1
|
Moreno L, Weston R, Owens C, Valteau-Couanet D, Gambart M, Castel V, Zwaan CM, Nysom K, Gerber N, Castellano A, Laureys G, Ladenstein R, Rössler J, Makin G, Murphy D, Morland B, Vaidya S, Thebaud E, van Eijkelenburg N, Tweddle DA, Barone G, Tandonnet J, Corradini N, Chastagner P, Paillard C, Bautista FJ, Gallego Melcon S, De Wilde B, Marshall L, Gray J, Burchill SA, Schleiermacher G, Chesler L, Peet A, Leach MO, McHugh K, Hayes R, Jerome N, Caron H, Laidler J, Fenwick N, Holt G, Moroz V, Kearns P, Gates S, Pearson ADJ, Wheatley K. Bevacizumab, Irinotecan, or Topotecan Added to Temozolomide for Children With Relapsed and Refractory Neuroblastoma: Results of the ITCC-SIOPEN BEACON-Neuroblastoma Trial. J Clin Oncol 2024:JCO2300458. [PMID: 38190578 DOI: 10.1200/jco.23.00458] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Revised: 07/25/2023] [Accepted: 10/05/2023] [Indexed: 01/10/2024] Open
Abstract
PURPOSE Outcomes for children with relapsed and refractory high-risk neuroblastoma (RR-HRNB) remain dismal. The BEACON Neuroblastoma trial (EudraCT 2012-000072-42) evaluated three backbone chemotherapy regimens and the addition of the antiangiogenic agent bevacizumab (B). MATERIALS AND METHODS Patients age 1-21 years with RR-HRNB with adequate organ function and performance status were randomly assigned in a 3 × 2 factorial design to temozolomide (T), irinotecan-temozolomide (IT), or topotecan-temozolomide (TTo) with or without B. The primary end point was best overall response (complete or partial) rate (ORR) during the first six courses, by RECIST or International Neuroblastoma Response Criteria for patients with measurable or evaluable disease, respectively. Safety, progression-free survival (PFS), and overall survival (OS) time were secondary end points. RESULTS One hundred sixty patients with RR-HRNB were included. For B random assignment (n = 160), the ORR was 26% (95% CI, 17 to 37) with B and 18% (95% CI, 10 to 28) without B (risk ratio [RR], 1.52 [95% CI, 0.83 to 2.77]; P = .17). Adjusted hazard ratio for PFS and OS were 0.89 (95% CI, 0.63 to 1.27) and 1.01 (95% CI, 0.70 to 1.45), respectively. For irinotecan ([I]; n = 121) and topotecan (n = 60) random assignments, RRs for ORR were 0.94 and 1.22, respectively. A potential interaction between I and B was identified. For patients in the bevacizumab-irinotecan-temozolomide (BIT) arm, the ORR was 23% (95% CI, 10 to 42), and the 1-year PFS estimate was 0.67 (95% CI, 0.47 to 0.80). CONCLUSION The addition of B met protocol-defined success criteria for ORR and appeared to improve PFS. Within this phase II trial, BIT showed signals of antitumor activity with acceptable tolerability. Future trials will confirm these results in the chemoimmunotherapy era.
Collapse
Affiliation(s)
- Lucas Moreno
- Vall d'Hebron University Hospital, Barcelona, Spain
| | | | | | | | | | | | | | | | | | | | | | | | | | - Guy Makin
- Central Manchester and Manchester Children's University Hospitals NHS Trust, Manchester, United Kingdom
| | - Dermot Murphy
- NHS Greater Glasgow and Clyde, Glasgow, United Kingdom
| | - Bruce Morland
- Birmingham Women's and Children's NHS Foundation Trust, Birmingham, United Kingdom
| | - Sucheta Vaidya
- The Royal Marsden NHS Foundation Trust & Institute for Cancer Research, London, United Kingdom
| | | | | | - Deborah A Tweddle
- The Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle, United Kingdom
| | | | | | | | | | | | | | | | | | - Lynley Marshall
- The Royal Marsden NHS Foundation Trust & Institute for Cancer Research, London, United Kingdom
| | - Juliet Gray
- University Hospital Southampton, Southampton, United Kingdom
| | | | | | - Louis Chesler
- The Royal Marsden NHS Foundation Trust & Institute for Cancer Research, London, United Kingdom
| | - Andrew Peet
- Birmingham Women's and Children's NHS Foundation Trust, Birmingham, United Kingdom
| | - Martin O Leach
- The Royal Marsden NHS Foundation Trust & Institute for Cancer Research, London, United Kingdom
| | - Kieran McHugh
- Great Ormond Street Hospital, London, United Kingdom
| | | | - Neil Jerome
- The Royal Marsden NHS Foundation Trust & Institute for Cancer Research, London, United Kingdom
| | | | | | | | - Grace Holt
- University of Birmingham, Birmingham, United Kingdom
| | | | - Pamela Kearns
- University of Birmingham, Birmingham, United Kingdom
| | - Simon Gates
- University of Birmingham, Birmingham, United Kingdom
| | - Andrew D J Pearson
- The Royal Marsden NHS Foundation Trust & Institute for Cancer Research, London, United Kingdom
| | | |
Collapse
|
2
|
Batra U, Nathany S, Sharma M, B P A, Vaidya S, Pasricha S, Mehta A. 202P Molecular kaleidoscope of EGFR mutant NSCLC: Be as precise as possible. J Thorac Oncol 2023. [DOI: 10.1016/s1556-0864(23)00455-0] [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: 04/04/2023]
|
3
|
Eysenbach L, Chick J, Vaidya S, Shin D, Valji K, Monsky W, Johnson E. Abstract No. 585 Utilization of a Dedicated Room Flow Coordinator Improves Efficiency in Interventional Radiology. J Vasc Interv Radiol 2023. [DOI: 10.1016/j.jvir.2022.12.443] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/27/2023] Open
|
4
|
Greenberg C, Shin D, Abad-Santos M, Monroe E, Ingraham C, Vaidya S, Bertino F, Johnson E, Makary M, Chick J. Abstract No. 589 Reconstruction of Upper Extremity and Thoracic Central Veins Using Dedicated Venous Stents: Deployment of 75 Stents in 46 Patients. J Vasc Interv Radiol 2023. [DOI: 10.1016/j.jvir.2022.12.447] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/27/2023] Open
|
5
|
Constantino D, Cook M, Shin D, Meissner M, Abad-Santos M, Bertino F, Monroe E, Hua E, Vaidya S, Chick J. Abstract No. 590 Sharp Recanalization of Symptomatic Chronic Central Venous Occlusions Using the Rösch-Uchida Transjugular Liver Access Set. J Vasc Interv Radiol 2023. [DOI: 10.1016/j.jvir.2022.12.448] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/27/2023] Open
|
6
|
Vaidya N, Karmacharya RM, Vaidya S, Bade S, Bade S, Paudel K, Kandel G, Thapa P, Maharjan R, Duwal S, Karki Y. Massive Hemoptysis and Pulmonary Thromboembolism in a Patient with Pulmonary Tuberculosis: A Therapeutic Conundrum Managed with Bronchial Artery Embolization. Kathmandu Univ Med J (KUMJ) 2022; 20:522-525. [PMID: 37795736] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/06/2023]
Abstract
Hemoptysis is a crucial entity taking into account its morbidity and mortality. Pulmonary tuberculosis is the leading cause for massive hemoptysis in our part of the world, which if left untreated may be life threatening. We present a case of a 37-year-old male patient with pulmonary tuberculosis with concurrent pulmonary thromboembolism presenting with massive hemoptysis, which was successfully managed with Bronchial Artery Embolization. This case represents that this measure can be a viable therapeutic choice for a patient with a severe lifethreatening hemoptysis, particularly when other treatment options are unavailable or ineffective.
Collapse
Affiliation(s)
- N Vaidya
- Department of Internal Medicine, Dhulikhel Hospital, Kathmandu University Hospital, Kathmandu University School of Medical Sciences, Dhulikhel, Kavre, Nepal
| | - R M Karmacharya
- Department of General Surgery (Cardiothoracic and Vascular), Dhulikhel Hospital, Kathmandu University Hospital, Kathmandu University School of Medical Sciences, Dhulikhel, Kavre, Nepal
| | - S Vaidya
- Department of General Surgery (Cardiothoracic and Vascular), Dhulikhel Hospital, Kathmandu University Hospital, Kathmandu University School of Medical Sciences, Dhulikhel, Kavre, Nepal
| | - S Bade
- Department of Internal Medicine, Dhulikhel Hospital, Kathmandu University Hospital, Kathmandu University School of Medical Sciences, Dhulikhel, Kavre, Nepal
| | - S Bade
- Department of Internal Medicine, Dhulikhel Hospital, Kathmandu University Hospital, Kathmandu University School of Medical Sciences, Dhulikhel, Kavre, Nepal
| | - K Paudel
- Department of Internal Medicine, Dhulikhel Hospital, Kathmandu University Hospital, Kathmandu University School of Medical Sciences, Dhulikhel, Kavre, Nepal
| | - G Kandel
- Department of General Surgery (Cardiothoracic and Vascular), Dhulikhel Hospital, Kathmandu University Hospital, Kathmandu University School of Medical Sciences, Dhulikhel, Kavre, Nepal
| | - P Thapa
- Interventional Radiology Department, Grande International Hospital, Kathmandu, Nepal
| | - R Maharjan
- Catheterization Laboratory, Dhulikhel Hospital, Kathmandu University Hospital, Dhulikhel, Kavre, Nepal
| | - S Duwal
- Catheterization Laboratory, Dhulikhel Hospital, Kathmandu University Hospital, Dhulikhel, Kavre, Nepal
| | - Y Karki
- Catheterization Laboratory, Dhulikhel Hospital, Kathmandu University Hospital, Dhulikhel, Kavre, Nepal
| |
Collapse
|
7
|
Karmacharya RM, Singh AK, Vaidya S, Tuladhar SM, Devbhandari M, Lama B, Kharel BB, Basnet S. Analysis of Lung Cancer Cases Presenting in Outpatient Department of University Hospital of Nepal. Kathmandu Univ Med J (KUMJ) 2022; 20:452-455. [PMID: 37795723] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/06/2023]
Abstract
Background Lung cancer is one of the leading cause of cancer related death. Most common histopathology of lung cancer is non-small cell carcinoma of which adenocarcinoma is the most common. There are limited number of studies done in Nepal to know different aspects of lung cancer. Objective To know demographic parameters of patients diagnosed as lung cancer in a university hospital. The study also aims to know the different histopathological diagnosis of lung cancer. Method All the patients presenting to outpatient department (Cardio Thoracic and Vascular unit) of Dhulikhel Hospital, if are diagnosed as cancer of lung/bronchus will be included in the study. The duration of the study was January 2017 to December 2021. The details on age, gender, presenting symptoms, histopathology of lung cancer, operability will be included in database and will be analyzed. Result There were total of 127 patients diagnosed as lung cancer. Male:female ratio was 1.7:1. Overall mean age was 63.23 years (SD 13.5 years, Range 19-89 years). Non small cell carcinoma was the most common type of lung cancer with 83.7%. In non small cell carcinoma, most common type was Squamous cell carcinoma followed by undifferentiated and Adenocarcinoma. Only five (3.93%) cases were in operable stage. Conclusion Despite the fact that lung cancer is one of the most common cancer, patients usually present late and moslty are not in operable stage. This study shows that squamous cell carcinoma is the most common histopathology in lung cancer cases.
Collapse
Affiliation(s)
- R M Karmacharya
- Department of Surgery (Cardio Thoracic and Vascular Surgery Unit), Dhulikhel Hospital, Kathmandu University Hospital, Kathmandu University School of Medical Sciences, Dhulikhel, Kavre, Nepal
| | - A K Singh
- Department of Surgery (Cardio Thoracic and Vascular Surgery Unit), Dhulikhel Hospital, Kathmandu University Hospital, Kathmandu University School of Medical Sciences, Dhulikhel, Kavre, Nepal
| | - S Vaidya
- Department of Surgery (Cardio Thoracic and Vascular Surgery Unit), Dhulikhel Hospital, Kathmandu University Hospital, Kathmandu University School of Medical Sciences, Dhulikhel, Kavre, Nepal
| | - S M Tuladhar
- Department of Surgery (Cardio Thoracic and Vascular Surgery Unit), Dhulikhel Hospital, Kathmandu University Hospital, Kathmandu University School of Medical Sciences, Dhulikhel, Kavre, Nepal
| | - M Devbhandari
- Department of Surgery (Cardio Thoracic and Vascular Surgery Unit), Dhulikhel Hospital, Kathmandu University Hospital, Kathmandu University School of Medical Sciences, Dhulikhel, Kavre, Nepal
| | - B Lama
- Department of Surgery (Cardio Thoracic and Vascular Surgery Unit), Dhulikhel Hospital, Kathmandu University Hospital, Kathmandu University School of Medical Sciences, Dhulikhel, Kavre, Nepal
| | - B B Kharel
- Department of Surgery (Cardio Thoracic and Vascular Surgery Unit), Dhulikhel Hospital, Kathmandu University Hospital, Kathmandu University School of Medical Sciences, Dhulikhel, Kavre, Nepal
| | - S Basnet
- Department of Surgery (Cardio Thoracic and Vascular Surgery Unit), Dhulikhel Hospital, Kathmandu University Hospital, Kathmandu University School of Medical Sciences, Dhulikhel, Kavre, Nepal
| |
Collapse
|
8
|
Singh AK, Karmacharya RM, Vaidya S, Shrestha I, Siwakoti S. The Cut-off Value of Great Saphenous Vein Diameter at the Level of Femoral Condyle to Predict the Sapheno-Femoral Junction Incompetence. Kathmandu Univ Med J (KUMJ) 2022; 20:280-283. [PMID: 37042366] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/13/2023]
Abstract
Background Varicose vein is one of the commonest problems that patients visit to a vascular out patient services (OPD). It causes a great deal of morbidity in today's population. Objective To see the correlation between the size of great saphenous and Saphenofemoral junction incompetence. Method From January 2019 till January 2020, 396 patients with symptomatic or clinically diagnosed varicose veins were screened for Saphenofemoral junction reflux. The diameter of the saphenous vein was measured with B-mode imaging, and reflux was quantified based on valve closure time using Doppler spectral measurements. Best saphenous vein diameter cutoff for predicting reflux was determined using receiver operating characteristics curve analysis. Result Out of 792 limbs, the Great Saphenous Venous System was involved in 452 limbs, the Short Saphenous Venous System was involved in 151 limbs and significant perforators were present in 240 limbs. Mean great Saphenous Vein diameter of diseased limb (Reflux Positive) was 5.68 mm and 4.0 mm in control group (Reflux Negative). Mean Saphenofemoral junction diameter was 8.23 mm in diseased limbs and 6.16 mm in control limbs. Receiver operating characteristics curve showed great saphenous vein diameter at femoral condyle of 4.5 mm as best cut-off value for diagnosis of sapheno femoral junction reflux. Conclusion Great Saphenous Vein diameter at femoral condyle of 4.5 mm is the best cut-off value for diagnosis Saphenofemoral junction reflux. The Sensitivity and specificity of this cut off value is 81.8% and 71% respectively.
Collapse
Affiliation(s)
- A K Singh
- National Consultant, WHO, Kathmandu, Nepal
| | - R M Karmacharya
- Department of Department of General Surgery (CTVS Unit), Dhulikhel Hospital, Kathmandu University Hospital, Dhulikhel, Kavre, Nepal
| | - S Vaidya
- Department of Department of General Surgery (CTVS Unit), Dhulikhel Hospital, Kathmandu University Hospital, Dhulikhel, Kavre, Nepal
| | - I Shrestha
- Department of Department of General Surgery (CTVS Unit), Dhulikhel Hospital, Kathmandu University Hospital, Dhulikhel, Kavre, Nepal
| | - S Siwakoti
- Department of Department of General Surgery (CTVS Unit), Dhulikhel Hospital, Kathmandu University Hospital, Dhulikhel, Kavre, Nepal
| |
Collapse
|
9
|
Karmacharya RM, Singh A, Devbhandari M, Napit D, Ghimire K, Mahat C, Vaidya S. Solving the Mystery of Giant Intrathoracic Mass. Kathmandu Univ Med J (KUMJ) 2022; 20:396-398. [PMID: 37042387] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/13/2023]
Abstract
Intrathoracic schwannoma are highly vascular nerve sheath benign tumors arising from neural crest derived schwann cells of the intercostal nerves. Common clinical presentation is palpable mass but in our case patient presented with shortness of breath which is rare presentation in Schwannoma. Imaging studies of the patient showed the lesion in left lung, however surgical finding showed mass to arise from chest wall and it was confirmed to be schwannoma by histopathological examination.
