2024-03-29T07:48:15Z
http://ir.lib.uwo.ca/do/oai/
oai:ir.lib.uwo.ca:biochempub-1002
2009-12-27T16:23:19Z
publication:pathol
publication:patholpub
publication:biochempub
publication:oncpub
publication:biochem
publication:faculties
publication:onc
Epigenetic Mapping and Functional Analysis in a Breast Cancer Metastasis Model Using Whole-genome Promoter Tiling Microarrays
Rodenhiser, David I.
Andrews, Joseph
Kennette, Wendy
Sadikovic, Bekim
Mendlowitz, Ariel
Tuck, Alan B.
Chambers, Ann F.
Introduction Breast cancer metastasis is a complex, multi-step biological process. Genetic mutations along with epigenetic alterations in the form of DNA methylation patterns and histone modifications contribute to metastasis-related gene expression changes and genomic instability. So far, these epigenetic contributions to breast cancer metastasis have not been well characterized, and there is only a limited understanding of the functional mechanisms affected by such epigenetic alterations. Furthermore, no genome-wide assessments have been undertaken to identify altered DNA methylation patterns in the context of metastasis and their effects on specific functional pathways or gene networks.
Methods We have used a human gene promoter tiling microarray platform to analyze a cell line model of metastasis to lymph nodes composed of a poorly metastatic MDA-MB-468GFP human breast adenocarcinoma cell line and its highly metastatic variant (468LN). Gene networks and pathways associated with metastasis were identified, and target genes associated with epithelial–mesenchymal transition were validated with respect to DNA methylation effects on gene expression.
Results We integrated data from the tiling microarrays with targets identified by Ingenuity Pathways Analysis software and observed epigenetic variations in genes implicated in epithelial–mesenchymal transition and with tumor cell migration. We identified widespread genomic hypermethylation and hypomethylation events in these cells and we confirmed functional associations between methylation status and expression of the CDH1, CST6, EGFR, SNAI2 and ZEB2 genes by quantitative real-time PCR. Our data also suggest that the complex genomic reorganization present in cancer cells may be superimposed over promoter-specific methylation events that are responsible for gene-specific expression changes.
Conclusion This is the first whole-genome approach to identify genome-wide and gene-specific epigenetic alterations, and the functional consequences of these changes, in the context of breast cancer metastasis to lymph nodes. This approach allows the development of epigenetic signatures of metastasis to be used concurrently with genomic signatures to improve mapping of the evolving molecular landscape of metastasis and to permit translational approaches to target epigenetically regulated molecular pathways related to metastatic progression.
2008-07-18T07:00:00Z
article
https://ir.lib.uwo.ca/biochempub/3
info:doi/10.1186/bcr2121
http://breast-cancer-research.com/content/10/4/R62
Biochemistry Publications
Scholarship@Western
Breast cancer
Breast cancer metastasis
Epigenetic mapping
Biochemistry
Oncology
Pathology
oai:ir.lib.uwo.ca:surgerypub-1000
2009-05-06T22:53:24Z
publication:pathol
publication:mnipub
publication:patholpub
publication:mni
publication:oncpub
publication:surgerypub
publication:surgery
publication:faculties
publication:onc
Exosomes as a Tumor Immune Escape Mechanism: Possible Therapeutic Implications
Ichim, Thomas E.
Zhong, Zhaohui
Kaushal, Shalesh
Zheng, Xiufen
Ren, Xiubao
Hao, Xishan
Joyce, James A.
Hanley, Harold H.
Riordan, Neil H.
Koropatnick, James
Bogin, Vladimir
Minev, Boris R.
Min, Wei-Ping
Tullis, Richard H.
Advances in cancer therapy have been substantial in terms of molecular understanding of disease mechanisms, however these advances have not translated into increased survival in the majority of cancer types. One unsolved problem in current cancer therapeutics is the substantial immune suppression seen in patients. Conventionally, investigations in this area have focused on antigennonspecific immune suppressive molecules such as cytokines and T cell apoptosis inducing molecules such as Fas ligand. More recently, studies have demonstrated nanovesicle particles termed exosomes are involved not only in stimulation but also inhibition of immunity in physiological conditions. Interestingly, exosomes secreted by cancer cells have been demonstrated to express tumor antigens, as well as immune suppressive molecules such as PD-1L and FasL. Concentrations of exosomes from plasma of cancer patients have been associated with spontaneous T cell apoptosis, which is associated in some situations with shortened survival. In this paper we place the "exosome-immune suppression" concept in perspective of other tumor immune evasion mechanisms. We conclude by discussing a novel therapeutic approach to cancer immune suppression by extracorporeal removal of exosomes using hollow fiber filtration technology.
2008-07-22T07:00:00Z
article
https://ir.lib.uwo.ca/surgerypub/1
http://www.translational-medicine.com/content/6/1/37
Surgery Publications
Scholarship@Western
Cancer therapeutics
Exosome
Exosome-immune suppression
Cancer immune suppression
Medical Immunology
Medical Microbiology
Oncology
Pathology
Surgery
oai:ir.lib.uwo.ca:surgerypub-1002
2009-05-12T21:52:25Z
publication:pathol
publication:patholpub
publication:oncpub
publication:surgerypub
publication:surgery
publication:faculties
publication:onc
Feasibility Investigation of Allogeneic Endometrial Regenerative Cells
Zhong, Zhaohui
Patel, Amit N.
Ichim, Thomas E.
Riordan, Neil H.
Wang, Hao
Min, Wei-Ping
Woods, Erik J.
Reid, Michael
Mansilla, Eduardo
Marin, Gustavo H.
Drago, Hugo
Murphy, Michael P.
Minev, Boris
Endometrial Regenerative Cells (ERC) are a population of mesenchymal-like stem cells having pluripotent differentiation activity and ability to induce neoangiogenesis. In vitro and animal studies suggest ERC are immune privileged and in certain situations actively suppress ongoing immune responses. In this paper we describe the production of clinical grade ERC and initial safety experiences in 4 patients with multiple sclerosis treated intravenously and intrathecally. The case with the longest follow up, of more than one year, revealed no immunological reactions or treatment associated adverse effects. These preliminary data suggest feasibility of clinical ERC administration and support further studies with this novel stem cell type.
2009-02-20T08:00:00Z
article
https://ir.lib.uwo.ca/surgerypub/3
http://www.translational-medicine.com/content/7/1/15
Surgery Publications
Scholarship@Western
Endometrial regenerative cell
Neoangiogenesis
Multiple sclerosis
Oncology
Pathology
Surgery
oai:ir.lib.uwo.ca:oncpub-1000
2009-05-16T01:07:13Z
publication:mnipub
publication:biochempub
publication:mni
publication:oncpub
publication:pmid
publication:biochem
publication:faculties
publication:onc
Transcriptional Control by Adenovirus E1A Conserved Region 3 via p300/CBP
Pelka, Peter
Ablack, Jailal N. G.
Torchia, Joseph
Turnell, Andrew S.
Grand, Roger J. A.
Mymryk, Joe S.
The human adenovirus type 5 (HAdV-5) E1A 13S oncoprotein is a potent regulator of gene expression and is used extensively as a model for transcriptional activation. It possesses two independent transcriptional activation domains located in the N-terminus/conserved region (CR) 1 and CR3. The protein acetyltransferase p300 was previously identified by its association with the N-terminus/CR1 portion of E1A and this association is required for oncogenic transformation by E1A. We report here that transcriptional activation by 13S E1A is inhibited by co-expression of sub-stoichiometric amounts of the smaller 12S E1A isoform, which lacks CR3. Transcriptional inhibition by E1A 12S maps to the N-terminus and correlates with the ability to bind p300/CBP, suggesting that E1A 12S is sequestering this limiting factor from 13S E1A. This is supported by the observation that the repressive effect of E1A 12S is reversed by expression of exogenous p300 or CBP, but not by a CBP mutant lacking actyltransferase activity. Furthermore, we show that transcriptional activation by 13S E1A is greatly reduced by siRNA knockdown of p300 and that CR3 binds p300 independently of the well-characterized N-terminal/CR1-binding site. Importantly, CR3 is also required to recruit p300 to the adenovirus E4 promoter during infection. These results identify a new functionally significant interaction between E1A CR3 and the p300/CBP acetyltransferases, expanding our understanding of the mechanism by which this potent transcriptional activator functions.
2009-03-01T08:00:00Z
article
https://ir.lib.uwo.ca/oncpub/1
http://nar.oxfordjournals.org/cgi/content/full/37/4/1095
Oncology Publications
Scholarship@Western
Human adenovirus type 5
HAdV-5
Transcriptional activation
Gene regulation
Chromatin
Epigenetics
Medical Biochemistry
Medical Genetics
Medical Microbiology
Oncology
oai:ir.lib.uwo.ca:oncpub-1002
2009-07-31T19:41:52Z
publication:biophysics
publication:biophysicspub
publication:oncpub
publication:surgerypub
publication:pmid
publication:surgery
publication:faculties
publication:onc
Tumour Dormancy in Breast Cancer: An Update
Brackstone, Muriel
Townson, Jason L.
Chambers, Ann F.
Delayed recurrences, common in breast cancer, are well explained by the concept of tumour dormancy. Numerous publications describe clinical times to disease recurrence or death, using mathematical approaches to infer mechanisms responsible for delayed recurrences. However, most of the clinical literature discussing tumour dormancy uses data from over a half century ago and much has since changed. This review explores how current breast cancer treatment could change our understanding of the biology of breast cancer tumour dormancy, and summarizes relevant experimental models to date. Current knowledge gaps are highlighted and potential areas of future research are identified.
2007-05-31T07:00:00Z
article
https://ir.lib.uwo.ca/oncpub/2
http://breast-cancer-research.com/content/9/3/208
Oncology Publications
Scholarship@Western
Antineoplastic Combined Chemotherapy Protocols
Breast Neoplasms
Cyclophosphamide
Female
Fluorouracil
Humans
Methotrexate
Neoplasm
Residual
Recurrence
Time Factors
Neoplasm, Residual
Medical Biophysics
Oncology
Surgery
oai:ir.lib.uwo.ca:mnipub-1003
2009-09-22T00:57:30Z
publication:mnipub
publication:mni
publication:oncpub
publication:pmid
publication:faculties
publication:onc
An Improved Genetic System for Detection and Analysis of Protein Nuclear Import Signals
Marshall, Kris S.
Zhang, Zhiying
Curran, Jennifer
Derbyshire, Stephanie
Mymryk, Joe S.
Background: Nuclear import of proteins is typically mediated by their physical interaction with soluble cytosolic receptor proteins via a nuclear localization signal (NLS). A simple genetic assay to detect active NLSs based on their function in the yeast Saccharomyces cerevisiae has been previously described. In that system, a chimera consisting of a modified bacterial LexA DNA binding domain and the transcriptional activation domain of the yeast Gal4 protein is fused to a candidate NLS. A functional NLS will redirect the chimeric fusion to the yeast cell nucleus and activate transcription of a reporter gene.
Results: We have reengineered this nuclear import system to expand its utility and tested it using known NLS sequences from adenovirus E1A. Firstly, the vector has been reconstructed to reduce the level of chimera expression. Secondly, an irrelevant "stuffer" sequence from the E. coli maltose binding protein was used to increase the size of the chimera above the passive diffusion limit of the nuclear pore complex. The improved vector also contains an expanded multiple cloning site and a hemagglutinin epitope tag to allow confirmation of expression.
Conclusion: The alterations in expression level and composition of the fusions used in this nuclear import system greatly reduce background activity in beta-galactosidase assays, improving sensitivity and allowing more quantitative analysis of NLS bearing sequences.
2007-01-25T08:00:00Z
article
https://ir.lib.uwo.ca/mnipub/4
http://www.biomedcentral.com/1471-2199/8/6
Microbiology & Immunology Publications
Scholarship@Western
Active Transport
Cell Nucleus
Adenovirus E1A Proteins
Amino Acid Sequence
Bacterial Proteins
Consensus Sequence
Escherichia coli Proteins
Genes
Reporter
Genes
Synthetic
Genetic Techniques
Genetic Vectors
Hemagglutinin Glycoproteins
Influenza Virus
Karyopherins
Molecular Sequence Data
Mutant Chimeric Proteins
Periplasmic Binding Proteins
Protein Sorting Signals
Saccharomyces cerevisiae
Saccharomyces cerevisiae Proteins
Serine Endopeptidases
Transcription Factors
Transformation
Genetic
Active Transport, Cell Nucleus
Genes, Reporter
Genes, Synthetic
Hemagglutinin Glycoproteins, Influenza Virus
Transformation, Genetic
Immunology and Infectious Disease
Microbiology
oai:ir.lib.uwo.ca:epidempub-1009
2009-09-21T00:35:13Z
publication:epidem
publication:oncpub
publication:surgerypub
publication:pmid
publication:surgery
publication:faculties
publication:onc
publication:epidempub
Neoadjuvant or Adjuvant Therapy for Resectable Esophageal Cancer: A Clinical Practice Guideline
Malthaner, Richard A.
Wong, Rebecca K. S.
Rumble, R. Bryan
Zuraw, Lisa
Gastrointestinal Cancer Disease Site Group of Cancer Care Ontario's Program in Evidence-based Care
Background: Carcinoma of the esophagus is an aggressive malignancy with an increasing incidence. Its virulence, in terms of symptoms and mortality, justifies a continued search for optimal therapy. A clinical practice guideline was developed based on a systematic review investigating neoadjuvant or adjuvant therapy on resectable thoracic esophageal cancer.
Methods: A systematic review with meta-analysis was developed and clinical recommendations were drafted. External review of the practice guideline report by practitioners in Ontario, Canada was obtained through a mailed survey, and incorporated. Final approval of the practice guideline was obtained from the Practice Guidelines Coordinating Committee.
Results: The systematic review was developed and recommendations were drafted, and the report was mailed to Ontario practitioners for external review. Ninety percent of respondents agreed with both the evidence summary and the draft recommendations, while only 69% approved of the draft recommendations as a practice guideline. Based on the external review, a revised document was created. The revised practice guideline was submitted to the Practice Guidelines Coordinating Committee for review. All 11 members of the PGCC returned ballots. Eight PGCC members approved the practice guideline report as written and three members approved the guideline conditional on specific concerns being addressed. After these recommended changes were made, the final practice guideline report was approved.
Conclusion: In consideration of the systematic review, external review, and subsequent Practice Guidelines Coordinating Committee revision suggestions, and final approval, the Gastrointestinal Cancer Disease Site Group recommends the following:For adult patients with resectable thoracic esophageal cancer for whom surgery is considered appropriate, surgery alone (i.e., without neoadjuvant or adjuvant therapy) is recommended as the standard practice.
2004-09-24T07:00:00Z
article
https://ir.lib.uwo.ca/epidempub/10
http://www.biomedcentral.com/1471-2407/4/67
Epidemiology and Biostatistics Publications
Scholarship@Western
Adenocarcinoma
Adult
Carcinoma
Squamous Cell
Chemotherapy
Adjuvant
Esophageal Neoplasms
Humans
Ontario
Population Surveillance
Radiotherapy
Adjuvant
Carcinoma, Squamous Cell
Chemotherapy, Adjuvant
Radiotherapy, Adjuvant
Biostatistics
Epidemiology
Oncology
Surgery
oai:ir.lib.uwo.ca:epidempub-1010
2009-11-03T08:28:48Z
publication:epidem
publication:oncpub
publication:surgerypub
publication:pmid
publication:surgery
publication:faculties
publication:onc
publication:epidempub
Neoadjuvant or Adjuvant Therapy for Resectable Esophageal Cancer: A Systematic Review and Meta-analysis
Malthaner, Richard A.
Wong, Rebecca K. S.
Rumble, R. Bryan
Zuraw, Lisa
Gastrointestinal Cancer Disease Site Group of Cancer Care Ontario's Program in Evidence-based Care
Background: Carcinoma of the esophagus is an aggressive malignancy with an increasing incidence. Its virulence, in terms of symptoms and mortality, justifies a continued search for optimal therapy. The large and growing number of patients affected, the high mortality rates, the worldwide geographic variation in practice, and the large body of good quality research warrants a systematic review with meta-analysis.
Methods: A systematic review and meta-analysis investigating the impact of neoadjuvant or adjuvant therapy on resectable thoracic esophageal cancer to inform evidence-based practice was produced.MEDLINE, CANCERLIT, Cochrane Library, EMBASE, and abstracts from the American Society of Clinical Oncology and the American Society for Therapeutic Radiology and Oncology were searched for trial reports.Included were randomized trials or meta-analyses of neoadjuvant or adjuvant treatments compared with surgery alone or other treatments in patients with resectable thoracic esophageal cancer. Outcomes of interest were survival, adverse effects, and quality of life. Either one- or three-year mortality data were pooled and reported as relative risk ratios.
Results: Thirty-four randomized controlled trials and six meta-analyses were obtained and grouped into 13 basic treatment approaches.Single randomized controlled trials detected no differences in mortality between treatments for the following comparisons:- Preoperative radiotherapy versus postoperative radiotherapy.- Preoperative and postoperative radiotherapy versus postoperative radiotherapy. Preoperative and postoperative radiotherapy was associated with a significantly higher mortality rate.- Postoperative chemotherapy versus postoperative radiotherapy.- Postoperative radiotherapy versus postoperative radiotherapy plus protein-bound polysaccharide versus chemoradiation versus chemoradiation plus protein-bound polysaccharide.Pooling one-year mortality detected no statistically significant differences in mortality between treatments for the following comparisons:- Preoperative radiotherapy compared with surgery alone (five randomized trials).- Postoperative radiotherapy compared with surgery alone (five randomized trials).- Preoperative chemotherapy versus surgery alone (six randomized trials).- Preoperative and postoperative chemotherapy versus surgery alone (two randomized trials).- Preoperative chemoradiation therapy versus surgery alone (six randomized trials).Single randomized controlled trials detected differences in mortality between treatments for the following comparison:- Preoperative hyperthermia and chemoradiotherapy versus preoperative chemoradiotherapy in favour of hyperthermia.Pooling three-year mortality detected no statistically significant difference in mortality between treatments for the following comparison:- Postoperative chemotherapy compared with surgery alone (two randomized trials).Pooling three-year mortality detected statistically significant differences between treatments for the following comparisons:- Preoperative chemoradiation therapy versus surgery alone (six randomized trials) in favour of preoperative chemoradiation with surgery.- Preoperative chemotherapy compared with preoperative radiotherapy (one randomized trial) in favour of preoperative radiotherapy.
Conclusion: For adult patients with resectable thoracic esophageal cancer for whom surgery is considered appropriate, surgery alone (i.e., without neoadjuvant or adjuvant therapy) is recommended as the standard practice.
2004-09-24T07:00:00Z
article
https://ir.lib.uwo.ca/epidempub/19
http://www.biomedcentral.com/1741-7015/2/35
Epidemiology and Biostatistics Publications
Scholarship@Western
Chemotherapy
Adjuvant
Esophageal Neoplasms
Humans
Hyperthermia
Induced
Neoadjuvant Therapy
Radiotherapy
Adjuvant
Randomized Controlled Trials as Topic
Chemotherapy, Adjuvant
Hyperthermia, Induced
Radiotherapy, Adjuvant
Biostatistics
Epidemiology
Oncology
Surgery
oai:ir.lib.uwo.ca:biochempub-1027
2011-07-10T21:35:10Z
publication:biochempub
publication:oncpub
publication:paed
publication:pmid
publication:biochem
publication:faculties
publication:onc
publication:paedpub
Chemically Induced DNA Hypomethylation in Breast Carcinoma Cells Detected by the Amplification of Intermethylated Sites
Sadikovic, Bekim
Haines, Thomas R.
Butcher, Darci T.
Rodenhiser, David I.
Introduction: Compromised patterns of gene expression result in genomic instability, altered patterns of gene expression and tumour formation. Specifically, aberrant DNA hypermethylation in gene promoter regions leads to gene silencing, whereas global hypomethylation events can result in chromosomal instability and oncogene activation. Potential links exist between environmental agents and DNA methylation, but the destabilizing effects of environmental exposures on the DNA methylation machinery are not understood within the context of breast cancer aetiology. Methods: We assessed genome-wide changes in methylation patterns using a unique methylation profiling technique called amplification of intermethylated sites (AIMS). This method generates easily readable fingerprints that represent the investigated cell line's methylation profile, based on the differential cleavage of DNA with methylation-specific isoschisomeric restriction endonucleases. Results: We validated this approach by demonstrating both unique and reoccurring sites of genomic hypomethylation in four breast carcinoma cell lines treated with the cytosine analogue 5-azacytidine. Comparison of treated with control samples revealed individual bands that exhibited methylation changes, and these bands were excized and cloned, and the precise genomic location individually identified. In most cases, these regions of hypomethylation coincided with susceptible target regions previously associated with chromosome breakage, rearrangement and gene amplification. Similarly, we observed that acute benzopyrene exposure is associated with altered methylation patterns in these cell lines. Conclusion: These results reinforce the link between environmental exposures, DNA methylation and breast cancer, and support a role for AIMS as a rapid, affordable screening method to identify environmentally induced DNA methylation changes that occur in tumourigenesis.
