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Westley R, Dunlop A, Alexander S, Mitchell A, Diamantopoulos S, Chick J, Hall E, Mohajer J, Tree A. Is the Motion Causing a Commotion? Two-Fraction Prostate SBRT on the MR-Linac. Int J Radiat Oncol Biol Phys 2023; 117:e449-e450. [PMID: 37785446 DOI: 10.1016/j.ijrobp.2023.06.1634] [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: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) In HERMES (NCT04595019) men with localized prostate cancer are treated on the Unity MR-Linac platform (MRL, Elekta AB, Stockholm) and randomized between stereotactic body radiotherapy (SBRT) with 36.25 Gy in 5 fractions and 24 Gy in 2 fractions. Patients randomized to two fractions receive 24 Gy to the high risk PTV, 20 Gy to the low risk PTV and a boost of 27 Gy to the dominant intraprostatic lesion. This study explores dose received by the target and organs at risk (OARs) when considering intrafraction motion in two fraction SBRT. MATERIALS/METHODS Targets and OARs were delineated and a reference plan generated on Monaco v5.40.01 (Elekta). An Adapt-to-Shape (ATS) workflow was used. Contours were propagated to the session MRI (MRIsession) and edited accordingly. Prior to delivery, a verification MRI (MRIverif) was acquired with baseline shifts corrected for using the Adapt-to-Position (ATP-of-ATS) workflow. A post treatment MRI (MRIpost) was acquired after delivery. Men in the 2-fraction arm received each fraction in 2 sub-fractions sequentially on the same day, to mitigate intrafraction motion. The plans of 5 men receiving 2 fraction SBRT were analyzed. The targets, urethra, bladder and rectum were recontoured on the MRIverif and MRIpost. Delivered plans were recalculated on the corresponding MRIverif and MRIpost. The percentage of optimal and mandatory target dose constraints met were calculated. Accumulated OAR doses were calculated by averaging their respective dose statistics across all sub-fractions, conservatively assuming that the same area of the OAR receives the maximum dose each fraction. Analysis was carried out separately for MRIverif and MRIpost as the true 'delivered dose' most likely lies between these two estimates. RESULTS There was good coverage across all fractions. The mandatory constraints of CTVpsv V24.0 Gy > 95% and CTVsv V20.0 Gy > 95% were met in 100% of fractions and V2700cGy > 95% in 90% on the MRIpost. Table 3 shows OAR dose. CONCLUSION This work demonstrates that target coverage is good, even for the GTV where no margin is applied. With our conservative dose calculation approach, we found dose constraints are exceeded for some patients. However, treatment has been well tolerated, suggesting that that our current dose constraints may be cautious. Once Elekta's True Tracking and automated gating software is implemented at our center we will be able to further improve OAR clinical goal compliance.
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Affiliation(s)
- R Westley
- The Royal Marsden NHS Foundation Trust, London, United Kingdom
| | - A Dunlop
- The Royal Marsden Hospital NHS Foundation Trust, London, United Kingdom
| | - S Alexander
- Institute of Cancer Research, Sutton, United Kingdom
| | - A Mitchell
- The Royal Marsden Hospital NHS Foundation Trust, London, United Kingdom
| | | | - J Chick
- The Royal Marsden, Sutton, United Kingdom
| | - E Hall
- The Institute of Cancer Research, Clinical Trials and Statistics Unit, London, United Kingdom
| | - J Mohajer
- The Royal Marsden NHS Foundation Trust, London, United Kingdom
| | - A Tree
- Radiotherapy and Imaging Division, Institute of Cancer Research, London, United Kingdom
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Woerner A, Chick J, Shin D, Meissner M. Abstract No. 595 Endovascular Recanalization and Reconstruction for the Treatment of Symptomatic Venous Ligation. J Vasc Interv Radiol 2023. [DOI: 10.1016/j.jvir.2022.12.453] [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: 02/27/2023] Open
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Eysenbach L, Chick J, Vaidya S, Shin D, Valji K, Monsky W, Johnson E. Abstract No. 585 Utilization of a Dedicated Room Flow Coordinator Improves Efficiency in Interventional Radiology. J Vasc Interv Radiol 2023. [DOI: 10.1016/j.jvir.2022.12.443] [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: 02/27/2023] Open
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Greenberg C, Shin D, Abad-Santos M, Monroe E, Ingraham C, Vaidya S, Bertino F, Johnson E, Makary M, Chick J. Abstract No. 589 Reconstruction of Upper Extremity and Thoracic Central Veins Using Dedicated Venous Stents: Deployment of 75 Stents in 46 Patients. J Vasc Interv Radiol 2023. [DOI: 10.1016/j.jvir.2022.12.447] [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: 02/27/2023] Open
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Constantino D, Cook M, Shin D, Meissner M, Abad-Santos M, Bertino F, Monroe E, Hua E, Vaidya S, Chick J. Abstract No. 590 Sharp Recanalization of Symptomatic Chronic Central Venous Occlusions Using the Rösch-Uchida Transjugular Liver Access Set. J Vasc Interv Radiol 2023. [DOI: 10.1016/j.jvir.2022.12.448] [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: 02/27/2023] Open
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Ingle M, White I, Chick J, Stankiewicz H, Mitchell A, Barnes H, Herbert T, Nill S, Oelfke U, Huddart R, Ng-Cheng-Hin B, Hafeez S, Lalondrelle S, Dunlop A, Bhide S. Understanding the Benefit of Magnetic Resonance-guided Adaptive Radiotherapy in Rectal Cancer Patients: a Single-centre Study. Clin Oncol (R Coll Radiol) 2023; 35:e135-e142. [PMID: 36336579 DOI: 10.1016/j.clon.2022.10.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Revised: 09/01/2022] [Accepted: 10/12/2022] [Indexed: 11/06/2022]
Abstract
AIMS Neoadjuvant chemoradiotherapy followed by surgery is the mainstay of treatment for patients with rectal cancer. Standard clinical target volume (CTV) to planning target volume (PTV) margins of 10 mm are used to accommodate inter- and intrafraction motion of target. Treating on magnetic resonance-integrated linear accelerators (MR-linacs) allows for online manual recontouring and adaptation (MRgART) enabling the reduction of PTV margins. The aim of this study was to investigate motion of the primary CTV (CTVA; gross tumour volume and macroscopic nodes with 10 mm expansion to cover microscopic disease) in order to develop a simultaneous integrated boost protocol for use on MR-linacs. MATERIALS AND METHODS Patients suitable for neoadjuvant chemoradiotherapy were recruited for treatment on MR-linac using a two-phase technique; only the five phase 1 fractions on MR-linac were used for analysis. Intrafraction motion of CTVA was measured between pre-treatment and post-treatment MRI scans. In MRgART, isotropically expanded pre-treatment PTV margins from 1 to 10 mm were rigidly propagated to post-treatment MRI to determine overlap with 95% of CTVA. The PTV margin was considered acceptable if overlap was >95% in 90% of fractions. To understand the benefit of MRgART, the same methodology was repeated using a reference computed tomography planning scan for pre-treatment imaging. RESULTS In total, nine patients were recruited between January 2018 and December 2020 with T3a-T4, N0-N2, M0 disease. Forty-five fractions were analysed in total. The median motion across all planes was 0 mm, demonstrating minimal intrafraction motion. A PTV margin of 3 and 5mm was found to be acceptable in 96 and 98% of fractions, respectively. When comparing to the computed tomography reference scan, the analysis found that PTV margins to 5 and 10 mm only acceptably covered 51 and 76% of fractions, respectively. CONCLUSION PTV margins can be reduced to 3-5 mm in MRgART for rectal cancer treatment on MR-linac within an simultaneous integrated boost protocol.
