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Elst L, Vreeburg MTA, de Vries HM, Vandermaesen K, Murphy T, Churchill J, Fallara G, Sanchez D, Falcone M, Garcia-Perdomo HA, Pettaway C, Hakenberg O, Johnstone P, Spiess PE, Muneer A, Sangar V, Parnham A, Ayres B, Watkin N, Brouwer OR, Albersen M. Corporal Skip Metastases in Penile Squamous Cell Carcinoma: An Unknown and Distinct Pattern of Spread with Poor Prognosis. Eur Urol Oncol 2024; 7:478-484. [PMID: 37813746 DOI: 10.1016/j.euo.2023.09.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Revised: 09/11/2023] [Accepted: 09/20/2023] [Indexed: 10/11/2023]
Abstract
BACKGROUND Penile squamous cell carcinoma (PSCC) is characterised by stepwise lymphatic dissemination. Skip metastases (SkMs) are rare metastases in the corpus cavernosum or spongiosum without continuity to the primary tumour or its resection site. OBJECTIVE To assess the distinct pattern of spread in SkM+ patients and the effect of SkM on prognosis. DESIGN, SETTING, AND PARTICIPANTS We conducted a retrospective analysis of patients with SkM+ PSCC at ten high-volume international referral centres between January 2006 and May 2022. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS We evaluated histopathological data, primary lymph node (LN) staging, and metastatic spread. We included a cohort of patients matched for pT stage, LN status, and grade who did not have SkM (SkM-) to compare the SkM prognosis and predictive value for cancer-specific mortality (CSM). RESULTS AND LIMITATIONS Among the 63 SkM+ patients who met our inclusion criteria, the SkM diagnosis was synchronous in 54.0% and metastases were mostly located in the corpus cavernosum. SkM was symptomatic in 14% of cases, was detected on imaging in 32%, and was found incidentally on pathological examination in 27%. Fifty-one patients (81%) presented with positive LNs and 28 (44%) developed distant metastases. Seven patients (11%) presented with or developed distant metastasis without displaying any LN involvement. The 2-yr cancer-specific survival estimates were 36% (95% confidence interval [CI] 25-52%) for SkM+ and 66% (95% CI 55-80%) for matched SkM- patients (p < 0.001). On multivariable Cox regression analysis, SkM presence was an independent predictor for higher CSM (hazard ratio 2.05, 95% CI 1.06-4,12; p = 0.03). CONCLUSIONS PSCC-related SkM is associated with aggressive disease behaviour and poor survival outcomes. Palpation of the entire penile shaft is essential, and distant staging is recommended in patients suspected of having SkM owing to the tendency for distant metastatic spread. PATIENT SUMMARY We investigated outcomes for patients with cancer of the penis who had metastases in the tissues responsible for erection. We found that metastases in this location were associated with poor prognosis, even in the absence of more typical spread of cancer via the lymph nodes.
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Affiliation(s)
- Laura Elst
- Department of Urology, University Hospitals Leuven, Leuven, Belgium; Young Academic Urologists Working Group on Penile and Testis Cancer, Arnhem, The Netherlands
| | - Manon T A Vreeburg
- Department of Urology, Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands
| | - Hielke Martijn de Vries
- Young Academic Urologists Working Group on Penile and Testis Cancer, Arnhem, The Netherlands; Department of Urology, Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands
| | | | - Titus Murphy
- Penile Cancer Centre, St. George's University Hospitals NHS Trust, London, UK
| | - James Churchill
- Department of Urology, The Christie NHS Foundation Trust, Manchester, UK
| | - Giuseppe Fallara
- Young Academic Urologists Working Group on Penile and Testis Cancer, Arnhem, The Netherlands; Male Genital Cancer Centre, Department of Urology, NIHR Biomedical Research Centre University College London Hospitals, London, UK; Department of Urology, IRCCS European Institute of Oncology, Milan, Italy
| | - Darren Sanchez
- Department of Urology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Marco Falcone
- Department of Urology, Molinette Hospital, University of Torino, AOU Città della Salute e della Scienza di Torino, Turin, Italy
| | - Herney Andres Garcia-Perdomo
- Division of Urology/Urooncology, Department of Surgery, School of Medicine, Universidad del Valle, Cali, Colombia
| | - Curtis Pettaway
- Department of Urology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Oliver Hakenberg
- Department of Urology, University Medical Center Rostock, Rostock, Germany
| | - Peter Johnstone
- Departments of Radiation Oncology and Urology, Moffitt Cancer Center, Tampa, FL, USA
| | - Philippe E Spiess
- Departments of Radiation Oncology and Urology, Moffitt Cancer Center, Tampa, FL, USA
| | - Asif Muneer
- Male Genital Cancer Centre, Department of Urology, NIHR Biomedical Research Centre University College London Hospitals, London, UK
| | - Vijay Sangar
- Department of Urology, The Christie NHS Foundation Trust, Manchester, UK
| | - Arie Parnham
- Department of Urology, The Christie NHS Foundation Trust, Manchester, UK
| | - Benjamin Ayres
- Penile Cancer Centre, St. George's University Hospitals NHS Trust, London, UK
| | - Nick Watkin
- Penile Cancer Centre, St. George's University Hospitals NHS Trust, London, UK
| | - Oscar R Brouwer
- Department of Urology, Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands
| | - Maarten Albersen
- Department of Urology, University Hospitals Leuven, Leuven, Belgium.
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Sachdeva A, McGuinness L, Zapala Ł, Greco I, Garcia-Perdomo HA, Kailavasan M, Antunes-Lopes T, Ayres B, Barreto L, Campi R, Crook J, Johnstone P, Kumar V, Manzie K, Marcus JD, Necchi A, Oliveira P, Osborne J, Pagliaro LC, Protzel C, Bryan Rumble R, Sánchez Martínez DF, Spiess PE, Tagawa ST, van der Heijden MS, Parnham AS, Pettaway CA, Albersen M, Sangar VK, Brouwer OR, Sakalis VI. Management of Lymph Node-positive Penile Cancer: A Systematic Review. Eur Urol 2024; 85:257-273. [PMID: 37208237 DOI: 10.1016/j.eururo.2023.04.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2022] [Revised: 03/27/2023] [Accepted: 04/19/2023] [Indexed: 05/21/2023]
Abstract
CONTEXT Lymph node (LN) involvement in penile cancer is associated with poor survival. Early diagnosis and management significantly impact survival, with multimodal treatment approaches often considered in advanced disease. OBJECTIVE To assess the clinical effectiveness of treatment options available for the management of inguinal and pelvic lymphadenopathy in men with penile cancer. EVIDENCE ACQUISITION EMBASE, MEDLINE, the Cochrane Database of Systematic Reviews, and other databases were searched from 1990 to July 2022. Randomised controlled trials (RCTs), nonrandomised comparative studies (NRCSs), and case series (CSs) were included. EVIDENCE SYNTHESIS We identified 107 studies, involving 9582 patients from two RCTs, 28 NRCSs, and 77 CSs. The quality of evidence is considered poor. Surgery is the mainstay of LN disease management, with early inguinal LN dissection (ILND) associated with better outcomes. Videoendoscopic ILND may offer comparable survival outcomes to open ILND with lower wound-related morbidity. Ipsilateral pelvic LN dissection (PLND) in N2-3 cases improves overall survival in comparison to no pelvic surgery. Neoadjuvant chemotherapy in N2-3 disease showed a pathological complete response rate of 13% and an objective response rate of 51%. Adjuvant radiotherapy may benefit pN2-3 but not pN1 disease. Adjuvant chemoradiotherapy may provide a small survival benefit in N3 disease. Adjuvant radiotherapy and chemotherapy improve outcomes after PLND for pelvic LN metastases. CONCLUSIONS Early LND improves survival in nodal disease in penile cancer. Multimodal treatments may provide additional benefit in pN2-3 cases; however, data are limited. Therefore, individualised management of patients with nodal disease should be discussed in a multidisciplinary team setting. PATIENT SUMMARY Spread of penile cancer to the lymph nodes is best managed with surgery, which improves survival and has curative potential. Supplementary treatment, including the use of chemotherapy and/or radiotherapy, may further improve survival in advanced disease. Patients with penile cancer with lymph node involvement should be treated by a multidisciplinary team.
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Affiliation(s)
- Ashwin Sachdeva
- Division of Cancer Sciences, University of Manchester, Manchester, UK; Department of Urology, The Christie NHS Foundation Trust, Manchester, UK.
| | - Luke McGuinness
- Department of Urology, South Tyneside and Sunderland NHS Foundation Trust, Sunderland, UK
| | - Łukasz Zapala
- Department of Urology, Medical University of Warsaw, Warsaw, Poland
| | - Isabella Greco
- Department of Urological Minimally Invasive and Robotic Surgery and Kidney Transplantation, Careggi Hospital, University of Florence, Florence, Italy
| | - Herney Andres Garcia-Perdomo
- Division of Urology/Uro-oncology, Department of Surgery, School of Medicine, Universidad Del Valle, Cali, Colombia
| | | | | | - Benjamin Ayres
- Department of Urology, St. George's University Hospitals NHS Foundation Trust, London, UK
| | - Lenka Barreto
- Department of Urology, University Hospital Nitra, Nitra, Slovakia
| | - Riccardo Campi
- Unit of Oncologic Minimally-Invasive Urology and Andrology, Careggi University Hospital, Florence, Italy
| | - Juanita Crook
- British Columbia Cancer Agency, University of British Columbia, Kelowna, Canada
| | - Peter Johnstone
- Departments of Radiation Oncology and Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL, USA
| | - Vivek Kumar
- Department of Urology, Norfolk and Norwich University Hospitals NHS Foundation Trust, Norwich, UK
| | | | | | - Andrea Necchi
- Department of Urology and Medical Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Pedro Oliveira
- Department of Pathology, The Christie NHS Foundation Trust, Manchester, UK; Centre for the Research and Technology of Agro-Environmental and Biological Sciences, University of Trásos-Montes and Alto Douro, Vila Real, Portugal; Veterinary Sciences Department, University of Trásos-Montes and Alto Douro, Vila Real, Portugal
| | | | | | | | - R Bryan Rumble
- American Society of Clinical Oncology, Alexandria, VA, USA
| | | | - Philippe E Spiess
- Department of Genitourinary Oncology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA
| | - Scott T Tagawa
- Division of Hematology and Medical Oncology, Weill Cornell Medical College, New York, NY, USA
| | | | - Arie S Parnham
- Department of Urology, The Christie NHS Foundation Trust, Manchester, UK
| | | | - Maarten Albersen
- Department of Urology, University Hospitals Leuven, Leuven, Belgium
| | - Vijay K Sangar
- Division of Cancer Sciences, University of Manchester, Manchester, UK; Department of Urology, The Christie NHS Foundation Trust, Manchester, UK
| | - Oscar R Brouwer
- The Netherlands Cancer Institute, Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands
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Ionescu F, Nguyen J, Segura CM, Paravathaneni M, Grass GD, Johnstone P, Zacharias NM, Pettaway CA, Lu X, Kim Y, Whiting J, Dhillon J, Eschrich SA, Chadha J, Gullapalli K, Roman Souza G, Miyagi H, Manley BJ, Spiess PE, Chahoud J. Multiplex Immunofluorescence Captures Progressive Immune Exhaustion with Advancing Penile Squamous Cell Cancer Stage. Cancers (Basel) 2024; 16:303. [PMID: 38275860 PMCID: PMC10814242 DOI: 10.3390/cancers16020303] [Citation(s) in RCA: 0] [Impact Index Per Article: 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: 12/04/2023] [Revised: 12/25/2023] [Accepted: 01/05/2024] [Indexed: 01/27/2024] Open
Abstract
Penile squamous cell carcinoma (PSCC) is a rare and deadly malignancy. Therapeutic advances have been stifled by a poor understanding of disease biology. Specifically, the immune microenvironment is an underexplored component in PSCC and the activity of immune checkpoint inhibitors observed in a subset of patients suggests immune escape may play an important role in tumorigenesis. Herein, we explored for the first time the immune microenvironment of 57 men with PSCC and how it varies with the presence of human papillomavirus (HPV) infection and across tumor stages using multiplex immunofluorescence of key immune cell markers. We observed an increase in the density of immune effector cells in node-negative tumors and a progressive rise in inhibitory immune players such as type 2 macrophages and upregulation of the PD-L1 checkpoint in men with N1 and N2-3 disease. There were no differences in immune cell densities with HPV status.
