivan B. The Truths and Myths of Radiotherapy for Verrucous Carcinoma of Larynx. Int J Radiat Oncol Biol Phys 2007. [DOI: 10.1016/j.ijrobp.2007.07.358] [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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Keller H, Tsang R, Vines D, Breen S, Lockwood G. Quantification of Local Tumor Response to Fractionated Radiation Therapy for Non-Hodgkin's Lymphoma Using Weekly 18F-FDG PET Imaging. Int J Radiat Oncol Biol Phys 2007. [DOI: 10.1016/j.ijrobp.2007.07.1781] [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: 11/28/2022]
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45
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Huang S, Hwang D, Lockwood G, O'Sullivan B. 5503 ORAL The predictive value of tumour thickness for cervical metastasis in squamous cell carcinoma of oral cavity: a meta-analysis of reported studies. EJC Suppl 2007. [DOI: 10.1016/s1359-6349(07)71220-x] [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] Open
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Ringash J, Huang S, Lockwood G, Bayley A, Cummings B, Dawson L, Kim J, Waldron J, O'Sullivan B. 5521 POSTER The anthology of outcomes: prospective point-of-care outcomes for head and neck cancer patients. EJC Suppl 2007. [DOI: 10.1016/s1359-6349(07)71238-7] [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] Open
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Crook J, Gillan C, Yeung I, McLean M, Lockwood G. MP-18.01: PSA kinetics and PSA bounce following permanent seed prostate brachytherapy. Urology 2007. [DOI: 10.1016/j.urology.2007.06.507] [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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Zaretsky Y, Rifkind J, Lockwood G, Tsang R, Kiss T, Hasegawa W, Fyles G, Tejpar I, Loach D, Minden M, Messner H, Lipton JH. Long-term follow-up of allogeneic bone marrow transplantation for patients with chronic phase chronic myeloid leukemia prepared with a regimen consisting of cyclophosphamide, cytarabine and single-dose total body irradiation conditioning. Bone Marrow Transplant 2007; 40:423-30. [PMID: 17603516 DOI: 10.1038/sj.bmt.1705755] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [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: 11/09/2022]
Abstract
We evaluated long-term toxicities and outcomes in 96 patients with chronic phase chronic myeloid leukemia treated with a single bone marrow allograft regimen. Conditioning was cytosine arabinoside, cyclophosphamide (120 mg/kg) and single fraction total body irradiation (500 cGy). Median follow-up was 12.8 years (0.4-19.9 years). Graft failure occurred in one patient, nonfatal veno-occlusive disease in 13 patients (14%). Overall incidences of acute (a) and chronic (c) graft-vs-host disease (GVHD) were 77 and 63%. The 100-day and 1-year transplant-related mortality (TRM) were 1 and 9.2%, respectively, with no change through 5 years. Five- and 10-year event-free survival rates were 56 and 49%, overall survival (OS) rates 72 and 70%, respectively. Forty patients have relapsed: 8 cytogenetic (20%), 10 hematologic (25%) and 22 molecular (55%). Most have been salvaged with donor-leukocyte infusion, second transplants and/or imatinib therapy. Survival was worse for patients transplanted >2 years from diagnosis (10-year OS 56 vs 78%, P=0.01), for patients over 50 years old (10-year OS 44 vs 75%, P=0.05) and for patients without cGVHD (10-year OS 53 vs 86%, P<0.001). This regimen resulted in successful engraftment, low risk of TRM and long-term survival. In an era when imatinib is first line therapy, this regimen offers a potentially low-toxicity, highly successful alternative in the event of poor imatinib response.
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Affiliation(s)
- Y Zaretsky
- Department of Medical Oncology and Hematology, University of Toronto Allogeneic Blood and Marrow Transplant Program, Toronto, Ontario, Canada
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Dawson LA, Tse R, Kim J, Dinniwell R, Lockwood G, Sherman M, Knox JJ, Gallinger S. Phase I study of stereotactic radiotherapy for unresectable hepatobiliary cancer and liver metastases. J Clin Oncol 2007. [DOI: 10.1200/jco.2007.25.18_suppl.4590] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
4590 Background: Safety of stereotactic radiotherapy (SRT) for unresectable hepatocellular carcinoma (HCC), intrahepatic cholangiocarcinoma (CC) and liver metastases (LM) has not been well established. Results from a phase I study of 6 fraction SRT are reported. Methods: Eligible patients had unresectable or medically inoperable HCC, CC or LM, liver enzymes < 6 fold higher than normal, platelets > 80,000 bil/L, Child score A, > 800 cc uninvolved liver, KPS = 60 and unsuitability for standard therapies. Patients were treated with breath hold and image guided 6 fraction SRT. Dose was individualized to maintain the same risk of liver toxicity at three risk levels (I-5%, II-10%, III-20%). Escalation to level II and III occurred once at least 3 patients had been followed for >3 months without dose limiting toxicity (grade 4/5 < 1 month or grade 4/5 liver < 3 months) for each stratum. Stratification was based on diagnosis and liver volume irradiated (low <20%, mid 20–50%, high 50–80%). Results: From Aug. 2003 to Dec. 2006, 82 patients initiated SRT. Two patients discontinued SRT after 1 fraction for progressive disease (LM) and a variceal bleed (HCC). 80 patients completed SRT (38 LM, 32 HCC, 10 CC). Median age was 64 years (38–92 years). Median tumor volume was 293 cc (3–3088 cc). 24 patients (30%) had extra-hepatic disease. 17 HCC patients had portal vein thrombosis (53%), 14 HBV, 12 HCV and 4 alcoholic cirrhosis. The median prescribed dose was 40 Gy (24 Gy - 60 Gy) in 6 fractions. Within 3 months post SRT, no dose-limiting grade 4/5 toxicity or classic radiation liver toxicity was observed. Grade 3 liver enzymes (2 new, 9 pre-existing), thrombocytopenia (3), nausea (3) and fatigue (1) was observed. Child score declined in 8 patients (5 HCC, 2 CC, 1 LM), 6 with progressive disease. Late toxicity included 1 tumor-duodenal fistula, 1 bowel obstruction and 2 GI bleeds. The in-field response rate was 60% (LM 57%, CC 50%, HCC 67%): CR 14%, PR 46%, SD 23%, PD 17%. Actuarial 12 month local control was 78% (95% CI: 58- 90%). The median survival for LM, CC and HCC was 16.6 months (7.9–25.6), 13.1 months (6.0–28.4) and 11.0 months (8.6–20.8) respectively. Conclusions: Individualized SRT is a safe, promising treatment for unresectable liver cancer. No significant financial relationships to disclose.