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Affiliation(s)
- M Ingle
- The Royal Marsden Hospital NHS Trust, London, UK; The Institute of Cancer Research, London, UK.
| | - I White
- Guys and St Thomas NHS Trust, London, UK
| | - J Chick
- The Royal Marsden Hospital NHS Trust, London, UK
| | | | - A Mitchell
- The Royal Marsden Hospital NHS Trust, London, UK
| | - H Barnes
- The Royal Marsden Hospital NHS Trust, London, UK
| | - T Herbert
- The Royal Marsden Hospital NHS Trust, London, UK
| | - S Nill
- The Institute of Cancer Research, London, UK
| | - U Oelfke
- The Institute of Cancer Research, London, UK
| | - R Huddart
- The Royal Marsden Hospital NHS Trust, London, UK; The Institute of Cancer Research, London, UK
| | | | - S Hafeez
- The Royal Marsden Hospital NHS Trust, London, UK; The Institute of Cancer Research, London, UK
| | - S Lalondrelle
- The Royal Marsden Hospital NHS Trust, London, UK; The Institute of Cancer Research, London, UK
| | - A Dunlop
- The Royal Marsden Hospital NHS Trust, London, UK
| | - S Bhide
- The Royal Marsden Hospital NHS Trust, London, UK; The Institute of Cancer Research, London, UK
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Mitchell A, Ingle M, Smith G, Chick J, Diamantopoulos S, Goodwin E, Herbert T, Huddart R, McNair H, Oelfke U, Nill S, Dunlop A, Hafeez S. Feasibility of tumour-focused adaptive radiotherapy for bladder cancer on the MR-linac. Clin Transl Radiat Oncol 2022; 35:27-32. [PMID: 35571274 PMCID: PMC9092067 DOI: 10.1016/j.ctro.2022.04.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Revised: 04/21/2022] [Accepted: 04/24/2022] [Indexed: 11/23/2022] Open
Abstract
Bladder tumour-focused magnetic resonance image-guided adaptive radiotherapy using a 1.5 Tesla MR-linac is feasible. A full online workflow adapting to anatomy at each fraction is achievable in approximately 30 min. Intra-fraction bladder filling did not compromise target coverage with the class solution employed.
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Affiliation(s)
- A. Mitchell
- The Joint Department of Physics, The Institute of Cancer Research and The Royal Marsden NHS Foundation Trust, London, UK
| | - M. Ingle
- The Institute of Cancer Research, London, UK
- The Royal Marsden NHS Foundation Trust, London, UK
| | - G. Smith
- The Royal Marsden NHS Foundation Trust, London, UK
| | - J. Chick
- The Joint Department of Physics, The Institute of Cancer Research and The Royal Marsden NHS Foundation Trust, London, UK
| | - S. Diamantopoulos
- The Joint Department of Physics, The Institute of Cancer Research and The Royal Marsden NHS Foundation Trust, London, UK
| | - E. Goodwin
- The Joint Department of Physics, The Institute of Cancer Research and The Royal Marsden NHS Foundation Trust, London, UK
| | - T. Herbert
- The Royal Marsden NHS Foundation Trust, London, UK
| | - R. Huddart
- The Institute of Cancer Research, London, UK
- The Royal Marsden NHS Foundation Trust, London, UK
| | - H. McNair
- The Institute of Cancer Research, London, UK
- The Royal Marsden NHS Foundation Trust, London, UK
| | - U. Oelfke
- The Joint Department of Physics, The Institute of Cancer Research and The Royal Marsden NHS Foundation Trust, London, UK
| | - S. Nill
- The Joint Department of Physics, The Institute of Cancer Research and The Royal Marsden NHS Foundation Trust, London, UK
| | - A. Dunlop
- The Joint Department of Physics, The Institute of Cancer Research and The Royal Marsden NHS Foundation Trust, London, UK
| | - S. Hafeez
- The Institute of Cancer Research, London, UK
- The Royal Marsden NHS Foundation Trust, London, UK
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Alexander S, Chick J, Herbert T, Huddart R, Ingle M, Mitchell A, Nill S, Oelfke U, Dunlop A, Hafeez S. MO-0312 Systematic multi-disciplinary sequence evaluation for integration into the MR-linac workflow. Radiother Oncol 2022. [DOI: 10.1016/s0167-8140(22)02344-1] [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: 11/24/2022]
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Laidlaw G, Chick J, Ingraham C, Monroe E, Johnson G, Valji K, Shin D. Abstract No. 178 Larger inferior vena cava diameter is associated with greater filter tilt change and need for advanced retrieval techniques: an analysis in 189 consecutive patients. J Vasc Interv Radiol 2021. [DOI: 10.1016/j.jvir.2021.03.184] [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] Open
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Jackson T, Shin D, Ingraham C, Vaidya S, Monroe E, Johnson G, Valji K, Chick J. Abstract No. 56 Double-barrel brachiocephalocaval Viabahn VBX stent-graft reconstruction for treatment of superior vena cava syndrome. J Vasc Interv Radiol 2021. [DOI: 10.1016/j.jvir.2021.03.475] [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] Open
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Brown D, Chick J, Johnson G, Ingraham C, Monroe E, Valji K, Shin D. Abstract No. 69 Bifurcated hepatocaval stent reconstruction for treatment of hepatic venous outflow obstruction in orthotopic liver transplantation. J Vasc Interv Radiol 2021. [DOI: 10.1016/j.jvir.2021.03.490] [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] Open
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Stockwell T, Zhao J, Pauly B, Chow C, Vallance K, Wettlaufer A, Saunders JB, Chick J. Trajectories of Alcohol Use and Related Harms for Managed Alcohol Program Participants over 12 Months Compared with Local Controls: A Quasi-Experimental Study. Alcohol Alcohol 2021; 56:651-659. [PMID: 33418568 DOI: 10.1093/alcalc/agaa134] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2020] [Revised: 11/12/2020] [Accepted: 11/12/2020] [Indexed: 11/14/2022] Open