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Affiliation(s)
- Filip Ionescu
- Genitourinary Oncology Department, H. Lee Moffitt Cancer Center, Tampa, FL 33612, USA; (F.I.); (M.P.); (J.C.); (P.E.S.)
| | - Jonathan Nguyen
- Pathology Department, H. Lee Moffitt Cancer Center, Tampa, FL 33612, USA
| | | | - Mahati Paravathaneni
- Genitourinary Oncology Department, H. Lee Moffitt Cancer Center, Tampa, FL 33612, USA; (F.I.); (M.P.); (J.C.); (P.E.S.)
| | - G. Daniel Grass
- Radiation Oncology Department, H. Lee Moffitt Cancer Center, Tampa, FL 33612, USA
| | - Peter Johnstone
- Radiation Oncology Department, H. Lee Moffitt Cancer Center, Tampa, FL 33612, USA
| | - Niki M. Zacharias
- Department of Urology, University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Curtis A. Pettaway
- Department of Urology, University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Xin Lu
- Department of Biological Sciences, University of Notre Dame, Norte Dame, IN 46556, USA;
| | - Youngchul Kim
- Biostatistics and Bioinformatics Department, H. Lee Moffitt Cancer Center, Tampa, FL 33612, USA
| | - Junmin Whiting
- Biostatistics and Bioinformatics Department, H. Lee Moffitt Cancer Center, Tampa, FL 33612, USA
| | - Jasreman Dhillon
- Pathology Department, H. Lee Moffitt Cancer Center, Tampa, FL 33612, USA
| | - Steven A. Eschrich
- Biostatistics and Bioinformatics Department, H. Lee Moffitt Cancer Center, Tampa, FL 33612, USA
| | - Juskaran Chadha
- Genitourinary Oncology Department, H. Lee Moffitt Cancer Center, Tampa, FL 33612, USA; (F.I.); (M.P.); (J.C.); (P.E.S.)
| | - Keerthi Gullapalli
- Genitourinary Oncology Department, H. Lee Moffitt Cancer Center, Tampa, FL 33612, USA; (F.I.); (M.P.); (J.C.); (P.E.S.)
| | - Gabriel Roman Souza
- Genitourinary Oncology Department, H. Lee Moffitt Cancer Center, Tampa, FL 33612, USA; (F.I.); (M.P.); (J.C.); (P.E.S.)
| | - Hiroko Miyagi
- Genitourinary Oncology Department, H. Lee Moffitt Cancer Center, Tampa, FL 33612, USA; (F.I.); (M.P.); (J.C.); (P.E.S.)
| | - Brandon J. Manley
- Genitourinary Oncology Department, H. Lee Moffitt Cancer Center, Tampa, FL 33612, USA; (F.I.); (M.P.); (J.C.); (P.E.S.)
| | - Philippe E. Spiess
- Genitourinary Oncology Department, H. Lee Moffitt Cancer Center, Tampa, FL 33612, USA; (F.I.); (M.P.); (J.C.); (P.E.S.)
| | - Jad Chahoud
- Genitourinary Oncology Department, H. Lee Moffitt Cancer Center, Tampa, FL 33612, USA; (F.I.); (M.P.); (J.C.); (P.E.S.)
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4
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Wong HCY, Lee SF, Chan AW, Caini S, Hoskin P, Simone CB, Johnstone P, van der Linden Y, van der Velden JM, Martin E, Alcorn S, Johnstone C, Isabelle Choi J, Nader Marta G, Oldenburger E, Raman S, Rembielak A, Vassiliou V, Bonomo P, Nguyen QN, Chow E, Ryu S. Stereotactic body radiation therapy versus conventional external beam radiotherapy for spinal metastases: A systematic review and meta-analysis of randomized controlled trials. Radiother Oncol 2023; 189:109914. [PMID: 37739318 DOI: 10.1016/j.radonc.2023.109914] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Revised: 08/24/2023] [Accepted: 09/11/2023] [Indexed: 09/24/2023]
Abstract
INTRODUCTION This study aimed to compare SBRT and cEBRT for treating spinal metastases through a systematic review and meta-analysis of randomized controlled trials (RCTs). METHODS PubMed, EMBASE and Cochrane Library were searched up to 6 May 2023 for RCTs comparing SBRT and cEBRT for spinal metastases. Overall and complete pain response, local progression, overall survival, quality of life and adverse events were extracted. Data were pooled using random-effects models. Results were reported as risk ratios (RRs) for dichotomous outcomes, and hazard ratios (HRs) for time-to-event outcomes, along with their 95% confidence intervals (CIs). Heterogeneity was evaluated using the I2 statistic. RESULTS Three RCTs were identified involving 642 patients. No differences were seen in overall pain response comparing SBRT and cEBRT (RR at 3 months: 1.12, 95% CI, 0.74-1.70, p = 0.59; RR at 6 months: 1.29, 95% CI, 0.97-1.72, p = 0.08). Only two of three studies presented complete pain response data. SBRT demonstrated a statistically significant improvement in complete pain response compared to cEBRT (RR at 3 months: 2.52; 95% CI, 1.58-4.01; P < 0.0001; RR at 6 months: 2.48; 95% CI, 1.23-4.99; P = 0.01). There were no significant differences in local progression and overall survival. Adverse events were similar, except for any grade radiation dermatitis, which was significantly lower in SBRT arm (RR 0.17, 95% CI 0.03-0.96, P = 0.04). CONCLUSION SBRT is a safe treatment option for spine metastases. It may provide better complete pain response compared to cEBRT. Additional trials are needed to determine the potential benefits of SBRT in specific patient subsets.
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Affiliation(s)
- Henry C Y Wong
- Department of Oncology, Princess Margaret Hospital, Kowloon West Cluster, Hospital Authority, Hong Kong S.A.R., China.
| | - Shing Fung Lee
- Department of Radiation Oncology, National University Cancer Institute, National University Hospital, Singapore; Department of Clinical Oncology, Tuen Mun Hospital, New Territories West Cluster, Hospital Authority, Hong Kong S.A.R., China
| | - Adrian Wai Chan
- Department of Clinical Oncology, Tuen Mun Hospital, New Territories West Cluster, Hospital Authority, Hong Kong S.A.R., China
| | - Saverio Caini
- Cancer Risk Factors and Lifestyle Epidemiology Unit, Institute for Cancer Research, Prevention and Clinical Network (ISPRO), Florence, Italy
| | - Peter Hoskin
- Mount Vernon Cancer Centre, Northwood, United Kingdom; Division of Cancer Sciences, University of Manchester, United Kingdom
| | - Charles B Simone
- Department of Radiation Oncology, New York Proton Center, New York, NY, USA
| | - Peter Johnstone
- Department of Radiation Oncology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA
| | - Yvette van der Linden
- Department of Radiotherapy, Leiden University Medical Centre, Leiden, the Netherlands; Centre of Expertise in Palliative Care, Leiden University Medical Centre, Leiden, the Netherlands
| | - Joanne M van der Velden
- Department of Radiation Oncology, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Emily Martin
- Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles, LA, USA
| | - Sara Alcorn
- Department of Radiation Oncology, University of Minnesota Medical Center, Minneapolis, MN, USA
| | - Candice Johnstone
- Department of Radiation Oncology, Medical College of Wisconsin, Milwaukee, WI, USA
| | - J Isabelle Choi
- Department of Radiation Oncology, New York Proton Center, New York, NY, USA
| | - Gustavo Nader Marta
- Department of Radiation Oncology, Hospital Sírio-Libanês, São Paulo, Brazil; Latin America Cooperative Oncology Group (LACOG), Brazil
| | - Eva Oldenburger
- Department of Radiation Oncology, University Hospital Leuven, Leuven, Belgium
| | - Srinivas Raman
- Radiation Medicine Program, Princess Margaret Cancer Centre, University of Toronto, Toronto, Canada
| | - Agata Rembielak
- Division of Cancer Sciences, University of Manchester, United Kingdom; Department of Clinical Oncology, The Christie NHS Foundation Trust, Manchester, United Kingdom
| | - Vassilios Vassiliou
- Bank of Cyprus Oncology Centre, Department of Radiation Oncology, Nicosia, Cyprus
| | - Pierluigi Bonomo
- Department of Oncology, Azienda, Ospedaliero-Universitaria Careggi, Florence, Italy
| | - Quynh-Nhu Nguyen
- Department of Radiation Oncology, the University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Edward Chow
- Department of Radiation Oncology, Sunnybrook Health Sciences Centre, University of Toronto, Canada
| | - Samuel Ryu
- Department of Radiation Oncology, Stony Brook University Hospital, New York, NY, USA
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5
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Wong HCY, Chan AW, Johnstone P, Simone CB, Navarro-Domenech I, Hoskin P, Johnstone C, Recht A, Menten J, van der Linden YM, van der Velden JM, Nguyen QN, Lutz S, Andratschke N, Wilmann J, Kazmierska J, Spalek M, Lim F, Yu HM, Perez B, Marta GN, Vassiliou V, Lee SF, Bonomo P, Rembielak A, Chow E, Oldenburger E, Raman S. A critical appraisal of the four systematic reviews and meta-analysis on stereotactic body radiation therapy versus external beam radiotherapy for painful bone metastases and where we go from here. Ann Palliat Med 2023; 12:1318-1330. [PMID: 37303218 DOI: 10.21037/apm-23-218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Accepted: 05/17/2023] [Indexed: 06/13/2023]
Abstract
Radiotherapy is an important treatment modality for pain control in patients with bone metastases. Stereotactic body radiation therapy (SBRT), which allows delivering a much higher dose per fraction while sparing critical structures compared to conventional external beam radiotherapy (cEBRT), has become more widely used, especially in the oligometastatic setting. Randomized controlled trials (RCTs) comparing the pain response rate of SBRT and cEBRT for bone metastases have shown conflicting results, as have four recent systematic reviews with meta-analyses of these trials. Possible reasons for the different outcomes between these reviews include differences in methodology, which trials were included, and the endpoints examined and how they were defined. We suggest ways to improve analysis of these RCTs, particularly performing an individual patient-level meta-analysis since the trials included heterogeneous populations. The results of such studies will help guide future investigations needed to validate patient selection criteria, optimize SBRT dose schedules, include additional endpoints (such as the time to onset of pain response, durability of pain response, quality of life (QOL), and side effects of SBRT), and better assess the cost-effectiveness and trade-offs of SBRT compared to cEBRT. An international Delphi consensus to guide selection of optimal candidates for SBRT is warranted before more prospective data is available.