Collapse
Affiliation(s)
- R M Karmacharya
- Department of Surgery (CardioThoracic and Vascular), Dhulikhel Hospital, Kathmandu University Hospital, Dhulikhek, Kavre, Nepal
| | - A Singh
- Department of Surgery (CardioThoracic and Vascular), Dhulikhel Hospital, Kathmandu University Hospital, Dhulikhek, Kavre, Nepal
| | - M Devbhandari
- Department of Surgery (CardioThoracic and Vascular), Dhulikhel Hospital, Kathmandu University Hospital, Dhulikhek, Kavre, Nepal
| | - D Napit
- Department of Surgery (CardioThoracic and Vascular), Dhulikhel Hospital, Kathmandu University Hospital, Dhulikhek, Kavre, Nepal
| | - K Ghimire
- Department of Surgery (CardioThoracic and Vascular), Dhulikhel Hospital, Kathmandu University Hospital, Dhulikhek, Kavre, Nepal
| | - C Mahat
- Department of Surgery (CardioThoracic and Vascular), Dhulikhel Hospital, Kathmandu University Hospital, Dhulikhek, Kavre, Nepal
| | - S Vaidya
- Department of Surgery (CardioThoracic and Vascular), Dhulikhel Hospital, Kathmandu University Hospital, Dhulikhek, Kavre, Nepal
| |
Collapse
|
10
|
Gray J, Moreno L, Weston R, Barone G, Rubio A, Makin G, Vaidya S, Ng A, Castel V, Nysom K, Laureys G, Van Eijkelenburg N, Owens C, Gambart M, Pearson ADJ, Laidler J, Kearns P, Wheatley K. BEACON-Immuno: Results of the dinutuximab beta (dB) randomization of the BEACON-Neuroblastoma phase 2 trial—A European Innovative Therapies for Children with Cancer (ITCC–International Society of Paediatric Oncology Europe Neuroblastoma Group (SIOPEN) trial. J Clin Oncol 2022. [DOI: 10.1200/jco.2022.40.16_suppl.10002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
10002 Background: The BEACON phase II trial (NCT02308527) addressed a number of questions in children with relapsed/refractory high-risk neuroblastoma (RR-HRNB). Here we report the chemo-immunotherapy randomisation, assessing if anti-GD2 (dB) demonstrates activity when added to chemotherapy. Methods: Patients aged 1-21 years with RR-HRNB with adequate organ function and performance status were randomised in a 1:2 ratio to receive chemotherapy alone or with dB, given concurrently as a 7 day continuous infusion (10 mg/m2/24hr). As the trial had a factorial design, some patients were also randomised between chemotherapy regimens (temozolomide (T) versus Temozolomide-Topotecan (TTo); this randomisation closed soon after the dB randomisation opened and all patients subsequently received TTo chemotherapy. Cross-over to dB with topotecan and cyclophosphamide was allowed for patients randomised to chemotherapy alone who experienced disease progression. The primary outcome measure was best response (complete or partial) at any point during the first 6 courses of treatment, by RECIST or International Neuroblastoma Response Criteria for patients with measurable and evaluable disease respectively. Progression free and overall survival (PFS & OS) and safety were secondary outcomes. The success criterion for proceeding to a Phase 3 trial was a one-sided p-value (1p) less than 0.23 for Objective Response Rate (ORR). Results: From Aug 2019 to Feb 2021, 65 patients were randomised to chemotherapy alone (3 T, 19 TTo) or with dB (6 dBT, 37 dBTTo). Median age was 4 years; 48 and 17 had measurable and evaluable disease respectively; 29 and 36 had refractory and relapsed disease respectively; 19 had MYCN amplification. Baseline characteristics were balanced between arms. Response was assessable in all patients. The ORR was 18% with chemotherapy alone and 35% for patients receiving chemotherapy with dB (risk ratio 1.66, 80% confidence interval (CI) 0.9 to 3.06, 1p = 0.19). 1-year PFS was 27% for chemotherapy alone, and 57% for those receiving chemotherapy +dB (HR 0.63, 95% CI 0.32 to 1.25, p = 0.19). Twelve patients in the chemotherapy only arm crossed over to receive dB at progression. OS did not differ between the arms: HR = 0.99, 95% CI 0.42 to 2.36, p = 0.99. Nine (41%) patients receiving chemotherapy alone and 13 (30%) receiving chemotherapy plus dB had grade ≥3 toxicities (CTCAE v4.0). Neurotoxicities were more common in patients receiving dB compared to chemotherapy alone (Grade 1-2: 67.4% vs 13.6%, Grade 3: 9.3 vs 0%). Other toxicities were similar with and without dB. Conclusions: The Phase 2 success criterion for ORR was met and PFS is also encouraging. The addition of dB to temozolomide-based chemotherapy shows promising activity in patients with RR-HR-NB. Clinical trial information: NCT02308527.
Collapse
Affiliation(s)
- Juliet Gray
- University of Southamtpon, Southampton, United Kingdom
| | - Lucas Moreno
- Hospital Infantil Universitario Niño Jesús, Madrid, Spain
| | - Rebekah Weston
- Cancer Research UK Clinical Trials Unit, University of Birmingham, Birmingham, United Kingdom, Birmingham, United Kingdom
| | - Giuseppe Barone
- Great Ormond Street Hospital for Children, London, United Kingdom
| | - Alba Rubio
- Alba Rubio, Children's University Hospital Niño Jesús, Madrid, Spain
| | - Guy Makin
- Division of Cancer Sciences, School of Medical Sciences, University of Manchester and Royal Manchester Children’s Hospital, Manchester, United Kingdom
| | | | - Antony Ng
- Royal Hospital for Children, Bristol, United Kingdom
| | - Victoria Castel
- Hospital Universiario y Politecnico La Fe Valencia, Valencia, Spain
| | - Karsten Nysom
- Department of Pediatrics and Adolescent Medicine, University Hospital Rigshospitalet, Copenhagen, Denmark
| | | | | | | | | | - Andrew DJ Pearson
- The Royal Marsden Hospital and The Institute of Cancer Research, Surrey, United Kingdom
| | - Jennifer Laidler
- University of Birmingham, Cancer Research Clinical Trials Unit, Birmingham, United Kingdom
| | - Pamela Kearns
- University of Birmingham, Birmingham, United Kingdom
| | | |
Collapse
|
11
|
Dahal S, Karmacharya RM, Vaidya S, Gautam K, Bhatt S, Bhandari N. A rare case of persistent lateral marginal vein of Servelle in Klippel Trenaunay Syndrome: A successful surgical management. Int J Surg Case Rep 2022; 94:107052. [PMID: 35405516 PMCID: PMC9006318 DOI: 10.1016/j.ijscr.2022.107052] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Revised: 04/04/2022] [Accepted: 04/05/2022] [Indexed: 01/19/2023] Open
Abstract
Introduction and importance Klippel-Trenaunay Syndrome (KTS) is a rare congenital vascular disorder characterized by capillary malformation, varicosities, and tissue overgrowth. It usually affects the unilateral lower extremities manifesting commonly as pain, localized rise of temperature, and venous tortuosity. However, in severe cases, ulceration, cellulitis, and chronic lymphatic malformation may be present. Management is mostly supportive and involves the use of compression stockings. Case presentation Here, we report a case of KTS with a persistent lateral marginal vein of Servelle managed with radiofrequency ablation along with sclerotherapy of selected perforators. On a two-year follow-up, the symptoms had resolved and Doppler ultrasonography revealed resolution of the defective vein along with the absence of incompetent perforators. Clinical discussion In cases with venous malformation with the persistence of embryonic avalvular venous structures, like the lateral marginal vein of Servelle, surgical intervention is warranted especially at a younger age to reduce the risk of future thromboembolic events and recurrence. Conclusion Varicosities of the lateral marginal vein of Servelle can be managed successfully by radiofrequency ablation and adjunct sclerotherapy in selected cases. Klippel-Trenaunay Syndrome (KTS) is a congenital vascular disorder which usually affects the unilateral lower extremities. Endovenous treatment of the greater saphenous vein is gradually becoming popular in the treatment of KTS. This case is managed by radiofrequency ablation of lateral marginal vein of Servelle.
Collapse
Affiliation(s)
- S Dahal
- Department of Surgery (CTVS), Dhulikhel Hospital, Kathmandu University Hospital, Nepal.
| | - R M Karmacharya
- Department of Surgery (CTVS), Dhulikhel Hospital, Kathmandu University Hospital, Nepal
| | - S Vaidya
- Department of Surgery (CTVS), Dhulikhel Hospital, Kathmandu University Hospital, Nepal
| | - K Gautam
- Department of Surgery (CTVS), Dhulikhel Hospital, Kathmandu University Hospital, Nepal
| | - S Bhatt
- Department of Surgery (CTVS), Dhulikhel Hospital, Kathmandu University Hospital, Nepal
| | - N Bhandari
- Department of Surgery (CTVS), Dhulikhel Hospital, Kathmandu University Hospital, Nepal
| |
Collapse
|
12
|
Naing P, Musameh M, Vaidya S, Broyd C, Townsend A, Ball K, Oliver K, Hiskens M, Zhang Z. Intravascular Lithotripsy Catheter Balloon for Calcified Coronary Artery Intervention for the First 10 Cases at Mackay Base Hospital. Heart Lung Circ 2022. [DOI: 10.1016/j.hlc.2022.06.598] [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]
|
13
|
Vaidya S, Karmacharya RM, Shrestha B, Adhikari MM, Sharma R, Khadka S, Bhandari N, Hada G. Comparative Study between the Use of Pigtail Catheters and Traditional Chest Tube Drain in Cases with Pneumothorax. Kathmandu Univ Med J (KUMJ) 2022; 20:24-28. [PMID: 36273286] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
Background Pneumothorax is a condition in which air or other gas is present in the pleural cavity. Mainstay of management of pneumothorax is to remove the air from the pleural space usually done by chest tube insertion. There is still uncertainty whether minimal invasive management with pigtail catheter is sufficient for the management of pneumothorax. Objective To find the effectiveness, safety, tolerability, efficacy of pigtail catheters and large bore chest tubes. Method Prospective comparative study was done in Dhulikhel Hospital between August 2019 till August 2021. Chest tube insertion used to be the only available treatment modality till December 2020 (15 months). Following January 2021 after obtaining ethical clearance for use of pigtail insertion for pneumothorax, this treatment modality was done (8 months). Result Among 76 patients, 52(68.4%) underwent a large bore chest tube and 24 (34.6%) pigtail catheter patients. Mean age of the patients was 48 years (SD 18.01). Duration of hospital stay and length of hospital stay was more in large bore catheters and less in pigtail catheters. Eight hours post tube placement of the expansion of the lungs was present in pigtail and was statistically significant. Pain killer used in pigtail catheters was limited to Non-steroidal anti-inflammatory drugs, for large bore catheter opioids were added and were statistically significant. Conclusion Pigtail catheter is nearly effective as compared to traditional wide bore catheters.
Collapse
Affiliation(s)
- S Vaidya
- Department of Surgery, Cardio Thoracic and Vascular Surgery Unit, Dhulikhel Hospital, Kathmandu University Hospital, Dhulikhel, Kavre, Nepal
| | - R M Karmacharya
- Department of Surgery, Cardio Thoracic and Vascular Surgery Unit, Dhulikhel Hospital, Kathmandu University Hospital, Dhulikhel, Kavre, Nepal
| | - B Shrestha
- Department of Surgery, Cardio Thoracic and Vascular Surgery Unit, Dhulikhel Hospital, Kathmandu University Hospital, Dhulikhel, Kavre, Nepal
| | - M M Adhikari
- Department of Surgery, Cardio Thoracic and Vascular Surgery Unit, Dhulikhel Hospital, Kathmandu University Hospital, Dhulikhel, Kavre, Nepal
| | - R Sharma
- Department of Surgery, Cardio Thoracic and Vascular Surgery Unit, Dhulikhel Hospital, Kathmandu University Hospital, Dhulikhel, Kavre, Nepal
| | - S Khadka
- Department of Surgery, Cardio Thoracic and Vascular Surgery Unit, Dhulikhel Hospital, Kathmandu University Hospital, Dhulikhel, Kavre, Nepal
| | - N Bhandari
- Department of Surgery, Cardio Thoracic and Vascular Surgery Unit, Dhulikhel Hospital, Kathmandu University Hospital, Dhulikhel, Kavre, Nepal
| | - G Hada
- Department of Surgery, Cardio Thoracic and Vascular Surgery Unit, Dhulikhel Hospital, Kathmandu University Hospital, Dhulikhel, Kavre, Nepal
| |
Collapse
|
14
|
Pearce J, Khabra K, Nanji H, Stone J, Powell K, Martin D, Zebian B, Hettige S, Reisz Z, Bodi I, Al-Sarraj S, Bridges LR, Clarke M, Jones C, Mandeville HC, Vaidya S, Marshall LV, Carceller F. High grade gliomas in young children: The South Thames Neuro-Oncology unit experience and recent advances in molecular biology and targeted therapies. Pediatr Hematol Oncol 2021; 38:707-721. [PMID: 33900873 DOI: 10.1080/08880018.2021.1907493] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Revised: 03/12/2021] [Accepted: 03/16/2021] [Indexed: 02/04/2023]
Abstract
High grade gliomas (HGG) have a dismal prognosis with survival rates of 15-35%. Approximately 10-12% of pediatric HGG occur in young children and their molecular biology and clinical outcomes differ from those arising at older ages. We report on four children aged <5 years newly diagnosed with non-brainstem HGG between 2011 and 2018 who were treated with surgery and BBSFOP chemotherapy. Two died of tumor progression. The other two are still alive without radiotherapy at 3.8 and 3.9 years from diagnosis: one of whom remains disease-free off treatment; and the other one, whose tumor harbored a KCTD16:NTRK2 fusion, went on to receive larotrectinib. Additionally we review the general management, outcomes and latest updates in molecular biology and targeted therapies for young children with HGG. Infant gliomas can be stratified in molecular subgroups with clinically actionable oncogenic drivers. Chemotherapy-based strategies can avoid or delay the need for radiotherapy in young children with HGG. Harnessing the potential of NTRK, ALK, ROS1 and MET inhibitors offers the opportunity to optimize the therapeutic armamentarium to improve current outcomes for these children.
Collapse
Affiliation(s)
- Janice Pearce
- Children & Young People's Unit, Pediatric & Adolescent Neuro-Oncology, The Royal Marsden NHS Foundation Trust, London, UK
| | - Komel Khabra
- Statistics Department, The Royal Marsden NHS Foundation Trust, London, UK
| | - Henry Nanji
- Statistics Department, The Royal Marsden NHS Foundation Trust, London, UK
| | - Joanna Stone
- Children & Young People's Unit, Pediatric & Adolescent Neuro-Oncology, The Royal Marsden NHS Foundation Trust, London, UK
| | - Karen Powell
- Children & Young People's Unit, Pediatric & Adolescent Neuro-Oncology, The Royal Marsden NHS Foundation Trust, London, UK
| | - Danielle Martin
- Children & Young People's Unit, Pediatric & Adolescent Neuro-Oncology, The Royal Marsden NHS Foundation Trust, London, UK
| | - Bassel Zebian
- Neurosurgery Department, King's College Hospital NHS Foundation Trust, London, UK
| | - Samantha Hettige
- Neurosurgery Department, St George's Hospital NHS Foundation Trust, London, UK
| | - Zita Reisz
- Department of Clinical Neuropathology, King's College Hospital NHS Foundation Trust, London, UK
| | - Istvan Bodi
- Department of Clinical Neuropathology, King's College Hospital NHS Foundation Trust, London, UK
| | - Safa Al-Sarraj
- Department of Clinical Neuropathology, King's College Hospital NHS Foundation Trust, London, UK
| | - Leslie R Bridges
- Department of Cellular Pathology, St George's Hospital NHS Foundation Trust, London, UK
| | - Matthew Clarke
- Division of Molecular Pathology, The Institute of Cancer Research, London, UK
| | - Chris Jones
- Division of Molecular Pathology, The Institute of Cancer Research, London, UK
| | - Henry C Mandeville
- Department of Radiation Oncology, The Royal Marsden NHS Foundation Trust, London, UK
- Division of Clinical Studies, The Institute of Cancer Research, London, UK
| | - Sucheta Vaidya
- Children & Young People's Unit, Pediatric & Adolescent Neuro-Oncology, The Royal Marsden NHS Foundation Trust, London, UK
- Division of Clinical Studies, The Institute of Cancer Research, London, UK
| | - Lynley V Marshall
- Children & Young People's Unit, Pediatric & Adolescent Neuro-Oncology, The Royal Marsden NHS Foundation Trust, London, UK
- Division of Clinical Studies, The Institute of Cancer Research, London, UK
| | - Fernando Carceller
- Children & Young People's Unit, Pediatric & Adolescent Neuro-Oncology, The Royal Marsden NHS Foundation Trust, London, UK
- Division of Clinical Studies, The Institute of Cancer Research, London, UK
| |
Collapse
|
15
|
Vaidya S, Karmacharya RM, Singh AK, Vaidya PR, Malinowski M, Dhakal A. C-ARM Guided Angiogram/Angioplasty for Selected Failed Arterio Venous Fistula. A Report of a Procedure at University Hospital of Nepal. Kathmandu Univ Med J (KUMJ) 2021; 19:399-401. [PMID: 36254434] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
End Stage Renal Disease is a last stage of Chronic Kidney Disease which is characterized by Glomerular Filtration rate of less than 15 ml/min/1.73 m2 . Hemodialysis is the most commonly used modality for treatment of Chronic Kidney disease. Among the access for hemodialysis arteriovenous fistula is the most common modality. However most common problems of fistula are significant stenosis of more than 50% which is characterized by limb swelling, pigmentation, tortuous veins, and difficulty maintaining flow during dialysis from AV fistula. These can be managed either by minimal intervention or with surgical intervention. Very few hospitals in Nepal and other countries have an angiographic suite to perform minimal intervention include angiogram with angioplasty. So in this case we try to address the use of C-Arm to perform angiogram or fistulogram and even angioplasty for the management of significant stenosis or complications of arteriovenous fistula.
Collapse
Affiliation(s)
- S Vaidya
- Department of Surgery (Cardio Thoracic and Vascular Surgery), Dhulikhel Hospital, Kathmandu University Hospital, Dhulikhel, Kavre, Nepal
| | - R M Karmacharya
- Department of Surgery (Cardio Thoracic and Vascular Surgery), Dhulikhel Hospital, Kathmandu University Hospital, Dhulikhel, Kavre, Nepal
| | - A K Singh
- Department of Surgery (Cardio Thoracic and Vascular Surgery), Dhulikhel Hospital, Kathmandu University Hospital, Dhulikhel, Kavre, Nepal
| | - P R Vaidya
- Consultant (Cardio and Vascular Surgery), KIST Medical College Teaching Hospital, Gwarko, Lalitpur
| | - M Malinowski
- Consultant (Medical College of Wisconsin), Wisconsin, USA
| | - A Dhakal
- Department of Surgery (Cardio Thoracic and Vascular Surgery), Dhulikhel Hospital, Kathmandu University Hospital, Dhulikhel, Kavre, Nepal
| |
Collapse
|
16
|
Jackson T, Shin D, Ingraham C, Vaidya S, Monroe E, Johnson G, Valji K, Chick J. Abstract No. 56 Double-barrel brachiocephalocaval Viabahn VBX stent-graft reconstruction for treatment of superior vena cava syndrome. J Vasc Interv Radiol 2021. [DOI: 10.1016/j.jvir.2021.03.475] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
|
17
|
Ghimire M, Vaidya S, Upadhyay HP. Clinico-pathological Profile of Kidney Biopsy Patients in a Tertiary Hospital of Central Nepal. Kathmandu Univ Med J (KUMJ) 2020; 18:217-222. [PMID: 34158426] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Background Kidney biopsy is an important diagnostic tool in Nephrology. As of now, we don't have a central kidney biopsy registry in our country and there are many studies showing heterogeneous patterns of pathologies observed in the country. We thought of looking on the clinico-pathological profile of kidney biopsy patients prevailing in our centre. Objective This study was carried out with an objective to know the clinico-pathological profile of kidney biopsy patients prevailing in our centre. Method This was a hospital based, prospective, observational study carried out in a tertiary teaching hospital of Chitwan over a period of 3 years from May 2016 to April 2019. All the consecutive kidney biopsy patients were included in the study. The indication of kidney biopsies were the standard indication based on clinical presentation and investigations. The patient`s demographic profile, indication of kidney biopsy and histological patterns were studied and analysed using appropriate statistical tools. Result A total of 210 kidney biopsies were analysed over a period of three years, that makes around 5-6 biopsies per month. The mean age of the patient was 35.7 ± 14.9 years. Male were 106 (50.5) and females were 104 (49.5) with male to female ratio of 1.01. The average number of glomeruli was 23.4 ± 11.0. The commonest indication of kidney biopsy and histological pattern were nephrotic syndrome 56 (26.7) and IgA nephropathy 51 (24.2) respectively. Among nephrotic syndrome group, the commonest histological pattern was minimal change disease 21 (37.5). Non-diabetic kidney diseases in diabetes were seen in eight (53.4) diabetic patients making it a significant problem in diabetes and the commonest histological pattern in them were minimal change disease and idiopathic cresentic glomerulonephritis two (13.3) each. Conclusion The commonest indication and histological pattern of the kidney biopsy were nephrotic syndrome 56 (26.7), and IgA Nephropathy 51 (24.2) respectively. Nondiabetic kidney diseases in diabetes were seen in eight (53.4) of the diabetic patient making it a significant problem in diabetes and the commonest histological pattern in them were minimal change disease and idiopathic cresentic glomerulonephritis two (13.3) each.