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Affiliation(s)
- L. A. Dawson
- Princess Margaret Hosp, Toronto, ON, Canada; Toronto General Hospital, Toronto, ON, Canada
| | - R. Tse
- Princess Margaret Hosp, Toronto, ON, Canada; Toronto General Hospital, Toronto, ON, Canada
| | - J. Kim
- Princess Margaret Hosp, Toronto, ON, Canada; Toronto General Hospital, Toronto, ON, Canada
| | - R. Dinniwell
- Princess Margaret Hosp, Toronto, ON, Canada; Toronto General Hospital, Toronto, ON, Canada
| | - G. Lockwood
- Princess Margaret Hosp, Toronto, ON, Canada; Toronto General Hospital, Toronto, ON, Canada
| | - M. Sherman
- Princess Margaret Hosp, Toronto, ON, Canada; Toronto General Hospital, Toronto, ON, Canada
| | - J. J. Knox
- Princess Margaret Hosp, Toronto, ON, Canada; Toronto General Hospital, Toronto, ON, Canada
| | - S. Gallinger
- Princess Margaret Hosp, Toronto, ON, Canada; Toronto General Hospital, Toronto, ON, Canada
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Wysocka BA, Kassam Z, Lockwood G, Brierley J, Dawson L, Ringash J. Assessment of intra and interfractional organ motion during adjuvant radiochemotherapy in gastric cancer. J Clin Oncol 2007. [DOI: 10.1200/jco.2007.25.18_suppl.15132] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
15132 Background: Adjuvant combined chemotherapy and radiotherapy (RT) in gastric cancer improves survival, however acute toxicity is substantial. Toxicity may be improved with three-dimensional (3D) RT, but organ motion must be considered in planning target volume (PTV) delineation. Methods: Participants (n=22) had baseline free breathing planning CT (CT0) with BodyFix immobilization. Abdominal CTs in free breathing (FB), inhale (I) and exhale (E) states were obtained in weeks 1, 3 and 5 of RT. Datasets were fused to CT0 in Pinnacle3 6.2 planning system using bone registration. Volumes of interest (VOIs) [right (R) and left (L) kidney, liver, stomach, pancreas, celiac axis and porta hepatis] were contoured and points of interest (POIs) were placed at each centre of mass. POIs were manually placed at the left dome of diaphragm and splenic hilum. Organ motion was determined by the difference between POI positions in cranial-caudal (CC), anterior-posterior (AP) and right-left (RL) directions. Maximal respiratory motion was determined from the difference between I and E positions. Interfractional displacement in organs relative to bones at weeks 1, 3 and 5 was determined on FB scans as compared to baseline. Results: Interfractional organ motion was maximal in CC direction with median absolute displacements (range) in mm of: splenic hilum 10 (0–52), stomach 8 (0.4–27.2), liver 7.4 (0.5–23.6), diaphragm 6 (0–28), L kidney 5.7 (0–37.3), R kidney 5.3 (0.2–35.3), pancreas 5.7 (0.3–29.1), porta hepatis 4 (0–14) and celiac axis 1.7 (0–9.1). Median interfraction displacement (range) in CC, AP and RL in mm for all organs was: 5.7 (0- 52), 2.1 (0–23.1), 2.3 (0–15.9). Positional difference between I and E state (median for all organs) was: 16 mm CC, 5.9 mm AP, and 1.7 mm RL with maximal individual breathing excursions of 59.9, 30.2 and 21.1 mm, respectively. Conclusions: Interfraction organ displacement relative to bones can be quantified and used in the safe design of 3D conformal radiotherapy. Respiratory motion can be substantial in some individuals. Accounting for organ motion in 3D RT planning is necessary and may reduce the toxicity of treatment. No significant financial relationships to disclose.
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Affiliation(s)
| | - Z. Kassam
- Princess Margaret Hospital, Tornoto, ON, Canada
| | - G. Lockwood
- Princess Margaret Hospital, Tornoto, ON, Canada
| | - J. Brierley
- Princess Margaret Hospital, Tornoto, ON, Canada
| | - L. Dawson
- Princess Margaret Hospital, Tornoto, ON, Canada
| | - J. Ringash
- Princess Margaret Hospital, Tornoto, ON, Canada
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