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Affiliation(s)
- Henry C Y Wong
- Department of Oncology, Princess Margaret Hospital, Hong Kong SAR, China
| | - Adrian Wai Chan
- Department of Clinical Oncology, Tuen Mun Hospital, Hong Kong SAR, China
| | - Peter Johnstone
- Department of Radiation Oncology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA
| | - Charles B Simone
- Department of Radiation Oncology, New York Proton Center, New York, NY, USA
| | | | - Peter Hoskin
- Mount Vernon Cancer Centre, Northwood, UK; Division of Cancer Sciences, The University of Manchester, UK
| | - Candice Johnstone
- Department of Radiation Oncology, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Abram Recht
- Department of Radiation Oncology, Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - Johan Menten
- Department of Radiation Oncology, University Hospital Leuven, Leuven, Belgium
| | - Yvette M van der Linden
- Department of Radiotherapy, Leiden University Medical Centre, Leiden, The Netherlands; Centre of Expertise in Palliative Care, Leiden University Medical Centre, Leiden, The Netherlands
| | - Joanne M van der Velden
- Department of Radiation Oncology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Quynh-Nhu Nguyen
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Stephen Lutz
- Eastern Woods Radiation Oncology, Blanchard Valley Health Organization, Findlay, OH, USA
| | - Nicolaus Andratschke
- Department of Radiation Oncology, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Jonas Wilmann
- Department of Radiation Oncology, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Joanna Kazmierska
- Radiotherapy Department II, Greater Poland Cancer Centre, Poznan, Poland; Department of Electroradiology, Poznań University of Medical Sciences, Poznan, Poland
| | - Mateusz Spalek
- Department of Soft Tissue/Bone Sarcoma and Melanoma, Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw, Poland; Department of Radiotherapy I, Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw, Poland
| | - Fiona Lim
- Department of Oncology, Princess Margaret Hospital, Hong Kong SAR, China
| | - H Michael Yu
- Department of Radiation Oncology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA
| | - Brad Perez
- Department of Radiation Oncology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA
| | - Gustavo Nader Marta
- Department of Radiation Oncology, Hospital Sírio-Libanês, São Paulo, Brazil; Latin America Cooperative Oncology Group (LACOG), Porto Alegre, Brazil
| | - Vassilios Vassiliou
- Department of Radiation Oncology, Bank of Cyprus Oncology Centre, Nicosia, Cyprus
| | - Shing Fung Lee
- Department of Clinical Oncology, Tuen Mun Hospital, Hong Kong SAR, China; Department of Radiation Oncology, National University Cancer Institute, National University Hospital, Singapore, Singapore
| | - Pierluigi Bonomo
- Department of Oncology, Azienda, Ospedaliero-Universitaria Careggi, Florence, Italy
| | - Agata Rembielak
- Department of Clinical Oncology, The Christie NHS Foundation Trust, Manchester, UK; Division of Cancer Sciences, School of Medical Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
| | - Edward Chow
- Department of Radiation Oncology, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Canada
| | - Eva Oldenburger
- Department of Radiation Oncology, University Hospital Leuven, Leuven, Belgium
| | - Srinivas Raman
- Radiation Medicine Program, Princess Margaret Cancer Centre, University of Toronto, Toronto, Canada
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6
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Navarro-Domenech I, Behroozian T, Hoskin P, Johnstone C, Recht A, Menten J, Oldenburger E, van der Linden YM, van der Velden JM, Nguyen QN, Simone CB, Johnstone P, Lutz S, Milton L, Andratschke N, Willmann J, Kazmierska J, Spałek M, Marta GN, Chow E, Raman S. Addressing concerns and uncertainties surrounding the application of palliative radiotherapy in cases with a 30-day expected mortality. Ann Palliat Med 2023; 12:1488-1490. [PMID: 37953216 DOI: 10.21037/apm-2023-03] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Accepted: 10/07/2023] [Indexed: 11/14/2023]
Affiliation(s)
| | - Tara Behroozian
- Department of Radiation Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Canada
| | - Peter Hoskin
- Mount Vernon Cancer Centre, Northwood, UK; Division of Cancer Sciences, University of Manchester, Manchester, UK
| | - Candice Johnstone
- Department of Radiation Oncology, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Abram Recht
- Department of Radiation Oncology, Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - Johan Menten
- Department of Radiation Oncology, University Hospital Leuven, Leuven, Belgium
| | - Eva Oldenburger
- Department of Radiation Oncology, University Hospital Leuven, Leuven, Belgium
| | - Yvette M van der Linden
- Department of Radiation Oncology, University Medical Center Utrecht, Utrecht, The Netherlands; Leiden University Medical Center, Leiden, The Netherlands
| | - Joanne M van der Velden
- Department of Radiation Oncology, University Medical Center Utrecht, Utrecht, The Netherlands; Leiden University Medical Center, Leiden, The Netherlands
| | - Quynh-Nhu Nguyen
- Department of Radiation Oncology, the University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Charles B Simone
- Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Peter Johnstone
- Department of Health Outcomes and Behavior, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA; Department of Radiation Oncology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA
| | - Stephen Lutz
- Eastern Woods Radiation Oncology, Blanchard Valley Health Organization, Findlay, OH, USA
| | - Lauren Milton
- Department of Radiation Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Canada
| | - Nicolaus Andratschke
- Department of Radiation Oncology, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Jonas Willmann
- Department of Radiation Oncology, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Joanna Kazmierska
- Radiotherapy Department II, Greater Poland Cancer Centre, Poznan, Poland; Department of Electroradiology, Poznań University of Medical Sciences, Poznań, Poland
| | - Mateusz Spałek
- Department of Soft Tissue/Bone Sarcoma and Melanoma, Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw, Poland; Department of Radiotherapy I, Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw, Poland
| | - Gustavo N Marta
- Department of Radiation Oncology, Hospital Sírio-Libanês, Sao Paulo, Brazil
| | - Edward Chow
- Department of Radiation Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Canada
| | - Srinivas Raman
- Department of Radiation Oncology, Princess Margaret Cancer Centre, University of Toronto, Toronto, Canada
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Navarro-Domenech I, Behroozian T, Hoskin P, Johnstone C, Recht A, Menten J, Oldenburger E, van der Linden YM, van der Velden JM, Nguyen QN, Simone CB, Johnstone P, Lutz S, Milton L, Andratschke N, Willmann J, Kazmierska J, Spałek M, Marta GN, Chow E, Raman S. Appropriateness of the 30-day expected mortality metric in palliative radiation treatment: a narrative review. Ann Palliat Med 2023:apm-23-56. [PMID: 37081704 DOI: 10.21037/apm-23-56] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/22/2023]
Abstract
BACKGROUND AND OBJECTIVE The 30-day expected mortality rate is frequently used as a metric to determine which patients benefit from palliative radiation treatment (RT). We conducted a narrative review to examine whether its use as a metric might be appropriate for patient selection. METHODS A literature review was conducted to identify relevant studies that highlight the benefits of palliative RT in timely symptom management among patients with a poor performance status, the accuracy of predicting survival near the end of life and ways to speed up the process of RT administration through rapid response clinics. KEY CONTENT AND FINDINGS Several trials have demonstrated substantial response rates for pain and/or bleeding by four weeks and sometimes within the first two weeks after RT. Models of patient survival have limited accuracy, particularly for predicting whether patients will die within the next 30 days. Dedicated Rapid Access Palliative RT (RAPRT) clinics, in which patients are assessed, simulated and treated on the same day, reduce the number of patient visits to the radiation oncology department and hence the burden on the patient as well as costs. CONCLUSIONS Single-fraction palliative RT should be offered to eligible patients if they are able to attend treatment and could potentially benefit from symptom palliation, irrespective of predicted life expectancy. We discourage the routine use of the 30-day mortality as the only metric to decide whether to offer RT. More common implementation of RAPRT clinics could result in a significant benefit for patients of all life expectancies, but particularly those having short ones.
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Affiliation(s)
| | - Tara Behroozian
- Department of Radiation Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Canada
| | - Peter Hoskin
- Mount Vernon Cancer Centre, Northwood, United Kingdom; Division of Cancer Sciences, University of Manchester, Manchester, UK
| | - Candice Johnstone
- Department of Radiation Oncology, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Abram Recht
- Department of Radiation Oncology, Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - Johan Menten
- Department of Radiation Oncology, University Hospital Leuven, Leuven, Belgium
| | - Eva Oldenburger
- Department of Radiation Oncology, University Hospital Leuven, Leuven, Belgium
| | - Yvette M van der Linden
- Department of Radiation Oncology, University Medical Center Utrecht, Utrecht, and Leiden University Medical Center, Leiden, The Netherlands
| | - Joanne M van der Velden
- Department of Radiation Oncology, University Medical Center Utrecht, Utrecht, and Leiden University Medical Center, Leiden, The Netherlands
| | - Quynh-Nhu Nguyen
- Department of Radiation Oncology, the University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Charles B Simone
- Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Peter Johnstone
- Department of Health Outcomes and Behavior and Department of Radiation Oncology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA
| | - Stephen Lutz
- Eastern Woods Radiation Oncology, Blanchard Valley Health Organization, Findlay, OH, USA
| | - Lauren Milton
- Department of Radiation Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Canada
| | - Nicolaus Andratschke
- Department of Radiation Oncology, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Jonas Willmann
- Department of Radiation Oncology, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Joanna Kazmierska
- Radiotherapy Department II, Greater Poland Cancer Centre, Poznan, Poland; Department of Electroradiology, Poznań University of Medical Sciences, Poznań, Poland
| | - Mateusz Spałek
- Department of Soft Tissue/Bone Sarcoma and Melanoma, Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw, Poland; Department of Radiotherapy I, Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw, Poland
| | - Gustavo N Marta
- Department of Radiation Oncology, Hospital Sírio-Libanês, Sao Paulo, Brazil
| | - Edward Chow
- Department of Radiation Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Canada
| | - Srinivas Raman
- Radiation Medicine Program, Princess Margaret Cancer Centre, University of Toronto, Toronto, Canada
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8
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Song EY, Chuang J, Frakes JM, Dilling T, Quinn JF, Rosenberg S, Johnstone P, Harrison L, Hoffe SE. Developing a Dedicated Leadership Curriculum for Radiation Oncology Residents. J Cancer Educ 2022; 37:1446-1453. [PMID: 33619686 DOI: 10.1007/s13187-021-01980-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 02/16/2021] [Indexed: 06/12/2023]
Abstract
The increasing complexity of healthcare emphasizes the need for continued physician leadership and leadership training. This study aims to determine baseline attitudes toward the perceptions and utility of a leadership development curriculum (LDC) for radiation oncology (RO) residents. A novel longitudinal LDC was implemented for RO residents at our institution from 2018 to 2019. Prior to the curriculum, current and past residents in our institution's RO residency program were surveyed on their attitudes towards leadership in healthcare, emotional intelligence competencies, and leadership training interests. After the completion of the LDC, a post-curriculum survey was forwarded to current residents. The response rate was 84% (21 of 24) for the baseline survey and 90% (9 of 10) for the post-curriculum survey. Having a leadership training curriculum during residency was rated as extremely useful, with top training interests involving leading clinical teams, effective communication strategies, and conflict management. After the LDC, the residents reported high satisfaction with the curriculum and utilization of leadership training into their daily work. Our LDC demonstrates significant potential to engage trainees and improve their leadership skills at the graduate medical education level.