Collapse
Affiliation(s)
- M Ghimire
- Department of Nephrology, College of Medical Sciences Teaching Hospital, Bharatpur, Nepal
| | - S Vaidya
- Department of Nephrology, College of Medical Sciences Teaching Hospital, Bharatpur, Nepal
| | - H P Upadhyay
- Department of Community Medicine, College of Medical Sciences Teaching Hospital, Bharatpur, Nepal
| |
Collapse
|
18
|
P P, Karmacharya R, Vaidya S, Singh A, Thapa P, Dhakal P, Dahal S, Bade S, Bhandari N. Case report of eventration of diaphragm due to an unknown febrile illness causing phrenic nerve palsy and other multiple nerve palsies. Ann Med Surg (Lond) 2020; 54:74-78. [PMID: 32382413 PMCID: PMC7201156 DOI: 10.1016/j.amsu.2020.04.003] [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: 02/12/2020] [Revised: 04/03/2020] [Accepted: 04/10/2020] [Indexed: 11/24/2022] Open
Abstract
INTRODUCTION Diaphragmatic eventration can be congenital or acquired. Diagnosis is delayed due to no symptoms or very mild ones and is generally done by imaging modalities. This condition is managed by plication of the affected part of diaphragm by various surgical approaches. PRESENTATION OF CASE A forty seven years lady presented with one year long history of abdominal pain, bloating and fullness after meals who was being treated in line of peptic acid disorder. She had developed bilateral foot drop after typhoid fever at seventeen years of age. Clinical examination and imaging with chest x-ray, chest ultrasound and computed tomography scan suggested eventration of left hemidiaphragm. Plication of eventration of left hemidiaphragm was done via mini thoracotomy of the left thorax. There were no postoperative complications and she was discharged on the sixth postoperative day. DISCUSSION Acquired eventration of diaphragm is commonly due to traumatic phrenic nerve palsy but rarely can be associated with a history of infection causing nerve palsies. Thoracic ultrasound is an emerging modality for diagnosis supporting X-rays and CT Scans. Plication of eventration with minimally invasive techniques has less number of hospital stay and less pain compared to open approaches. CONCLUSION Non-traumatic diaphragmatic eventration due to acquired phrenic nerve palsy following an unknown febrile illness is a rare case to be reported in Nepal. The aim of treatment is expansion of intra-thoracic space which is done by plication of the diaphragm.
Collapse
Affiliation(s)
- Pradhan P
- Department of Emergency Medicine, Kathmandu University School of Medical Sciences, Dhulikhel Hospital, Nepal
| | - R.M. Karmacharya
- Department of Emergency Medicine, Kathmandu University School of Medical Sciences, Dhulikhel Hospital, Nepal
| | - S Vaidya
- Department of Emergency Medicine, Kathmandu University School of Medical Sciences, Dhulikhel Hospital, Nepal
| | - A.K. Singh
- Department of Emergency Medicine, Kathmandu University School of Medical Sciences, Dhulikhel Hospital, Nepal
| | - P Thapa
- Department of Emergency Medicine, Kathmandu University School of Medical Sciences, Dhulikhel Hospital, Nepal
| | - P Dhakal
- Department of Emergency Medicine, Kathmandu University School of Medical Sciences, Dhulikhel Hospital, Nepal
| | - S Dahal
- Department of Emergency Medicine, Kathmandu University School of Medical Sciences, Dhulikhel Hospital, Nepal
| | - S Bade
- Department of Emergency Medicine, Kathmandu University School of Medical Sciences, Dhulikhel Hospital, Nepal
| | - N Bhandari
- Department of Emergency Medicine, Kathmandu University School of Medical Sciences, Dhulikhel Hospital, Nepal
| |
Collapse
|
19
|
Wheatley K, Holt G, Owens C, Laidler J, Valteau-Couanet D, Gambart M, Castel V, van Eijkelenburg N, Castellano A, Nysom K, Gerber NU, Laureys G, Ladenstein RL, Makin G, Vaidya S, Thebaud E, Kearns P, Pearson ADJ, Moreno L. Randomized comparisons of bevacizumab (B) and irinotecan (I), added to temozolomide (T), in children with relapsed or refractory high-risk neuroblastoma (RR-HRNB): First survival results of the ITCC-SIOPEN BEACON-Neuroblastoma phase II trial. J Clin Oncol 2020. [DOI: 10.1200/jco.2020.38.15_suppl.10501] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
10501 Background: BEACON is a randomized phase 2 trial assessing whether inhibiting angiogenesis with bevacizumab adds to the activity of chemotherapy and evaluating chemotherapy regimens for children with RR-HRNB. Methods: Patients with RR-HRNB were eligible. There were randomizations (rand), in a 3x2 factorial design, to: T, IT or topotecan (To)-T, +/- B. Toxicity and response were reported in 2019 (ASCO, ESMO). Survival outcomes – progression-free (PFS) and overall (OS) – for the I and B rands are reported here (To rand is still open). The B rand used a relaxed alpha (1-sided p=0.2) for PFS as its phase 2 success criterion; the I rand was Bayesian. Cox model hazard ratios (HR) <1.0 indicate benefit for I or B. Heterogeneity tests (HT) assessed interactions between B and I. Analysis was intention-to-treat. Results: From 2013-19, 160 patients were randomized to B v. no B, including 121 to I v. no I, with: median age 5.8 years; 113 and 47 measurable and evaluable disease; 67 and 93 refractory and relapsed disease; 35 had MYCN amplification. Median follow-up was 15.4 months. PFS and OS are shown in the table. In the main comparisons (I v. no I, B v. no B), I improved PFS and OS (98% probability that true HR<1.0 for both) and B just met its success criterion (PFS: 1p=0.20; OS: 1p=0.19). However, there was some, but not conclusive, evidence of a positive interaction between B and I for both PFS (HT: p=0.06) and OS (HT: p=0.12). If real, this would suggest that adding either I (IT) or B (BT) to T does not improve outcome, but adding both (BIT) does. Twice as many patients had serious adverse events with BIT (57%) than with T (26%) or IT (27%), with BT at 40%. Conclusions: The BEACON results show that single agent T is suboptimal. Statistical uncertainty about an interaction between I and B means two further interpretations are possible: 1) IT and possibly BT are better than T; 2) IT and BT are not better than T, but I and B together (BIT) are better. Hence, a definitive conclusion on the best combination(s) to take forward is not currently possible and further randomized evaluation is needed. Clinical trial information: ISRCTN40708286. [Table: see text]
Collapse
Affiliation(s)
| | - Grace Holt
- University of Birmingham, Birmingham, United Kingdom
| | | | - Jennifer Laidler
- University of Birmingham, Cancer Research Clinical Trials Unit, Birmingham, United Kingdom
| | | | | | - Victoria Castel
- Hospital Universiario y Politecnico La Fe Valencia, Valencia, Spain
| | | | | | | | | | | | - Ruth Lydia Ladenstein
- St. Anna Children's Hospital and St. Anna Kinderkrebsforschung, Department of Paediatrics, Medical University Vienna, Vienna, Austria
| | - Guy Makin
- Division of Cancer Sciences, School of Medical Sciences, University of Manchester and Royal Manchester Children’s Hospital, Manchester, United Kingdom
| | | | | | - Pamela Kearns
- University of Birmingham, Birmingham, United Kingdom
| | - Andrew DJ Pearson
- The Royal Marsden Hospital and The Institute of Cancer Research, Surrey, United Kingdom
| | - Lucas Moreno
- Hospital Universitario Niño Jesús, Madrid, Spain
| |
Collapse
|
20
|
Manna SS, Malik R, Douthwaite A, Vaidya S. Surgical tracheostomy in children with malignancy receiving intensive chemotherapy: A case series and review of literature. Pediatr Blood Cancer 2020; 67:e28105. [PMID: 31876351 DOI: 10.1002/pbc.28105] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2019] [Revised: 10/15/2019] [Accepted: 11/03/2019] [Indexed: 12/13/2022]
Abstract
We retrospectively reviewed a paediatric intensive care unit database that supports a tertiary oncology service to explore safety and outcome of tracheostomy in oncology patients over a 12-year period and reviewed literature. A total of 895 patients were admitted with a haematological or a solid tumour malignancy of which 222 were ventilated. Six of 222 (2.7%) ventilated children were tracheostomised. Four of six children tracheostomised for ventilatory support received intensive chemotherapy complicated by neutropenia and thrombocytopenia. There was no significant tracheostomy-related complication. Tracheostomy improved patient comfort, reduced sedative requirement, and may have helped recovery. Tracheostomy should be considered early in selected children with haemato-oncological diagnoses requiring prolonged ventilation.
Collapse
Affiliation(s)
- Soumendu S Manna
- Paediatric Intensive Care, Lanesborough Wing, St George's University Hospital NHS Foundation Trust, London, UK
| | - Rubina Malik
- Paediatric Intensive Care, Lanesborough Wing, St George's University Hospital NHS Foundation Trust, London, UK
| | - Amy Douthwaite
- Paediatric Intensive Care, Lanesborough Wing, St George's University Hospital NHS Foundation Trust, London, UK
| | - Sucheta Vaidya
- Paediatric Intensive Care, Lanesborough Wing, St George's University Hospital NHS Foundation Trust, London, UK
| |
Collapse
|
21
|
Ghimire M, Vaidya S, Upadhyay HP. Clinicodemographic Profile and Outcome of Maintenance Hemodialysis Patients in a Tertiary Hospital of Central Nepal, Chitwan. Kathmandu Univ Med J (KUMJ) 2020; 18:9-14. [PMID: 33582680] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Background Maintenance hemodialysis is a popular treatment modality of renal replacement therapy for end stage renal disease patients; however their mortality seemed to be rising in our centre. There were no previous studies regarding the clinicodemographic profile and outcome of maintenance hemodialysis patients from this region. Objective This study was carried out with an objective to know the clinicodemographic profile and outcome of maintenance hemodialysis patients in our centre. Method This study was a hospital based prospective observational study carried out over a period of three year, from May 2016 to April 2019, in the hemodialysis unit of the department of nephrology. All the consecutive end stage renal disease patients on maintenance hemodialysis were included in the study. The patient's demographic profile and outcome were studied and analysed using appropriate statistical tools. Result A total of 156 patients were enrolled in the study. Males were 96(61.5%) and females were 60(38.5%). The mean age of the patient was 52.2±15.6 years. The commonest causes of end stage renal disease and reasons for admission were Type 2 diabetes mellitus 68(43.6%) and volume overload with heart failure 101(64.7%) respectively. At the end of three years, 39(25%) were expired, 14(8.9%) were transferred to other centre and four (2.6%) underwent kidney transplantation. The average duration of hemodialysis was 20.3± 17.5 months. Majority of the patients 154(98.7%) had repeat admission ranging from 1 time 21(13.5%) to 10 times two (1.3%). There was a significant association between age ≥ 40 years and diabetes with mortality (p value < 0.003 and < 0.028 respectively). Conclusion The commonest cause of end stage renal disease and the reason of admission were Type 2 diabetes mellitus 68 (43.6%) and volume overload with heart failure 101 (64.7%) respectively. The overall mortality was 39 (25%) and the commonest cause of mortality was sepsis/health care associated pneumonia 30 (76.9%). There was significant association between age ≥ 40 years and diabetes with mortality (p value < 0.003 and < 0.028 respectively).
Collapse
Affiliation(s)
- M Ghimire
- Department of Nephrology, College of Medical Sciences Teaching Hospital, Bharatpur, Nepal
| | - S Vaidya
- Department of Nephrology, College of Medical Sciences Teaching Hospital, Bharatpur, Nepal
| | - H P Upadhyay
- Department of Community Medicine, College of Medical Sciences Teaching Hospital, Bharatpur, Nepal
| |
Collapse
|
22
|
George SL, Izquierdo E, Campbell J, Koutroumanidou E, Proszek P, Jamal S, Hughes D, Yuan L, Marshall LV, Carceller F, Chisholm JC, Vaidya S, Mandeville H, Angelini P, Wasti A, Bexelius T, Thway K, Gatz SA, Clarke M, Al-Lazikani B, Barone G, Anderson J, Tweddle DA, Gonzalez D, Walker BA, Barton J, Depani S, Eze J, Ahmed SW, Moreno L, Pearson A, Shipley J, Jones C, Hargrave D, Jacques TS, Hubank M, Chesler L. A tailored molecular profiling programme for children with cancer to identify clinically actionable genetic alterations. Eur J Cancer 2019; 121:224-235. [PMID: 31543384 PMCID: PMC6839402 DOI: 10.1016/j.ejca.2019.07.027] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [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: 04/18/2019] [Revised: 06/27/2019] [Accepted: 07/23/2019] [Indexed: 11/10/2022]
Abstract
BACKGROUND For children with cancer, the clinical integration of precision medicine to enable predictive biomarker-based therapeutic stratification is urgently needed. METHODS We have developed a hybrid-capture next-generation sequencing (NGS) panel, specifically designed to detect genetic alterations in paediatric solid tumours, which gives reliable results from as little as 50 ng of DNA extracted from formalin-fixed paraffin-embedded (FFPE) tissue. In this study, we offered an NGS panel, with clinical reporting via a molecular tumour board for children with solid tumours. Furthermore, for a cohort of 12 patients, we used a circulating tumour DNA (ctDNA)-specific panel to sequence ctDNA from matched plasma samples and compared plasma and tumour findings. RESULTS A total of 255 samples were submitted from 223 patients for the NGS panel. Using FFPE tissue, 82% of all submitted samples passed quality control for clinical reporting. At least one genetic alteration was detected in 70% of sequenced samples. The overall detection rate of clinically actionable alterations, defined by modified OncoKB criteria, for all sequenced samples was 51%. A total of 8 patients were sequenced at different stages of treatment. In 6 of these, there were differences in the genetic alterations detected between time points. Sequencing of matched ctDNA in a cohort of extracranial paediatric solid tumours also identified a high detection rate of somatic alterations in plasma. CONCLUSION We demonstrate that tailored clinical molecular profiling of both tumour DNA and plasma-derived ctDNA is feasible for children with solid tumours. Furthermore, we show that a targeted NGS panel-based approach can identify actionable genetic alterations in a high proportion of patients.
Collapse
Affiliation(s)
- Sally L George
- Paediatric Tumour Biology, Division of Clinical Studies, The Institute of Cancer Research, London, UK; Children and Young People's Unit, Royal Marsden NHS Foundation Trust, London, UK.
| | - Elisa Izquierdo
- Molecular Diagnostics Department, The Institute of Cancer Research and Clinical Genomics, The Royal Marsden NHS Foundation, London, UK; Glioma Team, Division of Molecular Pathology and Cancer Therapeutics, The Institute of Cancer Research, London, UK
| | - James Campbell
- Bioinformatics Core Facility, The Institute of Cancer Research, London, UK
| | - Eleni Koutroumanidou
- Molecular Diagnostics Department, The Institute of Cancer Research and Clinical Genomics, The Royal Marsden NHS Foundation, London, UK
| | - Paula Proszek
- Molecular Diagnostics Department, The Institute of Cancer Research and Clinical Genomics, The Royal Marsden NHS Foundation, London, UK
| | - Sabri Jamal
- Molecular Diagnostics Department, The Institute of Cancer Research and Clinical Genomics, The Royal Marsden NHS Foundation, London, UK
| | - Deborah Hughes
- Molecular Diagnostics Department, The Institute of Cancer Research and Clinical Genomics, The Royal Marsden NHS Foundation, London, UK
| | - Lina Yuan
- Molecular Diagnostics Department, The Institute of Cancer Research and Clinical Genomics, The Royal Marsden NHS Foundation, London, UK
| | - Lynley V Marshall
- Paediatric Tumour Biology, Division of Clinical Studies, The Institute of Cancer Research, London, UK; Children and Young People's Unit, Royal Marsden NHS Foundation Trust, London, UK
| | - Fernando Carceller
- Paediatric Tumour Biology, Division of Clinical Studies, The Institute of Cancer Research, London, UK; Children and Young People's Unit, Royal Marsden NHS Foundation Trust, London, UK
| | - Julia C Chisholm
- Paediatric Tumour Biology, Division of Clinical Studies, The Institute of Cancer Research, London, UK; Children and Young People's Unit, Royal Marsden NHS Foundation Trust, London, UK
| | - Sucheta Vaidya
- Paediatric Tumour Biology, Division of Clinical Studies, The Institute of Cancer Research, London, UK; Children and Young People's Unit, Royal Marsden NHS Foundation Trust, London, UK
| | - Henry Mandeville
- Children and Young People's Unit, Royal Marsden NHS Foundation Trust, London, UK
| | - Paola Angelini
- Children and Young People's Unit, Royal Marsden NHS Foundation Trust, London, UK
| | - Ajla Wasti
- Children and Young People's Unit, Royal Marsden NHS Foundation Trust, London, UK
| | - Tomas Bexelius
- Children and Young People's Unit, Royal Marsden NHS Foundation Trust, London, UK
| | - Khin Thway
- Pathology Department, Royal Marsden NHS Foundation Trust, London, UK
| | - Susanne A Gatz
- Children and Young People's Unit, Royal Marsden NHS Foundation Trust, London, UK; Sarcoma Molecular Pathology Team, Divisions of Molecular Pathology and Cancer Therapeutics, The Institute of Cancer Research, London, UK; Cancer Research UK Clinical Trials Unit, Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, UK
| | - Matthew Clarke
- Glioma Team, Division of Molecular Pathology and Cancer Therapeutics, The Institute of Cancer Research, London, UK
| | - Bissan Al-Lazikani
- Bioinformatics Core Facility, The Institute of Cancer Research, London, UK
| | - Giuseppe Barone
- Department of Haematology and Oncology, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
| | - John Anderson
- Department of Haematology and Oncology, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK; Developmental Biology and Cancer Programme, UCL GOS Institute of Child Health, London, UK
| | - Deborah A Tweddle
- Northern Institute for Cancer Research, Newcastle University, Newcastle, UK
| | - David Gonzalez
- Molecular Diagnostics Department, The Institute of Cancer Research and Clinical Genomics, The Royal Marsden NHS Foundation, London, UK; Centre for Cancer Research and Cell Biology, Queens University Belfast, Belfast, UK
| | - Brian A Walker
- Molecular Diagnostics Department, The Institute of Cancer Research and Clinical Genomics, The Royal Marsden NHS Foundation, London, UK; Myeloma Center, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Jack Barton
- Developmental Biology and Cancer Programme, UCL GOS Institute of Child Health, London, UK
| | - Sarita Depani
- Department of Haematology and Oncology, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
| | - Jessica Eze
- Department of Haematology and Oncology, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK; Department of Histology, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
| | - Saira W Ahmed
- Department of Haematology and Oncology, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK; Department of Histology, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
| | - Lucas Moreno
- Children and Young People's Unit, Royal Marsden NHS Foundation Trust, London, UK; HNJ-CNIO Clinical Research Unit, Hospital Universitario Nino Jesus, Madrid, Spain; Paediatric Oncology & Haematology, Vall d'Hebron University Hospital, Barcelona, Spain
| | - Andrew Pearson
- Children and Young People's Unit, Royal Marsden NHS Foundation Trust, London, UK
| | - Janet Shipley
- Sarcoma Molecular Pathology Team, Divisions of Molecular Pathology and Cancer Therapeutics, The Institute of Cancer Research, London, UK
| | - Chris Jones
- Glioma Team, Division of Molecular Pathology and Cancer Therapeutics, The Institute of Cancer Research, London, UK
| | - Darren Hargrave
- Cancer Research UK Clinical Trials Unit, Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, UK; Department of Haematology and Oncology, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
| | - Thomas S Jacques
- Department of Haematology and Oncology, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK; Department of Histology, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
| | - Michael Hubank
- Molecular Diagnostics Department, The Institute of Cancer Research and Clinical Genomics, The Royal Marsden NHS Foundation, London, UK
| | - Louis Chesler
- Paediatric Tumour Biology, Division of Clinical Studies, The Institute of Cancer Research, London, UK; Children and Young People's Unit, Royal Marsden NHS Foundation Trust, London, UK
| |
Collapse
|
23
|
Moreno L, Moroz V, Owens C, Valteau-Couanet D, Gambart M, Castel V, van Eijkelenburg N, Castellano A, Nysom K, Gerber N, Laureys G, Ladenstein R, Thebaud E, Murphy D, Morland B, Vaidya S, Elliott M, Pearson A, Wheatley K. Bevacizumab for children with relapsed & refractory high-risk neuroblastoma (RR-HRNB): Results of the BEACON-neuroblastoma randomized phase II trial - A European ITCC-SIOPEN trial. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz394.061] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
|
24
|
Roy Moulik N, Vaidya S, Mandeville H, Chisholm JC. Managing peritoneal involvement in children and young people with rhabdomyosarcoma: A single-center experience from the United Kingdom. Pediatr Blood Cancer 2019; 66:e27805. [PMID: 31131973 DOI: 10.1002/pbc.27805] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2018] [Revised: 03/05/2019] [Accepted: 04/15/2019] [Indexed: 12/12/2022]
Abstract
We describe our experience in managing nine children and adolescents with rhabdomyosarcoma (RMS) and peritoneal involvement. The radiological pattern of peritoneal involvement was diverse from only ascites to solid peritoneal mass/omental caking. Treatment included systemic chemotherapy in all, surgery in three, and radiotherapy in eight. Two patients with presumed nonmalignant ascites, no solid peritoneal metastasis, nonalveolar histology, near-complete resection of residual disease, and radiotherapy survived long term. One patient has just completed treatment, and the remaining six relapsed/progressed at the time of reporting. Five of six patients died after a median of 5 (3-7) months from relapse despite second-line chemotherapy.