2004-04-30T07:00:00Z
article
https://ir.lib.uwo.ca/biochempub/27
info:doi/10.1186/bcr799
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC468641/
Biochemistry Publications
Scholarship@Western
Azacitidine
Breast Neoplasms
Carcinoma
Cell Line
Tumor
DNA (Cytosine-5-)-Methyltransferase
DNA Methylation
DNA
Neoplasm
Humans
Nucleic Acid Amplification Techniques
Promoter Regions
Genetic
Cell Line, Tumor
DNA, Neoplasm
Promoter Regions, Genetic
Biochemistry
Oncology
Pediatrics
oai:ir.lib.uwo.ca:surgerypub-1012
2010-09-14T01:59:18Z
publication:pathol
publication:patholpub
publication:oncpub
publication:surgerypub
publication:pmid
publication:surgery
publication:faculties
publication:onc
Sentinel Node Biopsy as an Adjunct to Limb Salvage Surgery for Epithelioid Sarcoma of the Hand
Seal, Alex
Tse, Raymond
Wehrli, Bret
Hammond, Alex
Temple, Claire L. F.
Background: Epithelioid sarcomas of the hand are rare, high-grade tumors with a propensity for regional lymphatic spread approaching 40%.
Case Presentation: A 54-year-old male with an epithelioid sarcoma of the palm was treated with neoadjuvant radiation, wide excision, and two-stage reconstruction. Sentinel lymph node biopsy was used to stage the patient's axilla. Sentinel node biopsy results were negative. The patient has remained free of local, regional and distant disease for the follow-up time of 16 months.
Conclusion: The rarity of this tumor makes definitive conclusions difficult but SLN biopsy appears to be a useful adjunct in the treatment of these sarcomas.
2005-06-29T07:00:00Z
article
https://ir.lib.uwo.ca/surgerypub/14
info:doi/10.1186/1477-7819-3-41
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1192822/
Surgery Publications
Scholarship@Western
Sentinel node
Limb salvage
Epithelioid sarcoma
Oncology
Pathology
Surgery
oai:ir.lib.uwo.ca:oncpub-1003
2009-09-27T21:17:27Z
publication:med
publication:epidem
publication:oncpub
publication:pmid
publication:faculties
publication:onc
publication:medpub
publication:epidempub
Psychometric Properties of a Prostate Cancer Radiation Late Toxicity Questionnaire
Rodrigues, George
Bauman, Glenn
Lock, Michael
D'Souza, David
Mahon, Jeff
Background: To construct a short prostate cancer radiation late toxicity (PCRT) questionnaire with health-related quality-of-life (HRQoL) domains.
Methods: The PCRT was developed by item generation, questionnaire construction (n = 7 experts, n = 8 focus group patients), pilot testing (n = 37), item reduction (n = 100), reliability testing (n = 237), and validity testing (n = 274).
Results: Reliability of the three item-reduced subscales demonstrated intraclass correlation coefficients (CC) of 0.811 (GU), 0.842 (GI), and 0.740 (sexual). Discriminant validity demonstrated Pearson CC of 0.449 (GU-GI), 0.200 (sexual-GU), and 0.09 (sexual-GI). Content validity correlations between PCRT-PCQoL were 0.35-0.78, PCRT-FACT-G(c) were 0.19-0.39, and PCRT-SF-36(R) were 0.03-0.34.
Conclusion: We successfully generated a PCRT HRQoL questionnaire including subscales with very good psychometric properties.
2007-05-31T07:00:00Z
article
https://ir.lib.uwo.ca/oncpub/3
http://www.hqlo.com/content/5/1/29
Oncology Publications
Scholarship@Western
Aged
Aged
80 and over
Brachytherapy
Focus Groups
Follow-Up Studies
Humans
Male
Middle Aged
Ontario
Outcome Assessment (Health Care)
Pilot Projects
Prostatic Neoplasms
Psychometrics
Quality of Life
Questionnaires
Radiation Oncology
Radiation
Ionizing
Radiotherapy
Sickness Impact Profile
Aged, 80 and over
Outcome Assessment (Health Care)
Radiation, Ionizing
Epidemiology
Oncology
oai:ir.lib.uwo.ca:oncpub-1008
2009-10-03T01:13:32Z
publication:oncpub
publication:pmid
publication:faculties
publication:onc
Survival of Patients with Metastatic Breast Cancer: Twenty-year Data from Two SEER Registries
Tai, Patricia
Yu, Edward
Vinh-Hung, Vincent
Cserni, Gábor
Vlastos, Georges
Background: Many researchers are interested to know if there are any improvements in recent treatment results for metastatic breast cancer in the community, especially for 10- or 15-year survival.
Methods: Between 1981 and 1985, 782 and 580 female patients with metastatic breast cancer were extracted respectively from the Connecticut and San Francisco-Oakland registries of the Surveillance, Epidemiology, and End Results (SEER) database. The lognormal statistical method to estimate survival was retrospectively validated since the 15-year cause-specific survival rates could be calculated using the standard life-table actuarial method. Estimated rates were compared to the actuarial data available in 2000. Between 1991 and 1995, further 752 and 632 female patients with metastatic breast cancer were extracted respectively from the Connecticut and San Francisco-Oakland registries. The data were analyzed to estimate the 15-year cause-specific survival rates before the year 2005.
Results: The 5-year period (1981-1985) was chosen, and patients were followed as a cohort for an additional 3 years. The estimated 15-year cause-specific survival rates were 7.1% (95% confidence interval, CI, 1.8-12.4) and 9.1% (95% CI, 3.8-14.4) by the lognormal model for the two registries of Connecticut and San Francisco-Oakland respectively. Since the SEER database provides follow-up information to the end of the year 2000, actuarial calculation can be performed to confirm (validate) the estimation. The Kaplan-Meier calculation for the 15-year cause-specific survival rates were 8.3% (95% CI, 5.8-10.8) and 7.0% (95% CI, 4.3-9.7) respectively. Using the 1991-1995 5-year period cohort and followed for an additional 3 years, the 15-year cause-specific survival rates were estimated to be 9.1% (95% CI, 3.8-14.4) and 14.7% (95% CI, 9.8-19.6) for the two registries of Connecticut and San Francisco-Oakland respectively.
Conclusions: For the period 1981-1985, the 15-year cause-specific survival for the Connecticut and the San Francisco-Oakland registries were comparable. For the period 1991-1995, there was not much change in survival for the Connecticut registry patients, but there was an improvement in survival for the San Francisco-Oakland registry patients.
2004-09-02T07:00:00Z
article
https://ir.lib.uwo.ca/oncpub/8
http://www.biomedcentral.com/1471-2407/4/60
Oncology Publications
Scholarship@Western
Adult
Breast Neoplasms
California
Cause of Death
Connecticut
Female
Humans
Models
Statistical
Neoplasm Metastasis
Neoplasm Staging
Prognosis
Registries
Retrospective Studies
Survival Rate
Models, Statistical
Oncology
oai:ir.lib.uwo.ca:oncpub-1006
2009-10-03T01:08:44Z
publication:oncpub
publication:pmid
publication:faculties
publication:onc
Short- and Long-term Cause-specific Survival of Patients with Inflammatory Breast Cancer
Tai, Patricia
Yu, Edward
Shiels, Ross
Pacella, Juan
Jones, Kurian
Sadikov, Evgeny
Mahmood, Shazia
Background: Inflammatory breast cancer (IBC) had been perceived to have a poor prognosis. Oncologists were not enthusiastic in the past to give aggressive treatment. Single institution studies tend to have small patient numbers and limited years of follow-up. Most studies do not report 10-, 15- or 20-year results.
Methods: Data was obtained from the population-based database of the Surveillance, Epidemiology, and End Results program of the National Cancer Institute from 1975-1995 using SEER*Stat5.0 software. This period of 21 years was divided into 7 periods of 3 years each. The years were chosen so that there was adequate follow-up information to 2000. ICD-O-2 histology 8530/3 was used to define IBC. The lognormal model was used for statistical analysis.
Results: A total of 1684 patients were analyzed, of which 84% were white, 11% were African Americans, and 5% belonged to other races. Age distribution was < 30 years in 1%, 30-40 in 11%, 40-50 in 22%, 50-60 in 24%, 60-70 in 21%, and > 70 in 21%. The lognormal model was validated for 1975-77 and for 1978-80, since the 10-, 15- and 20-year cause-specific survival (CSS) rates, could be calculated using the Kaplan-Meier method with data available in 2000. The data were then used to estimate the 10-, 15- and 20-year CSS rates for the more recent years, and to study the trend of improvement in survival. There were increasing incidences of IBC: 134 patients in the 1975-77 period to 416 patients in the 1993-95 period. The corresponding 20-year CSS increased from 9% to 20% respectively with standard errors of less than 4%.
Conclusion: The improvement of survival during the study period may be due to introduction of more aggressive treatments. However, there seem to be no further increase of long-term CSS, which should encourage oncologists to find even more effective treatments. Because of small numbers of patients, randomized studies will be difficult to conduct. The SEER population-based database will yield the best possible estimate of the trend in improvement of survival for patients with IBC.
2005-10-22T07:00:00Z
article
https://ir.lib.uwo.ca/oncpub/6
http://www.biomedcentral.com/1471-2407/5/137
Oncology Publications
Scholarship@Western
Adult
Aged
Aged
80 and over
Animals
Breast Neoplasms
Female
Humans
Inflammation
Middle Aged
Models
Statistical
National Institutes of Health (U.S.)
Registries
SEER Program
Software
Time Factors
Treatment Outcome
United States
Aged, 80 and over
Models, Statistical
National Institutes of Health (U.S.)
Oncology
oai:ir.lib.uwo.ca:oncpub-1005
2009-10-03T01:05:49Z
publication:oncpub
publication:pmid
publication:faculties
publication:onc
Minimum Follow-up Time Required for the Estimation of Statistical Cure of Cancer Patients: Verification Using Data from 42 Cancer Sites in the SEER Database
Tai, Patricia
Yu, Edward
Cserni, Gábor
Vlastos, Georges
Royce, Melanie
Kunkler, Ian
Vinh-Hung, Vincent
Background: The present commonly used five-year survival rates are not adequate to represent the statistical cure. In the present study, we established the minimum number of years required for follow-up to estimate statistical cure rate, by using a lognormal distribution of the survival time of those who died of their cancer. We introduced the term, threshold year, the follow-up time for patients dying from the specific cancer covers most of the survival data, leaving less than 2.25% uncovered. This is close enough to cure from that specific cancer.
Methods: Data from the Surveillance, Epidemiology and End Results (SEER) database were tested if the survival times of cancer patients who died of their disease followed the lognormal distribution using a minimum chi-square method. Patients diagnosed from 1973-1992 in the registries of Connecticut and Detroit were chosen so that a maximum of 27 years was allowed for follow-up to 1999. A total of 49 specific organ sites were tested. The parameters of those lognormal distributions were found for each cancer site. The cancer-specific survival rates at the threshold years were compared with the longest available Kaplan-Meier survival estimates.
Results: The characteristics of the cancer-specific survival times of cancer patients who died of their disease from 42 cancer sites out of 49 sites were verified to follow different lognormal distributions. The threshold years validated for statistical cure varied for different cancer sites, from 2.6 years for pancreas cancer to 25.2 years for cancer of salivary gland. At the threshold year, the statistical cure rates estimated for 40 cancer sites were found to match the actuarial long-term survival rates estimated by the Kaplan-Meier method within six percentage points. For two cancer sites: breast and thyroid, the threshold years were so long that the cancer-specific survival rates could yet not be obtained because the SEER data do not provide sufficiently long follow-up.
Conclusion: The present study suggests a certain threshold year is required to wait before the statistical cure rate can be estimated for each cancer site. For some cancers, such as breast and thyroid, the 5- or 10-year survival rates inadequately reflect statistical cure rates, and highlight the need for long-term follow-up of these patients.
2005-05-17T07:00:00Z
article
https://ir.lib.uwo.ca/oncpub/5
http://www.biomedcentral.com/1471-2407/5/48
Oncology Publications
Scholarship@Western
Disease-Free Survival
Follow-Up Studies
Humans
Models
Statistical
Neoplasms
Prognosis
Registries
SEER Program
Time Factors
Treatment Outcome
Models, Statistical
Oncology
oai:ir.lib.uwo.ca:oncpub-1007
2009-10-03T01:10:44Z
publication:oncpub
publication:pmid
publication:faculties
publication:onc
Long-term Survival Rates of Laryngeal Cancer Patients Treated by Radiation and Surgery, Radiation Alone, and Surgery Alone: Studied by Lognormal and Kaplan-Meier Survival Methods
Tai, Patricia
Yu, Edward
Shiels, Ross
Tonita, Jon
Background: Validation of the use of the lognormal model for predicting long-term survival rates using short-term follow-up data.
Methods: 907 cases of laryngeal cancer were treated from 1973-1977 by radiation and surgery (248), radiation alone (345), and surgery alone (314), in registries of Connecticut and Metropolitan Detroit of the SEER database, with known survival status up to 1999. Phase 1 of this study used the minimum chi-square test to assess the goodness of fit of the survival times of those who died with disease to a lognormal distribution. Phase 2 used the maximum likelihood method to estimate long-term survival rates using short-term follow-up data. In order to validate the lognormal model, the estimated long-term cancer-specific survival rates (CSSR) were compared with the values calculated by the Kaplan-Meier (KM) method using long-term data.
Results: The 25-year CSSR were predicted to be 72%, 68% and 65% for treatments by radiation and surgery, by radiation alone, and by surgery alone respectively, using short-term follow-up data by the lognormal model. Corresponding results calculated by the KM method were: 72+/-3%, 68+/-3% and 66+/-4% respectively.
Conclusions: The lognormal model was validated for the prediction of the long-term survival rates of laryngeal cancer patients treated by these different methods. The lognormal model may become a useful tool in research on outcomes.
2005-01-31T08:00:00Z
article
https://ir.lib.uwo.ca/oncpub/7
http://www.biomedcentral.com/1471-2407/5/13
Oncology Publications
Scholarship@Western
Adult
Aged
Chi-Square Distribution
Combined Modality Therapy
Female
Humans
Laryngeal Neoplasms
Likelihood Functions
Male
Middle Aged
Models
Statistical
Normal Distribution
Survival Analysis
Survival Rate
Models, Statistical
Oncology
oai:ir.lib.uwo.ca:oncpub-1004
2009-10-03T01:15:40Z
publication:oncpub
publication:pmid
publication:faculties
publication:onc
Disease-specific Survival for Limited-stage Small-cell Lung Cancer Affected by Statistical Method of Assessment
Tai, Patricia
Chapman, Judith-Anne W.
Yu, Edward
Jones, Dennie
Yu, Changhong
Yuan, Fei
Sang-Joon, Lee
Background: In general, prognosis and impact of prognostic/predictive factors are assessed with Kaplan-Meier plots and/or the Cox proportional hazard model. There might be substantive differences from the results using these models for the same patients, if different statistical methods were used, for example, Boag log-normal (cure-rate model), or log-normal survival analysis.
Methods: Cohort of 244 limited-stage small-cell lung cancer patients, were accrued between 1981 and 1998, and followed to the end of 2005. The endpoint was death with or from lung cancer, for disease-specific survival (DSS). DSS at 1-, 3- and 5-years, with 95% confidence limits, are reported for all patients using the Boag, Kaplan-Meier, Cox, and log-normal survival analysis methods. Factors with significant effects on DSS were identified with step-wise forward multivariate Cox and log-normal survival analyses. Then, DSS was ascertained for patients with specific characteristics defined by these factors.
Results: The median follow-up of those alive was 9.5 years. The lack of events after 1966 days precluded comparison after 5 years. DSS assessed by the four methods in the full cohort differed by 0-2% at 1 year, 0-12% at 3 years, and 0-1% at 5 years. Log-normal survival analysis indicated DSS of 38% at 3 years, 10-12% higher than with other methods; univariate 95% confidence limits were non-overlapping. Surgical resection, hemoglobin level, lymph node involvement, and superior vena cava (SVC) obstruction significantly impacted DSS. DSS assessed by the Cox and log-normal survival analysis methods for four clinical risk groups differed by 1-6% at 1 year, 15-26% at 3 years, and 0-12% at 5 years; multivariate 95% confidence limits were overlapping in all instances.
Conclusion: Surgical resection, hemoglobin level, lymph node involvement, and superior vena cava (SVC) obstruction all significantly impacted DSS. Apparent DSS for patients was influenced by the statistical methods of assessment. This would be clinically relevant in the development or improvement of clinical management strategies.
2007-02-20T08:00:00Z
article
https://ir.lib.uwo.ca/oncpub/4
http://www.biomedcentral.com/1471-2407/7/31
Oncology Publications
Scholarship@Western
Adult
Aged
Aged
80 and over
Carcinoma
Small Cell
Cohort Studies
Comorbidity
Confidence Intervals
Female
Follow-Up Studies
Humans
Lung Neoplasms
Lymphatic Metastasis
Male
Middle Aged
Models
Statistical
Multivariate Analysis
Risk Factors
Saskatchewan
Superior Vena Cava Syndrome
Survival Analysis
Survival Rate
Aged, 80 and over
Carcinoma, Small Cell
Models, Statistical
Oncology
oai:ir.lib.uwo.ca:mnipub-1004
2009-10-12T04:28:24Z
publication:mnipub
publication:biochempub
publication:mni
publication:oncpub
publication:pmid
publication:biochem
publication:faculties
publication:onc
Requirements for E1A Dependent Transcription in the Yeast Saccharomyces Cerevisiae
Yousef, Ahmed F.
Brandl, Christopher J.
Mymryk, Joe S.
Background: The human adenovirus type 5 early region 1A (E1A) gene encodes proteins that are potent regulators of transcription. E1A does not bind DNA directly, but is recruited to target promoters by the interaction with sequence specific DNA binding proteins. In mammalian systems, E1A has been shown to contain two regions that can independently induce transcription when fused to a heterologous DNA binding domain. When expressed in Saccharomyces cerevisiae, each of these regions of E1A also acts as a strong transcriptional activator. This allows yeast to be used as a model system to study mechanisms by which E1A stimulates transcription.
Results: Using 81 mutant yeast strains, we have evaluated the effect of deleting components of the ADA, COMPASS, CSR, INO80, ISW1, NuA3, NuA4, Mediator, PAF, RSC, SAGA, SAS, SLIK, SWI/SNF and SWR1 transcriptional regulatory complexes on E1A dependent transcription. In addition, we examined the role of histone H2B ubiquitylation by Rad6/Bre1 on transcriptional activation.
Conclusion: Our analysis indicates that the two activation domains of E1A function via distinct mechanisms, identify new factors regulating E1A dependent transcription and suggest that yeast can serve as a valid model system for at least some aspects of E1A function.
2009-04-17T07:00:00Z
article
https://ir.lib.uwo.ca/mnipub/11
http://www.biomedcentral.com/1471-2199/10/32
Microbiology & Immunology Publications
Scholarship@Western
Adenovirus E1A Proteins
Gene Expression Regulation
Gene Expression Regulation
Fungal
Protein Structure
Tertiary
Saccharomyces cerevisiae
Saccharomyces cerevisiae Proteins
Transcription Factors
Gene Expression Regulation, Fungal
Protein Structure, Tertiary
Immunology and Infectious Disease
Microbiology
oai:ir.lib.uwo.ca:oncpub-1009
2009-10-12T04:41:35Z
publication:epidem
publication:oncpub
publication:pmid
publication:faculties
publication:onc
publication:epidempub
Comparing Two Strategies of Dynamic Intensity Modulated Radiation Therapy (dIMRT) with 3-Dimensional Conformal Radiation Therapy (3DCRT) in the Hypofractionated Treatment of High-risk Prostate Cancer
Yuen, Jasper
Rodrigues, George
Trenka, Kristina
Coad, Terry
Yartsev, Slav
D'Souza, David
Lock, Michael
Bauman, Glenn
Background: To compare two strategies of dynamic intensity modulated radiation therapy (dIMRT) with 3-dimensional conformal radiation therapy (3DCRT) in the setting of hypofractionated high-risk prostate cancer treatment.
Methods: 3DCRT and dIMRT/Helical Tomotherapy(HT) planning with 10 CT datasets was undertaken to deliver 68 Gy in 25 fractions (prostate) and simultaneously delivering 45 Gy in 25 fractions (pelvic lymph node targets) in a single phase. The paradigms of pelvic vessel targeting (iliac vessels with margin are used to target pelvic nodes) and conformal normal tissue avoidance (treated soft tissues of the pelvis while limiting dose to identified pelvic critical structures) were assessed compared to 3DCRT controls. Both dIMRT/HT and 3DCRT solutions were compared to each other using repeated measures ANOVA and post-hoc paired t-tests.