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Affiliation(s)
- Ethan Y Song
- USF Health Morsani College of Medicine, Tampa, FL, USA.
| | | | - Jessica M Frakes
- Department of Radiation Oncology, H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL, USA
| | - Thomas Dilling
- Department of Radiation Oncology, H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL, USA
| | - Joann F Quinn
- Department of Radiation Oncology, H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL, USA
| | - Stephen Rosenberg
- Department of Radiation Oncology, H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL, USA
| | - Peter Johnstone
- Department of Radiation Oncology, H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL, USA
| | - Louis Harrison
- Department of Radiation Oncology, H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL, USA
| | - Sarah E Hoffe
- Department of Radiation Oncology, H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL, USA
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Behroozian T, Navarro I, Hoskin P, Johnstone C, Recht A, Menten J, Oldenburger E, van der Linden Y, van der Velden JM, Nguyen QN, Simone CB, Johnstone P, Lutz S, Milton L, Andratschke N, Willmann J, Kazmierska J, Spałek M, Chow E, Raman S. Update on the systematic review/meta-analysis of uncomplicated bone metastases treated with external beam radiation. Radiother Oncol 2022; 174:109-110. [PMID: 35850265 DOI: 10.1016/j.radonc.2022.07.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Revised: 07/08/2022] [Accepted: 07/09/2022] [Indexed: 11/26/2022]
Affiliation(s)
- Tara Behroozian
- Department of Radiation Oncology, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Canada
| | - Inmaculada Navarro
- Radiation Medicine Program, Princess Margaret Cancer Centre, University of Toronto, Toronto, Canada
| | - Peter Hoskin
- Mount Vernon Cancer Centre, Northwood, United Kingdom; Division of Cancer Sciences, University of Manchester, United Kingdom
| | - Candice Johnstone
- Department of Radiation Oncology, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Abram Recht
- Department of Radiation Oncology, Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - Johan Menten
- Department of Radiation Oncology, University Hospital Leuven, Herestraat 49, B3000 Leuven, Belgium
| | - Eva Oldenburger
- Department of Radiation Oncology, University Hospital Leuven, Herestraat 49, B3000 Leuven, Belgium
| | - Yvette van der Linden
- Department of Radiotherapy, Leiden University Medical Centre, Leiden, the Netherlands; Netherlands Comprehensive Cancer Organisation, Utrecht, the Netherlands
| | - Joanne M van der Velden
- Department of Radiation Oncology, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Quynh-Nhu Nguyen
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Charles B Simone
- Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Peter Johnstone
- Department of Health Outcomes and Behavior, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA; Department of Radiation Oncology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA
| | - Stephen Lutz
- Eastern Woods Radiation Oncology, Blanchard Valley Health Organization, Findlay, OH, USA
| | - Lauren Milton
- Department of Radiation Oncology, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Canada
| | - Nicolaus Andratschke
- Department of Radiation Oncology, University Hospital Zurich, University of Zurich, Rämistrasse 100, 8091 Zurich, Switzerland
| | - Jonas Willmann
- Department of Radiation Oncology, University Hospital Zurich, University of Zurich, Rämistrasse 100, 8091 Zurich, Switzerland
| | - Joanna Kazmierska
- Radiotherapy Department II, Greater Poland Cancer Centre, Poznan, Poland
| | - Mateusz Spałek
- Department of Soft Tissue/Bone Sarcoma and Melanoma, Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw, Poland
| | - Edward Chow
- Department of Radiation Oncology, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Canada
| | - Srinivas Raman
- Radiation Medicine Program, Princess Margaret Cancer Centre, University of Toronto, Toronto, Canada.
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Johnstone P, Charlton P, Ajzensztejn D, Higgins G, Stuart R, Panakis N. Survival Outcomes Following Concomitant Chemoradiation (CRT) for Stage III Non-small Cell Lung Cancer (NSCLC) at Oxford University. Clin Oncol (R Coll Radiol) 2022. [DOI: 10.1016/j.clon.2022.01.013] [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: 11/03/2022]
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11
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Hoffman KE, Johnstone P. A 25-year perspective on the evolution of radiation treatment of urologic cancers. Urol Oncol 2021; 39:577-581. [PMID: 34325987 DOI: 10.1016/j.urolonc.2021.06.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 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: 02/08/2021] [Revised: 06/04/2021] [Accepted: 06/05/2021] [Indexed: 11/17/2022]
Abstract
Advances in radiotherapy technology and technique over the last 3 decades have revolutionized radiation treatment options for genitourinary malignancies. The development of more focused and accurate radiation treatment has facilitated safe delivery of dose-escalated treatment that improves disease control and the development of shorter-duration hypofractionated treatment regimens that are more convenient for patients and improve access to treatment. The management of oligometastatic disease is evolving with ablative treatment of oligometastasis and the primary for select patients and shorter-duration palliative treatment regimens. Work is ongoing to personalize radiation treatment regimens for genitourinary malignancies based on molecular biomarkers.
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Affiliation(s)
- Karen E Hoffman
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX.
| | - Peter Johnstone
- Department of Radiation Oncology, Moffitt Cancer Center, Tampa, FL
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12
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Bulls HW, Chang PH, Brownstein NC, Zhou JM, Hoogland AI, Gonzalez BD, Johnstone P, Jim HSL. Patient-reported symptom burden in routine oncology care: Examining racial and ethnic disparities. Cancer Rep (Hoboken) 2021; 5:e1478. [PMID: 34165256 PMCID: PMC8955049 DOI: 10.1002/cnr2.1478] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Revised: 05/27/2021] [Accepted: 06/01/2021] [Indexed: 11/07/2022] Open
Abstract
Background Racial and ethnic disparities are well‐documented in cancer outcomes such as disease progression and survival, but less is known regarding potential disparities in symptom burden. Aims The goal of this retrospective study was to examine differences in symptom burden by race and ethnicity in a large sample of cancer patients. We hypothesized that racial and ethnic minority patients would report greater symptom burden than non‐Hispanic and White patients. Methods and results A total of 5798 cancer patients completed the Edmonton Symptom Assessment Scale—revised (ESAS‐r‐CSS) at least once as part of clinical care. Two indicators of symptom burden were evaluated: (1) total ESAS‐r‐CSS score (i.e., overall symptom burden) and (2) number of severe symptoms (i.e., severe symptomatology). For patients completing the ESAS‐r‐CSS on multiple occasions, the highest score for each indicator was used. Zero‐inflated negative binomial regression analyses were conducted, adjusting for other sociodemographic and clinical characteristics. Symptomology varied across race. Patients who self‐identified as Black reported higher symptom burden (p = .016) and were more likely to report severe symptoms (p < .001) than self‐identified White patients. Patients with “other” race were also more likely to report severe symptoms than White patients (p = .032), but reported similar total symptom burden (p = .315). Asian and Hispanic patients did not differ from White or non‐Hispanic patients on symptom burden (ps > .05). Conclusion This study describes racial disparities in patient‐reported symptom burden during routine oncology care, primarily observed in Black patients. Clinic‐based electronic symptom monitoring may be useful to detect high symptom burden, particularly in patients who self‐identify their race as Black or other. Future research is needed to reduce symptom burden in racially diverse cancer populations.
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Affiliation(s)
- Hailey W Bulls
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, Florida, USA.,Division of General Internal Medicine, Department of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Pi-Hua Chang
- Department of Nursing, Taichung Veterans General Hospital, Taichung, Taiwan, ROC.,School of Nursing, College of Medicine, National Taiwan University, Taipei, Taiwan, ROC
| | - Naomi C Brownstein
- Department of Biostatistics and Bioinformatics, Moffitt Cancer Center, Tampa, Florida, USA.,Department of Radiation Oncology, Moffitt Cancer Center, Tampa, Florida, USA
| | - Jun-Min Zhou
- Department of Biostatistics and Bioinformatics, Moffitt Cancer Center, Tampa, Florida, USA
| | - Aasha I Hoogland
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, Florida, USA
| | - Brian D Gonzalez
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, Florida, USA
| | - Peter Johnstone
- Department of Radiation Oncology, Moffitt Cancer Center, Tampa, Florida, USA
| | - Heather S L Jim
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, Florida, USA
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13
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Stenman M, Benmakhlouf H, Wersäll P, Johnstone P, Hatiboglu MA, Mayer-da-Silva J, Harmenberg U, Lindskog M, Sinclair G. Metastatic renal cell carcinoma to the brain: optimizing patient selection for gamma knife radiosurgery. Acta Neurochir (Wien) 2021; 163:333-342. [PMID: 32902689 DOI: 10.1007/s00701-020-04537-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Accepted: 08/11/2020] [Indexed: 01/23/2023]
Abstract
INTRODUCTION The effects of single-fraction gamma knife radiosurgery (sf-GKRS) on patients with renal cell carcinoma (RCC) brain metastases (BM) in the era of targeted agents (TA) and immune checkpoint inhibitors (ICI) are insufficiently studied. METHODS AND MATERIALS Clear cell metastatic RCC patients treated with sf-GKRS due to BM in 2005-2014 at three European centres were retrospectively analysed (n = 43). Median follow-up was 56 months. Ninety-five percent had prior nephrectomy, 53% synchronous metastasis and 86% extracranial disease at first sf-GKRS. Karnofsky performance status (KPS) ranged from 60 to 100%. Outcome measures were overall survival (OS), local control (LC) and adverse radiation effects (ARE). RESULTS One hundred and ninety-four targets were irradiated. The median number of targets at first sf-GKRS was two. The median prescription dose was 22.0 Gy. Thirty-seven percent had repeated sf-GKRS. Eighty-eight percent received TA. LC rates at 12 and 18 months were 97% and 90%. Median OS from the first sf-GKRS was 15.7 months. Low serum albumin (HR for death 5.3), corticosteroid use pre-sf-GKRS (HR for death 5.8) and KPS < 80 (HR for death 9.1) were independently associated with worse OS. No further prognostic information was gleaned from MSKCC risk group, synchronous metastasis, age, number of BM or extracranial metastases. Other prognostic scores for BM radiosurgery, including DS-GPA, renal-GPA, LLV-SIR and CITV-SIR, again, did not add further prognostic value. ARE were seldom symptomatic and were associated with tumour volume, 10-Gy volume and pre-treatment perifocal oedema. ARE were less common among patients treated with TA within 1 month of sf-GKRS. CONCLUSIONS We identified albumin, corticosteroid use and KPS as independent prognostic factors for sf-GKRS of clear cell RCC BM. Studies focusing on the prognostic significance of albumin in sf-GKRS are rare. Further studies with a larger number of patients are warranted to confirm the above analytical outcome. Also, in keeping with previous studies, our data showed optimal rates of local tumour control and limited toxicity post radiosurgery, rendering GKRS the tool of choice in the management of RCC BM.