Collapse
Affiliation(s)
- Nirmalya Roy Moulik
- Children and Young People's Unit, Royal Marsden Hospital, Sutton, United Kingdom
| | - Sucheta Vaidya
- Children and Young People's Unit, Royal Marsden Hospital, Sutton, United Kingdom
| | - Henry Mandeville
- Children and Young People's Unit, Royal Marsden Hospital, Sutton, United Kingdom
| | - Julia C Chisholm
- Children and Young People's Unit, Royal Marsden Hospital, Sutton, United Kingdom
| |
Collapse
|
25
|
Hossain MA, Vaidya S, Acharya M, Joshi D, Sunny SA, Khan OS. Atypical Location of an Atrial Myxoma: A Case Report. Mymensingh Med J 2019; 28:705-707. [PMID: 31391449] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Here, we report a case of a right atrial myxoma attached to the lateral wall, which is seen in only 10% cases, impinging upon the tricuspid valve. A 57 year old male normotensive, non-diabetic, nonsmoker patient was presented to us on 5th of August 2018 with the complaints of cough, dyspnea and orthopnea for the last two years. This type of presentation is very rare. After excision of myxoma, there was a significant improvement in the signs and symptoms of the patient. In this report, we emphasize the rarity of myxoma in the Right Atrium, and its difficulty in diagnosis because of its uncommon location and atypical presentation, surgical management has shown to quickly alleviate the majority of symptom and expectant sequeale.
Collapse
Affiliation(s)
- M A Hossain
- Dr Md Aslam Hossain, Associate Professor, Department of Cardio Vascular and Thoracic Surgery, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh; E-mail:
| | | | | | | | | | | |
Collapse
|
26
|
Moreno L, Moroz V, Owens C, Laidler J, Valteau-Couanet D, Gambart M, Castel V, Van Eijkelenburg N, Castellano A, Nysom K, Gerber NU, Laureys G, Ladenstein RL, Makin G, Vaidya S, Thebaud E, Kearns P, Pearson ADJ, Wheatley K. Temozolomide versus irinotecan-temozolomide for children with relapsed and refractory high risk neuroblastoma (RR-HRNB): Results of the BEACON-Neuroblastoma randomized phase 2 trial—A European Innovative Therapies for Children with Cancer (ITCC) - International Society of Pediatric Oncology Europe Neuroblastoma Group (SIOPEN) trial. J Clin Oncol 2019. [DOI: 10.1200/jco.2019.37.15_suppl.10001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
10001 Background: BEACON-Neuroblastoma is a randomized Phase II trial to assess the activity of backbone chemotherapy regimens for children with RR-HRNB and to determine if inhibiting angiogenesis with bevacizumab adds to the activity of this chemotherapy. Methods: Patients aged 1-21 years with RR-HRNB with adequate organ function and performance status were randomized in a 2x2 factorial design to: temozolomide (T) versus irinotecan-temozolomide (IT), with or without bevacizumab. Here we report the results of the irinotecan randomization (T vs. IT), which had a probability-based Bayesian design. Primary endpoint was best overall response (complete or partial) during the first 6 courses, by RECIST for measurable disease patients and International Neuroblastoma Response Criteria for evaluable disease patients for which overall response rate (ORR) was calculated. Results: From 2013 to 2018, 61 patients were randomized to treatment with T and 60 to IT. Median age was 5.8 years. 85 and 36 had measurable and evaluable disease respectively; 55 and 66 had refractory and relapsed disease; 22 had MYCN amplification. Baseline characteristics were balanced between the arms. Response data was not yet available for 2 patients on T. Response was not assessable for 17 patients (did not have treatment or stopped early) who were considered non-responders. The ORR was 24% for T and 17% for IT (risk ratio (RR) = 0.70, 95% credible interval 0.32 to 1.44). The probability that the RR for ORR was >1.0 was 17%, meaning that IT did not show greater activity than T. There was no interaction between treatment with/without bevacizumab (heterogeneity test, p=0.7). 27 (44%) T and 35 (58%) IT patients had grade ≥3 toxicities as per CTCAE v4.0. Diarrhea occurred in no patients on T and 7 (12%) on IT; hematological toxicities included anemia (6 T, 4 IT), neutropenia (14 T, 22 IT) and thrombocytopenia (14 T, 11 IT). Conclusions: Irinotecan does not improve the response rate when added to temozolomide in RR-HRNB, but does increase diarrhea. Longer follow-up is needed before assessing whether it impacts progression-free or overall survival. Number of responses by treatment arm. Clinical trial information: NCT02308527. [Table: see text]
Collapse
Affiliation(s)
- Lucas Moreno
- Hospital Universitario Niño Jesús, Madrid, Spain
| | - Veronica Moroz
- University of Birmingham, Cancer Research UK Clinical Trials Unit, Birmingham, United Kingdom
| | - Cormac Owens
- Pediatric Haematology/Oncology, Our Lady’s Children’s Hospital, Crumlin, Dublin, Ireland
| | - Jennifer Laidler
- University of Birmingham, Cancer Research Clinical Trials Unit, Birmingham, United Kingdom
| | | | | | - Victoria Castel
- Hospital Universiario y Politecnico La Fe Valencia, Valencia, Spain
| | | | | | | | | | | | - Ruth Lydia Ladenstein
- St. Anna Children's Hospital and Department of Paediatrics, Medical University Vienna, Vienna, Austria
| | - Guy Makin
- University of Manchester, Manchester, United Kingdom
| | | | | | - Pamela Kearns
- University of Birmingham, Birmingham, United Kingdom
| | - Andrew DJ Pearson
- The Royal Marsden NHS Foundation Trust and Institute of Cancer Research, London, United Kingdom
| | | |
Collapse
|
27
|
Carceller F, Jerome NP, Fowkes LA, Khabra K, Mackinnon A, Bautista F, Marshall LV, Vaidya S, Mandeville H, Morgan V, Leach MO, Koh DM. Post-radiotherapy apparent diffusion coefficient (ADC) in children and young adults with high-grade gliomas and diffuse intrinsic pontine gliomas. Pediatr Hematol Oncol 2019; 36:103-112. [PMID: 30978130 DOI: 10.1080/08880018.2019.1592267] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2018] [Accepted: 03/05/2019] [Indexed: 01/14/2023]
Abstract
Objectives: Diffusion-weighted magnetic resonance imaging (DW-MRI) offers potential to monitor response and predict survival in high-grade gliomas (HGG) and diffuse intrinsic pontine gliomas (DIPG). We hypothesized that post-radiotherapy DW-MRI may provide prognostic imaging biomarkers in children and young adults with these tumors. Methods: Patients aged ≤21 years diagnosed between 2005 and 2012 were eligible. The tumor median apparent diffusion coefficient (ADC) and its 5th percentile (C5-ADC) were determined at the first post-radiotherapy scan and at the time of radiological progression. DW-MRI parameters were correlated with survival endpoints, temozolomide use and pseudoprogression, when it occurred. Results: Out of 40 patients (20 HGG, 20 DIPG), 23 had evaluable DW-MRI post-radiotherapy and 25 at radiological progression. There were 6 episodes of pseudoprogression. Hazard ratios (95%CI) for progression-free survival were 0.998 (0.993-1.003) for median ADC and 1.003 (0.996-1.010) for C5-ADC. Hazard ratios (95%CI) for overall survival were 1.0009 (0.996-1.006) for median ADC and 0.998 (0.992-1.004) for C5-ADC. Post-radiotherapy median and C5-ADC values were not significantly different between patients treated with radiotherapy alone versus radiotherapy/temozolomide. The median and C5-ADC values were not significantly different at the time of pseudoprogression compared to those at tumor progression. Conclusions: Post-radiotherapy median ADC and C5-ADC were not prognostic, nor able to differentiate radiosensitization with temozolomide or occurrence of pseudoprogression in this cohort of HGG and DIPG patients. Further exploration of alternative DW parameters, study timepoints or data modeling may contribute to the development of prognostic/predictive imaging biomarkers for children and young adults with HGG or DIPG.
Collapse
Affiliation(s)
- Fernando Carceller
- a Paediatric Neuro-Oncology and Drug Development Teams, Children & Young People's Unit , The Royal Marsden NHS Foundation Trust , London , UK
- b Division of Clinical Studies and Cancer Therapeutics , The Institute of Cancer Research , London , UK
| | - Neil P Jerome
- c Cancer Research UK Cancer Imaging Centre , The Institute of Cancer Research , London , UK
- d Department of Circulation and Medical Imaging , NTNU - Norwegian University of Science and Technology , Trondheim , Norway
| | - Lucy A Fowkes
- e Department of Radiology , The Royal Marsden NHS Foundation Trust , London , UK
| | - Komel Khabra
- f The Royal Marsden NHS Foundation Trust , Research Data Management and Statistics Unit , London , UK
- g MRC Clinical Trials Unit, University College London , London , UK
| | - Andrew Mackinnon
- e Department of Radiology , The Royal Marsden NHS Foundation Trust , London , UK
| | | | - Lynley V Marshall
- a Paediatric Neuro-Oncology and Drug Development Teams, Children & Young People's Unit , The Royal Marsden NHS Foundation Trust , London , UK
- b Division of Clinical Studies and Cancer Therapeutics , The Institute of Cancer Research , London , UK
| | - Sucheta Vaidya
- a Paediatric Neuro-Oncology and Drug Development Teams, Children & Young People's Unit , The Royal Marsden NHS Foundation Trust , London , UK
- b Division of Clinical Studies and Cancer Therapeutics , The Institute of Cancer Research , London , UK
| | - Henry Mandeville
- i Department of Radiotherapy , The Royal Marsden NHS Foundation Trust , London , UK
| | - Veronica Morgan
- e Department of Radiology , The Royal Marsden NHS Foundation Trust , London , UK
| | - Martin O Leach
- c Cancer Research UK Cancer Imaging Centre , The Institute of Cancer Research , London , UK
| | - Dow-Mu Koh
- e Department of Radiology , The Royal Marsden NHS Foundation Trust , London , UK
| |
Collapse
|
28
|
Triolo TM, Fouts A, Pyle L, Yu L, Gottlieb PA, Steck AK, Greenbaum CJ, Atkinson M, Baidal D, Battaglia M, Becker D, Bingley P, Bosi E, Buckner J, Clements M, Colman P, DiMeglio L, Gitelman S, Goland R, Gottlieb P, Herold K, Knip M, Krischer J, Lernmark A, Moore W, Moran A, Muir A, Palmer J, Peakman M, Philipson L, Raskin P, Redondo M, Rodriguez H, Russell W, Spain L, Schatz D, Sosenko J, Wentworth J, Wherrett D, Wilson D, Winter W, Ziegler A, Anderson M, Antinozzi P, Benoist C, Blum J, Bourcier K, Chase P, Clare-Salzler M, Clynes R, Eisenbarth G, Fathman C, Grave G, Hering B, Insel R, Kaufman F, Kay T, Leschek E, Mahon J, Marks J, Nanto-Salonen K, Nepom G, Orban T, Parkman R, Pescovitz M, Peyman J, Pugliese A, Roep B, Roncarolo M, Savage P, Simell O, Sherwin R, Siegelman M, Skyler J, Steck A, Thomas J, Trucco M, Wagner J, Krischer JP, Leschek E, Rafkin L, Bourcier K, Cowie C, Foulkes M, Insel R, Krause-Steinrauf H, Lachin JM, Malozowski S, Peyman J, Ridge J, Savage P, Skyler JS, Zafonte SJ, Rafkin L, Sosenko JM, Kenyon NS, Santiago I, Krischer JP, Bundy B, Abbondondolo M, Dixit S, Pasha M, King K, Adcock H, Atterberry L, Fox K, Englert N, Mauras J, Permuy K, Sikes T, Adams T, Berhe B, Guendling L, McLennan L, Paganessi C, Murphy M, Draznin M, Kamboj S, Sheppard V, Lewis L, Coates W, Amado D, Moore G, Babar J, Bedard D, Brenson-Hughes J, Cernich M, Clements R, Duprau S, Goodman L, Hester L, Huerta-Saenz A, Asif I, Karmazin T, Letjen S, Raman D, Morin W, Bestermann E, Morawski J, White A, Brockmyer R, Bays S, Campbell A, Boonstra M, Stapleton N, Stone A, Donoho H, Everett H, Hensley M, Johnson C, Marshall N, Skirvin P, Taylor R, Williams L, Burroughs C, Ray C, Wolverton D, Nickels C, Dothard P, Speiser M, Pellizzari L, Bokor K, Izuora S, Abdelnour P, Cummings S, Cuthbertson D, Paynor M, Leahy M, Riedl S, Shockley R, Saad T, Briones S, Casella C, Herz K, Walsh J, Greening F, Deemer M, Hay S, Hunt N, Sikotra L, Simons D, Karounos R, Oremus L, Dye L, Myers D, Ballard W, Miers R, Eberhard C, Sparks K, Thraikill K, Edwards J, Fowlkes S, Kemp A, Morales L, Holland L, Johnson P, Paul A, Ghatak K, Fiske S, Phelen H, Leyland T, Henderson D, Brenner E, Oppenheimer I, Mamkin C, Moniz C, Clarson M, Lovell A, Peters V, Ford J, Ruelas D, Borut D, Burt M, Jordan S, Castilla P, Flores M, Ruiz L, Hanson J, Green-Blair R, Sheridan K, Garmeson J, Wintergerst G, Pierce A, Omoruyi M, Foster S, Kingery A, Lunsford I, Cervantes T, Parker P, Price J, Urben I, Guillette H, Doughty H, Haydock V, Parker P, Bergman S, Duncum C, Rodda A, Perelman R, Calendo C, Barrera E, Arce-Nunez Y, Geyer S, Martinez M, De la Portilla I, Cardenas L, Garrido M, Villar R, Lorini E, Calandra G, D’Annuzio K, Perri N, Minuto C, Hays B, Rebora R, Callegari O, Ali J, Kramer B, Auble S, Cabrera P, Donohoue R, Fiallo-Scharer M, Hessner P, Wolfgram A, Henderson C, Kansra N, Bettin R, McCuller A, Miller S, Accacha J, Corrigan E, Fiore R, Levine T, Mahoney C, Polychronakos V, Henry M, Gagne H, Starkman M, Fox D, Chin F, Melchionne L, Silverman I, Marshall L, Cerracchio J, Cruz A, Viswanathan J, Heyman K, Wilson S, Chalew S, Valley S, Layburn A, Lala P, Clesi M, Genet G, Uwaifo A, Charron T, Allerton W, Hsiao B, Cefalu L, Melendez-Ramirez R, Richards C, Alleyn E, Gustafson M, Lizanna J, Wahlen S, Aleiwe M, Hansen H, Wahlen C, Karges C, Levy A, Bonaccorso R, Rapaport Y, Tomer D, Chia M, Goldis L, Iazzetti M, Klein C, Levister L, Waldman E, Keaton N, Wallach M, Regelmann Z, Antal M, Aranda C, Reynholds A, Vinik P, Barlow M, Bourcier M, Nevoret J, Couper S, Kinderman A, Beresford N, Thalagne H, Roper J, Gibbons J, Hill S, Balleaut C, Brennan J, Ellis-Gage L, Fear T, Gray L, Law P, Jones C, McNerney L, Pointer N, Price K, Few D, Tomlinson N, Leech D, Wake C, Owens M, Burns J, Leinbach A, Wotherspoon A, Murray K, Short G, Curry S, Kelsey J, Lawson J, Porter S, Stevens E, Thomson S, Winship L, Liu S, Wynn E, Wiltshire J, Krebs P, Cresswell H, Faherty C, Ross L, Denvir J, Drew T, Randell P, Mansell S, Lloyd J, Bell S, Butler Y, Hooton H, Navarra A, Roper G, Babington L, Crate H, Cripps A, Ledlie C, Moulds R, Malloy J, Norton B, Petrova O, Silkstone C, Smith K, Ghai M, Murray V, Viswanathan M, Henegan O, Kawadry J, Olson L, Maddox K, Patterson T, Ahmad B, Flores D, Domek S, Domek K, Copeland M, George J, Less T, Davis M, Short A, Martin J, Dwarakanathan P, O’Donnell B, Boerner L, Larson M, Phillips M, Rendell K, Larson C, Smith K, Zebrowski L, Kuechenmeister M, Miller J, Thevarayapillai M, Daniels H, Speer N, Forghani R, Quintana C, Reh A, Bhangoo P, Desrosiers L, Ireland T, Misla C, Milliot E, Torres S, Wells J, Villar M, Yu D, Berry D, Cook J, Soder A, Powell M, Ng M, Morrison Z, Moore M, Haslam M, Lawson B, Bradley J, Courtney C, Richardson C, Watson