Results: When compared to conformal pelvic vessel targeting, conformal normal tissue avoidance delivered more homogenous PTV delivery (2/2 t-test comparisons; p < 0.001), similar nodal coverage (8/8 t-test comparisons; p = ns), higher and more homogenous pelvic tissue dose (6/6 t-test comparisons; p < 0.03), at the cost of slightly higher critical structure dose (Ddose, 1-3 Gy over 5/10 dose points; p < 0.03). The dIMRT/HT approaches were superior to 3DCRT in sparing organs at risk (22/24 t-test comparisons; p < 0.05).
Conclusion: dIMRT/HT nodal and pelvic targeting is superior to 3DCRT in dose delivery and critical structure sparing in the setting of hypofractionation for high-risk prostate cancer. The pelvic targeting paradigm is a potential solution to deliver highly conformal pelvic radiation treatment in the setting of nodal location uncertainty in prostate cancer and other pelvic malignancies.
2008-01-07T08:00:00Z
article
https://ir.lib.uwo.ca/oncpub/9
http://www.ro-journal.com/content/3/1/1
Oncology Publications
Scholarship@Western
Dose-Response Relationship
Radiation
Humans
Male
Prostatic Neoplasms
Radiotherapy Dosage
Radiotherapy Planning
Computer-Assisted
Radiotherapy
Intensity-Modulated
Tomography
X-Ray Computed
Dose-Response Relationship, Radiation
Radiotherapy Planning, Computer-Assisted
Radiotherapy, Intensity-Modulated
Tomography, X-Ray Computed
Epidemiology
Oncology
oai:ir.lib.uwo.ca:oncpub-1010
2009-10-24T03:18:49Z
publication:biophysics
publication:epidem
publication:biophysicspub
publication:oncpub
publication:surgerypub
publication:pmid
publication:surgery
publication:faculties
publication:onc
publication:epidempub
Post-Operative Extended Volume External Beam Radiation Therapy in High Risk Esophageal Cancer Patients: A Prospective Experience
Yu, E.
Tai, P.
Younus, J.
Malthaner, R.
Truong, P.
Stitt, L.
Rodrigues, G.
Ash, R.
Dar, R.
Yaremko, B.
Tomiak, A.
Dingle, B.
Sanatani, M.
Vincent, M.
Kocha, W.
Fortin, D.
Inculet, R.
Background and purpose: Extended volume external beam radiation therapy (RT) following esophagectomy is controversial. This prospective study evaluates the feasibility of extended volume RT treatment in high-risk esophagectomy patients with cervical anastomosis receiving post–operative combined chemo-radiation therapy. Patients and methods: From 2001-2006, 15 patients with resected esophageal cancer were prospectively accrued to this pilot study, to evaluate the adverse effects of extended volume RT. Eligibility criteria were pathologically proven esophageal malignancy, T3-4, N0-1, disease amenable to surgical resection and esophagectomy with or without resection margin involvement. Patients with distant metastases (M1) and patients treated with previous RT were excluded. All 15 patients received four cycles of 5-fluorouracil-based chemotherapy. External beam RT utilized conformal computerized tomography (CT) planning, with multi-field arrangement tailored to the pathological findings with clinical target volume encompassing the primary tumour bed and anastomotic site in the neck. The radiation therapy dose was 50.40Gy at 1.8Gy per fraction, delivered concurrently with the third cycle of chemotherapy. Outcomes were disease-free survival (DFS) and overall survival (OS), calculated by Kaplan–Meier method. Treatment-related toxicities were assessed using NCI-CTC Grading System. Results: There were 10 male and 5 female patients. The median age was 64 years (ranging 48 to 80 years). The TNM stages included one T3N0, two T2N1, eleven T3N1 and one T4N1. The histopathology included 5 adenocarcinomas and 10 squamous cell carcinomas. Resection margins were clear in 10 patients. The median follow up time was 19 months (range: 3.5-53.4 months). Delay in chemotherapy occurred in 20% of patients and dose reduction was required in 13.3% of patients prior to radiation therapy. During the concurrent chemo-radiation therapy phase, 20% and 6.6% had chemotherapy delay and dose reduction, respectively. No patient experienced treatment related acute and chronic esophagitis of > Grade 2. Disease recurrence occurred in 40% (6/15) and the median time to relapse was 24 months. There was no tumour recurrence at the anastomotic site. The median DFS and OS rate were 23 months and 21 months, respectively. Conclusion: Extended volume external beam radiation therapy encompassing the tumour bed and the anastomotic site is feasible and safe after esophagectomy. These findings support proceeding with a larger trial to assess its efficacy in patients with high-risk esophageal cancer.
2009-01-01T08:00:00Z
article
https://ir.lib.uwo.ca/oncpub/10
http://www.current-oncology.com/index.php/oncology/article/view/355
Oncology Publications
Scholarship@Western
Pilot study
cancer
esophagus
extended volume
irradiation
Medical Biophysics
Oncology
Surgery
oai:ir.lib.uwo.ca:oncpub-1011
2009-10-24T03:37:20Z
publication:biophysics
publication:epidem
publication:biophysicspub
publication:oncpub
publication:surgerypub
publication:pmid
publication:surgery
publication:faculties
publication:onc
publication:epidempub
Is Extended Volume External Beam Radiation Therapy Covering the Anastomotic Site Beneficial in Post-esophagectomy High Risk Patients?
Yu, Edward
Dar, Rashid
Rodrigues, George B.
Stitt, Larry
Videtic, Gregory M. M.
Truong, Pauline
Tomiak, Anna
Ash, Robert
Brecevic, Ed
Inculet, Richard
Malthaner, Richard
Vincent, Mark
Craig, Ian
Kocha, Walter
Lefcoe, Michael
Background and purpose: To assess the impact of extended volume radiation therapy (RT) with anastomotic coverage on local control in high risk post-operative esophageal cancer patients.
Patients and methods: This is a retrospective study of high risk (T(3), T(4), nodes positive, with or without margin involvement) post-operative esophageal cancer patients treated at London Regional Cancer Centre from 1989 to 1999. After esophagectomy, all patients received adjuvant combined modality therapy consisting of four cycles of fluorouracil-based chemotherapy, and loco-regional RT with or without coverage of the anastomotic site. RT dose ranged from 45 to 60 Gy at 1.8-2.0 Gy/fraction with treatment fields tailored to the pathologic findings and location of the anastomosis. CT planning was used in all patients to design spinal cord sparing beam arrangements. First relapse rate (first incidence of an event), disease specific survival and overall survival were calculated by Chi-Square, Log-Rank, and Kaplan-Meier (K-M) methods.
Results: During the study period, 72 patients had underwent esophagectomy and were considered for adjuvant chemoradiation therapy. Three patients were excluded due to disease progression prior to therapy. The 69 remaining patients formed the study cohort for the present analysis. The median age of the study group was 60 years (range 35-82 years). Pathologic stage distribution (AJCC 1997 staging) was T(2,3) N(1) in 94% patients, 65% of the cases were adenocarcinoma and had undergone transhiatal esophagectomy (86%) with positive/close margins in 34 (49%) patients. Median follow-up was 30.5 months (range 3.4-116.3 months). Two- and 5-year actuarial overall survivals rates were 50 and 31%, respectively. First relapse rate after adjuvant therapy was 63.7% (n = 44) and median time to relapse was 27.2 months. Anastomosis recurrence rates were 29% with small volume and 0% with extended volume RT (P = 0.041). Local and regional relapse occurred in 74.2% of patients treated with small volume RT compared to 15.4% in patients treated with extended volume RT (P < 0.001). After adjusting for resection margin status, the local control benefit of extended volume RT remained significant (P = 0.003). Treatment interruptions and late gastrointestinal toxicity were not significantly increased with the use of extended volume RT.
Conclusions: A significant decrease in local and regional relapse without added late toxicity was achieved with the use of extended volume RT encompassing the anastomotic site post-operatively in high risk esophageal cancer patients.
2004-11-01T08:00:00Z
article
https://ir.lib.uwo.ca/oncpub/11
http://dx.doi.org/10.1016/j.radonc.2004.08.024
Oncology Publications
Scholarship@Western
Adult
Aged
Aged
80 and over
Anastomosis
Surgical
Brachytherapy
Combined Modality Therapy
Esophageal Neoplasms
Esophagectomy
Female
Humans
Male
Middle Aged
Neoplasm Recurrence
Local
Neoplasm Staging
Probability
Prognosis
Radiotherapy Dosage
Radiotherapy
Adjuvant
Registries
Retrospective Studies
Risk Assessment
Sensitivity and Specificity
Survival Analysis
Time Factors
Treatment Outcome
Aged, 80 and over
Anastomosis, Surgical
Neoplasm Recurrence, Local
Radiotherapy, Adjuvant
Oncology
Surgery
oai:ir.lib.uwo.ca:oncpub-1014
2009-10-26T00:38:55Z
publication:biophysics
publication:epidem
publication:biophysicspub
publication:oncpub
publication:pmid
publication:faculties
publication:onc
publication:epidempub
Eleven-year Follow-up Results in the Delay of Breast Irradiation after Conservative Breast Surgery in Node-negative Breast Cancer Patients
Vujovic, Olga
Yu, Edward
Cherian, Anil
Dar, A. Rashid
Stitt, Larry
Perera, Francisco
Purpose: This retrospective review was conducted to determine if delay in the start of radiotherapy after conservative breast surgery had any detrimental effect on local recurrence or disease-free survival in node-negative breast cancer patients.
Methods and materials: A total of 568 patients with T1 and T2, N0 breast cancer were treated with breast-conserving surgery and breast irradiation, without adjuvant systemic therapy, between January 1, 1985 and December 31, 1992 at the London Regional Cancer Centre. The time intervals from definitive breast surgery to breast irradiation used for analysis were 0 to 8 weeks (201 patients), greater than 8 to 12 weeks (235 patients), greater than 12 to 16 weeks (91 patients), and greater than 16 weeks (41 patients). Kaplan-Meier estimates of time to local-recurrence and disease-free survival rates were calculated.
Results: Median follow-up was 11.2 years. Patients in all 4 time intervals were similar in terms of age and pathologic features. No statistically significant difference was seen between the 4 groups in local recurrence or disease-free survival with surgery radiotherapy interval (p = 0.521 and p = 0.222, respectively). The overall local-recurrence rate at 5 and 10 years was 4.6% and 11.3%, respectively. The overall disease-free survival at 5 and 10 years was 79.6% and 67.0%, respectively.
Conclusion: This retrospective study suggests that delay in the start of breast irradiation of up to 16 weeks from definitive surgery does not increase the risk of recurrence in node-negative breast cancer patients. The certainty of these results is limited by the retrospective nature of this analysis.
2006-03-01T08:00:00Z
article
https://ir.lib.uwo.ca/oncpub/14
http://dx.doi.org/10.1016/j.ijrobp.2005.08.004
Oncology Publications
Scholarship@Western
Adult
Aged
Aged
80 and over
Breast Neoplasms
Carcinoma
Ductal
Breast
Carcinoma
Lobular
Combined Modality Therapy
Disease-Free Survival
Female
Follow-Up Studies
Humans
Mastectomy
Segmental
Middle Aged
Neoplasm Recurrence
Local
Regression Analysis
Retrospective Studies
Time Factors
Aged, 80 and over
Carcinoma, Ductal, Breast
Carcinoma, Lobular
Mastectomy, Segmental
Neoplasm Recurrence, Local
Oncology
oai:ir.lib.uwo.ca:oncpub-1013
2009-10-26T00:26:47Z
publication:biophysics
publication:biophysicspub
publication:oncpub
publication:pmid
publication:faculties
publication:onc
The Role of High-dose-rate Brachytherapy in the Palliation of Symptoms in Patients with Non-small-cell Lung Cancer: A Systematic Review
Ung, Yee C.
Yu, Edward
Falkson, Conrad
Haynes, Adam E.
Stys-Norman, Denise
Evans, William K.
Cancer Care Ontario's Program in Evidence-based Care, McMaster University
Purpose: This review addresses the role of high-dose-rate endobronchial brachytherapy (HDREB) for symptom palliation in patients with non-small-cell lung cancer.
Methods and materials: Relevant trials were identified through a systematic search of the literature.
Results: Twenty-nine trials were eligible. Six randomized trials involved HDREB alone or with external beam radiation therapy (EBR) or laser therapy. Median and 1-year survival ranged from 4 to 10 months and from 11% to 38%, respectively. Symptoms controlled by HDREB were dyspnea, cough, chest pain, and hemoptysis. Fatal hemoptysis ranged from 7% to 22%. Better overall symptom palliation and fewer retreatments were required in previously untreated patients using EBR alone or EBR with HDREB.
Conclusions: EBR alone is more effective than HDREB for symptom palliation in previously untreated patients with endobronchial non-small-cell lung cancer. HDREB with EBR seems to provide better symptom relief than EBR alone. HDREB is recommended for symptomatic patients with recurrent endobronchial obstruction previously treated by EBR, providing it is technically feasible.
2006-07-01T07:00:00Z
article
https://ir.lib.uwo.ca/oncpub/13
http://dx.doi.org/10.1016/j.brachy.2006.05.001
Oncology Publications
Scholarship@Western
Brachytherapy
Carcinoma
Non-Small-Cell Lung
Dose-Response Relationship
Radiation
Humans
Lung Neoplasms
Palliative Care
Treatment Outcome
Carcinoma, Non-Small-Cell Lung
Dose-Response Relationship, Radiation
Oncology
oai:ir.lib.uwo.ca:oncpub-1012
2009-10-26T00:13:46Z
publication:biophysics
publication:epidem
publication:biophysicspub
publication:oncpub
publication:surgerypub
publication:surgery
publication:faculties
publication:onc
publication:epidempub
Definitive Radiation Therapy Management for Medically Non-resectable Clinically Localised Non-small Cell Lung Cancer: Results & Prognostic Factors
Yu, Edward
Tai, Patricia
Ash, Robert
Lee, Michael
Stitt, Larry
Rodrigues, George
Dar, Rashid
Vincent, Mark
Inculet, Richard
Malthaner, Richard
The aim of this paper is to review the experience of radical radiation therapy and the prognostic factors of patient outcome for clinically localised, medically inoperable non-small cell lung cancer (NSCLC) patients. Clinically staged node-negative NSCLC patients who were not a surgical candidates due to co-morbid diseases but who were eligible for curative treatment, were reviewed in the London Regional Cancer Program (LRCP). This study population was treated between 1st Jan 1985 to 31st Jan 2004. Patients were excluded if they were previously treated with chest radiotherapy. Patients with localised disease, but who refused surgery, were also included in the study. Eligible patients received radiation therapy which was given via localised portals and underwent simulation prior to therapy. The dose prescription range was from 50 Gy in 2.5 Gy per fraction to 60 Gy in 2 Gy per fraction. Hazard ratios and P-values were determined for time to recurrence and patient survival. A total of 74 patients met the study eligibility criteria. The median age of the cohort was 70 years (range 38-92 years). The cohort consisted of 52 males and 22 females. 39/74 (53%) had a pathological diagnosis of squamous cell carcinoma. Clinical stages were 21 (28%) T1 , 40 (54%) T2 , and 13 (18%) T3 , respectively. 59/74 (78%) completed their planned radical radiotherapy but 15/74 declined radiotherapy. The median follow-up time was 17.6 months (range 0.4-123.6 months). For patients who completed radiotherapy, the two-year and five-year disease-free survival (DFS) rates were 38.1% and 11.4%. Overall survival (OS) two-year and five-year rates were 33.2% and 6.9%, respectively. The median DFS and OS for T1 , T2 , and T3 were 18.7, 14, 15 months; and 23.1, 18.5, 14.5 months, respectively. Patients who received radiotherapy compared to those who did not, had median lung cancer-specific survival (CSS) times of 21 months and 4.9 months (P<0.001); OS times of 20 months and 5 months (P<0.001), respectively. Tumour size had impact on patient survival in univariate (P=0.004) and multivariate (P=0.002) analyses. In conclusion, radical radiotherapy significantly improves survival for patients with medically inoperable clinically staged localised NSCLC, and tumour size is a predictor of patient outcome. The OS, CSS, and DFS rates for patients with tumour size greater than 6 cm are significantly worse than those with smaller size tumours.
2007-01-01T08:00:00Z
article
https://ir.lib.uwo.ca/oncpub/12
http://www.nowotwory.edu.pl/files/pdf/s_263e_Yu_-_Definitive_radiation.pdf
Oncology Publications
Scholarship@Western
radiation therapy
lung cancer
Epidemiology
Oncology
Surgery
oai:ir.lib.uwo.ca:oncpub-1015
2010-08-13T23:25:06Z
publication:biophysics
publication:biophysicspub
publication:oncpub
publication:pmid
publication:faculties
publication:onc
Practice Guideline on Prophylactic Cranial Irradiation in Small-cell Lung Cancer
Kotalik, Jaro
Yu, Edward
Markman, Barbara R.
Evans, William K.
Cancer Care Ontario, Toronto, ON
Purpose: To develop an evidence-based clinical practice guideline that would address the following questions: (a) What is the role of prophylactic cranial irradiation (PCI) in patients with limited or extensive stage small-cell lung cancer (SCLC) who have achieved complete remission in response to induction therapy (chemotherapy or chemoradiotherapy)? (b) What dose and fractionation schedules of PCI are optimal? (c) Does the use of PCI in patients with SCLC in complete remission affect quality of life? Survival, disease-free survival, quality of life, and adverse effects were the outcomes of interest.
Methods and materials: A systematic review of the published literature was undertaken to provide the data for an evidence-based practice guideline.
Results: Six randomized controlled trials and one fully published individual patient data meta-analysis were included in the systematic review of the evidence. For patients who have achieved complete response after induction therapy, there is evidence of a disease-free survival benefit (4 of 6 trials) and an overall survival benefit (meta-analysis). There is insufficient evidence to make a definitive recommendation with respect to dose. There is some indication that 30-36 Gy in 2-3 Gy per fraction, or a biologically equivalent dose, may produce a better outcome than a lower dose or less aggressive fractionation regimen. The schedule commonly used in Canada is 25 Gy in 10 fractions over 2 weeks. Data from further research, including a trial currently ongoing that compares 25 Gy in 10 fractions with 36 Gy in 18 fractions, will be required to determine optimal dose of PCI. There is insufficient evidence to make recommendations concerning the optimal timing of PCI in relation to the administration of chemotherapy. Lung DSG members generally felt that it should be given as soon as possible after completion of chemotherapy. There is evidence from trials with data for up to 2 years of follow-up that prophylactic cranial irradiation does not produce significant late neurotoxicity. There is evidence from one trial that prophylactic cranial irradiation does not have a detrimental effect on quality of life in the first 12 months following the completion of therapy. There is insufficient evidence to comment on the long-term effects of prophylactic cranial irradiation on quality of life.
Conclusion: For adult patients with limited or extensive SCLC who achieve a complete remission with induction therapy, PCI is recommended.
2001-06-01T07:00:00Z
article
https://ir.lib.uwo.ca/oncpub/15
info:doi/10.1016/S0360-3016(01)01448-1
http://dx.doi.org/10.1016/S0360-3016(01)01448-1
Oncology Publications
Scholarship@Western
Carcinoma
Small Cell
Cognition
Cranial Irradiation
Disease-Free Survival
Dose-Response Relationship
Radiation
Evidence-Based Medicine
Humans
Lung Neoplasms
Meta-Analysis as Topic
Physician's Practice Patterns
Practice Guidelines as Topic
Quality of Life
Randomized Controlled Trials as Topic
Survival Rate
Carcinoma, Small Cell
Dose-Response Relationship, Radiation
Oncology
oai:ir.lib.uwo.ca:oncpub-1016
2009-10-26T01:16:21Z
publication:biophysics
publication:epidem
publication:biophysicspub
publication:oncpub
publication:surgerypub
publication:surgery
publication:faculties
publication:onc
publication:epidempub
The 4th annual Ontario Thoracic Cancer Conference at Niagara-on-the-lake
Ung, Y. C.
Yu, E.
Malthaner, R.
Burkes, R.
Ellis, P.
Goss, G.
Solow, H.
Irvine, S.
Laffan, S.
The 4th annual Ontario Thoracic Cancer Conference at Niagara-on-the-lake focused on the themes of innova- tions in the management of lung cancer, controversies in the management of esophageal cancer, and molecu- lar targeted therapies in lung cancer. This conference summary highlights the presentations and provides clinicians with a referenced update on these topics.
2009-01-01T08:00:00Z
article
https://ir.lib.uwo.ca/oncpub/16
http://www.current-oncology.com/index.php/oncology/article/view/516
Oncology Publications
Scholarship@Western
lung cancer
esophageal cancer
molecular targeted therapies
Oncology
oai:ir.lib.uwo.ca:oncpub-1018
2009-11-23T01:24:18Z
publication:biophysics
publication:biophysicspub
publication:oncpub
publication:pmid
publication:faculties
publication:onc
Impact of Radiation Therapy Fraction Size on Local Control of Early Glottic Carcinoma
Yu, Edward
Shenouda, George
Beaudet, Marie P.
Black, Martin J.
Purpose: Different radiotherapy fractionation schedules were used over a 10-year period to treat patients with early squamous cell carcinoma of the vocal cords at McGill University. A retrospective analysis was performed to study the effect of fraction size on local control in this group of patients.