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Affiliation(s)
- M Stenman
- Department of Immunology, Genetics, and Pathology, Experimental and Clinical Oncology, Uppsala University, Uppsala, Sweden
| | - H Benmakhlouf
- Department of Medical Radiation Physics and Nuclear Medicine, Karolinska University Hospital, Stockholm, Sweden
| | - P Wersäll
- Department of Oncology-Pathology, Karolinska Institute and Karolinska University Hospital, Stockholm, Sweden
| | - P Johnstone
- Department of Oncology, Oxford University Hospitals NHS Trust, Oxford, UK
| | - M A Hatiboglu
- Department of Neurosurgery, Bezmialem Vakif University Medical School, Istanbul, Turkey
| | - J Mayer-da-Silva
- Centro Gamma Knife, CUF Infante Santo Hospital, Lisbon, Portugal
| | - U Harmenberg
- Department of Oncology-Pathology, Karolinska Institute and Karolinska University Hospital, Stockholm, Sweden
| | - M Lindskog
- Department of Immunology, Genetics, and Pathology, Experimental and Clinical Oncology, Uppsala University, Uppsala, Sweden
| | - G Sinclair
- Department of Neurosurgery, Bezmialem Vakif University Medical School, Istanbul, Turkey.
- Department of Neurosurgery, Karolinska University Hospital, Stockholm, Sweden.
- Department of Oncology, North Middlesex University Hospital NHS Trust, London, UK.
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Johnstone P, Wasserman S, Wuthrick E. Moving to a Hypofractionated New World Order. Int J Radiat Oncol Biol Phys 2020. [DOI: 10.1016/j.ijrobp.2020.02.490] [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: 11/29/2022]
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15
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McDonald J, Sim A, Frakes J, Michael Yu HH, Nanda R, Portman D, Hoffe S, Jim H, Johnstone P. The Role of Patient Reported Outcomes (PRO) in Esophageal Cancer (ESOCA) Patients Receiving Radiotherapy (RT). Int J Radiat Oncol Biol Phys 2020. [DOI: 10.1016/j.ijrobp.2020.02.624] [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: 12/01/2022]
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16
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Sim A, Zhang J, Jain R, Chatwal M, Sexton W, Spiess P, Gilbert S, Poch M, Pow-Sang J, Li R, Manley B, Torres-Roca J, Johnstone P, Yamoah K, Grass G. Outcomes and Evolving Treatment Paradigms for Small Cell Carcinoma of the Bladder. Int J Radiat Oncol Biol Phys 2020. [DOI: 10.1016/j.ijrobp.2020.02.547] [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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17
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Jim H, Bulls H, Brownstein N, Zhou JM, Chang PH, Hoogland A, Gonzalez B, Johnstone P. Patient-Reported Symptom Burden in Routine Oncology Care: Examining Racial and Ethnic Disparities. Int J Radiat Oncol Biol Phys 2020. [DOI: 10.1016/j.ijrobp.2020.02.629] [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: 11/30/2022]
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18
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Necchi A, Bandini M, Ross J, Zhu Y, Ding-Wei Y, Ornellas A, Watkin N, Ayres B, Hakenberg O, Heidenreich A, Raggi D, Giannatempo P, Marandino L, Chipollini J, Azizi M, Brouwer O, Grass D, Johnstone P, Albersen M, Spiess P. 706MO Association between human papillomavirus (HPV) infection and outcome of perioperative nodal radiotherapy for penile carcinoma. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.08.778] [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] Open
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19
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Johnstone P, Regan M. Gambling harm is everybody's business: A public health approach and call to action. Public Health 2020; 184:63-66. [PMID: 32684349 PMCID: PMC7366099 DOI: 10.1016/j.puhe.2020.06.010] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2019] [Revised: 05/12/2020] [Accepted: 06/08/2020] [Indexed: 01/31/2023]
Abstract
There is a growing consensus that gambling is a public health issue and that preventing gambling related harms requires a broad response. Although many policy decisions regarding gambling are made at a national level in the UK, there are clear opportunities to take action at local and regional levels to prevent the negative impacts on individuals, families and local communities. This response goes beyond the statutory roles of licencing authorities to include amongst others the National Health Service (NHS), the third sector, mental health services, homelessness and housing services, financial inclusion support. As evidence continues to emerge to strengthen the link between gambling and a wide range of risk factors and negative consequences, there is also a strong correlation with health inequalities. Because the North of England experiences increasing health inequalities, it offers an opportunity as a specific case study to share learning on reducing gambling-related harms within a geographic area. This article describes an approach to gambling as a public health issue identifying it as needing a cross-cutting, systemwide multisectoral approach to be taken at local and regional levels. Challenges at national and local levels require policy makers to adopt a ‘health in all policy’ approach and use the best evidence in their future decisions to prevent harm. A whole systems approach which aims to reduce poverty and health inequalities needs to incorporate gambling harm within place-based planning and draws on the innovative opportunities that exist to engage local stakeholders, builds local leadership and takes a collaborative approach to tackling gambling-related harms. This whole systems approach includes the following: (1) understanding the prevalence of gambling related harms with insights into the consequences and how individuals, their family and friends and wider community are affected; (2) ensuring tackling gambling harms is a key public health commitment at all levels by including it in strategic plans, with meaningful outcome measures, and communicating this to partners; (3) understanding the assets and resources available in the public, private and voluntary sectors and identifying what actions are underway; (4) raising awareness and sharing data, developing a compelling narrative and involving people who have been harmed and are willing to share their experience; (5) ensuring all regulatory authorities help tackle gambling-related harms under a ‘whole council’ approach. This piece presents the case for why gambling is a particularly unique public health issue which requires a cross-cutting, systemwide multisectoral approach. It explores opportunities for action at national and local level, using examples of work underway. It concludes with a call to action using lesson learnt from managing harms from similar public health threats.
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South J, Connolly AM, Stansfield JA, Johnstone P, Henderson G, Fenton KA. Putting the public (back) into public health: leadership, evidence and action. J Public Health (Oxf) 2020; 41:10-17. [PMID: 29546426 DOI: 10.1093/pubmed/fdy041] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2017] [Revised: 01/09/2018] [Indexed: 11/14/2022] Open
Abstract
There is a strong evidence-based rationale for community capacity building and community empowerment as part of a strategic response to reduce health inequalities. Within the current UK policy context, there are calls for increased public engagement in prevention and local decision-making in order to give people greater control over the conditions that determine health. With reference to the challenges and opportunities within the English public health system, this essay seeks to open debate about what is required to mainstream community-centred approaches and ensure that the public is central to public health. The essay sets out the case for a reorientation of public health practice in order to build impactful action with communities at scale leading to a reduction in the health gap. National frameworks that support local practice are described. Four areas of challenge that could potentially drive an implementation gap are discussed: (i) achieving integration and scale, (ii) effective community mobilization, (iii) evidencing impact and (iv) achieving a shift in power. The essay concludes with a call to action for developing a contemporary public health practice that is rooted in communities and offers local leadership to strengthen local assets, increase community control and reduce health inequalities.
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Affiliation(s)
- J South
- Public Health England, London, UK
- Leeds Beckett University, Leeds, UK
| | | | - J A Stansfield
- Public Health England, London, UK
- Leeds Beckett University, Leeds, UK
| | - P Johnstone
- Public Health England, London, UK
- Leeds Beckett University, Leeds, UK
| | | | - K A Fenton
- Public Health England, London, UK
- Health and Wellbeing, Southwark Council, London, UK
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Sinclair G, Stenman M, Benmakhlouf H, Johnstone P, Wersäll P, Lindskog M, Hatiboglu MA, Harmenberg U. Adaptive radiosurgery based on two simultaneous dose prescriptions in the management of large renal cell carcinoma brain metastases in critical areas: Towards customization. Surg Neurol Int 2020; 11:21. [PMID: 32123609 PMCID: PMC7049890 DOI: 10.25259/sni_275_2019] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2019] [Accepted: 12/13/2019] [Indexed: 12/23/2022] Open
Abstract
Background: The long-term benefits of local therapy in metastatic renal cell carcinoma (mRCC) have been widely documented. In this context, single fraction gamma knife radiosurgery (SF-GKRS) is routinely used in the management of brain metastases. However, SF-GKRS is not always feasible due to volumetric and regional constraints. We intend to illustrate how a dose-volume adaptive hypofractionated GKRS technique based on two concurrent dose prescriptions termed rapid rescue radiosurgery (RRR) can be utilized in this particular scenario. Case Description: A 56-year-old man presented with left-sided hemiparesis; the imaging showed a 13.1 cc brain metastasis in the right central sulcus (Met 1). Further investigation confirmed the histology to be a metastatic clear cell RCC. Met 1 was treated with upfront RRR. Follow-up magnetic resonance imaging (MRI) at 10 months showed further volume regression of Met 1; however, concurrently, a new 17.3 cc lesion was reported in the boundaries of the left frontotemporal region (Met 2) as well as a small metastasis (<1 cc) in the left temporal lobe (Met 3). Met 2 and Met 3 underwent RRR and SF-GKRS, respectively. Results: Gradual and sustained tumor ablation of Met 1 and Met 2 was demonstrated on a 20 months long follow- up. The patient succumbed to extracranial disease 21 months after the treatment of Met 1 without evidence of neurological impairment post-RRR. Conclusion: Despite poor prognosis and precluding clinical factors (failing systemic treatment, eloquent location, and radioresistant histology), RRR provided optimal tumor ablation and salvage of neurofunction with limited toxicity throughout follow-up.