E, Keely D, DeCurtis M, Vaccarcello-Cruz Z, Torres K, Muller S, Sandberg H, Hsiang B, Joy D, McCormick A, Powell H, Jones J, Bell S, Hargadon S, Hudson M, Kummer S, Nguyen T, Sauder E, Sutton K, Gensel R, Aguirre-Castaneda V, Benavides, Lopez D, Hemp S, Allen J, Stear E, Davis T, O’Donnell R, Jones A, Roberts J, Dart N, Paramalingam L, Levitt Katz N, Chaudhary K, Murphy S, Willi B, Schwartzman C, Kapadia D, Roberts A, Larson D, McClellan G, Shaibai L, Kelley G, Villa C, Kelley R, Diamond M, Kabbani T, Dajani F, Hoekstra M, Sadler K, Magorno J, Holst V, Chauhan N, Wilson P, Bononi M, Sperl A, Millward M, Eaton L, Dean J, Olshan H, Stavros T, Renna C, Milliard, Brodksy L, Bacon J, Quintos L, Topor S, Bialo B, Bancroft A, Soto W, Lagarde H, Tamura R, Lockemer T, Vanderploeg M, Ibrahim M, Huie V, Sanchez R, Edelen R, Marchiando J, Palmer T, Repas M, Wasson P, Wood K, Auker J, Culbertson T, Kieffer D, Voorhees T, Borgwardt L, DeRaad K, Eckert E, Isaacson H, Kuhn A, Carroll M, Xu P, Schubert G, Francis S, Hagan T, Le M, Penn E, Wickham C, Leyva K, Rivera J, Padilla I, Rodriguez N, Young K, Jospe J, Czyzyk B, Johnson U, Nadgir N, Marlen G, Prakasam C, Rieger N, Glaser E, Heiser B, Harris C, Alies P, Foster H, Slater K, Wheeler D, Donaldson M, Murray D, Hale R, Tragus D, Word J, Lynch L, Pankratz W, Badias F, Rogers R, Newfield S, Holland M, Hashiguchi M, Gottschalk A, Philis-Tsimikas R, Rosal S, Franklin S, Guardado N, Bohannon M, Baker A, Garcia T, Aguinaldo J, Phan V, Barraza D, Cohen J, Pinsker U, Khan J, Wiley L, Jovanovic P, Misra M, Bassi M, Wright D, Cohen K, Huang M, Skiles S, Maxcy C, Pihoker K, Cochrane J, Fosse S, Kearns M, Klingsheim N, Beam C, Wright L, Viles H, Smith S, Heller M, Cunningham A, Daniels L, Zeiden J, Field R, Walker K, Griffin L, Boulware D, Bartholow C, Erickson J, Howard B, Krabbenhoft C, Sandman A, Vanveldhuizen J, Wurlger A, Zimmerman K, Hanisch L, Davis-Keppen A, Bounmananh L, Cotterill J, Kirby M, Harris A, Schmidt C, Kishiyama C, Flores J, Milton W, Martin C, Whysham A, Yerka T, Bream S, Freels J, Hassing J, Webster R, Green P, Carter J, Galloway D, Hoelzer S, Roberts S, Said P, Sullivan H, Freeman D, Allen E, Reiter E, Feinberg C, Johnson L, Newhook D, Hagerty N, White L, Levandoski J, Kyllo M, Johnson C, Gough J, Benoit P, Iyer F, Diamond H, Hosono S, Jackman L, Barette P, Jones I, Sills S, Bzdick J, Bulger R, Ginem J, Weinstock I, Douek R, Andrews G, Modgill G, Gyorffy L, Robin N, Vaidya S, Crouch K, O’Brien C, Thompson N, Granger M, Thorne J, Blumer J, Kalic L, Klepek J, Paulett B, Rosolowski J, Horner M, Watkins J, Casey K, Carpenter C, Michelle Kieffer MH, Burns J, Horton C, Pritchard D, Soetaert A, Wynne C, Chin O, Molina C, Patel R, Senguttuvan M, Wheeler O, Lane P, Furet C, Steuhm D, Jelley S, Goudeau L, Chalmers D, Greer C, Panagiotopoulos D, Metzger D, Nguyen M, Horowitz M, Linton C, Christiansen E, Glades C, Morimoto M, Macarewich R, Norman K, Patin C, Vargas A, Barbanica A, Yu P, Vaidyanathan W, Nallamshetty L, Osborne R, Mehra S, Kaster S, Neace J, Horner G, Reeves C, Cordrey L, Marrs T, Miller S, Dowshen D, Oduah V, Doyle S, Walker D, Catte H, Dean M, Drury-Brown B, Hackman M, Lee S, Malkani K, Cullen K, Johnson P, Parrimon Y, Hampton M, McCarrell C, Curtis E, Paul, Zambrano Y, Paulus K, Pilger J, Ramiro J, Luvon Ritzie AQ, Sharma A, Shor A, Song X, Terry A, Weinberger J, Wootten M, Lachin JM, Foulkes M, Harding P, Krause-Steinrauf H, McDonough S, McGee PF, Owens Hess K, Phoebus D, Quinlan S, Raiden E, Batts E, Buddy C, Kirpatrick K, Ramey M, Shultz A, Webb C, Romesco M, Fradkin J, Leschek E, Spain L, Savage P, Aas S, Blumberg E, Beck G, Brillon D, Gubitosi-Klug R, Laffel L, Vigersky R, Wallace D, Braun J, Lernmark A, Lo B, Mitchell H, Naji A, Nerup J, Orchard T, Steffes M, Tsiatis A, Veatch R, Zinman B, Loechelt B, Baden L, Green M, Weinberg A, Marcovina S, Palmer JP, Weinberg A, Yu L, Babu S, Winter W, Eisenbarth GS, Bingley P, Clynes R, DiMeglio L, Eisenbarth G, Hays B, Leschek E, Marks J, Matheson D, Rafkin L, Rodriguez H, Spain L, Wilson D, Redondo M, Gomez D, McDonald A, Pena S, Pietropaolo M, Shippy K, Batts E, Brown T, Buckner J, Dove A, Hammond M, Hefty D, Klein J, Kuhns K, Letlau M, Lord S, McCulloch-Olson M, Miller L, Nepom G, Odegard J, Ramey M, Sachter E, St. Marie M, Stickney K, VanBuecken D, Vellek B, Webber C, Allen L, Bollyk J, Hilderman N, Ismail H, Lamola S, Sanda S, Vendettuoli H, Tridgell D, Monzavi R, Bock M, Fisher L, Halvorson M, Jeandron D, Kim M, Wood J, Geffner M, Kaufman F, Parkman R, Salazar C, Goland R, Clynes R, Cook S, Freeby M, Pat Gallagher M, Gandica R, Greenberg E, Kurland A, Pollak S, Wolk A, Chan M, Koplimae L, Levine E, Smith K, Trast J, DiMeglio L, Blum J, Evans-Molina C, Hufferd R, Jagielo B, Kruse C, Patrick V, Rigby M, Spall M, Swinney K, Terrell J, Christner L, Ford L, Lynch S, Menendez M, Merrill P, Pescovitz M, Rodriguez H, Alleyn C, Baidal D, Fay S, Gaglia J, Resnick B, Szubowicz S, Weir G, Benjamin R, Conboy D, deManbey A, Jackson R, Jalahej H, Orban T, Ricker A, Wolfsdorf J, Zhang HH, Wilson D, Aye T, Baker B, Barahona K, Buckingham B, Esrey K, Esrey T, Fathman G, Snyder R, Aneja B, Chatav M, Espinoza O, Frank E, Liu J, Perry J, Pyle R, Rigby A, Riley K, Soto A, Gitelman S, Adi S, Anderson M, Berhel A, Breen K, Fraser K, Gerard-Gonzalez A, Jossan P, Lustig R, Moassesfar S, Mugg A, Ng D, Prahalod P, Rangel-Lugo M, Sanda S, Tarkoff J, Torok C, Wesch R, Aslan I, Buchanan J, Cordier J, Hamilton C, Hawkins L, Ho T, Jain A, Ko K, Lee T, Phelps S, Rosenthal S, Sahakitrungruang T, Stehl L, Taylor L, Wertz M, Wong J, Philipson L, Briars R, Devine N, Littlejohn E, Grant T, Gottlieb P, Klingensmith G, Steck A, Alkanani A, Bautista K, Bedoy R, Blau A, Burke B, Cory L, Dang M, Fitzgerald-Miller L, Fouts A, Gage V, Garg S, Gesauldo P, Gutin R, Hayes C, Hoffman M, Ketchum K, Logsden-Sackett N, Maahs D, Messer L, Meyers L, Michels A, Peacock S, Rewers M, Rodriguez P, Sepulbeda F, Sippl R, Steck A, Taki I, Tran BK, Tran T, Wadwa RP, Zeitler P, Barker J, Barry S, Birks L, Bomsburger L, Bookert T, Briggs L, Burdick P, Cabrera R, Chase P, Cobry E, Conley A, Cook G, Daniels J, DiDomenico D, Eckert J, Ehler A, Eisenbarth G, Fain P, Fiallo-Scharer R, Frank N, Goettle H, Haarhues M, Harris S, Horton L, Hutton J, Jeffrrey J, Jenison R, Jones K, Kastelic W, King MA, Lehr D, Lungaro J, Mason K, Maurer H, Nguyen L, Proto A, Realsen J, Schmitt K, Schwartz M, Skovgaard S, Smith J, Vanderwel B, Voelmle M, Wagner R, Wallace A, Walravens P, Weiner L, Westerhoff B, Westfall E, Widmer K, Wright H, Schatz D, Abraham A, Atkinson M, Cintron M, Clare-Salzler M, Ferguson J, Haller M, Hosford J, Mancini D, Rohrs H, Silverstein J, Thomas J, Winter W, Cole G, Cook R, Coy R, Hicks E, Lewis N, Marks J, Pugliese A, Blaschke C, Matheson D, Pugliese A, Sanders-Branca N, Ray Arce LA, Cisneros M, Sabbag S, Moran A, Gibson C, Fife B, Hering B, Kwong C, Leschyshyn J, Nathan B, Pappenfus B, Street A, Boes MA, Peterson Eck S, Finney L, Albright Fischer T, Martin A, Jacqueline Muzamhindo C, Rhodes M, Smith J, Wagner J, Wood B, Becker D, Delallo K, Diaz A, Elnyczky B, Libman I, Pasek B, Riley K, Trucco M, Copemen B, Gwynn D, Toledo F, Rodriguez H, Bollepalli S, Diamond F, Eyth E, Henson D, Lenz A, Shulman D, Raskin P, Adhikari S, Dickson B, Dunnigan E, Lingvay I, Pruneda L, Ramos-Roman M, Raskin P, Rhee C, Richard J, Siegelman M, Sturges D, Sumpter K, White P, Alford M, Arthur J, Aviles-Santa ML, Cordova E, Davis R, Fernandez S, Fordan S, Hardin T, Jacobs A, Kaloyanova P, Lukacova-Zib I, Mirfakhraee S, Mohan A, Noto H, Smith O, Torres N, Wherrett D, Balmer D, Eisel L, Kovalakovska R, Mehan M, Sultan F, Ahenkorah B, Cevallos J, Razack N, Jo Ricci M, Rhode A, Srikandarajah M, Steger R, Russell WE, Black M, Brendle F, Brown A, Moore D, Pittel E, Robertson A, Shannon A, Thomas JW, Herold K, Feldman L, Sherwin R, Tamborlane W, Weinzimer S, Toppari J, Kallio T, Kärkkäinen M, Mäntymäki E, Niininen T, Nurmi B, Rajala P, Romo M, Suomenrinne S, Näntö-Salonen K, Simell O, Simell T, Bosi E, Battaglia M, Bianconi E, Bonfanti R, Grogan P, Laurenzi A, Martinenghi S, Meschi F, Pastore M, Falqui L, Teresa Muscato M, Viscardi M, Bingley P, Castleden H, Farthing N, Loud S, Matthews C, McGhee J, Morgan A, Pollitt J, Elliot-Jones R, Wheaton C, Knip M, Siljander H, Suomalainen H, Colman P, Healy F, Mesfin S, Redl L, Wentworth J, Willis J, Farley M, Harrison L, Perry C, Williams F, Mayo A, Paxton J, Thompson V, Volin L, Fenton C, Carr L, Lemon E, Swank M, Luidens M, Salgam M, Sharma V, Schade D, King C, Carano R, Heiden J, Means N, Holman L, Thomas I, Madrigal D, Muth T, Martin C, Plunkett C, Ramm C, Auchus R, Lane W, Avots E, Buford M, Hale C, Hoyle J, Lane B, Muir A, Shuler S, Raviele N, Ivie E, Jenkins M, Lindsley K, Hansen I, Fadoju D, Felner E, Bode B, Hosey R, Sax J, Jefferies C, Mannering S, Prentis R, She J, Stachura M, Hopkins D, Williams J, Steed L, Asatapova E, Nunez S, Knight S, Dixon P, Ching J, Donner T, Longnecker S, Abel K, Arcara K, Blackman S, Clark L, Cooke D, Plotnick L, Levin P, Bromberger L, Klein K, Sadurska K, Allen C, Michaud D, Snodgrass H, Burghen G, Chatha S, Clark C, Silverberg J, Wittmer C, Gardner J, LeBoeuf C, Bell P, McGlore O, Tennet H, Alba N, Carroll M, Baert L, Beaton H, Cordell E, Haynes A, Reed C, Lichter K, McCarthy P, McCarthy S, Monchamp T, Roach J, Manies S, Gunville F, Marosok L, Nelson T, Ackerman K, Rudolph J, Stewart M, McCormick K, May S, Falls T, Barrett T, Dale K, Makusha L, McTernana C, Penny-Thomas K, Sullivan K, Narendran P, Robbie J, Smith D, Christensen R, Koehler B, Royal C, Arthur T, Houser H, Renaldi J, Watsen S, Wu P, Lyons L, House B, Yu J, Holt H, Nation M, Vickers C, Watling R, Heptulla R, Trast J, Agarwal C, Newell D, Katikaneni R, Gardner C, Del A, Rio A, Logan H, Collier C, Rishton G, Whalley A, Ali S, Ramtoola T, Quattrin L, Mastrandea A, House M, Ecker C, Huang C, Gougeon J, Ho D, Pacuad D, Dunger J, May C, O’Brien C, Acerini B, Salgin A, Thankamony R, Williams J, Buse G, Fuller M, Duclos J, Tricome H, Brown D, Pittard D, Bowlby A, Blue T, Headley S, Bendre K, Lewis K, Sutphin C, Soloranzo J, Puskaric H, Madison M, Rincon M, Carlucci R, Shridharani B, Rusk E, Tessman D, Huffman H, Abrams B, Biederman M, Jones V, Leathers W, Brickman P, Petrie D, Zimmerman J, Howard L, Miller R, Alemzadeh D, Mihailescu R, Melgozza-Walker N, Abdulla C, Boucher-Berry D, Ize-Ludlow R, Levy C, Swenson, Brousell N, Crimmins D, Edler T, Weis C, Schultz D, Rogers D, Latham C, Mawhorter C, Switzer W, Spencer P, Konstantnopoulus S, Broder J, Klein L, Knight L, Szadek G, Welnick B, Thompson R, Hoffman A, Revell J, Cherko K, Carter E, Gilson J, Haines G, Arthur B, Bowen W, Zipf P, Graves R, Lozano D, Seiple K, Spicer A, Chang J, Fregosi J, Harbinson C, Paulson S, Stalters P, Wright D, Zlock A, Freeth J, Victory H, Maheshwari A, Maheshwari T, Holmstrom J, Bueno R, Arguello J, Ahern L, Noreika V, Watson S, Hourse P, Breyer C, Kissel Y, Nicholson M, Pfeifer S, Almazan J, Bajaj M, Quinn K, Funk J, McCance E, Moreno R, Veintimilla A, Wells J, Cook S, Trunnel J, Henske S, Desai K, Frizelis F, Khan R, Sjoberg K, Allen P, Manning G, Hendry B, Taylor S, Jones W, Strader M, Bencomo T, Bailey L, Bedolla C, Roldan C, Moudiotis B, Vaidya C, Anning S, Bunce S, Estcourt E, Folland E, Gordon C, Harrill J, Ireland J, Piper L, Scaife K, Sutton S, Wilkins M, Costelloe J, Palmer L, Casas C, Miller M, Burgard C, Erickson J, Hallanger-Johnson P, Clark W, Taylor A, Lafferty S, Gillett C, Nolan M, Pathak L, Sondrol T, Hjelle S, Hafner J, Kotrba R, Hendrickson A, Cemeroglu T, Symington M, Daniel Y, Appiagyei-Dankah D, Postellon M, Racine L, Kleis K, Barnes S, Godwin H, McCullough K, Shaheen G, Buck L, Noel M, Warren S, Weber S, Parker I, Gillespie B, Nelson C, Frost J, Amrhein E, Moreland A, Hayes J, Peggram J, Aisenberg M, Riordan J, Zasa E, Cummings K, Scott T, Pinto A, Mokashi K, McAssey E, Helden P, Hammond L, Dinning S, Rahman S, Ray C, Dimicri S, Guppy H, Nielsen C, Vogel C, Ariza L, Morales Y, Chang R, Gabbay L, Ambrocio L, Manley R, Nemery W, Charlton P, Smith L, Kerr B, Steindel-Kopp M, Alamaguer D, Liljenquist G, Browning T, Coughenour M, Sulk E, Tsalikan M, Tansey J, Cabbage N. Identical and Nonidentical Twins: Risk and Factors Involved in Development of Islet Autoimmunity and Type 1 Diabetes. Diabetes Care 2019; 42:192-199. [PMID: 30061316 PMCID: PMC6341285 DOI: 10.2337/dc18-0288] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2018] [Accepted: 06/28/2018] [Indexed: 02/03/2023]
Abstract
OBJECTIVE There are variable reports of risk of concordance for progression to islet autoantibodies and type 1 diabetes in identical twins after one twin is diagnosed. We examined development of positive autoantibodies and type 1 diabetes and the effects of genetic factors and common environment on autoantibody positivity in identical twins, nonidentical twins, and full siblings. RESEARCH DESIGN AND METHODS Subjects from the TrialNet Pathway to Prevention Study (N = 48,026) were screened from 2004 to 2015 for islet autoantibodies (GAD antibody [GADA], insulinoma-associated antigen 2 [IA-2A], and autoantibodies against insulin [IAA]). Of these subjects, 17,226 (157 identical twins, 283 nonidentical twins, and 16,786 full siblings) were followed for autoantibody positivity or type 1 diabetes for a median of 2.1 years. RESULTS At screening, identical twins were more likely to have positive GADA, IA-2A, and IAA than nonidentical twins or full siblings (all P < 0.0001). Younger age, male sex, and genetic factors were significant factors for expression of IA-2A, IAA, one or more positive autoantibodies, and two or more positive autoantibodies (all P ≤ 0.03). Initially autoantibody-positive identical twins had a 69% risk of diabetes by 3 years compared with 1.5% for initially autoantibody-negative identical twins. In nonidentical twins, type 1 diabetes risk by 3 years was 72% for initially multiple autoantibody-positive, 13% for single autoantibody-positive, and 0% for initially autoantibody-negative nonidentical twins. Full siblings had a 3-year type 1 diabetes risk of 47% for multiple autoantibody-positive, 12% for single autoantibody-positive, and 0.5% for initially autoantibody-negative subjects. CONCLUSIONS Risk of type 1 diabetes at 3 years is high for initially multiple and single autoantibody-positive identical twins and multiple autoantibody-positive nonidentical twins. Genetic predisposition, age, and male sex are significant risk factors for development of positive autoantibodies in twins.