Abstract
AIM Investigate changes in alcohol use and related harm using the first multisite, controlled, longitudinal study of Managed Alcohol Programs (MAPs). MAPs provide regular doses of alcohol, accommodation, social supports and healthcare to unstably housed people with alcohol dependence. METHODS A multisite, quasi-experimental, longitudinal study was conducted in day centres, shelters and residential programs for unstably housed people. There were 59 MAP participants from six Canadian cities and 116 local controls. Self-reported alcohol consumption and harms were assessed at 0-2, 6 and 12 months. Liver function test results were accessed for MAP participants. RESULTS Both groups had similar reductions in mean drinks per day (MAP: -8.11; controls: -8.54 controls, P < 0.001) and days drinking per month (MAP: -2.51 days, P < 0.05; control: -4.81 days, P = 0.0001) over 6--12 months. Both reduced non-beverage alcohol consumption. MAP participants reported significantly fewer harms at both 0-2 and 6 months than controls. MAP participants had similar total consumption to controls, but spread out over more days (25.41 versus 19.64 days per month, P = 0.001). After leaving a MAP, participants' liver status deteriorated, with increases in both aspartate transaminase and bilirubin levels. MAP sites with effective policies on outside drinking drank less and had fewer harms. CONCLUSION MAP participants drank less hazardously than controls, especially with effective management of non-MAP drinking. Reductions in alcohol use and harms occurred for both groups, although MAP participants reported fewer harms at 0-6 months. Departing an MAP was associated with deterioration in liver status. Although providing stable housing, MAPs did not worsen health or increase alcohol use.
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Affiliation(s)
- T Stockwell
- Canadian Institute for Substance Use Research, University of Victoria, Victoria, British Columbia, Canada.,Department of Psychology, University of Victoria, Victoria, British Columbia, Canada
| | - J Zhao
- Canadian Institute for Substance Use Research, University of Victoria, Victoria, British Columbia, Canada
| | - B Pauly
- Canadian Institute for Substance Use Research, University of Victoria, Victoria, British Columbia, Canada.,School of Nursing, University of Victoria, Victoria, British Columbia, Canada
| | - C Chow
- Canadian Institute for Substance Use Research, University of Victoria, Victoria, British Columbia, Canada.,Vancouver Coastal Health, Vancouver, British Columbia, Canada
| | - K Vallance
- Canadian Institute for Substance Use Research, University of Victoria, Victoria, British Columbia, Canada
| | - A Wettlaufer
- Canadian Institute for Substance Use Research, University of Victoria, Victoria, British Columbia, Canada.,Centre for Addiction and Mental Health, Institute for Mental Health Policy Research, Toronto, Ontario, Canada
| | - J B Saunders
- National Centre for Youth Substance Use Research, University of Queensland, Brisbane, Australia
| | - J Chick
- Castle Craig Hospital, UK.,School Health and Social Care, Edinburgh Napier University, Edinburgh, UK
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Chick J, Mitchell A, Sullivan J, Herbert T, Lawes R, McNair H, Schmidt M, Nill S, Kirby A, Oelfke U. PO-1766: A clinical solution for electron streaming shielding for partial breast treatments on Unity MRlinac. Radiother Oncol 2020. [DOI: 10.1016/s0167-8140(21)01784-9] [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: 11/27/2022]
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Mitchell R, Dunlop A, Chick J, Mohajer J, Goodwin E, Nill S, Lawes R, Herbert T, Kirby A, Oelfke U. PO-1437: Treatment plan robustness analysis for high field MR-linac partial breast plans. Radiother Oncol 2020. [DOI: 10.1016/s0167-8140(21)01455-9] [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] [Indexed: 10/22/2022]
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Hunt A, Hanson I, Dunlop A, Bower L, Barnes H, Chick J, Herbert T, Lawes R, McNair H, Mitchell A, Mohajer J, Morgan T, Smith G, Nill S, Oelfke U, Huddart R, Hafeez S. OC-0469: MR-guided online adaptive radiotherapy for muscle invasive bladder cancer: First UK experience. Radiother Oncol 2020. [DOI: 10.1016/s0167-8140(21)00491-6] [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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Hunt A, Hanson I, Dunlop A, Barnes H, Bower L, Chick J, Cruickshank C, Hall E, Herbert T, Lawes R, McQuaid D, McNair H, Mitchell A, Mohajer J, Morgan T, Oelfke U, Smith G, Nill S, Huddart R, Hafeez S. Feasibility of magnetic resonance guided radiotherapy for the treatment of bladder cancer. Clin Transl Radiat Oncol 2020; 25:46-51. [PMID: 33015380 PMCID: PMC7522378 DOI: 10.1016/j.ctro.2020.09.002] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Revised: 09/03/2020] [Accepted: 09/06/2020] [Indexed: 12/15/2022] Open
Abstract
Whole bladder magnetic resonance image-guided radiotherapy using the 1.5 Telsa MR-linac is feasible. Full online adaptive planning workflow based on the anatomy seen at each fraction was performed. This was delivered within 45 min. Intra-fraction bladder filling did not compromise target coverage. Patients reported acceptable tolerance of treatment.