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Affiliation(s)
- Georges Sinclair
- Departments of Neurosurgery, Karolinska University Hospital, Karolinska Institutet, Stockholm, Sweden.,Department of Neurosurgery, Bezmialem Vakif University Medical School, Istanbul, Turkey.,Department of Oncology, Royal Berkshire NHS Foundation Trust, Reading, United Kingdom
| | - M Stenman
- Department of Immunology Genetics and Pathology, Uppsala University, Uppsala, Sweden
| | - H Benmakhlouf
- Departments of Medical Radiation Physics and Nuclear Medicine, Karolinska University Hospital, Karolinska Institutet, Stockholm, Sweden
| | - P Johnstone
- Department of Oncology, Royal Berkshire NHS Foundation Trust, Reading, United Kingdom
| | - P Wersäll
- Department of Oncology-Pathology, Karolinska University Hospital, Karolinska Institutet, Stockholm, Sweden
| | - M Lindskog
- Department of Immunology Genetics and Pathology, Uppsala University, Uppsala, Sweden
| | - M A Hatiboglu
- Department of Neurosurgery, Bezmialem Vakif University Medical School, Istanbul, Turkey
| | - U Harmenberg
- Department of Oncology-Pathology, Karolinska University Hospital, Karolinska Institutet, Stockholm, Sweden
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22
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McCoard SA, Cristobal-Carballo O, Knol FW, Heiser A, Khan MA, Hennes N, Johnstone P, Lewis S, Stevens DR. Impact of early weaning on small intestine, metabolic, immune and endocrine system development, growth and body composition in artificially reared lambs. J Anim Sci 2020; 98:5643602. [PMID: 31768520 DOI: 10.1093/jas/skz356] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [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: 08/22/2019] [Accepted: 11/25/2019] [Indexed: 12/21/2022] Open
Abstract
AbstractThis study evaluated the effect of early weaning (EW) of artificially reared lambs using a restricted milk replacer (MR) feeding and step-down weaning system on the short- and long-term effects on growth, feed intake, selected blood metabolites and hormones, body composition, and small intestine development. Mixed-sex twin-born 2 to 5 d old lambs were randomly allocated to individual pens and fed MR at 20% of initial individual BW in week 1 and 15% in week 2 followed by weaning off MR by the end of week 4 (EW; n = 16) or week 6 (Control; Ctrl, n = 16) using a step-down procedure. Concentrate starter and fiber diets were offered ad libitum to week 9, then gradually removed over a 10-d period. All lambs were managed as a single group on pasture from weeks 6 to 16 of the trial. Feed intake was recorded daily in the first 6 wk, and BWs recorded weekly. At weeks 2, 4, 6, and 8, and pre- and postclostridial vaccination at week 8, blood samples were collected for analysis of selected blood metabolites, IGF-1, and immune function. Body composition was evaluated in eight animals per group at weeks 4 and 16 after euthanasia, and duodenal samples collected for histomorphometric evaluation. Early weaned lambs had lower DM, ME, CP, and NDF intake than Ctrl lambs at 21, 15, 21, and 36 d of rearing, respectively (P < 0.001), driven by lower intakes of MR from day 15 (P < 0.001) as per the experimental design, and lower total DMI of fiber (P = 0.001) from 21 to 42 d of rearing. Lamb BW tended (P = 0.097) to be lower in EW than Ctrl lambs from 5 to 10 wk of rearing, with lower ADG in EW lambs from weeks 3 to 6 (P = 0.041). Early weaning had negligible effects on duodenal morphology, organ, and carcass weights at weeks 4 and 16. Plasma metabolites (urea nitrogen, triglycerides, NEFA, glucose, and total protein) were similar between groups, while β-hydroxybutyrate was greater in EW than Ctrl lambs at weeks 4 and 6 (P = 0.018) but not week 8 indicative of early rumen development. Serum IGF-1 tended to be lower in EW than Ctrl lambs from weeks 2 to 6 only (P = 0.065). All lambs developed antibody responses postvaccination and there was no effect of treatment (P = 0.528). The results of this study illustrate that artificially reared lambs can be weaned off MR by 4 or 6 wk of rearing without compromising growth, small intestine morphology, major organ development, and body composition, nor immune function at either 4 (preweaning) or 16 (postweaning) wk of age.
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Affiliation(s)
- Sue A McCoard
- AgResearch Grasslands, Palmerston North, New Zealand
| | - Omar Cristobal-Carballo
- AgResearch Grasslands, Palmerston North, New Zealand.,Massey University, Palmerston North, New Zealand
| | | | - Axel Heiser
- AgResearch Grasslands, Palmerston North, New Zealand
| | | | - Nina Hennes
- AgResearch Grasslands, Palmerston North, New Zealand
| | | | - Sarah Lewis
- AgResearch Grasslands, Palmerston North, New Zealand
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23
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Addison M, Kaner E, Johnstone P, Hillier-Brown F, Moffatt S, Russell S, Barr B, Holland P, Salway S, Whitehead M, Bambra C. Equal North: how can we reduce health inequalities in the North of England? A prioritization exercise with researchers, policymakers and practitioners. J Public Health (Oxf) 2019; 41:652-664. [PMID: 30346563 PMCID: PMC6995035 DOI: 10.1093/pubmed/fdy170] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2018] [Revised: 08/06/2018] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND The Equal North network was developed to take forward the implications of the Due North report of the Independent Inquiry into Health Equity. The aim of this exercise was to identify how to reduce health inequalities in the north of England. METHODS Workshops (15 groups) and a Delphi survey (3 rounds, 368 members) were used to consult expert opinion and achieve consensus. Round 1 answered open questions around priorities for action; Round 2 used a 5-point Likert scale to rate items; Round 3 responses were re-rated alongside a median response to each item. In total, 10 workshops were conducted after the Delphi survey to triangulate the data. RESULTS In Round 1, responses from 253 participants generated 39 items used in Round 2 (rated by 144 participants). Results from Round 3 (76 participants) indicate that poverty/implications of austerity (4.87 m, IQR 0) remained the priority issue, with long-term unemployment (4.8 m, IQR 0) and mental health (4.7 m, IQR 1) second and third priorities. Workshop 3 did not diverge from findings in Round 1. CONCLUSIONS Practice professionals and academics agreed that reducing health inequalities in the North of England requires prioritizing research that tackles structural determinants concerning poverty, the implications of austerity measures and unemployment.
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Affiliation(s)
- M Addison
- Institute of Health and Society, Newcastle University, Baddiley Clark Building, Richardson Road, Newcastle Upon Tyne NE2 4AX, UK
| | - E Kaner
- Institute of Health and Society, Newcastle University, Baddiley Clark Building, Richardson Road, Newcastle Upon Tyne NE2 4AX, UK
| | - P Johnstone
- Public Health England, North of England, Blenheim House, West One, Leeds LS1 4PL, UK
| | - F Hillier-Brown
- Department of Sport and Exercise, Durham University, 42 Old Elvet, Durham DH1 3HN, UK
| | - S Moffatt
- Institute of Health and Society, Newcastle University, Baddiley Clark Building, Richardson Road, Newcastle Upon Tyne NE2 4AX, UK
| | - S Russell
- Institute of Health and Society, Newcastle University, Baddiley Clark Building, Richardson Road, Newcastle Upon Tyne NE2 4AX, UK
| | - B Barr
- Institute of Psychology, Health and Society, Department of Public Health and Policy, University of Liverpool, Whelan Building, The Quadrangle, Liverpool L69 3GB, UK
| | - P Holland
- Lecturer in Public Health, Division of Health Research, Faculty of Health and Medicine, Lancaster University, Furness Building, Lancaster LA1 4YG, UK
| | - S Salway
- Department of Sociological Studies, The University of Sheffield, Elmfield, Northumberland Road, Sheffield S10 2TU, UK
| | - M Whitehead
- Institute of Psychology, Health and Society, Department of Public Health and Policy, University of Liverpool, Whelan Building, The Quadrangle, Liverpool L69 3GB, UK
| | - C Bambra
- Institute of Health and Society, Newcastle University, Baddiley Clark Building, Richardson Road, Newcastle Upon Tyne NE2 4AX, UK
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McCoard S, Heiser A, Lowe K, Molenaar A, MacLean P, Johnstone P, Leath S, Hoskin SO, Khan MA. Effect of weaning age on growth, mammary gland development, and immune function in Holstein Friesian calves fed conserved alfalfa (FiberStart). J Dairy Sci 2019; 102:6076-6087. [PMID: 31079903 DOI: 10.3168/jds.2018-15615] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [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: 08/29/2018] [Accepted: 03/18/2019] [Indexed: 12/15/2022]
Abstract
This study aimed to evaluate intake, body growth, and the development of the rumen, mammary gland, and immune system in Holstein Friesian calves reared for 100 d on the commercially available feed FiberStart (conserved alfalfa, Medicago sativa; Fiber Fresh Feeds Ltd., Reporoa, New Zealand) and fed calf milk replacer (CMR) for either 56 or 91 d. Eighty calves (40 bulls and 40 heifer calves) were reared indoors in groups (n = 5 of the same sex/pen). All calves were fed 4 L of CMR/d (175 g/L of CMR) in 2 feeds/d for the first 10 d and then 1 feed/d until d 49 or 84. The calves were gradually weaned by d 56 (earlier weaned; n = 8 pens) and d 91 (later weaned; n = 8 pens). All calves were fed FiberStart ad libitum as the only solid feed source from d 1 to 100 of the study. Irrespective of treatment, all calves had similar body weights at d 0 (40.9 ± 3.0 kg) and d 49 (74.2 ± 5.1 kg) of the study. Calf sex had no effect on intake, growth, blood, and immune system parameters. Earlier-weaned calves consumed 18% more solid feed dry matter but had 16% lower body weight gain (28.9 vs. 38.5 kg, respectively) from d 56 to 100 relative to later-weaned calves, resulting in different body weight at 100 d (104 vs. 121 ± 1.3 kg). Although earlier-weaned calves could compensate for the loss of CMR dry matter and crude protein intake from d 56 to 100 by increasing forage intake, they were unable to compensate for the loss of energy from the CMR by increasing solid feed consumption. Plasma β-hydroxybutyrate concentrations were 52% greater in earlier-weaned calves than in later-weaned calves at d 84, indicating greater metabolic activity of the rumen wall. The duration of CMR feeding had no influence on humoral or cell-mediated immune functions of the calves, as evidenced by a lack of effect on antivaccine antibody responses as well as on immune gene expression. Earlier- versus later-weaned heifer calves had 5% lower mammary gland mass, indicating that greater energy supply increased mammary mass. The results of this experiment demonstrate the ability to artificially rear dairy calves on a conserved alfalfa as the only solid feed. Furthermore, earlier weaning off CMR promotes solid feed intake and an associated increase in blood β-hydroxybutyrate, an indicator of rumen development, but increasing the duration of CMR feeding improves growth and mammary gland mass by d 100. The implications of these findings on lifetime growth, health, and milk production in dairy heifers warrant further investigation.