Collapse
Affiliation(s)
- Taylor M. Triolo
- Barbara Davis Center for Diabetes, University of Colorado School of Medicine, Aurora, CO
| | - Alexandra Fouts
- Barbara Davis Center for Diabetes, University of Colorado School of Medicine, Aurora, CO
| | - Laura Pyle
- Department of Pediatrics, University of Colorado Anschutz Medical Campus, Aurora, CO
| | - Liping Yu
- Barbara Davis Center for Diabetes, University of Colorado School of Medicine, Aurora, CO
| | - Peter A. Gottlieb
- Barbara Davis Center for Diabetes, University of Colorado School of Medicine, Aurora, CO
| | - Andrea K. Steck
- Barbara Davis Center for Diabetes, University of Colorado School of Medicine, Aurora, CO
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
29
|
Vaidya S, Gothi D, Patro M, Sah R, Kulshreshtha R. "St. Peregrine tumor" with synchronous primary renal cell carcinoma. Lung India 2019. [DOI: 10.4103/0970-2113.257704] [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: 11/04/2022] Open
|
30
|
Maharjan BR, Bhandary S, Upadhyay S, Ghimire S, Shrestha I, Joshi M, Vaidya S, Pradhan P. Developing tool and Measuring Integration Characteristics of Basic Science Curriculum to Improve Curriculum Integration. Kathmandu Univ Med J (KUMJ) 2018; 16:338-344. [PMID: 31729350] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Background Integrated curriculum enhances students' learning and the retention of knowledge. At Patan Academy of Health Sciences, integrated organ system based curriculum is used with Problem Based Learning as the principle teaching learning method to foster students' learning. In addition, other approaches of integration were under taken such as integrated assessment; logical arrangement teaching learning methods (lectures and practicals); joint effort of faculty in curriculum planning and delivery; conducive environment to foster hidden curriculum. This study describes the perception of faculty and students on integration characteristics of Basic Science curriculum. Objective To measure the integration characteristics of Basic Science Curriculum. Method Tool was developed to measure integration characteristics of Basic Science Curriculum and ensure whether such planned integration has been achieved. Mixed method was used to measure the perception of the integration characteristics i) quantitatively by questionnaire survey to faculty and students ii) qualitatively by in-depth interview of students. Result Both faculty and students perceived that all the blocks in Basic Science was well integrated in the quantitative questionnaire survey. But, in the in-depth interview, students perceived integration of curriculum in organ system blocks were better integrated compared to Principle of Human Biology blocks where fundamentals of basic science disciplines were delivered. Students reflected that Problem Based Learning not only integrated Basic Science disciplines but also with clinical sciences and the social context. But, students perceived that Community Health Sciences curriculum was not so well integrated with Basic Science subjects. Conclusion Overall, this study showed that planned integration in Basic Science curriculum was successfully executed during curriculum implementation.
Collapse
Affiliation(s)
- B R Maharjan
- Department of Biochemistry, School of Medicine, Patan Academy of Health Sciences, Lagankhel-5, Lalitpur, Nepal
| | - S Bhandary
- Department of Community Health Sciences, School of Medicine, Patan Academy of Health Sciences, Lagankhel-5, Lalitpur, Nepal
| | - S Upadhyay
- Department of Community Health Sciences, School of Medicine, Patan Academy of Health Sciences, Lagankhel-5, Lalitpur, Nepal
| | - S Ghimire
- Department of Anatomy, School of Medicine, Patan Academy of Health Sciences, Lagankhel-5, Lalitpur, Nepal
| | - I Shrestha
- Department of Physiology, School of Medicine, Patan Academy of Health Sciences, Lagankhel-5, Lalitpur, Nepal
| | - M Joshi
- Department of Pharmacology, School of Medicine, Patan Academy of Health Sciences, Lagankhel-5, Lalitpur, Nepal
| | - S Vaidya
- Department of Pathology, School of Medicine, Patan Academy of Health Sciences, Lagankhel-5, Lalitpur, Nepal
| | - P Pradhan
- Department of Microbiology, School of Medicine, Patan Academy of Health Sciences, Lagankhel-5, Lalitpur, Nepal
| |
Collapse
|
31
|
Vinci M, Burford A, Molinari V, Kessler K, Popov S, Clarke M, Taylor KR, Pemberton HN, Lord CJ, Gutteridge A, Forshew T, Carvalho D, Marshall LV, Qin EY, Ingram WJ, Moore AS, Ng HK, Trabelsi S, H'mida-Ben Brahim D, Entz-Werle N, Zacharoulis S, Vaidya S, Mandeville HC, Bridges LR, Martin AJ, Al-Sarraj S, Chandler C, Sunol M, Mora J, de Torres C, Cruz O, Carcaboso AM, Monje M, Mackay A, Jones C. Functional diversity and cooperativity between subclonal populations of pediatric glioblastoma and diffuse intrinsic pontine glioma cells. Nat Med 2018; 24:1204-1215. [PMID: 29967352 PMCID: PMC6086334 DOI: 10.1038/s41591-018-0086-7] [Citation(s) in RCA: 121] [Impact Index Per Article: 20.2] [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: 07/26/2016] [Accepted: 05/03/2018] [Indexed: 12/16/2022]
Abstract
The failure to develop effective therapies for pediatric glioblastoma (pGBM) and diffuse intrinsic pontine glioma (DIPG) is in part due to their intrinsic heterogeneity. We aimed to quantitatively assess the extent to which this was present in these tumors through subclonal genomic analyses and to determine whether distinct tumor subpopulations may interact to promote tumorigenesis by generating subclonal patient-derived models in vitro and in vivo. Analysis of 142 sequenced tumors revealed multiple tumor subclones, spatially and temporally coexisting in a stable manner as observed by multiple sampling strategies. We isolated genotypically and phenotypically distinct subpopulations that we propose cooperate to enhance tumorigenicity and resistance to therapy. Inactivating mutations in the H4K20 histone methyltransferase KMT5B (SUV420H1), present in <1% of cells, abrogate DNA repair and confer increased invasion and migration on neighboring cells, in vitro and in vivo, through chemokine signaling and modulation of integrins. These data indicate that even rare tumor subpopulations may exert profound effects on tumorigenesis as a whole and may represent a new avenue for therapeutic development. Unraveling the mechanisms of subclonal diversity and communication in pGBM and DIPG will be an important step toward overcoming barriers to effective treatments.
Collapse
Affiliation(s)
- Mara Vinci
- Centre for Evolution and Cancer, The Institute of Cancer Research, London, UK
- Division of Molecular Pathology, The Institute of Cancer Research, London, UK
- Division of Cancer Therapeutics, The Institute of Cancer Research, London, UK
- Bambino Gesù Children's Hospital-IRCCS, Rome, Italy
| | - Anna Burford
- Centre for Evolution and Cancer, The Institute of Cancer Research, London, UK
- Division of Molecular Pathology, The Institute of Cancer Research, London, UK
- Division of Cancer Therapeutics, The Institute of Cancer Research, London, UK
| | - Valeria Molinari
- Centre for Evolution and Cancer, The Institute of Cancer Research, London, UK
- Division of Molecular Pathology, The Institute of Cancer Research, London, UK
- Division of Cancer Therapeutics, The Institute of Cancer Research, London, UK
| | - Ketty Kessler
- Centre for Evolution and Cancer, The Institute of Cancer Research, London, UK
- Division of Molecular Pathology, The Institute of Cancer Research, London, UK
- Division of Cancer Therapeutics, The Institute of Cancer Research, London, UK
| | - Sergey Popov
- Centre for Evolution and Cancer, The Institute of Cancer Research, London, UK
- Division of Molecular Pathology, The Institute of Cancer Research, London, UK
- Division of Cancer Therapeutics, The Institute of Cancer Research, London, UK
- Department of Cellular Pathology, University Hospital of Wales, Cardiff, UK
| | - Matthew Clarke
- Centre for Evolution and Cancer, The Institute of Cancer Research, London, UK
- Division of Molecular Pathology, The Institute of Cancer Research, London, UK
- Division of Cancer Therapeutics, The Institute of Cancer Research, London, UK
| | - Kathryn R Taylor
- Centre for Evolution and Cancer, The Institute of Cancer Research, London, UK
- Division of Molecular Pathology, The Institute of Cancer Research, London, UK
- Division of Cancer Therapeutics, The Institute of Cancer Research, London, UK
- Stanford University School of Medicine, Stanford, CA, USA
| | - Helen N Pemberton
- CRUK Gene Function Laboratory and Breast Cancer Now Toby Robins Research Centre, The Institute of Cancer Research, London, UK
| | - Christopher J Lord
- CRUK Gene Function Laboratory and Breast Cancer Now Toby Robins Research Centre, The Institute of Cancer Research, London, UK
| | | | - Tim Forshew
- UCL Cancer Institute, University College London, London, UK
| | - Diana Carvalho
- Centre for Evolution and Cancer, The Institute of Cancer Research, London, UK
- Division of Molecular Pathology, The Institute of Cancer Research, London, UK
- Division of Cancer Therapeutics, The Institute of Cancer Research, London, UK
| | - Lynley V Marshall
- Paediatric Oncology Drug Development Team, Children and Young People's Unit, Royal Marsden Hospital, Sutton, UK
| | | | - Wendy J Ingram
- UQ Child Health Research Centre, The University of Queensland, Brisbane, Queensland, Australia
- Oncology Services Group, Children's Health Queensland Hospital and Health Service, Brisbane, Queensland, Australia
| | - Andrew S Moore
- UQ Child Health Research Centre, The University of Queensland, Brisbane, Queensland, Australia
- Oncology Services Group, Children's Health Queensland Hospital and Health Service, Brisbane, Queensland, Australia
- The University of Queensland Diamantina Institute, Translational Research Institute, Brisbane, Queensland, Australia
| | - Ho-Keung Ng
- Department of Anatomical and Cellular Pathology, The Chinese University of Hong Kong, Hong Kong, China
| | - Saoussen Trabelsi
- Department of Cytogenetics and Reproductive Biology, Farhat HACHED Hospital, Sousse, Tunisia
| | - Dorra H'mida-Ben Brahim
- Department of Cytogenetics and Reproductive Biology, Farhat HACHED Hospital, Sousse, Tunisia
- Faculty of Medicine, Sousse, Tunisia
| | - Natacha Entz-Werle
- Centre Hospitalier Régional et Universitaire Hautepierre, Strasbourg, France
| | - Stergios Zacharoulis
- Paediatric Oncology Drug Development Team, Children and Young People's Unit, Royal Marsden Hospital, Sutton, UK
- Department of Pediatric Hematology Oncology, Columbia University Medical Center, New York, NY, USA
| | - Sucheta Vaidya
- Paediatric Oncology Drug Development Team, Children and Young People's Unit, Royal Marsden Hospital, Sutton, UK
| | | | - Leslie R Bridges
- Department of Cellular Pathology, St George's Hospital NHS Trust, London, UK
| | - Andrew J Martin
- Department of Neurosurgery, St George's Hospital NHS Trust, London, UK
| | - Safa Al-Sarraj
- Department of Neuropathology, Kings College Hospital, London, UK
| | | | | | - Jaume Mora
- Hospital Sant Joan de Deu, Barcelona, Spain
| | | | | | | | - Michelle Monje
- Department of Neurology, Stanford University School of Medicine, Stanford, CA, USA
| | - Alan Mackay
- Centre for Evolution and Cancer, The Institute of Cancer Research, London, UK
- Division of Molecular Pathology, The Institute of Cancer Research, London, UK
- Division of Cancer Therapeutics, The Institute of Cancer Research, London, UK
| | - Chris Jones
- Centre for Evolution and Cancer, The Institute of Cancer Research, London, UK.
- Division of Molecular Pathology, The Institute of Cancer Research, London, UK.
- Division of Cancer Therapeutics, The Institute of Cancer Research, London, UK.
| |
Collapse
|
32
|
Wasti A, Carceller F, George S, Koutroumanidou E, Izquierdo E, Guerra P, Zarowiecki M, Campbell J, Al-Lazikani B, Marshall L, Jones C, Clarke M, Powell K, Crowe T, Rogers T, Chisholm J, Vaidya S, Mandeville H, Saran F, Zebian B, Hettige S, Al-Sarraj S, Bridges L, Jacques T, Hargrave D, Pearson A, Walker B, de Castro DG, Hubank M, Chesler L. EAPH-05. MOLECULAR PROFILING AND IDENTIFICATION OF TARGETED THERAPIES FOR CHILDREN AND YOUNG ADULTS WITH PRIMARY CENTRAL NERVOUS SYSTEM TUMOURS IN THE UNITED KINGDOM. Neuro Oncol 2018. [DOI: 10.1093/neuonc/noy059.174] [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] [Indexed: 11/14/2022] Open
Affiliation(s)
| | - Fernando Carceller
- The Royal Marsden Hospital, Sutton, UK
- The Institute of Cancer Research, Sutton, UK
| | - Sally George
- The Institute of Cancer Research, Sutton, UK
- The Royal Marsden Hospital, Sutton, UK
| | | | | | | | | | | | | | - Lynley Marshall
- The Royal Marsden Hospital, Sutton, UK
- The Institute of Cancer Research, Sutton, UK
| | - Chris Jones
- The Institute of Cancer Research, Sutton, UK
| | | | | | | | | | - Julia Chisholm
- The Royal Marsden Hospital, Sutton, UK
- The Institute of Cancer Research, Sutton, UK
| | - Sucheta Vaidya
- The Royal Marsden Hospital, Sutton, UK
- The Institute of Cancer Research, Sutton, UK
| | - Henry Mandeville
- The Royal Marsden Hospital, Sutton, UK
- The Institute of Cancer Research, Sutton, UK
| | - Frank Saran
- The Royal Marsden Hospital, Sutton, UK
- The Institute of Cancer Research, Sutton, UK
| | | | | | | | | | | | | | - Andy Pearson
- The Royal Marsden Hospital, Sutton, UK
- The Institute of Cancer Research, Sutton, UK
| | - Brian Walker
- University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | | | | | - Louis Chesler
- The Institute of Cancer Research, Sutton, UK
- The Royal Marsden Hospital, Sutton, UK
| |
Collapse
|
33
|
Mackay A, Molinari V, Carvalho D, Pemberton H, Temelso S, Burford A, Clarke M, Fofana M, Boult J, Izquierdo E, Taylor K, Bjerke L, Salom JF, Kessler K, Rogers R, Chandler C, Zebian B, Martin A, Stapleton S, Hettige S, Marshall L, Carceller F, Mandeville H, Vaidya S, Bridges L, Al-Sarraj S, Pears J, Mastronuzzi A, Carai A, del Bufalo F, de Torres C, Sunol M, Cruz O, Mora J, Moore A, Robinson S, Lord C, Carcaboso AM, Vinci M, Jones C. HGG-23. DRUG SCREENING LINKED TO MOLECULAR PROFILING IDENTIFIES NOVEL DEPENDENCIES IN PATIENT-DERIVED PRIMARY CULTURES OF PAEDIATRIC HIGH GRADE GLIOMA AND DIPG. Neuro Oncol 2018. [DOI: 10.1093/neuonc/noy059.295] [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] [Indexed: 11/14/2022] Open
Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Jane Pears
- Our Lady Children’s Hospital, Dublin, Irel
| | | | | | | | | | | | | | - Jaume Mora
- Hospital San Joan de Deu, Barcelona, Spain
| | - Andrew Moore
- Queensland Children’s Tumour Bank, Brisbane, Australia
| | | | | | | | - Maria Vinci
- Ospedale Pediatrico Cambio Gesu, Rome, Italy
| | | |
Collapse
|
34
|
Wasti A, Boesten T, Powell K, Marshall L, Vaidya S, Angelini P, Mandeville H, Saran F, Chisholm J, Jones C, Chandler C, Stapleton S, Bridges L, Al-Sarraj S, Carceller F. HGG-13. SURVIVAL OUTCOMES OF CHILDREN AND ADOLESCENTS WITH BI-THALAMIC GLIOMAS: THE SOUTH THAMES NEURO-ONCOLOGY UNIT EXPERIENCE. Neuro Oncol 2018. [DOI: 10.1093/neuonc/noy059.285] [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] [Indexed: 11/12/2022] Open
Affiliation(s)
| | | | | | - Lynley Marshall
- The Royal Marsden Hospital, Sutton, UK
- The Institute of Cancer Research, Sutton, UK
| | - Sucheta Vaidya
- The Royal Marsden Hospital, Sutton, UK
- The Institute of Cancer Research, Sutton, UK
| | - Paola Angelini
- The Royal Marsden Hospital, Sutton, UK
- The Institute of Cancer Research, Sutton, UK
| | - Henry Mandeville
- The Royal Marsden Hospital, Sutton, UK
- The Institute of Cancer Research, Sutton, UK
| | - Frank Saran
- The Royal Marsden Hospital, Sutton, UK
- The Institute of Cancer Research, Sutton, UK
| | - Julia Chisholm
- The Royal Marsden Hospital, Sutton, UK
- The Institute of Cancer Research, Sutton, UK
| | - Chris Jones
- The Institute of Cancer Research, Sutton, UK
| | | | | | | | | | - Fernando Carceller
- The Royal Marsden Hospital, Sutton, UK
- The Institute of Cancer Research, Sutton, UK
| |
Collapse
|
35
|
Lavan N, Mc Quaid D, Smyth G, Vaidya S, Saran F, Oelfke U, Mandeville H. EP-2031: Kidney motion in children and young people quantified using 4DCT deformable registration. Radiother Oncol 2018. [DOI: 10.1016/s0167-8140(18)32340-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
36
|
Shiarli A, Smyth G, Carcellar F, Vaidya S, Marshall L, Zacharoulis S, Powell K, Conti L, Frost D, Saran F, Mandeville HC H. PO-0843: Outcomes of paediatric diffuse intrinsic pontine gliomas treated with hypofractionated radiotherapy. Radiother Oncol 2018. [DOI: 10.1016/s0167-8140(18)31153-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
|
37
|
Wagner MG, Fischer MR, Scaglione M, Linsenmaier U, Schueller G, Berger FH, Dick E, Basilico R, Stajgis M, Calli C, Vaidya S, Wirth S. Subspecialisation in Emergency Radiology: Proposal for a harmonised European curriculum. GMS J Med Educ 2017; 34:Doc61. [PMID: 29226229 PMCID: PMC5704608 DOI: 10.3205/zma001138] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Figures] [Subscribe] [Scholar Register] [Received: 10/21/2016] [Revised: 04/20/2017] [Accepted: 06/07/2017] [Indexed: 06/07/2023]
Abstract
Introduction: Radiology plays a crucial role in the emergency care setting by delivering early and precise diagnoses under pressure of time, right at the beginning of patient treatment. Although there is a need for postgraduate education in emergency radiology, most of the national bodies responsible do not offer it in a uniform fashion and a general proof of qualification is missing in Europe. Therefore, the European Society of Radiology (ESR) has founded the (Sub-)Society of Emergency Radiology (ESER), prompting them to develop a European curriculum. This trend, which is currently also encouraged in many other non-radiological specialties which demand the highest professional qualifications, often lacks expertise in medical education. Goals: The goal of this article is the general description of the curricular planning process for a European postgraduate subspecialisation programme, using the example of Emergency Radiology (European Diploma in Emergency Radiology, EDER), including the utilisation of TOOLS and recommendations derived from comparable projects. Project description: The project was divided into partial steps: the timeline displayed in a GANTT chart, and tasks and responsibilities assigned in a RASCI matrix. The curriculum was iteratively developed using the KERN approach and steps were prioritised using the PARETO principle. Furthermore, the following TOOLS were used: limitations and needs assessment, SWOT analysis, formulating learning objectives and categorising them after MILLER and SCLO, and using BLOOM's taxonomy for cognitive learning objectives and operationalising them according to MAGER. Psychomotoric and affective learning objectives were assigned to CANMEDS roles, grouped by topic using CLUSTERING, and then mapped by MATRIX analysis to appropriate learning and evaluation methods. Striving for continuous improvement, the curriculum was finally embedded in curricular quality management. Results: The standardisation of the EDER access, considering the different national conditions, the minimisation of European learners' attendance phases, restricting expenses by best possible use of existing structures, respecting the requirements and retaining the support of the European umbrella society ESR, finishing the project by a specific deadline and the demands of continuous improvement were particular challenges. A curriculum with the eligibility of five years' speciality training in general radiology has evolved on schedule. The subspeciality training lasts at least one year and is divided into webinars, workshops during congresses (e.g. the annual ESR and ESER congresses) and one year practical training at the individual learner's corresponding local hospitals, which adhere to a catalogue of requirements, comparable to national educational policies. The curriculum is completed by passing a written and oral exam (diploma) and re-accreditation every five years. Conclusions: Despite complex requirements, the TOOLS utilised allowed an almost seamless, resource-minimised, professional, location-independent distributed development of a European subspeciality curriculum within one year. The definitive implementation is still due. If any deviations from the draft presented should become necessary in the future, the embedment in the curricular quality management will lead to a redirection in the right way and, furthermore, secure a continuous improvement in the best way possible.