Methods and materials: A total of 126 previously untreated patients with T1 invasive squamous cell carcinoma of the true vocal cords were irradiated between January 1978 and December 1988 in the Department of Radiation Oncology at McGill University. All patients received megavoltage irradiation, 94 patients received daily fractions > 2 Gy (64 patients received 50 Gy with once-daily 2.5-Gy fractions, and 30 received 65.25 Gy in 29 fractions of 2.25 Gy each), and 32 patients were treated to a dose of 66 Gy in 33 fractions with 2 Gy/fraction. Patients' characteristics of prognostic importance were equally distributed between the two fractionation groups.
Results: At a median follow-up of 84 months, the 10-year disease-free survival and overall survival were 76% and 93%, respectively. Local control for patients treated with > 2 Gy fraction was 84%, compared to 65.6% for those treated with 2-Gy fractions (p = 0.026). Among the prognostic factors tested, such as gender, age, stage, anterior and posterior commissure involvement, smoking history, and fraction size, the latter was the only significant predictor of local control for the whole group of patients in univariate (p = 0.041) and multivariate (p = 0.023) analysis. There was no observed difference in the incidence of complications between the two fractionation groups.
Conclusions: From the results of this retrospective review of patients treated with radiotherapy for T1 true vocal cord cancer, and within the range of total doses and overall treatment times used in our patients, it was found that fractionation schedules using daily fraction size > 2 Gy are associated with a better local control than schedules delivering 2 Gy/fraction, with no increase in toxicity.
1997-02-01T08:00:00Z
article
https://ir.lib.uwo.ca/oncpub/18
info:doi/10.1016/S0360-3016(96)00578-0
http://www.redjournal.org/article/S0360-3016%2896%2900578-0/abstract
Oncology Publications
Scholarship@Western
Carcinoma
Squamous Cell
Disease-Free Survival
Female
Follow-Up Studies
Humans
Laryngeal Neoplasms
Male
Middle Aged
Neoplasm Staging
Radiotherapy Dosage
Retrospective Studies
Sex Factors
Treatment Failure
Vocal Cords
Carcinoma, Squamous Cell
Oncology
oai:ir.lib.uwo.ca:oncpub-1017
2009-11-15T11:01:35Z
publication:biophysics
publication:epidem
publication:biophysicspub
publication:oncpub
publication:pmid
publication:faculties
publication:onc
publication:epidempub
Chemotherapy in Neuroendocrine/Merkel Cell Carcinoma of the Skin: Case Series and Review of 204 Cases
Tai, Patricia T. H.
Yu, Edward
Winquist, Eric
Hammond, Alex
Stitt, Larry
Tonita, Jon
Gilchrist, Jim
Purpose: To study the use of chemotherapy for Merkel cell carcinoma (MCC) of the skin.
Patients and methods: Twenty-five cases of MCC were treated at the London Regional Cancer Center between 1987 and 1997. Thirteen cases treated with chemotherapy were reviewed with 191 cases from the literature.
Results: At presentation, 24 patients had localized skin lesions (stage I) and one had locoregional involvement (stage II). Among the nine cases with recurrent nodal disease, six had chemotherapy as a component of salvage treatment. They were all free of disease at a median of 19 months (range, 12 to 37 months). In contrast, two patients who had salvage radiotherapy alone died of disease. Overall survival (OS) and disease-free survival (DFS) were 59% and 43%, respectively, at two years. Median OS and DFS were 29 months (range, 1 to 133 months) and 9 months (range, 1 to 133 months), respectively. Nodal disease developed in 12 (50%) of 24 patients with stage I disease, and distant metastases developed in six (25%) of 24. Including those from the literature, there were 204 cases treated with chemotherapy. Cyclophosphamide/doxorubicin (or epirubicin)/vincristine combination +/- prednisone was the most commonly used chemotherapy regimen (47 cases), with an overall response rate of 75.7% (35.1% complete, 35. 1% partial, and 5.4% minor responses). Etoposide/cisplatin (or carboplatin) was the next most commonly used regimen (27 cases), with an overall response rate of 60% (36% complete and 24% partial responses). The difference in response rate was not statistically significant (P =.19). Among the 204 cases, there were seven (3.4%) toxic deaths.
Conclusion:: Chemoradiation for locally recurrent or advanced disease may be an option for patients with a good performance status.
2000-06-01T07:00:00Z
article
https://ir.lib.uwo.ca/oncpub/17
http://jco.ascopubs.org/cgi/content/abstract/18/12/2493
Oncology Publications
Scholarship@Western
Aged
Aged
80 and over
Antineoplastic Combined Chemotherapy Protocols
Carcinoma
Merkel Cell
Combined Modality Therapy
Disease-Free Survival
Female
Humans
Karnofsky Performance Status
Male
Middle Aged
Neoplasm Staging
Prognosis
Skin Neoplasms
Treatment Outcome
Aged, 80 and over
Carcinoma, Merkel Cell
Epidemiology
Oncology
oai:ir.lib.uwo.ca:oncpub-1019
2009-10-28T06:37:28Z
publication:biophysics
publication:biophysicspub
publication:oncpub
publication:pmid
publication:faculties
publication:onc
Accelerated Fractionation in Inoperable Non-small Cell Lung Cancer. A Phase I/II Study
Yu, Edward
Souhami, Luis
Guerra, Julio
Clark, Brenda
Gingras, Carole
Fava, Palma
Background: A prospective, single-treatment-arm, Phase I/II trial was performed to determine the tumor response to an accelerated regimen and assess the feasibility and toxic effects of this approach in patients with inoperable non-small cell lung cancer (NSCLC).
Methods: Thirty-seven previously untreated patients with inoperable NSCLC who had no evidence of metastatic disease entered the study. All patients were able to walk and had disease that was measurable or assessable. Patients with palpable supraclavicular disease and weight loss were also eligible. Radiation therapy consisted of an altered fractionation regimen with a concomitant boost technique. The original lung volume received a dose of 40 Gy in 20 daily fractions to the computerized axial tomography (CT)-defined primary tumor and mediastinal nodes. The boost dose (10 Gy) was administered concomitantly with the last five fractions of the original volume treatments, with an interfraction interval of 6-8 hours. The maximal allowed dose to the cord was 46 Gy.
Results: At a median follow-up of 36 months, complete response was achieved in 29% (9 of 31) of the patients and a partial response in 42% (13 of 31). The overall survival rate at 36 months was 10% (median survival time, 8 months). Survival rates were 25%, 8%, and 0% for the complete responders, partial responders, and nonresponders, respectively. Local failure alone was observed in 35.5% of all patients, local and distant failure in 42%, and distant failure only in 13%. Treatments were well tolerated, and all patients were able to complete the planned regimen. Grade 1 and 2 esophagitis occurred in 65% and 26% of the patients, respectively. The clinical condition of two patients (6%) was compatible with radiation pneumonitis. Moist desquamation of the skin occurred in two patients, but most had either mild (55%) or moderate (19%) skin erythema. Late complications have been limited to radiologically detected lung fibrosis.
Conclusions: The accelerated fractionation schedule used in this trial was well tolerated with shortening of overall treatment time. Local tumor control and overall survival are similar to those resulting from conventional fractionation without an increase in normal tissue effects. These results are encouraging, and additional studies testing higher tumor doses are warranted.
1993-05-01T07:00:00Z
article
https://ir.lib.uwo.ca/oncpub/19
http://www3.interscience.wiley.com/journal/112675825/abstract
Oncology Publications
Scholarship@Western
Aged
Carcinoma
Non-Small-Cell Lung
Feasibility Studies
Female
Follow-Up Studies
Humans
Lung Neoplasms
Male
Middle Aged
Neoplasm Staging
Prospective Studies
Radiation Injuries
Radiotherapy Dosage
Survival Rate
Treatment Failure
Carcinoma, Non-Small-Cell Lung
Oncology
oai:ir.lib.uwo.ca:oncpub-1020
2009-10-28T06:52:41Z
publication:biophysics
publication:biophysicspub
publication:oncpub
publication:pmid
publication:faculties
publication:onc
The Role of Biogenic Amines in the Regulation of Exocrine Gland Function: A Possible Mechanism for the Pathogenesis of Cystic Fibrosis
Tenenhouse, A.
Yu, E. W.-T.
1984-01-01T08:00:00Z
article
https://ir.lib.uwo.ca/oncpub/20
http://journals.lww.com/jpgn/Citation/1984/00031/The_Role_of_Biogenic_Amines_in_the_Regulation_of.6.aspx
Oncology Publications
Scholarship@Western
Animals
Biogenic Amines
Cystic Fibrosis
Pancreas
Pancreatic Ducts
Rats
Oncology
Pharmacology, Toxicology and Environmental Health
oai:ir.lib.uwo.ca:oncpub-1021
2009-10-28T07:02:18Z
publication:biophysics
publication:biophysicspub
publication:oncpub
publication:pmid
publication:faculties
publication:onc
Decarboxylation of L-Dopa and 5-Hydroxytryptophan in Dispersed Rat Pancreas Acinar Cells
Yu, E. W.-T.
Stern, L.
Tenenhouse, A.
Amino acid decarboxylation activity in dispersed rat pancreas acinar cells and fractions derived by differential centrifugation of homogenate of these cells was studied. The rate of decarboxylation was measured by determining the rate of production of the [3H]-amine from [3H]-amino acid or the rate of production of 14CO2 from the [14C]-carboxy-labelled amino acid. Only the hydroxylated amino acids L-dopa and 5-hydroxytryptophan are decarboxylated by intact dispersed pancreas acinar cells or cell homogenates at all pH values and amino acid concentrations tested. The decarboxylase activity is located exclusively in the cell cytosol. Each substrate competitively inhibits the decarboxylation of the other and the decarboxylation of each is inhibited by NSD-1055. The estimated Km and Vmax are, for L-dopa, 4.8 X 10(-5) M and 2.5 nmol/mg protein/min and for 5-hydroxytryptophan, 2.9 X 10(-5) M and 0.3 nmol/mg protein/min. The pH optimum for 5-hydroxytryptophan decarboxylation is from 7.0-8.5 while that for L-dopa is 7.0. It is concluded that pancreas acinar cells possess a single aromatic amino acid decarboxylase specific for the hydroxylated amino acids L-dopa and 5-hydroxytryptophan, and which is similar in all properties studied to the aromatic amino acid decarboxylase found in several other mammalian tissues.
1984-01-01T08:00:00Z
article
https://ir.lib.uwo.ca/oncpub/21
http://content.karger.com/ProdukteDB/produkte.asp?Aktion=ShowAbstract&ArtikelNr=138011&Ausgabe=236604&ProduktNr=224274
Oncology Publications
Scholarship@Western
Animals
Aromatic-L-Amino-Acid Decarboxylases
Binding
Competitive
Decarboxylation
Female
Histidine
Levodopa
Pancreas
Rats
Rats
Inbred Strains
Serotonin
Tryptophan
Tyrosine
Binding, Competitive
Rats, Inbred Strains
Oncology
Pharmacology, Toxicology and Environmental Health
oai:ir.lib.uwo.ca:oncpub-1022
2009-10-29T05:30:49Z
publication:biophysics
publication:biophysicspub
publication:oncpub
publication:faculties
publication:onc
Lung Cancer Trends. Part 1: North America
Tai, P.
Yu, E.
2004-01-01T08:00:00Z
article
https://ir.lib.uwo.ca/oncpub/25
http://www.current-oncology.com/
Oncology Publications
Scholarship@Western
lung cancer
North America
Oncology
oai:ir.lib.uwo.ca:oncpub-1024
2009-10-29T05:37:32Z
publication:biophysics
publication:biophysicspub
publication:oncpub
publication:faculties
publication:onc
Malignant Pleural Mesothelioma: World Trends
Tai, P.
Yu, E.
2004-01-01T08:00:00Z
article
https://ir.lib.uwo.ca/oncpub/23
http://www.current-oncology.com/
Oncology Publications
Scholarship@Western
Pleural mesothelioma
Oncology
oai:ir.lib.uwo.ca:oncpub-1023
2009-10-29T05:33:49Z
publication:biophysics
publication:biophysicspub
publication:oncpub
publication:faculties
publication:onc
Lung Cancer Trends. Part 2: Beyond North America
Tai, P.
Yu, E.
2005-01-01T08:00:00Z
article
https://ir.lib.uwo.ca/oncpub/24
http://www.current-oncology.com/
Oncology Publications
Scholarship@Western
lung cancer
Oncology
oai:ir.lib.uwo.ca:oncpub-1025
2009-10-29T05:51:44Z
publication:biophysics
publication:biophysicspub
publication:oncpub
publication:faculties
publication:onc
Altered Fractionation of Radical Radiation Therapy in the Management of Unresectable Non-Small Cell Lung Cancer
Yu, E.
Lochrin, K.
Dixon, P.
Ung, Y.
Gagliardi, A.
Evans, W. K.
2000-01-01T08:00:00Z
article
https://ir.lib.uwo.ca/oncpub/22
http://www.cma.ca/index.cfm/ci_id/54490/la_id/1.htm?cpgId=3278
Oncology Publications
Scholarship@Western
lung cancer
radiation therapy
Oncology
oai:ir.lib.uwo.ca:oncpub-1027
2009-11-02T00:24:14Z
publication:biophysics
publication:biophysicspub
publication:oncpub
publication:faculties
publication:onc
Cardiac Tumours
Tai, Patricia
Yu, Edward
Primary cardiac neoplasms are rare and they are not covered comprehensively in the literature, including textbooks. A Medline search from January 2007 to July 2008 was performed to update the existing literature. Cardiac tumour manifestation may mimic other conditions. It may lead to fatal complications like sudden death, and because the tumour can act as a nidus for the formation of fibrin-platelet aggregates, embolic events occur. Its rarity means that an average physician would have minimal experience with its management. This review will serve as a useful reference.
2009-01-01T08:00:00Z
article
https://ir.lib.uwo.ca/oncpub/27
http://www.nowotwory.edu.pl/files/pdf/2009/plik_s1e_Cardiac.pdf
Oncology Publications
Scholarship@Western
cardiac tumours
prognostic factors
diagnosis
treatment
Oncology
oai:ir.lib.uwo.ca:oncpub-1029
2011-05-05T01:16:53Z
publication:biophysics
publication:biophysicspub
publication:oncpub
publication:pmid
publication:faculties
publication:onc
A Long-Term Study of Radiation Therapy in T1-2 Node-Negative Breast Cancer Patients in Relation to the Number of Axillary Nodes Examined
Tai, Patricia
Yu, Edward
Sadikov, Evgeny
Joseph, Kurian
Purpose: The optimal number of axillary nodes to be resected is controversial. This large series investigated the effect of surgery with or without adjuvant radiotherapy among node-negative breast cancer patients in relation to the number of nodes examined.
Methods and materials: Node-negative patients from the Saskatchewan registry of 1981-1995 were studied. Because nodal status may be more reliable with more number of nodes examined, we analyzed T1-2 age < 90 patients with < 10 nodes examined treated with surgery alone (Group A_S, n = 509) vs. surgery and adjuvant radiotherapy (Group A_S+R, n = 342); and T1-2 age < 90 patients with > or = 10 nodes examined treated with surgery alone (Group B_S, n = 902) vs. surgery and adjuvant radiotherapy (Group B_S+R, n = 596).
Results: For the two radiotherapy groups, patients with < 10 nodes (Group A_S+R) vs. > or = 10 nodes (Group B_S+R), there was no difference in overall survival (p = 0.14). In the two nonradiotherapy groups (A_S and B_S), there is a statistically significant decrease in overall survival for patients with < 10 nodes removed (p < 0.001, log-rank test). The optimal number of axillary nodes examined could be 8 nodes with adjuvant radiotherapy (p = 0.05, logrank test) and 12 nodes without adjuvant radiotherapy (p = 0.02, log-rank test).
Conclusions: The poorer prognosis of a lesser number of nodes resected was overcome partly by the use of radiotherapy, raising the possibility of micrometastases in lymph nodes not removed. The optimal number of axillary nodes examined could be 8 nodes with adjuvant radiotherapy and 12 nodes without adjuvant radiotherapy.
2009-06-01T07:00:00Z
article
https://ir.lib.uwo.ca/oncpub/29
info:doi/10.1016/j.ijrobp.2008.08.035
http://dx.doi.org/10.1016/j.ijrobp.2008.08.035
Oncology Publications
Scholarship@Western
Adult
Aged
Aged
80 and over
Axilla
Breast Neoplasms
Female
Humans
Lymph Node Excision
Lymph Nodes
Lymphatic Metastasis
Mastectomy
Segmental
Middle Aged
Prospective Studies
Radiotherapy
Adjuvant
Registries
Saskatchewan
Survival Analysis
Aged, 80 and over
Mastectomy, Segmental
Radiotherapy, Adjuvant
Oncology
oai:ir.lib.uwo.ca:oncpub-1028
2009-11-02T00:38:49Z
publication:biophysics
publication:epidem
publication:biophysicspub
publication:oncpub
publication:surgerypub
publication:pmid
publication:surgery
publication:faculties
publication:onc
publication:epidempub
Management and Prognosis in Synchronous Solitary Resected Brain Metastasis from Non–Small-Cell Lung Cancer
Louie, Alexander V.
Rodrigues, George
Yaremko, Brian
Yu, Edward
Dar, A. Rashid
Dingle, Brian
Vincent, Mark
Sanatani, Michael
Malthaner, Richard
Inculet, Richard
Background: Reports in the medical literature have described cases of extended survival of patients with non-small-cell lung cancer (NSCLC) with solitary metastatic disease who have received aggressive treatment both to the brain metastasis and to the local/regional disease. The objective of this research is to analyze prognostic factors that predict for outcome in this unique patient population.
Patients and methods: A single-institution, retrospective chart review was performed on 35 patients with NSCLC and a synchronous solitary brain metastasis (SSBM) treated with craniotomy and whole-brain radiation therapy. Eight patients (22.9%) had chest surgery, 24 (68.6%) had chemotherapy, and 14 (40%) had thoracic radiation as part of their local management. Fourteen had stage I/II disease (42.9%), and 20 had stage III disease (57.1%). Mean age at diagnosis was 58.5 years. Eighteen patients (56.25%) had a brain metastasis < 3 cm, and 14 patients (43.75%) had a metastasis > 3 cm.
Results: Median survival was 7.8 months, and at last follow-up, 3 patients (8.6%) were alive and well, 6 patients (17.1%) were alive and with disease, 24 patients (68.6%) had died of disease, and 2 patients (5.7%) had died of other causes. Univariate analysis demonstrated that lung surgery (P = .0033), primary lung treatment > 8 weeks after brain surgery (P = .0128), and stage I/II disease (P = .0467) were predictive of overall survival.
Conclusion: Survival remains poor for patients with NSCLC with an SSBM. However, patients with thoracic disease amenable to local resection should be considered for such therapy because a survival advantage could exist compared with patients with more locally advanced disease.
2009-05-01T07:00:00Z
article
https://ir.lib.uwo.ca/oncpub/28
http://cigjournals.metapress.com/content/506526020m5610k1/?p=5f802118b7d04304af4114dab0debb4cπ=5
Oncology Publications
Scholarship@Western
Adult
Aged
Brain Neoplasms
Carcinoma
Non-Small-Cell Lung
Cranial Irradiation
Humans
Infant
Lung Neoplasms
Male
Middle Aged
Neoplasm Staging
Prognosis
Retrospective Studies
Carcinoma, Non-Small-Cell Lung
Epidemiology
Oncology
Surgery
oai:ir.lib.uwo.ca:oncpub-1026
2009-11-02T00:14:35Z
publication:biophysics
publication:epidem
publication:biophysicspub
publication:oncpub
publication:pmid
publication:faculties
publication:onc
publication:epidempub
Effect of Interval to Definitive Breast Surgery on Clinical Presentation and Survival in Early-Stage Invasive Breast Cancer
Vujovic, Olga
Yu, Edward
Cherian, Anil
Perera, Francisco
Dar, A. Rashid
Stitt, Larry
Hammond, A.
Purpose: To examine the effect of clinical presentation and interval to breast surgery on local recurrence and survival in early-stage breast cancer.
Methods and materials: The data from 397 patients with Stage T1-T2N0 breast carcinoma treated with conservative surgery and breast radiotherapy between 1985 and 1992 were reviewed at the London Regional Cancer Program. The clinical presentation consisted of a mammogram finding or a palpable lump. The intervals from clinical presentation to definitive breast surgery used for analysis were 0-4, >4-12, and >12 weeks. The Kaplan-Meier estimates of the time to local recurrence, disease-free survival, and cause-specific survival were determined for the three groups. Cox regression analysis was used to evaluate the effect of clinical presentation and interval to definitive surgery on survival.
Results: The median follow-up was 11.2 years. No statistically significant difference was found in local recurrence as a function of the interval to definitive surgery (p = .424). A significant difference was noted in disease-free survival (p = .040) and cause-specific survival (p = .006) with an interval of >12 weeks to definitive breast surgery. However, the interval to definitive surgery was dependent on the presentation for cause-specific survival, with a substantial effect for patients with a mammographic presentation and a negligible effect for patients with a lump presentation (interaction p = .041).