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Affiliation(s)
- A. Hunt
- The Institute of Cancer Research, London, UK
- The Royal Marsden NHS Foundation Trust, London, UK
| | - I. Hanson
- The Joint Department of Physics at The Institute of Cancer Research and The Royal Marsden NHS Foundation Trust, London, UK
| | - A. Dunlop
- The Joint Department of Physics at The Institute of Cancer Research and The Royal Marsden NHS Foundation Trust, London, UK
| | - H. Barnes
- The Royal Marsden NHS Foundation Trust, London, UK
| | - L. Bower
- The Institute of Cancer Research, London, UK
- The Royal Marsden NHS Foundation Trust, London, UK
| | - J. Chick
- The Joint Department of Physics at The Institute of Cancer Research and The Royal Marsden NHS Foundation Trust, London, UK
| | - C. Cruickshank
- Clinical Trials and Statistics Unit, The Institute of Cancer Research, London, UK
| | - E. Hall
- Clinical Trials and Statistics Unit, The Institute of Cancer Research, London, UK
| | - T. Herbert
- The Royal Marsden NHS Foundation Trust, London, UK
| | - R. Lawes
- The Royal Marsden NHS Foundation Trust, London, UK
| | - D. McQuaid
- The Joint Department of Physics at The Institute of Cancer Research and The Royal Marsden NHS Foundation Trust, London, UK
| | - H. McNair
- The Institute of Cancer Research, London, UK
- The Royal Marsden NHS Foundation Trust, London, UK
| | - A. Mitchell
- The Joint Department of Physics at The Institute of Cancer Research and The Royal Marsden NHS Foundation Trust, London, UK
| | - J. Mohajer
- The Joint Department of Physics at The Institute of Cancer Research and The Royal Marsden NHS Foundation Trust, London, UK
| | - T. Morgan
- The Institute of Cancer Research, London, UK
- The Royal Marsden NHS Foundation Trust, London, UK
| | - U. Oelfke
- The Joint Department of Physics at The Institute of Cancer Research and The Royal Marsden NHS Foundation Trust, London, UK
| | - G. Smith
- The Royal Marsden NHS Foundation Trust, London, UK
| | - S. Nill
- The Joint Department of Physics at The Institute of Cancer Research and The Royal Marsden NHS Foundation Trust, London, UK
| | - R. Huddart
- The Institute of Cancer Research, London, UK
- The Royal Marsden NHS Foundation Trust, London, UK
| | - S. Hafeez
- The Institute of Cancer Research, London, UK
- The Royal Marsden NHS Foundation Trust, London, UK
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Bundy J, Hage A, Jiao A, Wadhwa V, Gutta N, Srinivasa R, Gemmete J, Chick J. Abstract No. 577 Limited clinical utility of chest radiography in asymptomatic patients after interventional radiology-performed ultrasound-guided thoracentesis: analysis of 3022 consecutive patients. J Vasc Interv Radiol 2020. [DOI: 10.1016/j.jvir.2019.12.638] [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: 11/17/2022] Open
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Jiao A, Wadhwa V, Bundy J, Hage A, Srinivasa R, Gemmete J, Lee E, Chick J. Abstract No. 462 Scholarly activities and indices among academic endovascular specialists: a comparative analysis between interventional radiologists and vascular surgeons. J Vasc Interv Radiol 2020. [DOI: 10.1016/j.jvir.2019.12.523] [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: 10/25/2022] Open
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McCracken I, Jones S, Ingraham C, Shin D, Monroe E, Johnson G, Chick J, Kanal K, Valji K. Abstract No. 633 Endovascular interventions with high radiation doses exceeding 5000-mGy reference point kerma: a dosimetric analysis of 89,855 consecutive patient encounters. J Vasc Interv Radiol 2020. [DOI: 10.1016/j.jvir.2019.12.694] [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: 10/25/2022] Open
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Hanson I, Nill S, Chick J, Oelfke U. PO-1035 Linac commissioning methodology for the Elekta Unity MR Linac. Radiother Oncol 2019. [DOI: 10.1016/s0167-8140(19)31455-0] [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: 10/26/2022]
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Chick J, Hanson I, Nill S, Oelfke U. EP-2110 Developing a QA programme for the Elekta Unity MR-linac. Radiother Oncol 2019. [DOI: 10.1016/s0167-8140(19)32530-7] [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: 10/26/2022]
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Bundy J, Hage A, Srinivasa R, Gemmete J, Srinivasa R, Jairath N, Anand R, Dasika N, Chauhan N, Chick J. 03:09 PM Abstract No. 249 Intra-arterial ampicillin and gentamicin and the incidence of splenic abscesses following splenic artery embolization: a 20-year case control study in 213 patients. J Vasc Interv Radiol 2019. [DOI: 10.1016/j.jvir.2018.12.310] [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] Open
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Gill J, Black H, Rush R, O'May F, Chick J. Heavy Drinkers and the Potential Impact of Minimum Unit Pricing-No Single or Simple Effect? Alcohol Alcohol 2018; 52:722-729. [PMID: 29016713 DOI: 10.1093/alcalc/agx060] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2016] [Accepted: 08/09/2017] [Indexed: 12/15/2022] Open
Abstract
Aims To explore the potential impact of a minimum unit price (MUP: 50 pence per UK unit) on the alcohol consumption of ill Scottish heavy drinkers. Methods Participants were 639 patients attending alcohol treatment services or admitted to hospital with an alcohol-related condition. From their reported expenditure on alcohol in their index week, and assuming this remained unchanged, we estimated the impact of a MUP (50 ppu) on future consumption. (Around 15% purchased from both the more expensive on-sale outlets (hotels, pubs, bars) and from off-sales (shops and supermarkets). For them we estimated the change in consumption that might follow MUP if (i) they continued this proportion of 'on-sales' purchasing or (ii) their reported expenditure was moved entirely to off-sale purchasing (to maintain consumption levels)). Results Around 69% of drinkers purchased exclusively off-sale alcohol at <50 ppu. Their drinking, post MUP, may reduce by a mean of 33%. For this group, from a population of very heavy, ill consumers, we were unable to show a differential effect across multiple deprivation quintiles. For other drinkers there might be no reduction, especially if after MUP there were many products priced close to 50 ppu. Moving away from on-sales purchases could support, for some, an increase in consumption. Conclusions While a proportion of our harmed, heavy drinkers might be able to mitigate the impact of MUP by changing purchasing habits, the majority are predicted to reduce purchasing. This analysis, focusing specifically on harmed drinkers, adds a unique dimension to the evidence base informing current pricing policy. Short Summary From drink purchasing data of heavy drinkers, we estimated the impact of legislating £0.50 minimum unit price. Over two thirds of drinkers, representing all multiple deprivation quintiles, were predicted to decrease alcohol purchasing; remainder, hypothetically, could maintain consumption. Our data address an important gap within the evidence base informing policy.