Collapse
Affiliation(s)
- M. G. Wagner
- University Hospital, LMU Munich, Department of Radiology, Munich, Germany
| | - M. R. Fischer
- University Hospital, LMU Munich, Department of Didactics and Educational Research in Medicine, Munich, Germany
| | - M. Scaglione
- Pineta Grande Medical Center, Department of Imaging, Castel Volturno, Italy
- Dartford & Gravesham NHS Trust, Darford, United Kingdom
| | - U. Linsenmaier
- Helios Klinikum München, Department of Radiology, Munich, Germany
| | | | | | - E. Dick
- Imperial College NHS Trust, St. Mary's Campus, London, United Kingdom
| | | | | | - C. Calli
- Ege University Medical Faculty, Dept. of Radiology, Neuroradiology Section, Bornova Izmir, Turkey
| | - S. Vaidya
- Barts Health NHS Trust, Royal London Hospital, London, United Kingdom
| | - Stefan Wirth
- University Hospital, LMU Munich, Department of Radiology, Munich, Germany
| |
Collapse
|
38
|
Mackay A, Burford A, Carvalho D, Izquierdo E, Fazal-Salom J, Taylor KR, Bjerke L, Clarke M, Vinci M, Nandhabalan M, Temelso S, Popov S, Molinari V, Raman P, Waanders AJ, Han HJ, Gupta S, Marshall L, Zacharoulis S, Vaidya S, Mandeville HC, Bridges LR, Martin AJ, Al-Sarraj S, Chandler C, Ng HK, Li X, Mu K, Trabelsi S, Brahim DHB, Kisljakov AN, Konovalov DM, Moore AS, Carcaboso AM, Sunol M, de Torres C, Cruz O, Mora J, Shats LI, Stavale JN, Bidinotto LT, Reis RM, Entz-Werle N, Farrell M, Cryan J, Crimmins D, Caird J, Pears J, Monje M, Debily MA, Castel D, Grill J, Hawkins C, Nikbakht H, Jabado N, Baker SJ, Pfister SM, Jones DTW, Fouladi M, von Bueren AO, Baudis M, Resnick A, Jones C. Integrated Molecular Meta-Analysis of 1,000 Pediatric High-Grade and Diffuse Intrinsic Pontine Glioma. Cancer Cell 2017; 32:520-537.e5. [PMID: 28966033 PMCID: PMC5637314 DOI: 10.1016/j.ccell.2017.08.017] [Citation(s) in RCA: 621] [Impact Index Per Article: 88.7] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2017] [Revised: 07/14/2017] [Accepted: 08/29/2017] [Indexed: 12/20/2022]
Abstract
We collated data from 157 unpublished cases of pediatric high-grade glioma and diffuse intrinsic pontine glioma and 20 publicly available datasets in an integrated analysis of >1,000 cases. We identified co-segregating mutations in histone-mutant subgroups including loss of FBXW7 in H3.3G34R/V, TOP3A rearrangements in H3.3K27M, and BCOR mutations in H3.1K27M. Histone wild-type subgroups are refined by the presence of key oncogenic events or methylation profiles more closely resembling lower-grade tumors. Genomic aberrations increase with age, highlighting the infant population as biologically and clinically distinct. Uncommon pathway dysregulation is seen in small subsets of tumors, further defining the molecular diversity of the disease, opening up avenues for biological study and providing a basis for functionally defined future treatment stratification.
Collapse
Affiliation(s)
- Alan Mackay
- Division of Molecular Pathology, The Institute of Cancer Research, London, UK; Division of Cancer Therapeutics, The Institute of Cancer Research, London, UK
| | - Anna Burford
- Division of Molecular Pathology, The Institute of Cancer Research, London, UK; Division of Cancer Therapeutics, The Institute of Cancer Research, London, UK
| | - Diana Carvalho
- Division of Molecular Pathology, The Institute of Cancer Research, London, UK; Division of Cancer Therapeutics, The Institute of Cancer Research, London, UK
| | - Elisa Izquierdo
- Division of Molecular Pathology, The Institute of Cancer Research, London, UK; Division of Cancer Therapeutics, The Institute of Cancer Research, London, UK
| | - Janat Fazal-Salom
- Division of Molecular Pathology, The Institute of Cancer Research, London, UK; Division of Cancer Therapeutics, The Institute of Cancer Research, London, UK
| | - Kathryn R Taylor
- Division of Molecular Pathology, The Institute of Cancer Research, London, UK; Division of Cancer Therapeutics, The Institute of Cancer Research, London, UK; Department of Neurology, Stanford University School of Medicine, Stanford, CA, USA
| | - Lynn Bjerke
- Division of Molecular Pathology, The Institute of Cancer Research, London, UK; Division of Cancer Therapeutics, The Institute of Cancer Research, London, UK
| | - Matthew Clarke
- Division of Molecular Pathology, The Institute of Cancer Research, London, UK; Division of Cancer Therapeutics, The Institute of Cancer Research, London, UK
| | - Mara Vinci
- Division of Molecular Pathology, The Institute of Cancer Research, London, UK; Division of Cancer Therapeutics, The Institute of Cancer Research, London, UK
| | - Meera Nandhabalan
- Division of Molecular Pathology, The Institute of Cancer Research, London, UK; Division of Cancer Therapeutics, The Institute of Cancer Research, London, UK
| | - Sara Temelso
- Division of Molecular Pathology, The Institute of Cancer Research, London, UK; Division of Cancer Therapeutics, The Institute of Cancer Research, London, UK
| | - Sergey Popov
- Division of Molecular Pathology, The Institute of Cancer Research, London, UK; Division of Cancer Therapeutics, The Institute of Cancer Research, London, UK; Department of Cellular Pathology, University Hospital of Wales, Cardiff, UK
| | - Valeria Molinari
- Division of Molecular Pathology, The Institute of Cancer Research, London, UK; Division of Cancer Therapeutics, The Institute of Cancer Research, London, UK
| | - Pichai Raman
- The Center for Data Driven Discovery in Biomedicine (D(3)b), Children's Hospital of Philadelphia, Philadelphia, PA, USA; Division of Neurosurgery, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Angela J Waanders
- The Center for Data Driven Discovery in Biomedicine (D(3)b), Children's Hospital of Philadelphia, Philadelphia, PA, USA; Division of Oncology, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Harry J Han
- The Center for Data Driven Discovery in Biomedicine (D(3)b), Children's Hospital of Philadelphia, Philadelphia, PA, USA; Division of Oncology, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Saumya Gupta
- Institute of Molecular Life Sciences, Swiss Institute of Bioinformatics, University of Zürich, Zürich, Switzerland
| | - Lynley Marshall
- Pediatric Oncology Drug Development Team, Children and Young People's Unit, Royal Marsden Hospital, Sutton, UK
| | - Stergios Zacharoulis
- Pediatric Oncology Drug Development Team, Children and Young People's Unit, Royal Marsden Hospital, Sutton, UK
| | - Sucheta Vaidya
- Pediatric Oncology Drug Development Team, Children and Young People's Unit, Royal Marsden Hospital, Sutton, UK
| | | | - Leslie R Bridges
- Department of Cellular Pathology, St George's Hospital NHS Trust, London, UK
| | - Andrew J Martin
- Department of Neurosurgery, St George's Hospital NHS Trust, London, UK
| | - Safa Al-Sarraj
- Department of Neuropathology, Kings College Hospital, London, UK
| | | | - Ho-Keung Ng
- Department of Anatomical and Cellular Pathology, The Chinese University of Hong Kong, Hong Kong, China
| | - Xingang Li
- Department of Neurosurgery, Qilu Hospital of Shandong University and Brain Science Research Institute, Shandong University, Jinan, China
| | - Kun Mu
- Department of Pathology, Shandong University School of Medicine, Jinan, China
| | - Saoussen Trabelsi
- Department of Cytogenetics and Reproductive Biology, Farhat Hached Hospital, Sousse, Tunisia
| | - Dorra H'mida-Ben Brahim
- Department of Cytogenetics and Reproductive Biology, Farhat Hached Hospital, Sousse, Tunisia
| | - Alexei N Kisljakov
- Department of Pathology, Morozov Children's Hospital, Moscow, Russian Federation
| | - Dmitry M Konovalov
- Department of Pathology, Dmitrii Rogachev Research and Clinical Centre of Pediatric Hematology, Oncology and Immunology, Moscow, Russian Federation
| | - Andrew S Moore
- UQ Child Health Research Centre, The University of Queensland, Brisbane, Australia; Oncology Services Group, Children's Health Queensland Hospital and Health Service, Brisbane, Australia; The University of Queensland Diamantina Institute, Translational Research Institute, Brisbane, Australia
| | | | - Mariona Sunol
- Institut de Recerca Sant Joan de Deu, Barcelona, Spain
| | | | - Ofelia Cruz
- Institut de Recerca Sant Joan de Deu, Barcelona, Spain
| | - Jaume Mora
- Institut de Recerca Sant Joan de Deu, Barcelona, Spain
| | - Ludmila I Shats
- Division of Oncology, Pediatric Oncology and Radiotherapy, St Petersburg State Pediatric Medical University, St Petersburg, Russian Federation
| | - João N Stavale
- Department of Pathology, Federal University of São Paulo, São Paulo, São Paulo, Brazil
| | - Lucas T Bidinotto
- Molecular Oncology Research Centre, Barretos Cancer Hospital, Barretos, São Paulo, Brazil
| | - Rui M Reis
- Molecular Oncology Research Centre, Barretos Cancer Hospital, Barretos, São Paulo, Brazil; Life and Health Sciences Research Institute (ICVS), Medical School, University of Minho, Braga, Portugal and ICVS/3B's-PT Government Associate Laboratory, Braga/Guimarães, Portugal
| | - Natacha Entz-Werle
- Pédiatrie Onco-Hématologie - Pédiatrie III, Centre Hospitalier Régional et Universitaire Hautepierre, Strasbourg, France
| | - Michael Farrell
- Histopathology Department, Beaumont Hospital, Dublin, Ireland
| | - Jane Cryan
- Histopathology Department, Beaumont Hospital, Dublin, Ireland
| | - Darach Crimmins
- Department of Neurosurgery, Temple Street Children's University Hospital, Dublin, Ireland
| | - John Caird
- Department of Neurosurgery, Temple Street Children's University Hospital, Dublin, Ireland
| | - Jane Pears
- Department of Paediatric Oncology, Our Lady's Children's Hospital, Dublin, Ireland
| | - Michelle Monje
- Department of Neurology, Stanford University School of Medicine, Stanford, CA, USA
| | - Marie-Anne Debily
- Département de Cancerologie de l'Enfant et de l'Adolescent, Institut Gustav Roussy, Villejuif, France
| | - David Castel
- Département de Cancerologie de l'Enfant et de l'Adolescent, Institut Gustav Roussy, Villejuif, France
| | - Jacques Grill
- Département de Cancerologie de l'Enfant et de l'Adolescent, Institut Gustav Roussy, Villejuif, France
| | - Cynthia Hawkins
- Pediatric Laboratory Medicine, Hospital for Sick Children, Toronto, Canada
| | - Hamid Nikbakht
- Department of Pediatrics, McGill University, Montreal, Canada
| | - Nada Jabado
- The Center for Data Driven Discovery in Biomedicine (D(3)b), Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Suzanne J Baker
- Department of Developmental Neurobiology, St Jude Children's Research Hospital, Memphis, TN, USA
| | - Stefan M Pfister
- Division of Pediatric Neuro-oncology, German Cancer Research Center (DKFZ), Heidelberg, Germany; Department of Pediatric Hematology and Oncology, Heidelberg University Hospital, Heidelberg, Germany; Hopp-Children's Cancer Center at the NCT Heidelberg (KiTZ), Heidelberg, Germany
| | - David T W Jones
- Division of Pediatric Neuro-oncology, German Cancer Research Center (DKFZ), Heidelberg, Germany; Hopp-Children's Cancer Center at the NCT Heidelberg (KiTZ), Heidelberg, Germany
| | - Maryam Fouladi
- Department of Pediatrics, Cancer and Blood Diseases Institute, Cincinnati Children's Hospital, Cincinnati, OH, USA
| | - André O von Bueren
- Department of Pediatrics, Division of Pediatric Hematology and Oncology, University Medical Center Goettingen, Goettingen, Germany; Department of Pediatrics and Adolescent Medicine, Division of Pediatric Hematology and Oncology, University Hospital of Geneva, Geneva, Switzerland; Department of Pediatrics, CANSEARCH Research Laboratory, Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Michael Baudis
- Institute of Molecular Life Sciences, Swiss Institute of Bioinformatics, University of Zürich, Zürich, Switzerland
| | - Adam Resnick
- The Center for Data Driven Discovery in Biomedicine (D(3)b), Children's Hospital of Philadelphia, Philadelphia, PA, USA; Division of Neurosurgery, Children's Hospital of Philadelphia, Philadelphia, PA, USA; Division of Oncology, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Chris Jones
- Division of Molecular Pathology, The Institute of Cancer Research, London, UK; Division of Cancer Therapeutics, The Institute of Cancer Research, London, UK.
| |
Collapse
|
39
|
Vaidya S, Biswas M, Rai K. Traumatic Diaphragmatic Hernia: Diagnostic Dilemma. Kathmandu Univ Med J (KUMJ) 2017; 15:265-267. [PMID: 30353906] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Traumatic rupture of the diaphragm is an uncommon condition. The prevalence of diaphragmatic rupture among blunt trauma victim ranges from 0.8 to 8%. The etiologic factors are blunt trauma (for example, in motor vehicle accidents) and penetrating trauma. The diagnosis is often missed because of non-specific clinical signs, and the absence of additional intra-abdominal and thoracic injuries. We present a case which was misdiagnosed as a case of left sided hemopneumothorax and treated with tube thoracotomy in other center.