Conclusion: The results of this study suggest that an interval of >12 weeks to breast surgery might be associated with decreased survival for patients with a mammographic presentation, but it appeared to have no effect on survival for patients presenting with a palpable breast lump.
2009-11-01T07:00:00Z
article
https://ir.lib.uwo.ca/oncpub/26
http://www.redjournal.org/article/S0360-3016%2808%2903837-6/abstract
Oncology Publications
Scholarship@Western
Adult
Aged
Aged
80 and over
Axilla
Breast Neoplasms
Disease-Free Survival
Female
Follow-Up Studies
Humans
Lymph Node Excision
Mammography
Middle Aged
Neoplasm Recurrence
Local
Neoplasm Staging
Palpation
Radiotherapy Dosage
Regression Analysis
Retrospective Studies
Time Factors
Aged, 80 and over
Neoplasm Recurrence, Local
Epidemiology
Oncology
oai:ir.lib.uwo.ca:oncpub-1030
2009-11-02T01:59:40Z
publication:physics
publication:biophysics
publication:robartspub
publication:biophysicspub
publication:medimagingpub
publication:oncpub
publication:pmid
publication:robarts
publication:medimaging
publication:institutes
publication:faculties
publication:physicspub
publication:onc
The Use of CT Density Changes at Internal Tissue Interfaces to Correlate Internal Organ Motion with an External Surrogate
Gaede, Stewart
Carnes, Gregory
Yu, Edward
Van Dyk, Jake
Battista, Jerry
Lee, Ting-Yim
The purpose of this paper is to describe a non-invasive method to monitor the motion of internal organs affected by respiration without using external markers or spirometry, to test the correlation with external markers, and to calculate any time shift between the datasets. Ten lung cancer patients were CT scanned with a GE LightSpeed Plus 4-Slice CT scanner operating in a ciné mode. We retrospectively reconstructed the raw CT data to obtain consecutive 0.5 s reconstructions at 0.1 s intervals to increase image sampling. We defined regions of interest containing tissue interfaces, including tumour/lung interfaces that move due to breathing on multiple axial slices and measured the mean CT number versus respiratory phase. Tumour motion was directly correlated with external marker motion, acquired simultaneously, using the sample coefficient of determination, r(2). Only three of the ten patients showed correlation higher than r(2) = 0.80 between tumour motion and external marker position. However, after taking into account time shifts (ranging between 0 s and 0.4 s) between the two data sets, all ten patients showed correlation better than r(2) = 0.8. This non-invasive method for monitoring the motion of internal organs is an effective tool that can assess the use of external markers for 4D-CT imaging and respiratory-gated radiotherapy on a patient-specific basis.
2009-01-21T08:00:00Z
article
https://ir.lib.uwo.ca/oncpub/30
http://www.iop.org/EJ/abstract/0031-9155/54/2/006
Oncology Publications
Scholarship@Western
Biophysical Phenomena
Humans
Imaging
Three-Dimensional
Lung Neoplasms
Movement
Organ Specificity
Radiotherapy Planning
Computer-Assisted
Radiotherapy
Computer-Assisted
Respiration
Respiratory Mechanics
Tomography Scanners
X-Ray Computed
Tomography
X-Ray Computed
Imaging, Three-Dimensional
Radiotherapy Planning, Computer-Assisted
Radiotherapy, Computer-Assisted
Tomography Scanners, X-Ray Computed
Tomography, X-Ray Computed
Bioimaging and Biomedical Optics
Medical Biophysics
Oncology
oai:ir.lib.uwo.ca:biophysicspub-1004
2009-11-02T02:00:48Z
publication:physics
publication:robartspub
publication:biophysicspub
publication:oncpub
publication:pmid
publication:medimaging
publication:faculties
publication:physicspub
publication:biophysics
publication:medimagingpub
publication:robarts
publication:institutes
publication:onc
A Fully Automated Non-external Marker 4D-CT Sorting Algorithm Using a Serial Cine Scanning Protocol
Carnes, Greg
Gaede, Stewart
Yu, Edward
Van Dyk, Jake
Battista, Jerry
Lee, Ting-Yim
Current 4D-CT methods require external marker data to retrospectively sort image data and generate CT volumes. In this work we develop an automated 4D-CT sorting algorithm that performs without the aid of data collected from an external respiratory surrogate. The sorting algorithm requires an overlapping cine scan protocol. The overlapping protocol provides a spatial link between couch positions. Beginning with a starting scan position, images from the adjacent scan position (which spatial match the starting scan position) are selected by maximizing the normalized cross correlation (NCC) of the images at the overlapping slice position. The process was continued by 'daisy chaining' all couch positions using the selected images until an entire 3D volume was produced. The algorithm produced 16 phase volumes to complete a 4D-CT dataset. Additional 4D-CT datasets were also produced using external marker amplitude and phase angle sorting methods. The image quality of the volumes produced by the different methods was quantified by calculating the mean difference of the sorted overlapping slices from adjacent couch positions. The NCC sorted images showed a significant decrease in the mean difference (p < 0.01) for the five patients.
2009-04-07T07:00:00Z
article
https://ir.lib.uwo.ca/biophysicspub/5
http://www.iop.org/EJ/abstract/0031-9155/54/7/013
Medical Biophysics Publications
Scholarship@Western
Algorithms
Artifacts
Automation
Humans
Image Processing
Computer-Assisted
Neoplasms
Radiography
Thoracic
Reference Standards
Respiration
Tomography
X-Ray Computed
Image Processing, Computer-Assisted
Radiography, Thoracic
Tomography, X-Ray Computed
Bioimaging and Biomedical Optics
Medical Biophysics
oai:ir.lib.uwo.ca:oncpub-1031
2010-07-27T19:59:37Z
publication:biophysicspub
publication:oncpub
publication:pmid
publication:faculties
publication:biophysics
publication:epidem
publication:onc
publication:epidempub
The Number of Axillary Nodes Removed as a Predictor of Regional Recurrence in Node Negative Breast Cancer
Vujovic, Olga
Yu, Edward
Cherian, Anil
Dar, A. Rashid
Stitt, Larry
Perera, Francisco
Purpose: To determine if the number of axillary nodes removed is a predictor of recurrence in node negative breast cancer.
Materials and methods: Five hundred thirty-six patients with T1-T2, N0 invasive breast cancer, treated with lumpectomy and axillary node dissection (AND), were reviewed from January 1, 1986 to December 31, 1992. Patients received radiation to whole breast only, without regional nodal radiation. There was no adjuvant chemotherapy or Tamoxifen given. Patients were grouped according to the number of axillary nodes dissected as follows: 1-5 nodes (91 patients), 6-10 nodes (225 patients) and > 10 nodes (220 patients). Hazard ratios and p-values were determined for time to local recurrence, regional recurrence and for disease specific survival.
Results: Median follow-up was 11.2 years. The overall local recurrence and regional recurrence rates for the three groups were: 1-5 nodes, 9.9% and 8.8%, respectively, 6-10 nodes, 10.2% and 2.2%, respectively, and > 10 nodes, 11.8% and 2.7%, respectively. The effect of number of axillary nodes removed was statistically significant only for regional recurrence (p = 0.017). There was no adverse effect on disease specific survival (p = 0.363).
Conclusion: The number of axillary nodes removed predicts only for regional recurrence in node negative breast cancer patients, with less than 6 nodes removed associated with higher regional recurrence. This may have clinical implications with the current practice of sentinel node biopsy (SNB) replacing axillary node dissection in early stage breast cancer.
2009-04-01T07:00:00Z
article
https://ir.lib.uwo.ca/oncpub/31
info:doi/10.1016/j.radonc.2008.05.003
http://dx.doi.org/10.1016/j.radonc.2008.05.003
Oncology Publications
Scholarship@Western
Adult
Axilla
Breast Neoplasms
Female
Follow-Up Studies
Humans
Lymph Node Excision
Lymphatic Metastasis
Neoplasm Recurrence
Local
Neoplasm Staging
Predictive Value of Tests
Proportional Hazards Models
Survival Rate
Neoplasm Recurrence, Local
Epidemiology
Oncology
oai:ir.lib.uwo.ca:epidempub-1018
2012-03-29T00:14:24Z
publication:biophysicspub
publication:oncpub
publication:faculties
publication:biophysics
publication:epidem
publication:onc
publication:epidempub
Dosimetric Evaluation of Helical Tomotherapy Treatment Planning for Non-small Cell Lung Cancer
Chu, Karen
Rodrigues, George
Yartsev, Slav
Dar, A. Rashid
Yu, Edward
Ash, Robert
Yaremko, Brian
MacKenzie, Marc
Quon, Harvey
Bauman, Glenn
Roa, Wilson
Helical tomotherapy (HT) is a novel technique to deliver intensity modulated radiation therapy guided by 3D megavoltage CT imaging. The purpose of our study is to assess the dosimetric parameters related to HT and 3DCRT in advanced non-small cell lung cancer (NSCLC). Eleven patients from the London Regional Cancer Centre and the Cross Cancer Institute with NSCLC underwent individualized treatment planning on both HT and 3DCRT. Corresponding HT and 3DCRT plans for each patient were analyzed using dose-volume histograms for GTV, PTV (median dose 60Gy/30 fractions), and critical structures (lung V5-30, esophageal V50-60, and spinal cord D1). Observed differences in tumor and normal tissue dosimetry were assessed for statistical significance using paired t-tests. A statistically significant improvement on GTV homogeneity but not PTV homogeneity was found in relation with HT. 3DCRT was associated with improved V5 (14%, p = 0.02), V10 (9%, p = 0.04) and V15 (6%, p = 0.04). However, there was no difference in V20 (2%, p = NS); while HT demonstrated superior V30 (5%, p = 0.002). HT achieved excellent tumor coverage relative to 3DCRT in the setting of routinely clinically planned radiation therapy with improvements in the V30 lung parameter. This was at the expense of a modest increase in V5-V15 total lung dose.
2008-09-01T07:00:00Z
article
https://ir.lib.uwo.ca/epidempub/18
http://www.cancer-therapy.org/CT/v6/B/PDF/60._Chu_et_al,_571-576.pdf
Epidemiology and Biostatistics Publications
Scholarship@Western
Helical tomotherapy
non-small cell lung cancer
Three-dimensional Conformal Radiotherapy
Dosimetric Comparison
Lung Cancer
Biostatistics
Epidemiology
Oncology
oai:ir.lib.uwo.ca:oncpub-1032
2010-11-15T04:53:01Z
publication:biophysicspub
publication:oncpub
publication:pmid
publication:faculties
publication:biophysics
publication:onc
Nodal Ratios in Node-Positive Breast Cancer—Long-Term Study to Clarify Discrepancy of Role of Supraclavicular and Axillary Regional Radiotherapy
Tai, Patricia
Joseph, Kurian
Sadikov, Evgeny
Mahmood, Shazia
Lien, Francis
Yu, Edward
Purpose: To study the absolute number of involved nodes/the number of nodes examined or the nodal ratio (NR) in breast cancer. The primary study endpoint was to evaluate the role of supraclavicular and axillary radiotherapy (SART) according to the NR.
Methods and materials: From the Saskatchewan provincial registry of 1981-1995, the charts of 5,996 consecutive patients were retrieved to collect detailed prognostic factors. Among these patients, 1,985 were node positive. Because the NRs are more reliable the greater the number of nodes examined, we analyzed 1,255 patients with > or =10 nodes examined. Of these 1,255 patients, 667, 389, and 199 were categorized into three NR groups--low (< or =25%), medium (>25% to < or =75%), and high (>75%) nodal involvement, respectively.
Results: The NR correlated significantly with the primary tumor size (< or =2 cm, >2 to < or =5 cm, and >5 cm; p = 2.2 x 10(-16)), clinical stage group (p = 5.5 x 10(-16)), pathologic stage group (p < 2.2 x 10(-16)), and the risk of any first recurrence (p = 5.0 x 10(-15)) using chi-square tests. For a low NR, the 10-year overall survival rate with and without SART was 57% and 58% (p = 0.18), and the cause-specific survival rate was 68% and 71% (p = 0.32), respectively. For a medium NR, the 10-year overall survival rate with and without SART was 48% and 34% (p = 0.007), and the cause-specific survival rate was 57% and 43% (p = 0.002), respectively. For a high NR, the 10-year overall survival rate with and without SART was 19% and 10% (p = 0.005), and the cause-specific survival rate was 26% and 14% (p = 0.005), respectively.
Conclusion: This is the first study demonstrating that for patients with > or =10 nodes examined, SART significantly improved the survival for the median and high NR groups but not for the low NR group.
2007-07-01T07:00:00Z
article
https://ir.lib.uwo.ca/oncpub/32
info:doi/10.1016/j.ijrobp.2007.01.057
http://dx.doi.org/10.1016/j.ijrobp.2007.01.057
Oncology Publications
Scholarship@Western
Adult
Aged
Aged
80 and over
Axilla
Breast Neoplasms
Clavicle
Female
Humans
Longitudinal Studies
Lymph Nodes
Lymphatic Metastasis
Middle Aged
Neoplasm Recurrence
Local
Radiotherapy
Risk Assessment
Risk Factors
Saskatchewan
Survival Analysis
Survival Rate
Treatment Outcome
Aged, 80 and over
Neoplasm Recurrence, Local
Oncology
oai:ir.lib.uwo.ca:oncpub-1033
2009-11-04T07:54:51Z
publication:biophysicspub
publication:oncpub
publication:faculties
publication:biophysics
publication:onc
Radiotherapy for Merkel Cell Carcinoma of the Skin
Tai, Patricia
Yu, Edward
Pacella, Juan
We examine the impact of radiotherapy in the treatment of Merkel cell carcinoma (MCC) of the skin. Data at two Canadian institutions (Allan Blair Cancer Centre and London Regional Cancer Program) were collected and charts were retrieved from the registry of 1987 to 2005. A total of 79 patients with definite MCC were studied. All except three had a primary skin lesion. Six patients presented with nodal metastases and three patients with distant metastases. Fourteen patients were referred to the cancer centers at the time of recurrence: 2/14 with local recurrence, 8/14 with nodal recurrence, 2/14 with both local and nodal recurrence, and 2/14 with distant recurrence. The series consisted of 40 males and 39 females with a median age of 80 years (range 48-94). The median follow up was 21 months (range 0.5-150.4).
Twenty-two patients (group A) received radiotherapy at the time of presentation,21 being post-operative adjuvant treatment and one being primary treatment without surgery. The 5-year cause-specific survival rate (CSSR) was 42%. The 5-year rates equals the 10-year rate since the CSSR plateaus at a survival of 4.5 years and thereafter, patients died from causes other than MCC. The 5-year overall survival rate (OSR) was 19% for group A.
Fifty-seven patients (group B) had surgery alone without post-operative adjuvant radiotherapy. 5-year and 10-year CSSRs were both 63% (P=0.8, using the logrank test when comparing the two groups of patients). The 5-year OSR was 30% and the 10-year OSR was 13% (P=0.6, group A versus group B). Morbidity from radiotherapy was minimal. Only one patient with an ankle lesion did not take the skin graft well and had drainage for one year before healing. One patient had lymphoedema of the arm (which required a pressure garment) after axillary dissection and radiotherapy of 50 Gy in 25 fractions over 35 days. Radiotherapy after surgical excision is well tolerated. It is recommended if there are high risk factors for recurrence and radiotherapy should be started as soon as possible after referral.
2006-01-01T08:00:00Z
article
https://ir.lib.uwo.ca/oncpub/33
http://www.nowotwory.edu.pl/files/pdf/s%20637%20Radiotherapy%20for%20Merkel.pdf
Oncology Publications
Scholarship@Western
Merkel cell carcinoma
skin
radiotherapy
prognostic factors
Oncology
oai:ir.lib.uwo.ca:oncpub-1034
2009-11-06T08:09:56Z
publication:biophysicspub
publication:oncpub
publication:pmid
publication:faculties
publication:biophysics
publication:onc
The Role of Radiation Therapy in Malignant Pleural Mesothelioma: A Systematic Review
Ung, Yee C.
Yu, Edward
Falkson, Conrad
Haynes, Adam E.
Stys-Norman, Denise
Evans, William K.
Cancer Care Ontario Program in Evidence-based Care, McMaster University
Introduction: Radiation therapy may offer patients presenting with malignant pleural mesothelioma (MPM) symptom palliation and improvements in quality of life. This systematic review will address the role of radiation therapy in the management of MPM.
Methods: A thorough systematic search of the literature was conducted for published articles and conference proceedings for applicable abstracts. Relevant trials were selected and assessed.
Results: Three small randomized controlled trials compared prophylactic external beam radiation therapy to no radiation therapy for patients with thoracic tracts caused by drainage tubes or diagnostic procedures. None of those trials reported any serious adverse effects. A pooled analysis found no significant reduction in the frequency of procedure tract metastases. Four non-comparative studies have shown that hemithoracic irradiation alone resulted in significant toxicity, including radiation-induced pulmonary fibrosis, radiation pneumonitis, and bronchopleural fistula, without any survival benefit. Few of the identified studies reported on symptom control, and no studies included formal measures of quality of life.
Conclusion: There is limited evidence for the role of radiotherapy in the management of patients with MPM. Future studies including radiotherapy for the treatment of such patients should include formal measures of quality of life and symptom control.
2006-07-01T07:00:00Z
article
https://ir.lib.uwo.ca/oncpub/34
http://dx.doi.org/10.1016/j.radonc.2006.06.002
Oncology Publications
Scholarship@Western
Clinical Trials as Topic
Databases
Bibliographic
Humans
Mesothelioma
Pleural Neoplasms
Prospective Studies
Quality of Life
Radiation Oncology
Radiotherapy
Randomized Controlled Trials as Topic
Time Factors
Treatment Outcome
Databases, Bibliographic
Oncology
oai:ir.lib.uwo.ca:oncpub-1035
2009-11-08T08:35:56Z
publication:physics
publication:robartspub
publication:biophysicspub
publication:oncpub
publication:surgerypub
publication:pmid
publication:faculties
publication:physicspub
publication:biophysics
publication:epidem
publication:robarts
publication:surgery
publication:institutes
publication:onc
publication:epidempub
3D Thoracoscopic Ultrasound Volume Measurement Validation in an Ex Vivo and In Vivo Porcine Model of Lung Tumours
Hornblower, V. D. M.
Yu, E.
Fenster, A.
Battista, J. J.
Malthaner, R. A.
The purpose of this study was to validate the accuracy and reliability of volume measurements obtained using three-dimensional (3D) thoracoscopic ultrasound (US) imaging. Artificial "tumours" were created by injecting a liquid agar mixture into spherical moulds of known volume. Once solidified, the "tumours" were implanted into the lung tissue in both a porcine lung sample ex vivo and a surgical porcine model in vivo. 3D US images were created by mechanically rotating the thoracoscopic ultrasound probe about its long axis while the transducer was maintained in close contact with the tissue. Volume measurements were made by one observer using the ultrasound images and a manual-radial segmentation technique and these were compared with the known volumes of the agar. In vitro measurements had average accuracy and precision of 4.76% and 1.77%, respectively; in vivo measurements had average accuracy and precision of 8.18% and 1.75%, respectively. The 3D thoracoscopic ultrasound can be used to accurately and reproducibly measure "tumour" volumes both in vivo and ex vivo.
2007-01-07T08:00:00Z
article
https://ir.lib.uwo.ca/oncpub/35
http://www.iop.org/EJ/abstract/0031-9155/52/1/007
Oncology Publications
Scholarship@Western
Agar
Algorithms
Animals
Automation
Humans
Image Processing
Computer-Assisted
Imaging
Three-Dimensional
Lung
Lung Neoplasms
Neoplasm Transplantation
Phantoms
Imaging
Reproducibility of Results
Swine
Ultrasonography
Image Processing, Computer-Assisted
Imaging, Three-Dimensional
Phantoms, Imaging
Bioimaging and Biomedical Optics
Oncology
Surgery
oai:ir.lib.uwo.ca:oncpub-1037
2009-11-08T09:08:17Z
publication:biophysicspub
publication:oncpub
publication:pmid
publication:faculties
publication:biophysics
publication:onc
Syndrome of Inappropriate Antidiuretic Hormone Secretion (SIADH) in Patients with Limited Stage Small Cell Lung Cancer
Tai, Patricia
Yu, Edward
Jones, Kurian
Sadikov, Evgeny
Mahmood, Shazia
Tonita, Jon
A few series in the literature were published before 1987 on syndrome of inappropriate antidiuretic hormone secretion (SIADH) in small cell lung cancer (SCLC). This study examines the outcome in more recent era.
From 1981-1998, there were 1417 new cases of SCLC diagnosed in the provincial registry, of which 244 were of limited stage (LS). A chart review and statistical analyses were performed using Mann-Whitney test, chi-square test and Kaplan-Meier method. Fourteen LS patients (group A) had SIADH at presentation. Group B consisted of 230 LS patients without SIADH.