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Affiliation(s)
- S McCoard
- AgResearch Ltd., Grasslands Research Centre, Private Bag 11008, Palmerston North 4474, New Zealand
| | - A Heiser
- AgResearch Ltd., Grasslands Research Centre, Private Bag 11008, Palmerston North 4474, New Zealand
| | - K Lowe
- AgResearch Ltd., Grasslands Research Centre, Private Bag 11008, Palmerston North 4474, New Zealand
| | - A Molenaar
- AgResearch Ltd., Grasslands Research Centre, Private Bag 11008, Palmerston North 4474, New Zealand
| | - P MacLean
- AgResearch Ltd., Lincoln Research Centre, Private Bag 4749, Christchurch 8140, New Zealand
| | - P Johnstone
- AgResearch Ltd., Grasslands Research Centre, Private Bag 11008, Palmerston North 4474, New Zealand; AgResearch Ltd., Ruakura Research Centre, Private Bag 3123, Hamilton 3240, New Zealand
| | - S Leath
- AgResearch Ltd., Lincoln Research Centre, Private Bag 4749, Christchurch 8140, New Zealand
| | - S O Hoskin
- Fiber Fresh Feeds Ltd, RD2, Reporoa, New Zealand
| | - M A Khan
- AgResearch Ltd., Grasslands Research Centre, Private Bag 11008, Palmerston North 4474, New Zealand.
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Nanda RH, Boulware D, Baz R, Portman D, Michael Yu H, Jim H, Johnstone P. Patient Reported Outcomes Regarding Radiation Therapy in Patients with Multiple Myeloma. Int J Radiat Oncol Biol Phys 2019. [DOI: 10.1016/s0360-3016(19)30529-2] [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: 10/27/2022]
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26
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Johnstone P, Grass G, Azizi M, Ahmed K, Yoder G, Welsh E, Fulp W, Dhillon J, Torres-Roca J, Giuliano A, Yuan Z, Spiess P. OC-0268 Intrinsic radiosensitivity, genomic-adjusted radiation dose and patterns of failure of penile cancer. Radiother Oncol 2019. [DOI: 10.1016/s0167-8140(19)30688-7] [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: 11/29/2022]
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27
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Witt CM, Balneaves LG, Cardoso MJ, Cohen L, Greenlee H, Johnstone P, Kücük Ö, Mailman J, Mao JJ. A Comprehensive Definition for Integrative Oncology. J Natl Cancer Inst Monogr 2018; 2017:4617827. [PMID: 29140493 DOI: 10.1093/jncimonographs/lgx012] [Citation(s) in RCA: 97] [Impact Index Per Article: 16.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2016] [Accepted: 08/14/2017] [Indexed: 11/12/2022] Open
Abstract
Background Integrative oncology, which is generally understood to refer to the use of a combination of complementary medicine therapies in conjunction with conventional cancer treatments, has been defined in different ways, but there is no widely accepted definition. We sought to develop and establish a consensus for a comprehensive definition of the field of integrative oncology. Methods We used a mixed-methods approach that included a literature analysis and a consensus procedure, including an interdisciplinary expert panel and surveys, to develop a comprehensive and acceptable definition for the term "integrative oncology." Results The themes identified in the literature and from the expert discussion were condensed into a two-sentence definition. Survey respondents had very positive views on the draft definition, and their comments helped to shape the final version. The final definition for integrative oncology is: "Integrative oncology is a patient-centered, evidence-informed field of cancer care that utilizes mind and body practices, natural products, and/or lifestyle modifications from different traditions alongside conventional cancer treatments. Integrative oncology aims to optimize health, quality of life, and clinical outcomes across the cancer care continuum and to empower people to prevent cancer and become active participants before,during, and beyond cancer treatment." Conclusions This short and comprehensive definition for the term integrative oncology will facilitate a better understanding and communication of this emerging field. This definition will also drive focused and cohesive effort to advance the field of integrative oncology.
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Affiliation(s)
- Claudia M Witt
- Institute for Complementary and Integrative Medicine, University of Zurich and University Hospital Zurich, Zurich, Switzerland; Institute for Social Medicine, Epidemiology and Health Economics, Charité - Universitätsmedizin Berlin, Berlin, Germany; Center for Integrative Medicine, University of Maryland School of Medicine, Baltimore, MD; College of Nursing, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada; Breast Cancer Unit, Champalimaud Cancer Center, Lisbon, Portugal; Mama Help Association, Support Centre for Breast Cancer Patients, Porto, Portugal; Integrative Medicine Program, The University of Texas MD Anderson Cancer Center, Houston, TX; Department of Epidemiology, Mailman School of Public Health, and Herbert Irving Comprehensive Cancer Center, Columbia University, New York, NY; Moffitt Cancer Center and Research Institute, Tampa, FL; Winship Cancer Institute of Emory University, Atlanta, GA; NorCal CarciNET Community, Oakland, CA; Memorial Sloan Kettering Cancer Center, New York, NY
| | - Lynda G Balneaves
- Institute for Complementary and Integrative Medicine, University of Zurich and University Hospital Zurich, Zurich, Switzerland; Institute for Social Medicine, Epidemiology and Health Economics, Charité - Universitätsmedizin Berlin, Berlin, Germany; Center for Integrative Medicine, University of Maryland School of Medicine, Baltimore, MD; College of Nursing, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada; Breast Cancer Unit, Champalimaud Cancer Center, Lisbon, Portugal; Mama Help Association, Support Centre for Breast Cancer Patients, Porto, Portugal; Integrative Medicine Program, The University of Texas MD Anderson Cancer Center, Houston, TX; Department of Epidemiology, Mailman School of Public Health, and Herbert Irving Comprehensive Cancer Center, Columbia University, New York, NY; Moffitt Cancer Center and Research Institute, Tampa, FL; Winship Cancer Institute of Emory University, Atlanta, GA; NorCal CarciNET Community, Oakland, CA; Memorial Sloan Kettering Cancer Center, New York, NY
| | - Maria J Cardoso
- Institute for Complementary and Integrative Medicine, University of Zurich and University Hospital Zurich, Zurich, Switzerland; Institute for Social Medicine, Epidemiology and Health Economics, Charité - Universitätsmedizin Berlin, Berlin, Germany; Center for Integrative Medicine, University of Maryland School of Medicine, Baltimore, MD; College of Nursing, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada; Breast Cancer Unit, Champalimaud Cancer Center, Lisbon, Portugal; Mama Help Association, Support Centre for Breast Cancer Patients, Porto, Portugal; Integrative Medicine Program, The University of Texas MD Anderson Cancer Center, Houston, TX; Department of Epidemiology, Mailman School of Public Health, and Herbert Irving Comprehensive Cancer Center, Columbia University, New York, NY; Moffitt Cancer Center and Research Institute, Tampa, FL; Winship Cancer Institute of Emory University, Atlanta, GA; NorCal CarciNET Community, Oakland, CA; Memorial Sloan Kettering Cancer Center, New York, NY
| | - Lorenzo Cohen
- Institute for Complementary and Integrative Medicine, University of Zurich and University Hospital Zurich, Zurich, Switzerland; Institute for Social Medicine, Epidemiology and Health Economics, Charité - Universitätsmedizin Berlin, Berlin, Germany; Center for Integrative Medicine, University of Maryland School of Medicine, Baltimore, MD; College of Nursing, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada; Breast Cancer Unit, Champalimaud Cancer Center, Lisbon, Portugal; Mama Help Association, Support Centre for Breast Cancer Patients, Porto, Portugal; Integrative Medicine Program, The University of Texas MD Anderson Cancer Center, Houston, TX; Department of Epidemiology, Mailman School of Public Health, and Herbert Irving Comprehensive Cancer Center, Columbia University, New York, NY; Moffitt Cancer Center and Research Institute, Tampa, FL; Winship Cancer Institute of Emory University, Atlanta, GA; NorCal CarciNET Community, Oakland, CA; Memorial Sloan Kettering Cancer Center, New York, NY
| | - Heather Greenlee
- Institute for Complementary and Integrative Medicine, University of Zurich and University Hospital Zurich, Zurich, Switzerland; Institute for Social Medicine, Epidemiology and Health Economics, Charité - Universitätsmedizin Berlin, Berlin, Germany; Center for Integrative Medicine, University of Maryland School of Medicine, Baltimore, MD; College of Nursing, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada; Breast Cancer Unit, Champalimaud Cancer Center, Lisbon, Portugal; Mama Help Association, Support Centre for Breast Cancer Patients, Porto, Portugal; Integrative Medicine Program, The University of Texas MD Anderson Cancer Center, Houston, TX; Department of Epidemiology, Mailman School of Public Health, and Herbert Irving Comprehensive Cancer Center, Columbia University, New York, NY; Moffitt Cancer Center and Research Institute, Tampa, FL; Winship Cancer Institute of Emory University, Atlanta, GA; NorCal CarciNET Community, Oakland, CA; Memorial Sloan Kettering Cancer Center, New York, NY
| | - Peter Johnstone
- Institute for Complementary and Integrative Medicine, University of Zurich and University Hospital Zurich, Zurich, Switzerland; Institute for Social Medicine, Epidemiology and Health Economics, Charité - Universitätsmedizin Berlin, Berlin, Germany; Center for Integrative Medicine, University of Maryland School of Medicine, Baltimore, MD; College of Nursing, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada; Breast Cancer Unit, Champalimaud Cancer Center, Lisbon, Portugal; Mama Help Association, Support Centre for Breast Cancer Patients, Porto, Portugal; Integrative Medicine Program, The University of Texas MD Anderson Cancer Center, Houston, TX; Department of Epidemiology, Mailman School of Public Health, and Herbert Irving Comprehensive Cancer Center, Columbia University, New York, NY; Moffitt Cancer Center and Research Institute, Tampa, FL; Winship Cancer Institute of Emory University, Atlanta, GA; NorCal CarciNET Community, Oakland, CA; Memorial Sloan Kettering Cancer Center, New York, NY
| | - Ömer Kücük
- Institute for Complementary and Integrative Medicine, University of Zurich and University Hospital Zurich, Zurich, Switzerland; Institute for Social Medicine, Epidemiology and Health Economics, Charité - Universitätsmedizin Berlin, Berlin, Germany; Center for Integrative Medicine, University of Maryland School of Medicine, Baltimore, MD; College of Nursing, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada; Breast Cancer Unit, Champalimaud Cancer Center, Lisbon, Portugal; Mama Help Association, Support Centre for Breast Cancer Patients, Porto, Portugal; Integrative Medicine Program, The University of Texas MD Anderson Cancer Center, Houston, TX; Department of Epidemiology, Mailman School of Public Health, and Herbert Irving Comprehensive Cancer Center, Columbia University, New York, NY; Moffitt Cancer Center and Research Institute, Tampa, FL; Winship Cancer Institute of Emory University, Atlanta, GA; NorCal CarciNET Community, Oakland, CA; Memorial Sloan Kettering Cancer Center, New York, NY
| | - Josh Mailman