Collapse
Affiliation(s)
- S Vaidya
- Department of CardioVascular and Thoracic Surgery, Banghabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh
| | - M Biswas
- Department of Thoracic Surgery, National Institute of Diseases of Chest Hospital, Dhaka, Bangladesh
| | - K Rai
- Department of CardioVascular and Thoracic Surgery, Banghabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh
| |
Collapse
|
40
|
Stone J, Waern S, Khabra K, Wharram B, Middleton A, Edwards L, Kuhlthau K, Crouch C, Marshall L, Zacharoulis S, Vaidya S, Powell K, Saran F, Yock T, Mandeville H. Impact of toxicities and neurocognitive impairment on the health related quality of life (HR-QoL) for survivors of medulloblastoma. Eur J Cancer 2017. [DOI: 10.1016/s0959-8049(17)30631-7] [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: 11/26/2022]
|
41
|
Abstract
Nodal status is a significant predictor for survival of patients with oral squamous cell carcinoma (SCC), sentinel lymph node (SLN) biopsy, step sectioning of SLNs, and immunohistochemistry have changed the detection of tumor deposits in lymph nodes (LNs). The extent of LN metastasis is a major determinant for the staging and the prognosis of most human malignancies and often guides therapeutic decisions. Metastasis to regional lymph node (RLN) is a complex process. It is often associated with several clinical and pathological characteristics. The involvement of RLN is often, a harbinger for increased risk of metastasis. New knowledge in this area can enable the clinicians and pathologists to study and treat tumors in a more directed fashion. A molecular approach to factors that predicts the likelihood of RLN metastasis could eliminate the reoccurrence of the tumor in the form of "micrometastasis" and "skip" metastasis. The aim of this review is to discuss different modes of spread of metastasis in SCC.
Collapse
Affiliation(s)
- C Kapoor
- Department of Oral Pathology and Microbiology, Bhojia Dental College, Budd, Baddi, Solan, Himachal Pradesh, India
| | | | | | | |
Collapse
|
42
|
Carceller F, Fowkes LA, Khabra K, Moreno L, Saran F, Burford A, Mackay A, Jones DTW, Hovestadt V, Marshall LV, Vaidya S, Mandeville H, Jerome N, Bridges LR, Laxton R, Al-Sarraj S, Pfister SM, Leach MO, Pearson ADJ, Jones C, Koh DM, Zacharoulis S. Pseudoprogression in children, adolescents and young adults with non-brainstem high grade glioma and diffuse intrinsic pontine glioma. J Neurooncol 2016; 129:109-21. [PMID: 27180091 DOI: 10.1007/s11060-016-2151-8] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2015] [Accepted: 05/07/2016] [Indexed: 02/01/2023]
Abstract
Pseudoprogression (PsP) is a treatment-related phenomenon which hinders response interpretation. Its prevalence and clinical impact have not been evaluated in children/adolescents. We assessed the characteristics, risk factors and prognosis of PsP in children/adolescents and young-adults diagnosed with non-brainstem high grade gliomas (HGG) and diffuse intrinsic pontine gliomas (DIPG). Patients aged 1-21 years diagnosed with HGG or DIPG between 1995 and 2012 who had completed radiotherapy were eligible. PsP was assessed according to study-specific criteria and correlated with first-line treatment, molecular biomarkers and survival. Ninety-one patients (47 HGG, 44 DIPG) were evaluable. Median age: 10 years (range, 2-20). Eleven episodes of PsP were observed in 10 patients (4 HGG, 6 DIPG). Rates of PsP: 8.5 % (HGG); 13.6 % (DIPG). Two episodes of PsP were based on clinical findings alone; nine episodes had concurrent radiological changes: increased size of lesions (n = 5), new focal enhancement (n = 4). Temozolomide, MGMT methylation or H3F3A mutations were not found to be associated with increased occurrence of PsP. For HGG, 1-year progression-free survival (PFS) was 41.9 % no-PsP versus 100 % PsP (p = 0.041); differences in 1-year overall survival (OS) were not significant. For DIPG, differences in 1-year PFS and OS were not statistically significant. Hazard ratio (95 %CI) of PsP for OS was 0.551 (0.168-1.803; p = 0.325) in HGG; and 0.308 (0.107-0.882; p = 0.028) in DIPG. PsP occurred in both pediatric HGG and DIPG patients at a comparable rate to adult HGG. PsP was associated with improved 1-yr PFS in HGG patients. PsP had a protective effect upon OS in DIPG patients.
Collapse
Affiliation(s)
- Fernando Carceller
- Children & Young People's Unit, The Royal Marsden NHS Foundation Trust, Downs Road, Sutton, Surrey, SM2 5PT, UK.
- Division of Clinical Studies and Cancer Therapeutics, Institute of Cancer Research, 15 Cotswold Road, Sutton, SM2 5NG, UK.
| | - Lucy A Fowkes
- Department of Radiology, The Royal Marsden NHS Foundation Trust, Downs Road, Sutton, SM2 5PT, UK
| | - Komel Khabra
- Research Data Management and Statistics Unit, The Royal Marsden NHS Foundation Trust, Downs Road, Sutton, SM2 5PT, UK
| | - Lucas Moreno
- Children & Young People's Unit, The Royal Marsden NHS Foundation Trust, Downs Road, Sutton, Surrey, SM2 5PT, UK
- Division of Clinical Studies and Cancer Therapeutics, Institute of Cancer Research, 15 Cotswold Road, Sutton, SM2 5NG, UK
- Clinical Research Unit - Pediatric Phase I-II Clinical Trials, Pediatric Oncology-Hematology Service, Hospital Niño Jesús, Av. de Menéndez Pelayo, num 65, 28009, Madrid, Spain
| | - Frank Saran
- Department of Neuro Oncology, The Royal Marsden NHS Foundation Trust, Downs Road, Sutton, SM2 5PT, UK
| | - Anna Burford
- Division of Clinical Studies and Cancer Therapeutics, Institute of Cancer Research, 15 Cotswold Road, Sutton, SM2 5NG, UK
- Division of Molecular Pathology, Institute of Cancer Research, 15 Cotswold Road, Sutton, SM2 5NG, UK
| | - Alan Mackay
- Division of Clinical Studies and Cancer Therapeutics, Institute of Cancer Research, 15 Cotswold Road, Sutton, SM2 5NG, UK
- Division of Molecular Pathology, Institute of Cancer Research, 15 Cotswold Road, Sutton, SM2 5NG, UK
| | - David T W Jones
- Division of Pediatric Neurooncology, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 280, 69121, Heidelberg, Germany
| | - Volker Hovestadt
- Division of Molecular Genetics, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 280, 69121, Heidelberg, Germany
| | - Lynley V Marshall
- Children & Young People's Unit, The Royal Marsden NHS Foundation Trust, Downs Road, Sutton, Surrey, SM2 5PT, UK
- Division of Clinical Studies and Cancer Therapeutics, Institute of Cancer Research, 15 Cotswold Road, Sutton, SM2 5NG, UK
- Division of Molecular Pathology, Institute of Cancer Research, 15 Cotswold Road, Sutton, SM2 5NG, UK
| | - Sucheta Vaidya
- Children & Young People's Unit, The Royal Marsden NHS Foundation Trust, Downs Road, Sutton, Surrey, SM2 5PT, UK
- Division of Clinical Studies and Cancer Therapeutics, Institute of Cancer Research, 15 Cotswold Road, Sutton, SM2 5NG, UK
| | - Henry Mandeville
- Department of Radiotherapy, The Royal Marsden NHS Foundation Trust, Downs Road, Sutton, SM2 5PT, UK
| | - Neil Jerome
- CRUK Cancer Imaging Centre, Institute of Cancer Research, 15 Cotswold Road, Sutton, SM2 5NG, UK
| | - Leslie R Bridges
- Department of Cellular Pathology, St George's Hospital, Blackshaw Road, London, SW17 0QT, UK
| | - Ross Laxton
- Department of Clinical Neuropathology, King's College Hospital, Denmark Hill, London, SE5 9RS, UK
| | - Safa Al-Sarraj
- Department of Clinical Neuropathology, King's College Hospital, Denmark Hill, London, SE5 9RS, UK
| | - Stefan M Pfister
- Division of Pediatric Neurooncology, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 280, 69121, Heidelberg, Germany
- Department of Pediatric Oncology and Hematology, Universitätsklinikum Heidelberg, Im Neuenheimer Feld 672, 69120, Heidelberg, Germany
| | - Martin O Leach
- CRUK Cancer Imaging Centre, Institute of Cancer Research, 15 Cotswold Road, Sutton, SM2 5NG, UK
| | - Andrew D J Pearson
- Children & Young People's Unit, The Royal Marsden NHS Foundation Trust, Downs Road, Sutton, Surrey, SM2 5PT, UK
- Division of Clinical Studies and Cancer Therapeutics, Institute of Cancer Research, 15 Cotswold Road, Sutton, SM2 5NG, UK
| | - Chris Jones
- Division of Clinical Studies and Cancer Therapeutics, Institute of Cancer Research, 15 Cotswold Road, Sutton, SM2 5NG, UK
- Division of Molecular Pathology, Institute of Cancer Research, 15 Cotswold Road, Sutton, SM2 5NG, UK
| | - Dow-Mu Koh
- Department of Radiology, The Royal Marsden NHS Foundation Trust, Downs Road, Sutton, SM2 5PT, UK
| | - Stergios Zacharoulis
- Children & Young People's Unit, The Royal Marsden NHS Foundation Trust, Downs Road, Sutton, Surrey, SM2 5PT, UK
- Division of Clinical Studies and Cancer Therapeutics, Institute of Cancer Research, 15 Cotswold Road, Sutton, SM2 5NG, UK
| |
Collapse
|
43
|
Vinci M, Burford A, Molinari V, Popov S, Taylor KR, Pemberton H, Lord CJ, Gutteridge A, Forshew T, Marshall LV, Qin EY, Ingram WJ, Moore AS, Ng HK, Trabelsi S, Brahim DHB, Zacharoulis S, Vaidya S, Mandeville HC, Bridges LR, Martin AJ, Al-Sarraj S, Chandler C, Sunol M, Mora J, de Torres C, Cruz O, Carcaboso AM, Monje M, Mackay A, Jones C. HG-97PAEDIATRIC GBM AND DIPG SUBCLONES CO-OPERATE TO PROMOTE TUMORIGENESIS. Neuro Oncol 2016. [DOI: 10.1093/neuonc/now073.93] [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
|
44
|
O'Leary B, Mandeville HC, Fersht N, Solda F, Mycroft J, Zacharoulis S, Vaidya S, Saran F. Craniospinal irradiation with concomitant and adjuvant temozolomide--a feasibility assessment of toxicity in patients with glioblastoma with a PNET component. J Neurooncol 2016; 127:295-302. [PMID: 26842817 DOI: 10.1007/s11060-015-2033-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2015] [Accepted: 12/26/2015] [Indexed: 12/22/2022]
Abstract
There is no standard treatment for glioblastoma with elements of PNET (GBM-PNET). Conventional treatment for glioblastoma is surgery followed by focal radiotherapy with concurrent temozolomide. Given the increased propensity for neuroaxial metastases seen with GBM-PNETs, craniospinal irradiation (CSI) with temozolomide (TMZ) could be a feasible treatment option but little is known regarding its toxicity. The clinical records of all patients treated at two UK neuro-oncology centres with concurrent CSI and TMZ were examined for details of surgery, radiotherapy, chemotherapy and toxicities related to the CSI-TMZ component of their treatment. Eight patients were treated with CSI-TMZ, the majority (6/8) for GBM-PNET. All patients completed radiotherapy to the craniospinal axis 35-40 Gy in 20-24 daily fractions with a focal boost to the tumour of 14-23.4 Gy in 8-13 daily fractions. Concurrent TMZ was administered at 75 mg/m(2) for seven of the cohort, with the other patient receiving 50 mg/m(2). The most commonly observed non-haematological toxicities were nausea and vomiting, with all patients experiencing at least grade 2 symptoms of either or both. All patients had at least grade 3 lymphopaenia. Two patients experience grade 4 neutropaenia and grade 3 thrombocytopaenia. Three of the eight patients required omission of TMZ for part of their chemoradiotherapy and 3/8 required hospital admission at some point during chemoradiotherapy. The addition of TMZ to CSI did not interrupt radiotherapy. Principal toxicities were neutropaenia, lymphopaenia, thrombocytopaenia, nausea and vomiting. Treatment with CSI-TMZ merits further investigation and may be suitable for patients with tumours at high-risk of metastatic spread throughout the CNS who have TMZ-sensitive pathologies.
Collapse
Affiliation(s)
- Ben O'Leary
- The Royal Marsden Hospital NHS Trust, The Royal Marsden Hospital, Fulham Rd, London, SW3 6JJ, UK
- The Institute of Cancer Research, 237 Fulham Rd, London, SW3 6JB, UK
| | - Henry C Mandeville
- The Royal Marsden Hospital NHS Trust, The Royal Marsden Hospital, Fulham Rd, London, SW3 6JJ, UK
| | - Naomi Fersht
- Department of Oncology, University College London Hospitals NHS Foundation Trust, 250 Euston Road, London, NW1 2PG, UK
| | - Francesca Solda
- Department of Oncology, University College London Hospitals NHS Foundation Trust, 250 Euston Road, London, NW1 2PG, UK
| | - Julie Mycroft
- The Royal Marsden Hospital NHS Trust, The Royal Marsden Hospital, Fulham Rd, London, SW3 6JJ, UK
| | - Stergios Zacharoulis
- The Royal Marsden Hospital NHS Trust, The Royal Marsden Hospital, Fulham Rd, London, SW3 6JJ, UK
| | - Sucheta Vaidya
- The Royal Marsden Hospital NHS Trust, The Royal Marsden Hospital, Fulham Rd, London, SW3 6JJ, UK
| | - Frank Saran
- The Royal Marsden Hospital NHS Trust, The Royal Marsden Hospital, Fulham Rd, London, SW3 6JJ, UK.
| |
Collapse
|
45
|
Chewning R, Lindberg A, Monroe E, Vaidya S, Shivaram G. Glue embolization of pediatric non-head and neck venous malformations. J Vasc Interv Radiol 2016. [DOI: 10.1016/j.jvir.2015.12.490] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
|
46
|
Breen DP, Deeb J, Vaidya S, Lockwood DN, Radunovic A. Leprosy: a 'common' and curable cause of peripheral neuropathy with skin lesions. J R Coll Physicians Edinb 2015; 45:38-42. [PMID: 25874829 DOI: 10.4997/jrcpe.2015.109] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Leprosy (or Hansen's disease) is a curable chronic infectious disease caused by the acid-fast bacillus Mycobacterium leprae. While leprosy remains one of the most common causes of neuropathy worldwide, its rarity in the UK means that many doctors are unfamiliar with the typical clinical features. This is problematic because early recognition and treatment is vital in order to minimise disease-related complications such as nerve injury. We describe a 75-year-old man who presented with multiple mononeuropathy (mononeuritis multiplex, particularly affecting the ulnar nerves) and typical granulomatous skin lesions, in whom the diagnosis was made on the basis of skin biopsy. We highlight the clinical features, investigations and treatment of the patient, and provide information about the epidemiology and pathogenesis of leprosy.
Collapse
Affiliation(s)
- D P Breen
- DP Breen, National Hospital for Neurology and Neurosurgery, 33 Queen Square, London WC1N 3BG, UK. Email
| | | | | | | | | |
Collapse
|
47
|
Abstract
Background: A spectrum of primary and secondary disorders that affect the bone marrow may manifestwith pancytopenia. This study was carried out to identify the various causes of pancytopenia in patients attending a tertiary care hospital in Lalitpur, Nepal.Materials and Methods: A descriptive study of 83 cases of pancytopenia was carried out in the Department of Pathology, Patan Academy of Health Sciences, Lalitpur, Nepal over a two year period from August 2010 to July 2012.Results: Eighty three patients underwent bone marrow examination. Mean age of the patients was 34 years (range: 4 to 75 years). Maximum number of patients (31.33%) was seen in the age group of 16 - 30 years. The commonest cause of pancytopenia was megaloblastic anemia which was seen in 34.94% (29/83) cases followed by aplastic anemia and hematological malignancies in 31.32% (26/83) and 14.46% (12/83) cases, respectively.Conclusion: This study concluded that megaloblastic anemia and aplastic anemia were the two most common causes of pancytopenia. Bone marrow aspiration is an established diagnostic modality in the evaluation of pancytopenia.Journal of Pathology of Nepal (2015) Vol. 5, 691 - 695
Collapse
|
48
|
Verraich J, Shivaram G, Ghodke B, Vaidya S, Zopf D, Perkins J. Pre-operative n-butyl-2-cyanoacrylate glue embolization of pediatric head and neck venous malformations: technique and clinical outcomes. J Vasc Interv Radiol 2015. [DOI: 10.1016/j.jvir.2014.12.120] [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: 10/24/2022] Open
|
49
|
Vaidya S, Vaidya SA. Patterns of Lesions in Hysterectomy Specimens in a Tertiary Care Hospital. JNMA J Nepal Med Assoc 2015; 53:18-23. [PMID: 26983042] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023] Open
Abstract
INTRODUCTION Hysterectomy is one of the most common gynaecological procedures performed all over the world. The most frequent indications for hysterectomy are fibroids, abnormal uterine bleeding uterovaginal prolapse and endometriosis. The objective of this study was to present the histopathological patterns of various uterine and adnexal pathologies in the hysterectomy specimens and also to correlate its pre-operative clinical diagnosis with histopathology. METHODS This is a two-year descriptive study of hysterectomy specimens carried out in the Department of Pathology, Patan Academy of Health Sciences (PAHS), Lalitpur, Nepal. Data of all the hysterectomy specimens collected during this period was analyzed. RESULTS Out of the 533 cases, fibroid was the most common indication for hysterectomy that was seen in 229 (42.94%) cases followed by uterovaginal prolapse in 101 (18.93%) cases. Leiomyoma was the most common pathology reported in 250 (46.90%) hysterectomy specimens, followed by ovarian tumours in 95 (17.82%) cases. In 17.82% (95/533) cases, no pathology was seen. Overall, the pre-operative indications in 533 cases of hysterectomy were histopathologically verifiable in 487 (91.37%) cases. CONCLUSIONS Though the histopathological examination correlates well with the pre-operative clinical diagnosis, a number of lesions were also encountered as pure incidental findings. Hence, it is mandatory that every hysterectomy specimen should be subjected to histopathological examination so as to ensure better post-operative management.
Collapse
Affiliation(s)
- S Vaidya
- Department of Pathology, Kathmandu Medical College, Sinamangal, Kathmandu, Nepal
| | - S A Vaidya
- Department of Obstertrics and Gynaecology, Maternity Hospital, Thapathali, Kathmandu, Nepal
| |
Collapse
|
50
|
Vundinti BR, Kerketta L, Korgaonkar S, Vaidya S, Ghosh K. Isodicentric Philadelphia [idic(Ph)] chromosome in a case of CML at chronic phase. Indian J Cancer 2014; 51:383-384. [PMID: 25494152 DOI: 10.4103/0019-509x.146749] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
- B R Vundinti
- Department of Cytogenetics, National Institute of Immunohaematology (ICMR), 13th Floor, New Multistoried Building, K. E. M Hospital Campus, Parel, Mumbai, Maharashtra, India
| | | | | | | | | |
Collapse
|