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Affiliation(s)
- J Gill
- School of Health and Social Care, Edinburgh Napier University, Edinburgh, EH11 4BN, Scotland, UK
| | - H Black
- School of Health and Social Care, Edinburgh Napier University, Edinburgh, EH11 4BN, Scotland, UK
| | - R Rush
- School of Health Sciences, Queen Margaret University Edinburgh, EH21 6UU, Scotland, UK
| | - F O'May
- School of Health Sciences, Queen Margaret University Edinburgh, EH21 6UU, Scotland, UK
| | - J Chick
- School of Health and Social Care, Edinburgh Napier University, Edinburgh, EH11 4BN, Scotland, UK
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Srinivasa R, Chick J, Hage A, Shields J, Cooper K, Saad W, Majdalany B. Abstract No. 567 Transnasal and transgastric snare technique for the placement of retrograde primary jejunostomy tubes. J Vasc Interv Radiol 2018. [DOI: 10.1016/j.jvir.2018.01.612] [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: 10/17/2022] Open
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Srinivasa R, Chick J, Gemmete J. Abstract No. 598 Neonatal thoracic duct embolization: technical and clinical outcomes. J Vasc Interv Radiol 2018. [DOI: 10.1016/j.jvir.2018.01.643] [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: 11/24/2022] Open
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Bundy J, Srinivasa R, Gemmete J, Hage A, Majdalany B, Khaja M, Saad W, Chick J. Abstract No. 589 Vascular and lymphatic complications following thoracic duct cannulation: experience in 58 patients. J Vasc Interv Radiol 2018. [DOI: 10.1016/j.jvir.2018.01.634] [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: 10/17/2022] Open
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Bundy J, Srinivasa R, Gemmete J, Hage A, Majdalany B, Saad W, Chick J. 4:03 PM Abstract No. 168 Results of percutaneous cholecystostomy tube placement in 324 patients. J Vasc Interv Radiol 2018. [DOI: 10.1016/j.jvir.2018.01.190] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022] Open
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Hage A, Srinivasa R, Chick J. 3:45 PM Abstract No. 356 Technical Success, Complications, and Reinterventions of Sharp Recanalization for the Treatment of Chronic Venous Occlusions: Experience in 142 Patients. J Vasc Interv Radiol 2018. [DOI: 10.1016/j.jvir.2018.01.395] [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: 12/01/2022] Open
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Srinivasa R, Majdalany B, Saad W, Hage A, Gemmete J, Chick J. Abstract No. 419 Prone transradial catheterization for combined single-session endovascular and percutaneous interventions: approach, technical success, safety, and outcomes in 15 patients. J Vasc Interv Radiol 2018. [DOI: 10.1016/j.jvir.2018.01.464] [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] Open
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Chick J. S12-2BARRIERS TO PROFESSIONAL’S USAGE OF MUTUAL AID GROUPS. Alcohol Alcohol 2017. [DOI: 10.1093/alcalc/agx075.43] [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] Open
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Chick J, Sammarco T, Chittams J, Trerotola S. A prospective, randomized, controlled comparison of first attempt success between an intravenous catheter system with a retractable coiled tip guidewire and conventional peripheral intravenous catheters. J Vasc Interv Radiol 2017. [DOI: 10.1016/j.jvir.2016.12.1177] [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] Open
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Bazzi M, Abdullah N, Karabon P, Chick J, Dabaja A. Trends in embryo transfer rate, multiple birth rate, and pregnancy rate in response to the american society of reproductive medicine's recommendation to limit embryo transfer. Fertil Steril 2016. [DOI: 10.1016/j.fertnstert.2016.07.921] [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: 11/24/2022]
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Epelboym Y, Shyn P, Kelil T, Chick J, Chauhan N, Ripley B, Hosny A, Scholz F. Three-dimensional printing of an abdominal compression device to facilitate CT-fluoroscopy-guided interventional procedures. J Vasc Interv Radiol 2016. [DOI: 10.1016/j.jvir.2015.12.452] [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: 10/22/2022] Open
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Hoffmann J, Chick J, Hall G, Azimov N, Behbahani S, Rochon P, Watts M. The current status of the interventional radiology fellowship match: results of a 2015 resident survey. J Vasc Interv Radiol 2016. [DOI: 10.1016/j.jvir.2015.12.208] [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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Chick J, Stavropoulos S, Mondschein J, Sudheendra D, Nadolski G, Watts M, Trerotola S. 16F sheath with endobronchial forceps improves reported retrieval success of “closed cell” IVC filter designs. J Vasc Interv Radiol 2016. [DOI: 10.1016/j.jvir.2015.12.052] [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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Gill J, Chick J, Black H, Rees C, O'May F, Rush R, McPake BA. Alcohol purchasing by ill heavy drinkers; cheap alcohol is no single commodity. Public Health 2015; 129:1571-8. [PMID: 26411488 PMCID: PMC4684143 DOI: 10.1016/j.puhe.2015.08.013] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2014] [Revised: 07/14/2015] [Accepted: 08/20/2015] [Indexed: 12/02/2022]
Abstract
Objectives Potential strategies to address alcohol misuse remain contentious. We aim to characterise the drink purchases of one population group: heavy drinkers in contact with Scottish health services. We contrast our findings with national sales data and explore the impact of socio-economic status on purchasing behaviour. Study design Cross-sectional study comparing alcohol purchasing and consumption by heavy drinkers in Edinburgh and Glasgow during 2012. Methods 639 patients with serious health problems linked to alcohol (recruited within NHS hospital clinics (in- and out-patient settings) 345 in Glasgow, 294 in Edinburgh) responded to a questionnaire documenting demographic data and last week's or a ‘typical’ weekly consumption (type, brand, volume, price, place of purchase). Scottish Index of Multiple Deprivation quintile was derived as proxy of sociodemographic status. Results Median consumption was 184.8 (IQR = 162.2) UK units/week paying a mean of 39.7 pence per alcohol unit (£0.397). Off-sales accounted for 95% of purchases with 85% of those <50 pence (£0.5 UK) per alcohol unit. Corresponding figures for the Scottish population are 69% and 60%. The most popular low-priced drinks were white cider, beer and vodka with the most common off-sales outlet being the corner shop, despite supermarkets offering cheaper options. Consumption levels of the cheapest drink (white cider) were similar across all quintiles apart from the least deprived. Conclusions Heavy drinkers from all quintiles purchase the majority of their drinks from off-sale settings seeking the cheapest drinks, often favouring local suppliers. While beer was popular, recent legislation impacting on the sale of multibuys may prevent the heaviest drinkers benefiting from the lower beer prices available in supermarkets. Non-etheless, drinkers were able to offset higher unit prices with cheaper drink types and maintain high levels of consumption. Whilst price is key, heavy drinkers are influenced by other factors and adapt their purchasing as necessary. We surveyed drinking behaviour in 639 patients with alcohol-related harm. Consumption was predominantly from off-sale settings (median = 184.8 UK units/week). Popular drinks were cheap varieties of white cider and vodka. Price and location of point of sale were key drivers of consumption. 85% of units cost less that the proposed minimum unit price for alcohol.