There were more patients with poorer performance status (ECOG 2-4) in group A than B (28.6% versus 7.8%, P=0.03). Otherwise, sex, age at diagnosis, nodal spread, pleural effusion, bronchial obstruction, superior vena cava obstruction, performance status, weight loss, and lactic dehydrogenase at presentation, were comparable between the two groups. Treatments given, e.g., extent of surgical resection (if performed, whether complete/incomplete), total number of chemotherapy cycles, radiotherapy doses, were comparable (P>0.05). The response to chemo-radiation was not significantly different (P=0.7). Five-year overall survival (8% versus 19%, P=0.08), and cause-specific survival (16% versus 20%, P=0.13) showed that group A patients had a worse outcome, though of borderline significance.
Symptoms related to SIADH included: weakness, 4 patients; tiredness, 3; change in level of consciousness, 1; seizure, 1. The range of lowest sodium level was 110-129. Two patients also had paraneoplastic myopathy. SIADH resolved in 12 patients at 1.6-44.7 weeks (median: 4.3). Among the 14 patients who initially presented with SIADH and recurred later, 10 had recurrence of SIADH at the time of tumor recurrence.
Serum sodium was useful for post-treatment surveillance in SCLC patients who presented with SIADH, with 71% (10/14) developing SIADH again at the time of recurrence. SIADH is a poor prognostic factor for LS SCLC.
2006-08-01T07:00:00Z
article
https://ir.lib.uwo.ca/oncpub/37
http://dx.doi.org/10.1016/j.lungcan.2006.05.009
Oncology Publications
Scholarship@Western
Aged
Biological Markers
Carcinoma
Small Cell
Female
Humans
Inappropriate ADH Syndrome
Lung Neoplasms
Male
Medical Records
Middle Aged
Neoplasm Recurrence
Local
Neoplasm Staging
Recurrence
Retrospective Studies
Sickness Impact Profile
Survival Analysis
Carcinoma, Small Cell
Neoplasm Recurrence, Local
Oncology
oai:ir.lib.uwo.ca:oncpub-1036
2009-11-08T08:54:56Z
publication:biophysicspub
publication:oncpub
publication:pmid
publication:faculties
publication:biophysics
publication:epidem
publication:onc
publication:epidempub
The Effect of Timing of Radiotherapy after Breast-conserving Surgery in Patients with Positive or Close Resection Margins, Young Age, and Node-negative Disease, with Long Term Follow-up
Vujovic, Olga
Cherian, Anil
Yu, Edward
Dar, A. Rashid
Stitt, Larry
Perera, Francisco
Purpose: The aim of this study was to determine the effect of timing of radiotherapy after conservative breast surgery on local recurrence in women with positive resection margins and young age, treated without systemic therapy.
Methods and Materials: A total of 568 patients with T1 and T2, N0 breast cancer were treated with breast-conserving surgery and breast irradiation, between January 1, 1985, and December 31, 1992, at the London Regional Cancer Centre. 63 patients (11.1%) had positive/close resection margins (< 2 mm) and 48 patients (8.4%) were age < or = 40 years. For patients with positive resection margins, the time intervals from breast surgery to breast irradiation used for analysis were, 0 to 8 weeks, > 8 to 12 weeks and > 12 weeks. For patients < or = 40 years, the intervals used for analysis were 0 to 8 weeks and > 8 weeks.
Results: Median follow up was 11.2 years. For patients < or = 40 years, local recurrence rate at 5 and 10 years was 17.2% and 19.8% respectively. Four patients (17.4%) treated in the 0-week to 8-week interval and 7 patients (28.0%) treated in the > 8 week interval had local recurrences. For patients < or = 40 years with positive resection margins, the local recurrence rate was 25.0%. For patients with positive resection margins, 5-year and 10-year local recurrence rates were as follows: 0 to 8 weeks, 0% and 10.5% respectively; > 8 to 12 weeks, 10.3% and 10.3% respectively; and > 12 weeks, 13.3% and 20.0% respectively.
Conclusion: Patients < or = 40 years have an increased local recurrence rate which occurs early. Patients with positive resection margins have higher local recurrence rates that become apparent when breast irradiation is delayed.
2006-11-01T08:00:00Z
article
https://ir.lib.uwo.ca/oncpub/36
http://www.redjournal.org/article/S0360-3016%2806%2900978-3/abstract
Oncology Publications
Scholarship@Western
Adult
Age Factors
Aged
Aged
80 and over
Breast Neoplasms
Carcinoma
Ductal
Breast
Carcinoma
Lobular
Disease-Free Survival
Female
Follow-Up Studies
Humans
Mastectomy
Segmental
Middle Aged
Neoplasm Recurrence
Local
Neoplasm
Residual
Time Factors
Aged, 80 and over
Carcinoma, Ductal, Breast
Carcinoma, Lobular
Mastectomy, Segmental
Neoplasm Recurrence, Local
Neoplasm, Residual
Epidemiology
Medical Biophysics
Oncology
oai:ir.lib.uwo.ca:oncpub-1038
2009-11-09T00:09:32Z
publication:physics
publication:rwkex_researcharticles
publication:biophysicspub
publication:oncpub
publication:pmid
publication:medimaging
publication:faculties
publication:physicspub
publication:rwkex
publication:biophysics
publication:medimagingpub
publication:onc
Comparative Planning Evaluation of Intensity-modulated Radiotherapy Techniques for Complex Lung Cancer Cases
Yartsev, Slav
Chen, Jeff
Yu, Edward
Kron, Tomas
Rodrigues, George
Coad, Terry
Trenka, Kristina
Wong, Eugene
Bauman, Glenn
Van Dyk, Jake
Background and Purpose: Lung cancer treatment can be one of the most challenging fields in radiotherapy. The aim of the present study was to compare different modalities of radiation delivery based on a balanced scoring scheme for target coverage and normal tissue avoidance.
Patients and Methods: Treatment plans were developed for 15 patients with stage III inoperable non-small cell lung cancer using 3D conformal technique and intensity-modulated radiotherapy (IMRT). Elective nodal irradiation was included for all cases to create the most challenging scenarios with large target volumes. A 2 cm margin was used around the gross tumour volume (GTV) to generate PTV2 and 1cm margin around elective nodes for PTV1 resulting in PTV1 volumes larger than 1000 cm(3) in 13 of the 15 patients. 3D conformal and IMRT plans were generated on a commercial treatment planning system (TheraPlan Plus, Nucletron) with various combinations of beam energies and gantry angles. A 'dose quality factor' (DQF) was introduced to correlate the plan quality with patient specific parameters.
Results: A good correlation was found between the quality of the plans and the overlap between PTV1 and lungs. The patient feature factor (PFF), which is a product of several pertinent characteristics, was introduced to facilitate the choice of a particular technique for a particular patient.
Conclusions: This approach may allow the evaluation of different treatment options prior to actual planning, subject to validation in larger prospective data sets.
2006-02-01T08:00:00Z
article
https://ir.lib.uwo.ca/oncpub/38
http://dx.doi.org/10.1016/j.radonc.2005.12.007
Oncology Publications
Scholarship@Western
Carcinoma
Non-Small-Cell Lung
Esophagus
Female
Heart
Humans
Imaging
Three-Dimensional
Lung
Lung Neoplasms
Lymph Nodes
Male
Neoplasm Staging
Radiotherapy Dosage
Radiotherapy Planning
Computer-Assisted
Radiotherapy
Conformal
Radiotherapy
High-Energy
Radiotherapy
Intensity-Modulated
Spinal Cord
Carcinoma, Non-Small-Cell Lung
Imaging, Three-Dimensional
Radiotherapy Planning, Computer-Assisted
Radiotherapy, Conformal
Radiotherapy, High-Energy
Radiotherapy, Intensity-Modulated
Medical Biophysics
Oncology
oai:ir.lib.uwo.ca:oncpub-1040
2009-11-09T00:48:36Z
publication:biophysicspub
publication:oncpub
publication:pmid
publication:faculties
publication:biophysics
publication:onc
Evaluation of Intra- and Inter-fraction Motion in Breast Radiotherapy Using Electronic Portal Cine Imaging
Kron, Tomas
Lee, Chrison
Perera, Francisco
Yu, Edward
Breast irradiation is one of the most challenging problems in radiotherapy due to the complex shape of the target volume, proximity of radiation sensitive normal structures and breathing motion. It was the aim of the present study to use electronic portal imaging (EPI) during treatment to determine intra- and inter-fraction motion in patients undergoing radiotherapy and to correlate the magnitude of motion with patient specific parameters.
EPI cine images were acquired from the medial tangential fields of twenty radiotherapy patients on a minimum of 5 days each over the course of their treatment. The treatments were administered using 10 MV X-rays and dynamic wedges on a Varian Clinac 2100CD linear accelerator. Depending on the incident dose and the angle of the wedge, between 4 and 16 images could be acquired in one session using an EPI device based on liquid ionization chambers (Varian).
The border between lung and chest-wall could be easily detected in all images and quantitative measurements were taken for the amount of lung in the field and the distance of the breast tissue from the field edges. Inter-fraction variability was found to be about twice as large as intra-fraction variability. The largest variability was detected in cranio/caudal direction (intra-fraction: 1.3 +/- 0.4 mm; inter-fraction: 2.6 +/- 1.3 mm) while the lung involvement varied by 1.1 +/- 0.2 mm and 1.8 +/- 0.6 mm intra- and inter-fraction, respectively. This indicates that the effect of breathing motion on the amount of radiated lung was not of major concern in the patients studied. Of other patient specific parameters such as body weight, breast separation, field size and location of the target, only increasing age was significantly correlated with larger inter-fraction motion.
Acquisition of EPI cine loops proved to be a quick and easy technique to establish the amount of patient movement during breast radiotherapy. The relatively small variability found in the present pilot study justifies considerations for more conformal dose delivery.
2004-10-01T07:00:00Z
article
https://ir.lib.uwo.ca/oncpub/40
http://www.tcrt.org/index.cfm?d=3018&c=4161&p=12478&do=detail
Oncology Publications
Scholarship@Western
Aged
Breast Neoplasms
Female
Humans
Image Processing
Computer-Assisted
Middle Aged
Observer Variation
Radiotherapy Planning
Computer-Assisted
Reproducibility of Results
Image Processing, Computer-Assisted
Radiotherapy Planning, Computer-Assisted
Oncology
oai:ir.lib.uwo.ca:oncpub-1039
2009-11-09T00:32:16Z
publication:biophysicspub
publication:oncpub
publication:pmid
publication:faculties
publication:biophysics
publication:epidem
publication:onc
publication:epidempub
Does Sex Influence the Impact that Smoking, Treatment Interruption and Impaired Pulmonary Function Have on Outcomes in Limited Stage Small Cell Lung Cancer Treatment?
Videtic, Gregory M. M.
Truong, Pauline T.
Ash, Robert B.
Yu, Edward W.
Kocha, Walter I.
Vincent, Mark D.
Tomiak, Anna T.
Dar, A Rashid
Whiston, Frances
Stitt, Larry W.
PURPOSE: To look for survival differences between men and women with limited stage small cell lung cancer (LS-SCLC) by examining stratified variables that impair treatment efficacy.
METHODS: A retrospective review of 215 LS-SCLC patients treated from 1989 to 1999 with concurrent chemotherapy-radiotherapy modelled on the 'early-start' thoracic radiotherapy arm of a National Cancer Institute of Canada randomized trial.
RESULTS: Of 215 LS-SCLC patients, 126 (58.6%) were men and 89 (41.4%) were women. Smoking status during treatment for 186 patients (86.5%) was: 107 (58%) nonsmoking (NS) (76 [71%] male [M]; 31 [29%] female [F]) and 79 (42%) smoking (S) (36 M [46%]; 43 F [54%]) (continuing-to-smoke F versus M, P=0.001). Fifty-six patients (26%) had radiotherapy interruptions (RTI) during chemotherapy-radiotherapy because of toxicity. Radiotherapy breaks were not associated with sex (P=0.95). Survival by sex and smoking status at two years was: F + NS = 38.7%; F + S = 21.6%; M + NS = 22.9%; and M + S = 9.1% (P=0.0046). Survival by sex and RTI status at two years was: F + no RTI = 32.4%; F + RTI = 23.6%; M + no RTI = 23.0%; and M + RTI = 3.8% (P=0.0025). Diffusion capacity for carbon monoxide (DLCO) was recorded for 86 patients (40%) and median survival by sex and DLCO was F = 16.7 months and M = 12.1 months for a DLCO less than 60%; and for a DLCO 60% or more, F = 15.1 months and M = 15.3 months. First relapses were recorded in 132 cases (61%), with chest failure in men (45%) greater than for women (35%) and cranial failure rates similar between sexes (48%). Upon multivariable analysis, continued smoking was the strongest negative factor affecting survival.
CONCLUSIONS: In LS-SCLC, women overall do better than men, with or without a negative variable. The largest quantifiable improvement in survival for women came from smoking cessation, and for men from avoidance of breaks during treatment.
2005-07-01T07:00:00Z
article
https://ir.lib.uwo.ca/oncpub/39
http://www.pulsus.com/journals/abstract.jsp?sCurrPg=abstract&jnlKy=4&atlKy=1191&isuKy=357&isArt=t&fromfold=
Oncology Publications
Scholarship@Western
Adult
Aged
Aged
80 and over
Carcinoma
Small Cell
Female
Humans
Lung Neoplasms
Male
Middle Aged
Multivariate Analysis
Radiotherapy Dosage
Retrospective Studies
Sex Factors
Smoking
Survival Analysis
Aged, 80 and over
Carcinoma, Small Cell
Epidemiology
Medical Biophysics
Oncology
oai:ir.lib.uwo.ca:oncpub-1041
2009-11-09T01:01:58Z
publication:physics
publication:biophysicspub
publication:oncpub
publication:pmid
publication:medimaging
publication:faculties
publication:physicspub
publication:biophysics
publication:medimagingpub
publication:onc
Planning Evaluation of Radiotherapy for Complex Lung Cancer Cases Using Helical Tomotherapy
Kron, Tomas
Grigorov, Grigor
Yu, Edward
Yartsev, Slav
Chen, Jeff Z.
Wong, Eugene
Rodrigues, George
Trenka, Kris
Coad, Terry
Bauman, Glenn
Van Dyk, Jake
Lung cancer treatment is one of the most challenging fields in radiotherapy. The aim of the present study was to investigate what role helical tomotherapy (HT), a novel approach to the delivery of highly conformal dose distributions using intensity-modulated radiation fan beams, can play in difficult cases with large target volumes typical for many of these patients. Tomotherapy plans were developed for 15 patients with stage III inoperable non-small-cell lung cancer. While not necessarily clinically indicated, elective nodal irradiation was included for all cases to create the most challenging scenarios with large target volumes. A 2 cm margin was used around the gross tumour volume (GTV) to generate primary planning target volume (PTV2) and 1 cm margin around elective nodes for secondary planning target volume (PTV1) resulting in PTV1 volumes larger than 1000 cm3 in 13 of the 15 patients. Tomotherapy plans were created using an inverse treatment planning system (TomoTherapy Inc.) based on superposition/convolution dose calculation for a fan beam thickness of 25 mm and a pitch factor between 0.3 and 0.8. For comparison, plans were created using an intensity-modulated radiation therapy (IMRT) approach planned on a commercial treatment planning system (TheraplanPlus, Nucletron). Tomotherapy delivery times for the large target volumes were estimated to be between 4 and 19 min. Using a prescribed dose of 60 Gy to PTV2 and 46 Gy to PTV1, the mean lung dose was 23.8+/-4.6 Gy. A 'dose quality factor' was introduced to correlate the plan outcome with patient specific parameters. A good correlation was found between the quality of the HT plans and the IMRT plans with HT being slightly better in most cases. The overlap between lung and PTV was found to be a good indicator of plan quality for HT. The mean lung dose was found to increase by approximately 0.9 Gy per percent overlap volume. Helical tomotherapy planning resulted in highly conformal dose distributions. It allowed easy achievement of two different dose levels in the target simultaneously. As the overlap between PTV and lung volume is a major predictor of mean lung dose, future work will be directed to control of margins. Work is underway to investigate the possibility of breath-hold techniques for tomotherapy delivery to facilitate this aim.
2004-08-21T07:00:00Z
article
https://ir.lib.uwo.ca/oncpub/41
http://www.iop.org/EJ/abstract/0031-9155/49/16/014
Oncology Publications
Scholarship@Western
Carcinoma
Non-Small-Cell Lung
Dose-Response Relationship
Radiation
Female
Hot Temperature
Humans
Lung
Lung Neoplasms
Lymphatic Metastasis
Male
Models
Statistical
Radiometry
Radiotherapy
Radiotherapy Dosage
Radiotherapy Planning
Computer-Assisted
Radiotherapy
Computer-Assisted
Radiotherapy
Conformal
Time Factors
Carcinoma, Non-Small-Cell Lung
Dose-Response Relationship, Radiation
Models, Statistical
Radiotherapy Planning, Computer-Assisted
Radiotherapy, Computer-Assisted
Radiotherapy, Conformal
Bioimaging and Biomedical Optics
Medical Biophysics
Oncology
oai:ir.lib.uwo.ca:oncpub-1042
2009-11-11T08:21:16Z
publication:physics
publication:biophysicspub
publication:oncpub
publication:pmid
publication:medimaging
publication:faculties
publication:physicspub
publication:biophysics
publication:medimagingpub
publication:onc
Radiation Treatment of Lung Cancer--Patterns of Practice in Canada
Tai, Patricia
Yu, Edward
Battista, Jerry
Van Dyk, Jake
BACKGROUND AND PURPOSE: To assess the patterns of practice among Canadian radiation oncologists who treat lung cancers.
PATIENTS AND METHODS: A questionnaire detailing different aspects of radiation treatment of lung cancer was mailed to all radiation oncologists treating lung cancer in Canada. Seventy-two percent (74/103) of radiation oncologists who treat lung cancer from all 34 Canadian cancer centres replied to the questionnaire.
RESULTS: (a) Radiotherapy regimens in Canadian cancer centres are in accordance with several major randomised studies. There is still some variation in treatment practice that may be due to unresolved controversies or limited resources. The most frequently used prescription dose was 40Gy/15f/3w (where f stands for fractions and w stands for weeks) for small cell lung cancer (SCLC) and 60Gy/30f/6w for non-small cell lung cancer (NSCLC). If there were no resource constraints, 30% (22/74) and 20% (15/74) would prefer to use a different dose-fractionation scheme for SCLC and NSCLC, respectively; 95% (70/74) would prefer to use 3D-conformal or intensity-modulated radiotherapy. (b) Among the various modern technologies assessed by respondents, CT (computed tomography) simulator, multi-leaf collimator, on-line electronic portal imaging and PET (positron-emission tomography) scanning were rated the highest in terms of potential patient benefit. Discrepancy between demand and availability of technology was greatest for PET scanning.
CONCLUSIONS: Canadian practice in the treatment of lung cancers shows some variations although it is consistent with the trends in the literature. The lack of some modern technologies and human resources is an ongoing concern, especially the lack of PET imaging equipment.
2004-05-01T07:00:00Z
article
https://ir.lib.uwo.ca/oncpub/42
info:doi/10.1016/j.radonc.2003.11.021
http://dx.doi.org/10.1016/j.radonc.2003.11.021
Oncology Publications
Scholarship@Western
Adult
Attitude of Health Personnel
Female
Health Care Surveys
Humans
Lung Neoplasms
Male
Middle Aged
Ontario
Physician's Practice Patterns
Quality of Health Care
Questionnaires
Radiation Oncology
Radiotherapy Dosage
Radiotherapy
Conformal
Risk Assessment
Radiotherapy, Conformal
Medical Biophysics
Oncology
oai:ir.lib.uwo.ca:epidempub-1020
2009-11-11T08:11:40Z
publication:biophysicspub
publication:oncpub
publication:pmid
publication:faculties
publication:biophysics
publication:epidem
publication:onc
publication:epidempub
Prediction of Radiation Pneumonitis by Dose-volume Histogram Parameters in Lung Cancer--A Systematic Review
Rodrigues, George
Lock, Michael
D'Souza, David
Yu, Edward
Van Dyk, Jake
BACKGROUND AND PURPOSE: To perform a systematic review of the predictive ability of various dose-volume histogram (DVH) parameters (V(dose), mean lung dose (MLD), and normal tissue complication probability (NTCP)) in the incidence of radiation pneumonitis (RP) caused by external-beam radiation therapy.
METHODS AND MATERIALS: Studies assessing the relationship between CT-based DVH reduction parameters and RP rate in radically treated lung cancer were eligible for the review. Synonyms for RP, lung cancer, DVH and its associated parameters (NTCP, V(20), V(30), MLD) were combined in a search strategy involving electronic databases, secondary reference searching, and consultation with experts. Individual or group data were abstracted from the various reports to calculate operating characteristics and odds ratios for the different DVH metrics.