- Institute for Complementary and Integrative Medicine, University of Zurich and University Hospital Zurich, Zurich, Switzerland; Institute for Social Medicine, Epidemiology and Health Economics, Charité - Universitätsmedizin Berlin, Berlin, Germany; Center for Integrative Medicine, University of Maryland School of Medicine, Baltimore, MD; College of Nursing, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada; Breast Cancer Unit, Champalimaud Cancer Center, Lisbon, Portugal; Mama Help Association, Support Centre for Breast Cancer Patients, Porto, Portugal; Integrative Medicine Program, The University of Texas MD Anderson Cancer Center, Houston, TX; Department of Epidemiology, Mailman School of Public Health, and Herbert Irving Comprehensive Cancer Center, Columbia University, New York, NY; Moffitt Cancer Center and Research Institute, Tampa, FL; Winship Cancer Institute of Emory University, Atlanta, GA; NorCal CarciNET Community, Oakland, CA; Memorial Sloan Kettering Cancer Center, New York, NY
| | - Jun J Mao
- Institute for Complementary and Integrative Medicine, University of Zurich and University Hospital Zurich, Zurich, Switzerland; Institute for Social Medicine, Epidemiology and Health Economics, Charité - Universitätsmedizin Berlin, Berlin, Germany; Center for Integrative Medicine, University of Maryland School of Medicine, Baltimore, MD; College of Nursing, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada; Breast Cancer Unit, Champalimaud Cancer Center, Lisbon, Portugal; Mama Help Association, Support Centre for Breast Cancer Patients, Porto, Portugal; Integrative Medicine Program, The University of Texas MD Anderson Cancer Center, Houston, TX; Department of Epidemiology, Mailman School of Public Health, and Herbert Irving Comprehensive Cancer Center, Columbia University, New York, NY; Moffitt Cancer Center and Research Institute, Tampa, FL; Winship Cancer Institute of Emory University, Atlanta, GA; NorCal CarciNET Community, Oakland, CA; Memorial Sloan Kettering Cancer Center, New York, NY
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Orman AG, Ma Z, Zhou JM, Portman D, Jim H, Johnstone P, Yu M. (P110) A Modified Edmonton Symptom Assessment Scale for Symptom Clusters in Radiation Oncology Patients. Int J Radiat Oncol Biol Phys 2017. [DOI: 10.1016/j.ijrobp.2017.02.206] [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: 10/19/2022]
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Yuan Z, Dhillon J, Naghavi A, Tang D, Ahmed K, Spiess PE, Giuliano A, Johnstone P. (P041) Effect of HPV/P16 Status on Response to Postoperative Radiotherapy (RT) in Squamous Cell Carcinoma of the Penis (PECA). Int J Radiat Oncol Biol Phys 2017. [DOI: 10.1016/j.ijrobp.2017.02.136] [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: 10/19/2022]
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Johnstone P, Scott J, Eschrich S, Torres-Roca J. RSI: A genomic signature of radiosensitivity. Radiother Oncol 2016. [DOI: 10.1016/s0167-8140(16)30112-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Ahmed K, Scott J, Johnstone P, Fulp W, Torres-Roca J, Caudell J. RTRB-01UTILIZING THE GENOMICALLY ADJUSTED DOSE (GAD) TO IDENTIFY PATIENTS FOR ADJUVANT RADIATION DOSE ESCALATION IN GLIOBLASTOMA. Neuro Oncol 2015. [DOI: 10.1093/neuonc/nov231.01] [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: 11/12/2022] Open
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Mackintosh C, Johnstone P, Shaw R. Observations on the phenotypic relationships between anti-CarLA salivary IgA antibody response, nematode infection levels and growth rates in farmed red (Cervus elaphus) and wapiti hybrid deer (Cervus elaphus canadensis). Vet Parasitol 2014; 203:160-6. [DOI: 10.1016/j.vetpar.2014.01.030] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2013] [Revised: 01/27/2014] [Accepted: 01/30/2014] [Indexed: 10/25/2022]
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McMullen K, Buchsbaum J, Douglas J, McDonald M, Johnstone P. Growth abnormalities of the spine after radiation therapy: Respecting the past while moving forward in proton craniospinal irradiation. Pract Radiat Oncol 2013; 3:337-43. [DOI: 10.1016/j.prro.2012.10.006] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2012] [Revised: 10/23/2012] [Accepted: 10/23/2012] [Indexed: 10/27/2022]
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34
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Johnstone P, Matheson AS. An invisible enemy: Panton-Valentine leukocidin Staphylococcus aureus on deployed troops. J R Nav Med Serv 2013; 99:9-12. [PMID: 23691856] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Over the last seven years Primary Care establishments in the Royal Navy and Royal Marines have dealt with a number of severe and fatal infections caused by Panton-Valentine leukocidin (PVL) producing Staphylococcus aureus, and appear to be seeing these infections more commonly than their civilian colleagues. This retrospective study looked at the levels of PVL S. aureus isolated in deployed personnel during Op HERRICK 14 to determine if the levels seen in British military troops are higher than the national average. We found that the percentage of PVL positive S. aureus isolates sent to the UK HPA reference laboratory from the Camp Bastion laboratory during OP Herrick 14 was 41%, considerably higher rate than the UK civilian rate. Future research, including a larger study into the carriage levels of PVL S. aureus in the military will hopefully shed more light on the spread and transmission of this potentially deadly bacterium.
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Affiliation(s)
- P Johnstone
- Pathology Department, MDHU Portsmouth, Hants, UK
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Newman ENC, Johnstone P, Hatch R, Hayward-Karlsson J, Green AD, Hewson R. Undifferentiated febrile illnesses amongst British troops in Helmand, Afghanistan. J ROY ARMY MED CORPS 2012; 158:143-145. [PMID: 22860509] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
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Cheng C, Allgower C, Simmons J, Conley T, Das I, Zhao L, Zhao Q, Johnstone P, Buchsbaum J. SU-C-BRCD-05: A Failure Mode and Effects Analysis (FMEA) Approach for Craniospinal Irradiation (CSI) with Proton Therapy (PT). Med Phys 2012. [DOI: 10.1118/1.4734616] [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: 11/07/2022] Open
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Johnstone P. 26 DOSE FALLOFF IN PROTON CRANIOSPINAL IRRADIATION: WHERE AND WHY? Radiother Oncol 2012. [DOI: 10.1016/s0167-8140(12)70013-0] [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: 11/25/2022]
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Fakiris A, Forquer J, Henderson M, Barriger R, Shapiro R, Brabham J, Johnstone P. Stereotactic Body Radiotherapy for Non-small Cell Lung Carcinoma: The Indiana University Experience. Int J Radiat Oncol Biol Phys 2011. [DOI: 10.1016/j.ijrobp.2011.06.1670] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Srivastava S, Das I, Cheng C, Kumar A, Johnstone P. TH-E-BRB-08: Effect of Rectal Balloon Fillings on Doses to Prostate, PTV and Rectum: An IMRT Planning Study. Med Phys 2011. [DOI: 10.1118/1.3613565] [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: 11/07/2022] Open
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40
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Cheng C, Srivastava S, Buchsbaum J, Zhao L, Wolanski M, Simmons J, Johnstone P, Das I. SU-E-T-496: Dosimetric Comparison between Protons and Photons in the Field Junction in Craniospinal Irradiation (CSI). Med Phys 2011. [DOI: 10.1118/1.3612449] [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: 11/07/2022] Open
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Srivastava S, Das I, Cheng C, Kumar A, Johnstone P. Optimum Margin for Target Expansion in Head and Neck IMRT with Daily IGRT. Int J Radiat Oncol Biol Phys 2010. [DOI: 10.1016/j.ijrobp.2010.07.1721] [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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42
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Gansler T, Ganz PA, Grant M, Greene FL, Johnstone P, Mahoney M, Newman LA, Oh WK, Thomas CR, Thun MJ, Vickers AJ, Wender RC, Brawley OW. Sixty years of CA: a cancer journal for clinicians. CA Cancer J Clin 2010; 60:345-50. [PMID: 21075954 DOI: 10.3322/caac.20088] [Citation(s) in RCA: 65] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
The first issue of CA: A Cancer Journal for Clinicians was published in November of 1950. On the 60th anniversary of that date, we briefly review several seminal contributions to oncology and cancer control published in our journal during its first decade.
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Affiliation(s)
- Ted Gansler
- Health Promotions, American Cancer Society, Atlanta, GA 30303, USA.
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Cheng C, Zhao L, Wolanski M, Allgower C, Zhao Q, James J, Dikeman K, Mills M, Li M, Frye D, Lu X, Srivastava S, Das I, Johnstone P. SU-GG-I-03: Implications for Proton Therapy Treatment Planning of Tissue Characterization Curves from Different CT Scanners. Med Phys 2010. [DOI: 10.1118/1.3468036] [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: 11/07/2022] Open
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Das I, Cao M, Srivastava S, Cheng C, Li M, Gautam A, DesRosiers C, Johnstone P. SU-GG-T-581: Volume Variability in Treatment Planning Systems. Med Phys 2010. [DOI: 10.1118/1.3468982] [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: 11/07/2022] Open
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Moskvin V, Das I, Cheng C, Zhao L, Wolanski M, Andrews J, Johnstone P. SU-GG-T-385: Dose Perturbation by a Steel Magnetic Injection Port in a Breast Tissue Expander in Proton Radiotherapy: A Monte Carlo Study. Med Phys 2010. [DOI: 10.1118/1.3468782] [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: 11/07/2022] Open
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46
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Srivastava S, Das I, Andrews J, Kumar A, Cheng C, Johnstone P. SU-GG-T-322: Dose Perturbation Due to Metallic Breast Tissue Expander in Electron Treatment of Breast Cancer. Med Phys 2010. [DOI: 10.1118/1.3468718] [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: 11/07/2022] Open
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47
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Moskvin V, Das I, Cheng C, Zhao L, Johnstone P. SU-GG-T-396: Secondary Neutron Production by a Scanning Proton Beam. Med Phys 2010. [DOI: 10.1118/1.3468793] [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: 11/07/2022] Open
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Zook J, Sandrasegaran K, Saxena R, Price T, Maluccio M, Kwo P, Johnstone P, Cardenes H. Orthotopic Liver Transplant (OLT) following Stereotactic Body Radiation Therapy (SBRT) in Patients with Hepatocellular Carcinoma (HCC): Radiologic and Pathologic Correlation. Int J Radiat Oncol Biol Phys 2009. [DOI: 10.1016/j.ijrobp.2009.07.658] [Citation(s) in RCA: 3] [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: 11/27/2022]
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Kang T, Ahn M, Johnstone P, Kao C, Ko S, Gardner T. MP-15.06: Enhancement of FCYttk-Armed Prostate-Restricted Replicative Adenovirus Effect with Prodrugs Gancyclovir and 5-FC In Prostate Cancer. Urology 2009. [DOI: 10.1016/j.urology.2009.07.840] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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50
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Das I, Nichiporov D, Moskvin V, Shahnazi K, Fanelli L, Fitzek M, Johnstone P. SU-FF-T-328: Dose Perturbation and Range Shift with High-Z Medium in Proton Beam. Med Phys 2009. [DOI: 10.1118/1.3181808] [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: 11/07/2022] Open
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