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Affiliation(s)
- J Gill
- School of Nursing and Midwifery, Napier University, Edinburgh, EH11 4BN, UK.
| | - J Chick
- School of Nursing and Midwifery, Napier University, Edinburgh, EH11 4BN, UK
| | - H Black
- School of Nursing and Midwifery, Napier University, Edinburgh, EH11 4BN, UK
| | - C Rees
- School of Health Sciences, Queen Margaret University, Edinburgh, EH21 6UU, Scotland, UK
| | - F O'May
- School of Health Sciences, Queen Margaret University, Edinburgh, EH21 6UU, Scotland, UK
| | - R Rush
- School of Health Sciences, Queen Margaret University, Edinburgh, EH21 6UU, Scotland, UK
| | - B A McPake
- School of Health Sciences, Queen Margaret University, Edinburgh, EH21 6UU, Scotland, UK
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Gill J, Chick J, Lachenmeier DW, Rush R, O'May F, Black H. FOC6-8WHITE CIDER; A PRICE WORTH PAYING? Alcohol Alcohol 2015. [DOI: 10.1093/alcalc/agv079.27] [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: 11/14/2022] Open
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Chick J. SY16-1 * CONSTRAINTS AND RESPONSES IN TREATMENT SERVICES FOR ALCOHOL USE DISORDERS IN THE U.K. Alcohol Alcohol 2014. [DOI: 10.1093/alcalc/agu052.68] [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: 11/14/2022] Open
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Thekiso TB, Farren C, Agyapong V, Ahern S, Farren C, Farren C, Milnes J, Thomas K, Ahern S, Chick J. S24 * NEW DEVELOPMENTS IN THE TREATMENT OF ALCOHOL USE DISORDERS. Alcohol Alcohol 2013. [DOI: 10.1093/alcalc/agt102] [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: 11/14/2022] Open
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Walczak J, Jarosz J, Miernik K, Wachal M, Krumpl G, Gual A, Sorensen P, Gual A, van den Brink W, Sorensen P, Torup L, Mann K, Aubin HJ, van den Brink W, Bladstrom A, Torup L, Mann K, Gual A, Aubin HJ, van den Brink W, Sorensen P, Usieto EG, Carmen M, Higuera P, Veiga AR, Roblego F, Perney P, Lehert P, Haass-Koffler C, Kenna G, Simms J, Bartlett S, Cacciaglia R, Lesch OM, Vivet P, Guerri C, Orrico A, Marti-Prats L, Sinclair J, Chick J, Bineau S, LeReun C, Daeppen JB, Bineau S, LeReun C, Daeppen JB, Peuskens H, Dierckx E, Santens E, Basinska-Szafranska A, Silczuk A, Habrat B, Pirog-Balcerzak A, Cieslak U, Basinska-Szafranska A, Silczuk A, Habrat B, Pirog-Balcerzak A, Cieslak U. TREATMENT. Alcohol Alcohol 2013. [DOI: 10.1093/alcalc/agt114] [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: 11/14/2022] Open
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Schuckit M, Mann K, Chick J. SAT1 * ALCOHOL DEPENDENCE - FROM RISK TO REALITY (LUNDBECK). Alcohol Alcohol 2013. [DOI: 10.1093/alcalc/agt100] [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] Open
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Aguiar P, Neto D, Lambaz R, Chick J, Ferrinho P. Prognostic Factors During Outpatient Treatment for Alcohol Dependence: Cohort Study with 6 months of Treatment Follow-up. Alcohol Alcohol 2012; 47:702-10. [DOI: 10.1093/alcalc/ags097] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [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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Murray MM, Chick J, Gill J, Tsang C, Black H, Hillemacher T, Grassel E, Karagulle D, Baier D, Bleich S, Donath C, Barroso T, Barbosa A, Mendes A, Riegler AJ, Erfurth A, Kapusta N, Kogoj D, Schmid R, Walter H, Lesch OM, Jakovljevic MB, Jovanovic M, Nikic K, Radovanovic A, Pirkovic I, Dejanovic SD, Yamada T. FREE ORAL COMMUNICATIONS 1: ALCOHOL AND HEALTH * O1.1 * THE ROLE OF THE NIH IN RESPONSE TO THE GLOBAL BURDEN OF ALCOHOL AND HEALTH: OPPORTUNITIES FOR USA-EUROPEAN COLLABORATION. Alcohol Alcohol 2011. [DOI: 10.1093/alcalc/agr093] [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: 11/12/2022] Open
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Gill J, Tsang C, Black H, Chick J. Can Part of the Health Damage Linked to Alcohol Misuse in Scotland be Attributable to the Type of Drink and its Low Price (by Permitting a Rapid Rate of Consumption)? A Point of View. Alcohol Alcohol 2010; 45:398-400. [DOI: 10.1093/alcalc/agq023] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [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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Macpherson I, Stewart K, Chick J, Brock K, Poondru S, Gedrich R, Stephens AW, Evans TR. A dose escalation (DE), pharmacokinetic (PK), and pharmacodynamic (PD) study of OSI-930 and erlotinib (E) in patients (pts) with advanced solid tumors. J Clin Oncol 2009. [DOI: 10.1200/jco.2009.27.15_suppl.3550] [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
3550 Background: EGFR and VEGFR are important targets in a number of human cancers with common downstream signalling pathways. Combined blockade of EGFR-VEGFR with E and OSI-930 has shown additional antitumor activity compared to either agent alone with long-term remissions in multiple xenograft models. Methods: Sequential cohorts of pts with advanced refractory solid tumors were treated with OSI-930 BID with addition of E QD from Day 8 and beyond to determine the maximum tolerated dose (MTD) and to evaluate safety, PK and efficacy of the combination. Escalation followed a standard 3+3 design until dose-limiting toxicity (DLT) was observed in ≥ 2/6 pts. PK of OSI-930, E and its metabolite OSI-420 were determined. Levels of soluble VEGFR2 (sVEGFR2) in plasma were also measured. Results: 16 pts have been entered (13M/3F); median age 63 years (range 41–78), PS ≤2 and 38% pts with mCRC. OSI-930/E were administered at 3 levels [mg(pts entered/evaluable)]; 200 BID/100 QD (7/6), 200 BID/150 QD (4/3), and 300 BID/150 QD (5/5). Median duration of therapy was 8 weeks (range 1–22). DLT was seen in 1/6 pts at 200 BID/100 QD (>5 day interruption due to G4 neutropenia); and 