RESULTS: A total of 12 published studies and two abstracts were identified. Eleven studies assessed V(dose), seven assessed MLD, and eight assessed NTCP. Nine studies exclusively analyzed the association between various DVH metrics and RP risk. Five studies also analyzed other patient, tumor, and treatment variables in conjunction with standard DVH metrics. A direct comparison between studies and the generation of summary statistics (i.e. meta-analysis) could not be achieved due to significant predictive and outcome variable heterogeneity. Most studies did show an association between DVH parameters and RP risk. However, overall accuracy, sensitivity, specificity, and positive predictive value were generally poor to fair for all three classes of DVH metrics.
CONCLUSIONS: An association between DVH parameters and RP risk has been demonstrated in the literature. However, the ideal DVH metric with excellent operating characteristics, either alone or in a model with other predictive variables, for RP risk prediction has not yet been identified. Several recommendations for reporting and conduct of future research into the association between DVH metrics and RP risk are provided.
2004-05-01T07:00:00Z
article
https://ir.lib.uwo.ca/epidempub/20
info:doi/10.1016/j.radonc.2004.02.015
http://dx.doi.org/10.1016/j.radonc.2004.02.015
Epidemiology and Biostatistics Publications
Scholarship@Western
Carcinoma
Non-Small-Cell Lung
Carcinoma
Small Cell
Dose-Response Relationship
Radiation
Female
Humans
Lung
Lung Neoplasms
Male
Predictive Value of Tests
Prognosis
Radiation Pneumonitis
Radiation Tolerance
Radiotherapy Dosage
Radiotherapy Planning
Computer-Assisted
Radiotherapy
Conformal
Randomized Controlled Trials as Topic
Risk Assessment
Severity of Illness Index
Carcinoma, Non-Small-Cell Lung
Carcinoma, Small Cell
Dose-Response Relationship, Radiation
Radiotherapy Planning, Computer-Assisted
Radiotherapy, Conformal
Biostatistics
Epidemiology
Oncology
oai:ir.lib.uwo.ca:oncpub-1043
2009-11-12T03:25:15Z
publication:biophysicspub
publication:oncpub
publication:pmid
publication:faculties
publication:biophysics
publication:epidem
publication:onc
publication:epidempub
Shifting from Hypofractionated to "Conventionally" Fractionated Thoracic Radiotherapy: A Single Institution's 10-year Experience in the Management of Limited-stage Small-cell Lung Cancer Using Concurrent Chemoradiation
Videtic, Gregory M. M.
Truong, Pauline T.
Dar, A. Rashid
Yu, Edward W.
Stitt, Larry W.
PURPOSE: To perform a retrospective review of a single institution's 10-year experience in treating limited-stage small-cell lung cancer (LS-SCLC) with a concurrent chemoradiation regimen modeled after the experimental arm of a randomized National Cancer Institute of Canada trial in which hypofractionated radiotherapy started with cycle 2 of chemotherapy. We then looked at the impact on patient outcomes of changing the RT during the course of the decade to a "conventionally" (2 Gy) fractionated regimen, with a focus on toxicity and survival rates.
METHODS AND MATERIALS: Between 1989 and 1999, 215 LS-SCLC patients received six cycles of chemotherapy consisting of cyclophosphamide, doxorubicin, and vincristine alternating with etoposide and cisplatin every 3 weeks. Thoracic RT was administered concurrently with etoposide and cisplatin (at cycle 2 or 3) only and consisted of either 40 Gy in 15 fractions for 3 weeks or 50 Gy in 25 fractions for 5 weeks. RT fields encompassed gross and suspected microscopic disease with 2-cm margins. Prophylactic cranial irradiation (PCI) was offered to complete responders according to clinician preference. RT interruption during concurrent chemoradiation was used as the "marker" for treatment toxicity. The analysis compared the RT schedules for differences in toxicity, survival, and recurrence patterns.
RESULTS: The overall survival rate for 215 patients at 2 and 5 years was 22.7% and 7.2%, respectively, with a median survival of 14.7 months. Thoracic RT consisted of 40 Gy in 3 weeks for 122 patients (57%) and 50 Gy in 5 weeks for 92 patients (43%). PCI was administered to 21 (44%) and 47 (56%) patients receiving 40 Gy and 50 Gy, respectively. The patient- and treatment-related variables were comparable between the two cohorts treated with the different RT prescriptions. RT interruptions during concurrent chemoradiation were recorded in 56 cases (26%), with a median duration of 5 days (range 1-18). No differences in treatment-related toxicity rates were demonstrated between the two dose cohorts (p = 0.35). The overall and disease-free survival rates (patients stratified by PCI use) at 5 years for the 40- and 50-Gy schedules were 14.3% and 12.0% (p = 0.71) and 20.7% and 22.2% (p = 0.76), respectively. Sites of first failure were recorded in 132 patients (61%). Comparing the 40-Gy and 50-Gy cohorts, the rate of any first relapse was 40% vs. 42% and the chest as the first relapse site was 34% vs. 45% (patients stratified by PCI use), respectively. The brain failure rate reflected PCI use and was not related to the thoracic RT schedule.
CONCLUSION: Changing from a hypofractionated to a conventionally fractionated RT thoracic prescription did not alter outcomes because the survival, thoracic control, and toxicity rates were statistically similar. This suggests that the hypofractionated schedule remains practicable and should be considered in the setting of randomized clinical trials. In view of the benefits that accelerated schedules provide for both patients and cost containment, clinicians may opt to use this tolerable regimen in managing LS-SCLC. Regarding the future development of novel chemoradiation programs, the most critical factor in ensuring improved outcomes for LS-SCLC may be limiting the duration of RT and overall treatment time.
2003-11-01T08:00:00Z
article
https://ir.lib.uwo.ca/oncpub/43
info:doi/10.1016/S0360-3016(03)00635-7
http://www.redjournal.org/article/S0360-3016%2803%2900635-7/abstract
Oncology Publications
Scholarship@Western
Adult
Aged
Aged
80 and over
Antineoplastic Combined Chemotherapy Protocols
Carcinoma
Small Cell
Cisplatin
Cyclophosphamide
Dose Fractionation
Doxorubicin
Etoposide
Female
Humans
Lung Neoplasms
Male
Middle Aged
Multivariate Analysis
Neoplasm Staging
Retrospective Studies
Survival Rate
Vincristine
Aged, 80 and over
Carcinoma, Small Cell
Epidemiology
Oncology
oai:ir.lib.uwo.ca:epidempub-1021
2009-11-12T03:14:21Z
publication:biophysicspub
publication:oncpub
publication:pmid
publication:faculties
publication:biophysics
publication:epidem
publication:onc
publication:epidempub
Impaired Diffusion Capacity Predicts for Decreased Treatment Tolerance and Survival in Limited Stage Small Cell Lung Cancer Patients Treated with Concurrent Chemoradiation
Videtic, Gregory M. M.
Stitt, Larry W.
Ash, Robert B.
Truong, Pauline T.
Dar, A. Rashid
Yu, Edward W.
Whiston, Frances
PURPOSE: To determine if stratification of limited stage small cell lung cancer (LSCLC) patients by pre-treatment pulmonary function test (PFT) prognostic indicators predicts for treatment-related toxicity risks and survival following concurrent chemoradiation.
MATERIALS AND METHODS: From 1989 to 1999, 215 LSCLC patients received six cycles of alternating cyclophosphamide/doxorubicin/vincristine and etoposide/cisplatin (EP). Thoracic radiation (RT) was initiated only with EP and at cycle 2 or 3. RT dose was: 40 Gy/15 fractions/3 weeks or 50 Gy/25 fractions/5 weeks. RT fields encompassed gross and suspected microscopic disease with a 2 cm margin. Pre-treatment PFT values analyzed included forced expiratory volume in 1s (FEV1) (in liter and as % predicted) and diffusion capacity for carbon monoxide (DLCO) (as % predicted). The "marker" for toxicity during concurrent chemoradiation was the duration of any RT breaks initiated for severe hematologic or locoregional symptomatology. Patient outcomes were analyzed for associations between recognized PFT cut-offs (FEV1 <2l, > or =2l; FEV1 <60%, > or =60% predicted; DLCO <60%, > or =60% predicted), toxicity rates, and survival.
RESULTS: For the whole study cohort, median, 2- and 5-year overall survivals were: 14.7 months, 22.7 and 7.2%, respectively. Fifty-six patients (26%) required treatment breaks due to toxicity. FEV1 and DLCO results were available for 96 (45%) and 86 (40%) patients, respectively. Two thirds of FEV1s measured were <2l. On statistical analysis, the incidence of toxicity-related interruptions was significant for DLCO<60% (P=0.043), suggestive for FEV1<2l (P=0.1) and non-significant for FEV1<60%. Patients with simultaneous DLCO<60% and FEV1<2l showed a trend toward increase toxicity risk (P=0.1). For selected PFT measures, median overall survivals were: 12.7 months versus 14.8 months for DLCO<60% versus > or =60%; 13.4 months versus 17.7 months for FEV1<2l versus> or =2l; 15.4 months versus 19.9 months for DLCO<60% + FEV1<2l versus DLCO> or =60% + FEV1> or =2l. Although absolute differences favored all patients with PFT values above the prognostic cut-offs, differences were not statistically significant on this analysis. Patients with both a treatment break and a DLCO<60% had the poorest median survival of all patient subsets, at 11.4 months (P=0.09).
CONCLUSIONS: Impaired DLCO (i.e. <60%) is a novel predictor of increased treatment-related toxicity leading to interruptions. The present study suggests a probable role for DLCO and FEV1 (in l) as prognostic factors for predicting survival but larger patient samples are required for confirmation. Patients with impaired DLCOs experiencing treatment interruptions have the poorest survival. Assessment of pre-treatment PFTs contributes to determining optimal management strategies for LSCLC patients receiving definitive chemoradiation.
2004-02-01T08:00:00Z
article
https://ir.lib.uwo.ca/epidempub/21
info:doi/10.1016/j.lungcan.2003.08.026
http://dx.doi.org/10.1016/j.lungcan.2003.08.026
Epidemiology and Biostatistics Publications
Scholarship@Western
Adult
Aged
Aged
80 and over
Algorithms
Antineoplastic Combined Chemotherapy Protocols
Cisplatin
Combined Modality Therapy
Cyclophosphamide
Doxorubicin
Etoposide
Female
Humans
Lung Neoplasms
Male
Middle Aged
Predictive Value of Tests
Prognosis
Radiation Injuries
Retrospective Studies
Risk Factors
Spirometry
Survival Analysis
Treatment Outcome
Vincristine
Aged, 80 and over
Epidemiology
Oncology
oai:ir.lib.uwo.ca:oncpub-1045
2009-11-14T08:15:35Z
publication:biophysicspub
publication:oncpub
publication:surgerypub
publication:pmid
publication:faculties
publication:biophysics
publication:surgery
publication:onc
Patterns of Breast Recurrence in a Pilot Study of Brachytherapy Confined to the Lumpectomy Site for Early Breast Cancer with Six Years' Minimum Follow-up
Perera, Francisco
Yu, Edward
Engel, Jay
Holliday, Ronald
Scott, Leslie
Chisela, Frank
Venkatesan, Varagur
PURPOSE: In this pilot study of high-dose-rate brachytherapy to the lumpectomy site as the sole radiation, ipsilateral and contralateral breast recurrences are documented with specific attention to the location of recurrence relative to the lumpectomy site.
METHODS: Between March 1992 and January 1996, 39 patients with T1 (32 patients) and T2 breast cancers received 37.2 Gy in 10 fractions (b.i.d.) over 1 week prescribed to a volume encompassing the surgical clips. Thirteen received adjuvant tamoxifen, and 4 received chemotherapy. Follow-up included annual bilateral mammograms and clinical breast examination every 3 to 6 months. Whereas 13 patients had intraoperative implantation of the lumpectomy site, 26 had postoperative implantation. The latter group and 7 of the former group had surgical clips marking the lumpectomy site, which allowed estimates of the distance of any ipsilateral breast recurrence from the lumpectomy site, using the mediolateral and cranio-caudad mammographic views.
RESULTS: At a median follow-up of 91 months, 33 women are alive, 4 have died of disease, and 2 have died of other causes. The 5-year actuarial rate of ipsilateral breast recurrence was 16.2%. Of 6 ipsilateral recurrences, 2 occurred within the lumpectomy site (in-field recurrences). One of the 2 patients had a 1-mm microscopic margin at initial diagnosis; the recurrence was a 3.5-mm microscopic focus of duct carcinoma in situ. The other patient had a 1.5-cm, high-grade infiltrating mammary carcinoma with no residual at wider resection at first diagnosis; the 5-mm invasive recurrence was also of high grade. Four women developed invasive recurrences at least 1.6 cm or more from the lumpectomy site (out-of-field recurrences). Two of these women had gross multifocal recurrences with two cancers in each patient; 1 of the 2 patients had an extensive intraductal component at initial diagnosis. The estimated nearest distances between the out-of-field recurrences and the surgical clips were 1.6, 5.5, 7.7, and 12.0 cm. All ipsilateral breast recurrences were salvaged by mastectomy (4 patients) or by repeat lumpectomy (2 patients) and whole-breast radiation. The interval postdiagnosis to ipsilateral recurrence ranged from 20 months to 58 months. There were two contralateral breast recurrences at intervals of 34 and 36 months; 1 of these patients also had a multifocal, ipsilateral recurrence at 58 months, as previously described. Among patients with any breast recurrence, 1 patient had a family history of prostate cancer; there was no family history of breast or ovarian cancer. Of 17 patients who received adjuvant systemic therapy, only 1 had a breast recurrence.
CONCLUSIONS: In this pilot study, breast recurrences outside of the lumpectomy site were the predominant pattern of recurrence.
2003-12-01T08:00:00Z
article
https://ir.lib.uwo.ca/oncpub/44
info:doi/10.1016/S0360-3016(03)00816-2
http://dx.doi.org/10.1016/S0360-3016(03)00816-2
Oncology Publications
Scholarship@Western
Adult
Aged
Aged
80 and over
Brachytherapy
Breast Neoplasms
Carcinoma in Situ
Carcinoma
Intraductal
Noninfiltrating
Chemotherapy
Adjuvant
Dose Fractionation
Female
Follow-Up Studies
Humans
Mastectomy
Segmental
Middle Aged
Neoplasm Recurrence
Local
Pilot Projects
Salvage Therapy
Treatment Failure
Aged, 80 and over
Carcinoma, Intraductal, Noninfiltrating
Chemotherapy, Adjuvant
Mastectomy, Segmental
Neoplasm Recurrence, Local
Oncology
Surgery
oai:ir.lib.uwo.ca:oncpub-1046
2009-11-14T08:24:01Z
publication:biophysicspub
publication:oncpub
publication:pmid
publication:faculties
publication:biophysics
publication:onc
Twenty-year Follow-up Study of Long-term Survival of Limited-stage Small-cell Lung Cancer and Overview of Prognostic and Treatment Factors
Tai, Patricia
Tonita, Jon
Yu, Edward
Skarsgard, David
PURPOSE: To predict the long-term survival results of clinical trials earlier than using actuarial methods and to assess the factors predictive of long-term cure in patients with limited-stage small-cell lung cancer.
METHODS AND MATERIALS: Between 1981 and 1998, 1417 new cases of small-cell lung cancer were diagnosed in Saskatchewan, Canada, of which 244 were limited stage and treated with curative intent. They were followed to the end of February 2002. A parametric lognormal statistical model was retrospectively validated to determine whether long-term survival rates could be estimated several years earlier than is possible using the standard life-table actuarial method.
RESULTS: The survival time of the uncured group followed a lognormal distribution. Four 2-year periods of diagnosis were combined, and patients were followed as a cohort for an additional 2 years. The estimated 10-year cause-specific survival rate was 13% by the lognormal model. The Kaplan-Meier calculation for 10-year cause-specific survival rate was 15% +/- 3%. The data also showed that the absence of mediastinal lymphadenopathy and higher chest radiotherapy dose were significant prognostic factors on multivariate analysis (p < 0.05). Among the 163 patients given prophylactic cranial irradiation, a higher biologically effective dose to the brain did not improve survival or decrease the incidence of brain metastases.
CONCLUSION: The lognormal model has been validated for the estimation of survival in patients with limited-stage small-cell lung cancer. A higher biologically effective dose to the brain did not improve survival or decrease the incidence of brain metastases.
2003-07-01T07:00:00Z
article
https://ir.lib.uwo.ca/oncpub/45
info:doi/10.1016/S0360-3016(03)00070-1
http://dx.doi.org/10.1016/S0360-3016(03)00070-1
Oncology Publications
Scholarship@Western
Algorithms
Antineoplastic Combined Chemotherapy Protocols
Brain Neoplasms
Carcinoma
Small Cell
Cranial Irradiation
Follow-Up Studies
Humans
Lung Neoplasms
Models
Statistical
Multivariate Analysis
Prognosis
Radiotherapy Dosage
Salvage Therapy
Saskatchewan
Statistics as Topic
Survival Rate
Carcinoma, Small Cell
Models, Statistical
Oncology
oai:ir.lib.uwo.ca:oncpub-1044
2009-11-14T08:26:43Z
publication:biophysicspub
publication:oncpub
publication:faculties
publication:biophysics
publication:onc
Validation of the Lognormal Model for Prediction of Long-term Survival Rates from Short-term Follow up Data in Stages III and IV Breast Cancer
Tai, P.
Yu, E.
Skarsgard, D.
Tonita, J.
2003-01-01T08:00:00Z
article
https://ir.lib.uwo.ca/oncpub/46
http://www.current-oncology.com/index.php/oncology
Oncology Publications
Scholarship@Western
breast cancer
survival rate
Oncology
oai:ir.lib.uwo.ca:oncpub-1048
2009-11-22T04:43:25Z
publication:physics
publication:biophysicspub
publication:oncpub
publication:pmid
publication:faculties
publication:physicspub
publication:biophysics
publication:onc
Monte Carlo Simulations of DNA Damage from Incorporated Cold Iodine Following Photoelectrically Induced Auger Electron Cascades
Moiseenko, V. V.
Karnas, S. J.
Yu, E.
Battista, J. J.
Radiation-induced damage in nucleosomal DNA from Auger electron cascades due to incorporated cold IUdR has been modelled through Monte Carlo simulations. Probabilities of DNA double strand break (DSB) production following a vacancy in the K, L, M and N shells of iodine are estimated. DSB complexity from the base damage accompanying a break was also estimated. Multiple DSB events were analysed for correlated breaks due to nucleosome periodicity. The probability of an Auger cascade causing at least one DSB strongly depended on the shell in which the initial vacancy was produced. This probability was approximately 0.35 for K and L shells and fell to 0.02 for the N shell. As expected, DSBs were predominantly induced in a nucleosome containing incorporated iodine and were accompanied with extensive base damage. Analysis of multiple DSB events showed that approximately 14% of the DSBs produced following a vacancy in the L1 orbital can be interpreted as correlated with base pair separation attributable to the nucleosome periodicity. The data generated in this work provide a basis for the development of photon-activation therapy using kilovoltage X rays incident upon IUdR sensitised tumours.
2002-01-01T08:00:00Z
article
https://ir.lib.uwo.ca/oncpub/48
http://rpd.oxfordjournals.org/cgi/content/abstract/99/1-4/113
Oncology Publications
Scholarship@Western
Computer Simulation
DNA Damage
Electrochemistry
Electrons
Iodine
Monte Carlo Method
Nucleosomes
Photochemistry
Medical Biophysics
Oncology
oai:ir.lib.uwo.ca:oncpub-1047
2009-11-15T10:02:12Z
publication:biophysicspub
publication:oncpub
publication:surgerypub
publication:pmid
publication:medimaging
publication:faculties
publication:biophysics
publication:epidem
publication:medimagingpub
publication:surgery
publication:onc
publication:epidempub
Subsets More Likely to Benefit From Surgery or Prophylactic Cranial Irradiation After Chemoradiation for Localized Non-Small-Cell Lung Cancer
Keith, Bruce
Vincent, Mark
Stitt, Larry
Tomiak, Anna
Malthaner, Richard
Yu, Edward
Truong, Pauline
Inculet, Richard
Lefcoe, Michael
Dar, A. Rashid
Kocha, Walter
Craig, Ian
After chemoradiation for localized non-small-cell lung cancer, surgery and prophylactic cranial irradiation (PCI) have been used as additional therapies. Less than a third of patients develop brain recurrences, or have local recurrence as their sole initial site of recurrence; these are groups that would benefit from PCI or surgery, respectively. Pretreatment identification of patients more likely to benefit from surgery or PCI would be useful. A retrospective analysis of 80 patients was performed to determine prognostic factors for such patterns of failure. Twenty-nine patients were subsequently selected for surgery in a nonrandomized manner. Seventeen patients had isolated local initial recurrence and 15 had brain recurrences. In multivariable analysis, female gender and elevated LDH were found to be risk factors for brain recurrence. In the subset with stage III disease (n = 76), squamous cell histology was a risk factor for isolated initial local recurrence in both univariable and multivariable analysis. It is possible to identify subsets that may show increased benefit from PCI or surgery.