1/5 at 300 BID/150 QD (G3 Asthenia/lethargy). Other common related toxicities (% all grades:% g3/4) were: skin-related (rash, HFS etc) (85:23), Asthenia/lethargy/fatigue (69:15), diarrhea (77:8), anorexia (92:0), and transaminitis (31:15). Reduction and/or interruptions of one or both study drugs during or beyond the initial 28 days were required in 8/14 pts. Six of 11 pts evaluable for response achieved SD ≥12 weeks. Median plasma Cmax (and AUCTau) of OSI -930 for Cohort 3 (300 BID/150 QD) were: 0.826 (6.08), 0.947 (5.57), and 1.66 (14.3) μg/mL (μg.hr/mL) on Days 7, 8 and 22, respectively. Exposure of OSI-930 increased approximately 2-fold upon co-administration with E at steady-state. OSI-930 appeared not to alter the PK properties of E or the ratio of OSI-420 to E. Decreases in plasma sVEGFR2 were observed, indicating a PD effect of OSI-930. Conclusions: Additional patients are being added to confirm the MTD of the combination. PK data indicate a drug-drug interaction with doubling of the OSI-930 exposure on co-administration with E. [Table: see text]
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Affiliation(s)
- I. Macpherson
- Beatson West of Scotland Cancer Centre, Glasgow, United Kingdom; OSI Pharmaceuticals, Oxford, United Kingdom; OSI Pharmaceuticals, Boulder, CO
| | - K. Stewart
- Beatson West of Scotland Cancer Centre, Glasgow, United Kingdom; OSI Pharmaceuticals, Oxford, United Kingdom; OSI Pharmaceuticals, Boulder, CO
| | - J. Chick
- Beatson West of Scotland Cancer Centre, Glasgow, United Kingdom; OSI Pharmaceuticals, Oxford, United Kingdom; OSI Pharmaceuticals, Boulder, CO
| | - K. Brock
- Beatson West of Scotland Cancer Centre, Glasgow, United Kingdom; OSI Pharmaceuticals, Oxford, United Kingdom; OSI Pharmaceuticals, Boulder, CO
| | - S. Poondru
- Beatson West of Scotland Cancer Centre, Glasgow, United Kingdom; OSI Pharmaceuticals, Oxford, United Kingdom; OSI Pharmaceuticals, Boulder, CO
| | - R. Gedrich
- Beatson West of Scotland Cancer Centre, Glasgow, United Kingdom; OSI Pharmaceuticals, Oxford, United Kingdom; OSI Pharmaceuticals, Boulder, CO
| | - A. W. Stephens
- Beatson West of Scotland Cancer Centre, Glasgow, United Kingdom; OSI Pharmaceuticals, Oxford, United Kingdom; OSI Pharmaceuticals, Boulder, CO
| | - T. R. Evans
- Beatson West of Scotland Cancer Centre, Glasgow, United Kingdom; OSI Pharmaceuticals, Oxford, United Kingdom; OSI Pharmaceuticals, Boulder, CO
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George S, Lal R, Camidge DR, Arkenau H, Chick J, Poondru S, Yap TA, Eckhardt SG, Demetri GD, Scurr M. Final results of a dose escalation (DE), pharmacokinetic (PK), and pharmacodynamic (PD) study of two schedules of OSI-930 in patients (pts) with advanced solid tumors. J Clin Oncol 2009. [DOI: 10.1200/jco.2009.27.15_suppl.3564] [Citation(s) in RCA: 2] [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
3564 Background: OSI-930 is an oral TKI with potent activity against Kit, VEGFR2, and PDGFR. Preclinical studies demonstrate tumor regression with long-term remissions across multiple xenograft models. Methods: Sequential cohorts of pts with advanced solid tumors received continuous daily OSI-930 to determine the maximum tolerated dose (MTD) and to evaluate safety, PK/PD and efficacy of OSI-930 with both QD and BID dosing. An expansion cohort was enrolled for detailed PD analysis including sVEGFR2 plasma levels, PET imaging in GIST pts or DCE-MRI in selected pts. Results: A total of 58 pts were treated (20M/38F; median 60 years (range 19–83)). OSI-930 was dosed up to 1600 mg QD without reaching MTD. 46 pts received BID dosing [mg(# pts treated)]; 400(7), 500 (31) and 600(8). DLT's were seen in 3/8 pts at 600 mg BID; G3 rash (2 pts) and G4 GGT; and 3/31 at 500 mg BID; G3 myalgia, G3 fatigue and G3 lipase. G3 hypertension was noted in 3/46 pts but not dose-limiting. Common G1/2 toxicities were fatigue (37%), diarrhea (27%), nausea (31%), and rash (24%). Objective (CA125) responses were seen in platinum-resistant ovarian cancer (2 PR/8) while in heavily pretreated GIST (median 4 prior therapies including imatinib/sunitinib), 8/18 pts achieved SD ≥12 w. Median therapy duration in the BID arm was 9 w and 18/46 pts with SD ≥12 w. PK indicated that Css were achieved after ∼7d with BID dosing. PET scans showed reduction in glycolytic activity in 4/9 pts and DCE-MRI response was seen in 4/6 pts. A trend in decreased sVEGFR levels was seen at higher doses. Conclusions: At the MTD level of 500 mg BID OSI-930 is an active, well-tolerated compound with clinically relevant antitumor activity and exposure levels consistent with antitumor activity in preclinical models. PD data indicate mechanistic proof of concept for OSI-930. OSI-930/erlotinib combination phase I study is currently enrolling. [Table: see text]
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Affiliation(s)
- S. George
- Dana-Farber Cancer Institute, Boston, MA; Royal Marsden Hospital, Sutton, United Kingdom; University of Colorado Cancer Center, Denver, CO; OSI Pharmaceuticals (UK) Ltd, Oxford, United Kingdom; OSI Pharmaceuticals (UK) Ltd, Boulder, CO
| | - R. Lal
- Dana-Farber Cancer Institute, Boston, MA; Royal Marsden Hospital, Sutton, United Kingdom; University of Colorado Cancer Center, Denver, CO; OSI Pharmaceuticals (UK) Ltd, Oxford, United Kingdom; OSI Pharmaceuticals (UK) Ltd, Boulder, CO
| | - D. R. Camidge
- Dana-Farber Cancer Institute, Boston, MA; Royal Marsden Hospital, Sutton, United Kingdom; University of Colorado Cancer Center, Denver, CO; OSI Pharmaceuticals (UK) Ltd, Oxford, United Kingdom; OSI Pharmaceuticals (UK) Ltd, Boulder, CO
| | - H. Arkenau
- Dana-Farber Cancer Institute, Boston, MA; Royal Marsden Hospital, Sutton, United Kingdom; University of Colorado Cancer Center, Denver, CO; OSI Pharmaceuticals (UK) Ltd, Oxford, United Kingdom; OSI Pharmaceuticals (UK) Ltd, Boulder, CO
| | - J. Chick
- Dana-Farber Cancer Institute, Boston, MA; Royal Marsden Hospital, Sutton, United Kingdom; University of Colorado Cancer Center, Denver, CO; OSI Pharmaceuticals (UK) Ltd, Oxford, United Kingdom; OSI Pharmaceuticals (UK) Ltd, Boulder, CO
| | - S. Poondru
- Dana-Farber Cancer Institute, Boston, MA; Royal Marsden Hospital, Sutton, United Kingdom; University of Colorado Cancer Center, Denver, CO; OSI Pharmaceuticals (UK) Ltd, Oxford, United Kingdom; OSI Pharmaceuticals (UK) Ltd, Boulder, CO
| | - T. A. Yap
- Dana-Farber Cancer Institute, Boston, MA; Royal Marsden Hospital, Sutton, United Kingdom; University of Colorado Cancer Center, Denver, CO; OSI Pharmaceuticals (UK) Ltd, Oxford, United Kingdom; OSI Pharmaceuticals (UK) Ltd, Boulder, CO
| | - S. G. Eckhardt
- Dana-Farber Cancer Institute, Boston, MA; Royal Marsden Hospital, Sutton, United Kingdom; University of Colorado Cancer Center, Denver, CO; OSI Pharmaceuticals (UK) Ltd, Oxford, United Kingdom; OSI Pharmaceuticals (UK) Ltd, Boulder, CO
| | - G. D. Demetri
- Dana-Farber Cancer Institute, Boston, MA; Royal Marsden Hospital, Sutton, United Kingdom; University of Colorado Cancer Center, Denver, CO; OSI Pharmaceuticals (UK) Ltd, Oxford, United Kingdom; OSI Pharmaceuticals (UK) Ltd, Boulder, CO
| | - M. Scurr
- Dana-Farber Cancer Institute, Boston, MA; Royal Marsden Hospital, Sutton, United Kingdom; University of Colorado Cancer Center, Denver, CO; OSI Pharmaceuticals (UK) Ltd, Oxford, United Kingdom; OSI Pharmaceuticals (UK) Ltd, Boulder, CO
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Hough B, Posner M, Chung C, Hainsworth J, Horan J, Chick J, Gibson MK. A phase II study of single agent OSI-7904L in patients with metastatic or recurrent squamous cell carcinoma of the head and neck (SCCHN). J Clin Oncol 2009. [DOI: 10.1200/jco.2009.27.15_suppl.e17005] [Citation(s) in RCA: 4] [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: 11/20/2022] Open
Abstract
e17005 Background: Given the limited efficacy and relative toxicity of chemotherapy for metastatic or recurrent squamous cell carcinoma of the head and neck, further research is needed to both increase the efficacy and decrease the toxicity of treatment. OSI-7904L is a novel liposomal formulation of a non-competitive thymidylate synthase inhibitor. In a phase I study, 12 mg/m2 dosing given every 21 days was both feasible and well tolerated. Methods: This multi-center, two-stage, phase II trial was designed to assess the efficacy and toxicity of OSI-7904L in patients with advanced, refractory SCCHN. A total of 41 patients were to be enrolled by completion of stage II. Enrollment was limited to patients with histologically proven squamous histology, locally recurrent and/or metastatic disease, with no more than one prior chemotherapy regimen. Patients were required to have a performance status of ≤ 2, predicted life expectancy of at least three months and adequate hematopoietic, hepatic and renal function. Efficacy was assessed according to RECIST guidelines, and toxicity was evaluated per CTC AE 3.0. Results: Ten patients enrolled in stage 1. Median age was 60 (range 42–66). Nine were evaluable for response assessment with one withdrawn after one cycle due to a grade 4 papular rash. There were no objective responses while 4 of the 10 patients had stable disease during their first restaging. Median time to progression was 2.5 months for the 9 evaluable patients. Besides the one grade 4 dermatologic reaction, other toxicities were grade 3 fatigue and dehydration, and grade 2 anorexia. Assuming an expected 20% response rate required to initiate enrollment in stage II, the probability of the tenth patient being a responder was less than 3%, thus the study was closed due to lack of response in this population. Conclusions: OSI-7904L was well tolerated similar to the phase I data, but did not demonstrate efficacy in metastatic or recurrent HNSCC patients. Further study of this drug as a single-agent with the current dosing regimen is not recommended. [Table: see text]
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Affiliation(s)
- B. Hough
- University of Pittsburgh Medical Center, Pittsburgh, PA; Dana-Faber Cancer Institute, Boston, MA; Vanderbilt, Nashville, TN; Sarah Cannon Research Institute, Nashville, TN; OSI Pharmaceuticals, Oxford, United Kingdom
| | - M. Posner
- University of Pittsburgh Medical Center, Pittsburgh, PA; Dana-Faber Cancer Institute, Boston, MA; Vanderbilt, Nashville, TN; Sarah Cannon Research Institute, Nashville, TN; OSI Pharmaceuticals, Oxford, United Kingdom
| | - C. Chung
- University of Pittsburgh Medical Center, Pittsburgh, PA; Dana-Faber Cancer Institute, Boston, MA; Vanderbilt, Nashville, TN; Sarah Cannon Research Institute, Nashville, TN; OSI Pharmaceuticals, Oxford, United Kingdom
| | - J. Hainsworth
- University of Pittsburgh Medical Center, Pittsburgh, PA; Dana-Faber Cancer Institute, Boston, MA; Vanderbilt, Nashville, TN; Sarah Cannon Research Institute, Nashville, TN; OSI Pharmaceuticals, Oxford, United Kingdom
| | - J. Horan
- University of Pittsburgh Medical Center, Pittsburgh, PA; Dana-Faber Cancer Institute, Boston, MA; Vanderbilt, Nashville, TN; Sarah Cannon Research Institute, Nashville, TN; OSI Pharmaceuticals, Oxford, United Kingdom
| | - J. Chick
- University of Pittsburgh Medical Center, Pittsburgh, PA; Dana-Faber Cancer Institute, Boston, MA; Vanderbilt, Nashville, TN; Sarah Cannon Research Institute, Nashville, TN; OSI Pharmaceuticals, Oxford, United Kingdom
| | - M. K. Gibson
- University of Pittsburgh Medical Center, Pittsburgh, PA; Dana-Faber Cancer Institute, Boston, MA; Vanderbilt, Nashville, TN; Sarah Cannon Research Institute, Nashville, TN; OSI Pharmaceuticals, Oxford, United Kingdom
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