2002-12-01T08:00:00Z
article
https://ir.lib.uwo.ca/oncpub/47
http://journals.lww.com/amjclinicaloncology/Abstract/2002/12000/Subsets_More_Likely_to_Benefit_From_Surgery_or.11.aspx
Oncology Publications
Scholarship@Western
Adult
Aged
Antineoplastic Combined Chemotherapy Protocols
Brain Neoplasms
Carcinoma
Non-Small-Cell Lung
Combined Modality Therapy
Cranial Irradiation
Female
Humans
L-Lactate Dehydrogenase
Lung Neoplasms
Male
Middle Aged
Multivariate Analysis
Neoplasm Recurrence
Local
Pneumonectomy
Prognosis
Radiotherapy Dosage
Radiotherapy
Adjuvant
Retrospective Studies
Risk Factors
Carcinoma, Non-Small-Cell Lung
Neoplasm Recurrence, Local
Radiotherapy, Adjuvant
Epidemiology
Oncology
Surgery
oai:ir.lib.uwo.ca:oncpub-1050
2009-11-15T10:47:08Z
publication:biophysicspub
publication:oncpub
publication:pmid
publication:faculties
publication:biophysics
publication:onc
Prophylactic Cranial Irradiation Revisited: Cost-effectiveness and Quality of Life in Small-cell Lung Cancer
Tai, T. H. Patricia
Yu, Edward
Dickof, Peter
Beck, Glen
Tonita, Jon
Ago, Tete
Skarsgard, David
Schmidt, Marlene
Schmid, Matthew
Liem, John S. K.
PURPOSE: To investigate the therapeutic usefulness and cost-effectiveness of prophylactic cranial irradiation (PCI) in patients with limited-stage small-cell lung cancer (SCLC) who had achieved a complete remission.
METHODS: A retrospective chart review was undertaken of all patients diagnosed in Saskatchewan with SCLC between 1987 and 1998 inclusive. Patients who achieved a complete remission were divided into two groups, depending on whether they underwent PCI (PCI+ and PCI-, respectively). The quality-of-life-adjusted survival was estimated by the Q-TWiST method (quality time without symptoms and toxicity). The mean incremental costs per month of incremental OS were calculated in a cost-effectiveness analysis.
RESULTS: Among the 98 complete remission patients, the median OS for PCI+ and PCI- patients was 20.0 and 19.0 months, respectively (p > 0.05, nonsignificant). The median disease-free survival was 14.7 and 10.0 months, respectively (p < 0.05). The difference in the mean Q-TWiST survival was significant (p < 0.01). The mean marginal cost was $18,834/PCI+ patient and $17,885/PCI- patient (p > 0.05, nonsignificant). The cost-effectiveness ratio was $70/mo of incremental OS if u(tox) and u(rel) (the utility coefficients to reflect the value of time in health states of toxicity and relapse) were assumed to be 1.0.
CONCLUSION: PCI is a cost-effective treatment that improves the quality-of-life-adjusted survival for patients with a complete remission of SCLC.
2002-01-01T08:00:00Z
article
https://ir.lib.uwo.ca/oncpub/50
info:doi/10.1016/S0360-3016(01)01748-5
http://dx.doi.org/10.1016/S0360-3016(01)01748-5
Oncology Publications
Scholarship@Western
Aged
Antineoplastic Combined Chemotherapy Protocols
Brain Neoplasms
Carcinoma
Small Cell
Confidence Intervals
Cost-Benefit Analysis
Cranial Irradiation
Female
Humans
Lung Neoplasms
Male
Middle Aged
Prognosis
Quality of Life
Remission Induction
Retrospective Studies
Survival Rate
Carcinoma, Small Cell
Epidemiology
Oncology
oai:ir.lib.uwo.ca:oncpub-1051
2009-11-15T10:58:54Z
publication:biophysicspub
publication:oncpub
publication:pmid
publication:medimaging
publication:faculties
publication:biophysics
publication:medimagingpub
publication:onc
Computed Tomography to Assess Pulmonary Injury Associated with Concurrent Chemo-radiotherapy for Inoperable Non-small Cell Lung Cancer
Aviram, Galit
Yu, Edward
Tai, Patricia
Lefcoe, Michael S.
OBJECTIVE: To characterize serial computed tomography (CT) findings of pulmonary injury after a uniform regimen of concurrent chemo-radiotherapy in inoperable non-small cell lung cancer, and to compare the radiation-induced lung toxicity with other concurrent chemo-radiation regimens.
METHODS: Twenty-four patients with advanced non-small cell lung cancer received 2 induction cycles of cisplatin and vinblastine, followed by 2 further cycles of cisplatin and vinblastine, concurrent with 60 Gy radiation at 2 Gy per fraction. Radiation-induced lung injury in the acute and chronic phases was assessed by serial CT scans and compared with preradiation baseline scans. Acute radiation pneumonitis was evaluated using the Common Toxicity Criteria, and chronic radiation fibrosis was graded according to the European Organisation for Research and Treatment of Cancer--Radiation Therapy Oncology Group Scale.
RESULTS: Seventeen (81%) patients had characteristic CT findings of radiation-induced pulmonary damage, which were confined to the radiation ports. Although patchy nonhomogeneous and air-space opacities characterized acute radiation pneumonitis, and homogeneous opacities with loss of volume were typical for chronic fibrosis, ground-glass opacities were found frequently in both phases. Acute radiation pneumonitis grade 1 was seen in 29% and grade 2 in 9.5%. Chronic radiation fibrosis grades 1, 2 and 3 were found in 14%, 33% and 19% of the patients respectively. Median survival time was 13 months.
CONCLUSION: CT enables detailed evaluation of radiation-induced pulmonary injury after concurrent chemo-radiation for inoperable non-small cell lung cancer. Although survival time with the present regimen is comparable to other concurrent chemo-radiation regimens, a high incidence of radiation injury was found, though the severity was not life threatening.
2001-12-01T08:00:00Z
article
https://ir.lib.uwo.ca/oncpub/51
http://www.carj.ca/issues/2001-Dec/385/385.html
Oncology Publications
Scholarship@Western
Adult
Aged
Antineoplastic Combined Chemotherapy Protocols
Carcinoma
Non-Small-Cell Lung
Chemotherapy
Adjuvant
Chronic Disease
Cisplatin
Combined Modality Therapy
Female
Follow-Up Studies
Humans
Lung Neoplasms
Male
Middle Aged
Radiation Pneumonitis
Vinblastine
Carcinoma, Non-Small-Cell Lung
Chemotherapy, Adjuvant
Bioimaging and Biomedical Optics
Oncology
oai:ir.lib.uwo.ca:oncpub-1049
2009-11-15T10:34:32Z
publication:physics
publication:biophysicspub
publication:oncpub
publication:pmid
publication:medimaging
publication:faculties
publication:physicspub
publication:biophysics
publication:epidem
publication:medimagingpub
publication:onc
publication:epidempub
Improving the Consistency in Cervical Esophageal Target Volume Definition by Special Training
Tai, Patricia
Van Dyk, Jake
Battista, Jerry
Yu, Edward
Stitt, Larry
Tonita, Jon
Agboola, Olusegun
Brierley, James
Dar, Rashid
Leighton, Christopher
Malone, Shawn
Strang, Barbara
Truong, Pauline
Videtic, Gregory
Wong, C. Shun
Wong, Rebecca
Youssef, Youssef
PURPOSE: Three-dimensional conformal radiation therapy requires the precise definition of the target volume. Its potential benefits could be offset by the inconsistency in target definition by radiation oncologists. In a previous survey of radiation oncologists, a large degree of variation in target volume definition of cervical esophageal cancer was noted for the boost phase of radiotherapy. The present study evaluated whether special training could improve the consistency in target volume definitions.
METHODS AND MATERIALS: A pre-training survey was performed to establish baseline values. This was followed by a special one-on-one training session on treatment planning based on the RTOG 94-05 protocol to 12 radiation oncologists. Target volumes were redrawn immediately and at 1-2 months later. Post-training vs. pre-training target volumes were compared.
RESULTS: There was less variability in the longitudinal positions of the target volumes post-training compared to pre-training (p < 0.05 in 5 of 6 comparisons). One case had more variability due to the lack of a visible gross tumor on CT scans. Transverse contours of target volumes did not show any significant difference pre- or post-training.
CONCLUSION: For cervical esophageal cancer, this study suggests that special training on protocol guidelines may improve consistency in target volume definition. Explicit protocol directions are required for situations where the gross tumor is not easily visible on CT scans. This may be particularly important for multicenter clinical trials, to reduce the occurrences of protocol violations.
2002-07-01T07:00:00Z
article
https://ir.lib.uwo.ca/oncpub/49
info:doi/10.1016/S0360-3016(02)02752-9
http://dx.doi.org/10.1016/S0360-3016(02)02752-9
Oncology Publications
Scholarship@Western
Education
Medical
Continuing
Esophageal Neoplasms
Humans
Imaging
Three-Dimensional
Physical Phenomena
Physics
Radiation Oncology
Radiotherapy
Conformal
Tomography
X-Ray Computed
Education, Medical, Continuing
Imaging, Three-Dimensional
Radiotherapy, Conformal
Tomography, X-Ray Computed
Epidemiology
Medical Biophysics
Oncology
oai:ir.lib.uwo.ca:epidempub-1023
2009-11-15T09:44:50Z
publication:biophysicspub
publication:oncpub
publication:pmid
publication:faculties
publication:biophysics
publication:epidem
publication:onc
publication:epidempub
Continued Cigarette Smoking by Patients Receiving Concurrent Chemoradiotherapy for Limited-Stage Small-Cell Lung Cancer Is Associated With Decreased Survival
Videtic, Gregory M. M.
Stitt, Larry W.
Dar, A. Rashid
Kocha, Walter I.
Tomiak, Anna T.
Truong, Pauline T.
Vincent, Mark D.
Yu, Edward W.
PURPOSE: To determine the impact of continued smoking by patients receiving chemotherapy (CHT) and radiotherapy (RT) for limited-stage small-cell lung cancer (LSCLC) on toxicity and survival.
PATIENTS AND METHODS: A retrospective review was carried out on 215 patients with LSCLC treated between 1989 and 1999. Treatment consisted of six cycles of alternating cyclophosphamide, doxorubicin, vincristine and etoposide, cisplatin (EP). Thoracic RT was concurrent with EP (cycle 2 or 3) only. Patients were known smokers, with their smoking status recorded at the start of chemoradiotherapy (CHT/RT). RT interruption during concurrent CHT/RT was used as the marker for treatment toxicity.
RESULTS: Of 215 patients, smoking status was recorded for 186 patients (86.5%), with 79 (42%) continuing to smoke and 107 (58%) abstaining during CHT/RT. RT interruptions were recorded in 38 patients (20.5%), with a median duration of 5 days (range, 1 to 18 days). Median survival for former smokers was greater than for continuing smokers (18 v 13.6 months), with 5-year actuarial overall survival of 8.9% versus 4%, respectively (log-rank P =.0017). Proportion of noncancer deaths was comparable between the two cohorts. Continuing smokers did not have a greater incidence of toxicity-related treatment breaks (P =.49), but those who continued to smoke and also experienced a treatment break had the poorest overall survival (median, 13.4 months; log-rank P =.0014).
CONCLUSION: LSCLC patients who continue to smoke during CHT/RT have poorer survival rates than those who do not. Smoking did not have an impact on the rate of treatment interruptions attributed to toxicity.
2003-04-15T07:00:00Z
article
https://ir.lib.uwo.ca/epidempub/22
http://jco.ascopubs.org/cgi/content/abstract/21/8/1544
Epidemiology and Biostatistics Publications
Scholarship@Western
Actuarial Analysis
Antineoplastic Combined Chemotherapy Protocols
Carcinoma
Small Cell
Chemotherapy
Adjuvant
Female
Humans
Lung Neoplasms
Male
Middle Aged
Neoplasm Staging
Radiotherapy
Adjuvant
Retrospective Studies
Smoking
Survival Analysis
Treatment Outcome
Carcinoma, Small Cell
Chemotherapy, Adjuvant
Radiotherapy, Adjuvant
Epidemiology
Oncology
oai:ir.lib.uwo.ca:biophysicspub-1006
2009-11-22T04:40:54Z
publication:biophysicspub
publication:oncpub
publication:pmid
publication:faculties
publication:biophysics
publication:onc
Monte Carlo Simulations and Measurement of DNA Damage from X-ray-triggered Auger Cascades in Iododeoxyuridine (IUdR)
Karnas, S. J.
Moiseenko, V. V.
Yu, E.
Truong, P.
Battista, J. J.
We investigated the DNA damage from Auger electrons emitted from incorporated stable iodine (127I), following photoelectric absorption of external x-rays. The effectiveness of the Auger electrons in producing DNA double-strand breaks (DSB) was determined theoretically, using Monte Carlo simulations of the radiation physics and chemistry, and was shown to be in reasonable agreement with DNA damage measured using the comet assay. The DSB yields were measured in CHO cells for 60Co (as a non-Auger-promoting radiation) and for tungsten-filtered 100 kVp x-rays capable of producing Auger electron emission. The theoretical study showed that on average, 2.5 Auger electrons were emitted for N-shell orbital vacancies and up to 10 Auger electrons were emitted from L1-shell vacancies. These Auger bursts produced approximately 0.03 DSB per N-shell vacancy and 0.3 DSB per K-shell or L-shell vacancy. The calculated yield of DSB from Auger cascades per unit dose (1 Gy) in water was approximately 1.7 for tungsten-filtered 100 kVp x-rays, assuming 20% IUdR substitution of thymidine. The comet assay yielded an experimental value of 3.6+/-1.6 per 1 Gy for the same conditions. The Monte Carlo simulations also demonstrated a high complexity of DSB produced by Auger cascades with virtually all DSB from inner shell orbitals (i.e. K, L shells) accompanied by compounded strand breakage and base damage, indicating a difficult lesion to repair. This finding agrees well with comet assay results of DNA repair, where an increase in the DSB yield in IUdR-sensitized cells was shown to persist after a time of 24 h. We conclude that Auger cascades in iodine produce a modest increase in the number of initial strand breaks of the order of 10% but the complex nature of these DSB makes them very difficult to repair or potentially prone to misrepair. The accentuated DNA damage may have major consequences for cell survival and may be exploitable in kilovoltage photon activation therapy (PAT) of tumors sensitized with iodine.
2001-09-01T07:00:00Z
article
https://ir.lib.uwo.ca/biophysicspub/6
info:doi/10.1007/s004110100099
http://www.springerlink.com/content/5ymf312yyq3fv6p1/?p=11424eb5730942d0b6d15220b8bffebdπ=4
Medical Biophysics Publications
Scholarship@Western
Animals
CHO Cells
Comet Assay
Cricetinae
DNA Damage
Electrons
Idoxuridine
Models
Theoretical
Monte Carlo Method
Nucleic Acid Synthesis Inhibitors
Photons
Radiation-Sensitizing Agents
Tungsten
X-Rays
Models, Theoretical
Medical Biophysics
Oncology
oai:ir.lib.uwo.ca:epidempub-1024
2009-11-18T08:17:20Z
publication:biophysicspub
publication:oncpub
publication:pmid
publication:faculties
publication:biophysics
publication:epidem
publication:onc
publication:epidempub
Using Treatment Interruptions to Palliate the Toxicity from Concurrent Chemoradiation for Limited Small Cell Lung Cancer Decreases Survival and Disease Control
Videtic, Gregory M. M.
Fung, Karen
Tomiak, Anna T.
Stitt, Larry W.
Dar, A. Rashid
Truong, Pauline T.
Yu, Edward W.
Vincent, Mark D.
Kocha, Walter I.
BACKGROUND AND PURPOSE: We analyzed the impact on survival outcomes of treatment interruptions due to toxicity arising during the concurrent phase of chemotherapy/radiotherapy (ChT/RT) for our limited-stage small-cell cancer (LSCLC) population over the past 10 years.
MATERIALS AND METHODS: From 1989 to 1999, 215 patients received treatment for LSCLC, consisting of six cycles of alternating cyclophosphamide/doxorubicin or epirubicin/vincristine (CAV; CEV) and etoposide/cisplatin (EP). Thoracic RT was started with EP at either the second or third cycle (85% of patients). RT dose was either 40 Gy in 15 fractions over 3 weeks or 50 Gy in 25 fractions over 5 weeks, delivered to a target volume encompassing gross disease and suspected microscopic disease with a 2 cm margin. Treatment breaks arising during concurrent ChT+RT were used to manage severe symptomatic or hematologic toxicities. We used the interruptions in thoracic RT as the 'marker' for any concurrent break and measured 'break duration' by the total length of time (in days) RT was interrupted, since that also signaled that ChT could be re-initiated. Patient results were analyzed for the impact of interruptions/treatment prolongation on overall and disease-free survival.
RESULTS: For all patients, 2-year and 5-year overall and disease-specific survivals were 22.7 and 7.2, 27.6 and 9.3%, respectively; overall and disease-specific median survivals were 14.7 months each. A total of 56 patients (26%) had treatment breaks due to toxicity. Hematologic depression caused the majority of breaks (88%). The median duration of breaks was 5 days (range 1-18). Patients with and without interruptions were compared for a range of prognostic factors and were not found to have any significant differences. Comparing interrupted/uninterrupted courses, median survivals were 13.8 versus 15.6 months, respectively, and 5-year overall survivals were 4.2 versus 8.3%, respectively. There was a statistical difference between overall survival curves which favored the uninterrupted group (P=0.01). When comparing a series of prognostic variables, multivariable analysis found that the most significant factor influencing survival in the present study was the presence of treatment breaks (P=0.006). There was a trend for development of any recurrence in the patients with breaks (P=0.08). When controlling for the use of prophylactic cranial irradiation (PCI) in the two groups, the rate of failure in the chest was higher in the patients with RT breaks (58 vs. 33%). The rate of failure in the brain was dependent on the use of PCI only.
CONCLUSIONS: Interruptions in treatment to palliate the toxicity from concurrent chemoradiation result in poorer local control and decreased survival.
2001-08-01T07:00:00Z
article
https://ir.lib.uwo.ca/epidempub/23
info:doi/10.1016/S0169-5002(00)00240-3
http://dx.doi.org/10.1016/S0169-5002(00)00240-3
Epidemiology and Biostatistics Publications
Scholarship@Western
Adult
Aged
Aged
80 and over
Antineoplastic Combined Chemotherapy Protocols
Carcinoma
Small Cell
Cyclophosphamide
Doxorubicin
Epirubicin
Female
Humans
Lung Neoplasms
Male
Middle Aged
Neoplasm Recurrence
Local
Remission Induction
Survival Rate
Treatment Failure
Vincristine
Aged, 80 and over
Carcinoma, Small Cell
Neoplasm Recurrence, Local
Epidemiology
Medical Biophysics
Oncology
oai:ir.lib.uwo.ca:oncpub-1052
2009-11-23T00:07:05Z
publication:biophysicspub
publication:oncpub
publication:faculties
publication:biophysics
publication:onc
Merkel Cell Carcinoma of the Skin
Tai, Patricia T. H.
Yu, Edward
Tonita, Jon
Gilchrist, James
Background: Neuroendocrine/Merkel cell carcinoma (MCC) of the skin is an uncommon tumour. Currently, there are only limited data available on the natural history, prognostic factors, and patient management of MCC.
Objective: To review our experience and build the largest database from the literature.
Methods: Twenty-eight cases from the London Regional Cancer Center were combined with 633 cases obtained from the literature searched in English, French, German, and Chinese for the years 1966 to 1998. The database included age, sex, initial disease status at presentation to the clinic, site of primary, any coexisting disease, any previous irradiation, sizes of primary/nodal/distant metas-tases, management details, and final disease status. A new modified staging system was used: stage Ia (primary disease only, size £ 2 cm), stage Ib (primary disease only, size > 2 cm); stage II (regional nodal disease), and stage III (beyond regional nodes and/or distant disease).
Results: Age > 65 years, male sex, size of primary > 2 cm, truncal site, nodal/distant disease at presentation, and duration of disease b e f o re presentation (£ 3 months) were poor prognostic factors. Surg e ry was the initial treatment of choice and it significantly impro v e d overall survival (p = .004).
Conclusion : We identified poor prognostic factors that may necessitate more aggressive treatment. The suggested staging system, incorporating primary tumour size, accurately predicted outcomes.
2000-10-01T07:00:00Z
article
https://ir.lib.uwo.ca/oncpub/52
http://www.dermweb.com/jcms/abstracts_4_4/186.html
Oncology Publications
Scholarship@Western
Merkel cell carcinoma
skin
prognostic factors
Oncology
oai:ir.lib.uwo.ca:biophysicspub-1007
2009-11-22T04:39:39Z
publication:physics
publication:biophysicspub
publication:oncpub
publication:pmid
publication:faculties
publication:physicspub
publication:biophysics
publication:onc
Operational Characteristics of a Prototype X-ray Needle Device
Karnas, S. J.
Avvakumov, N.
Yu, E.
Battista, J. J.
A prototype x-ray needle, which emits 62.5 kVp x-rays at the tip of a 20 cm long, 4 mm diameter steel needle, has been developed by Titan Pulse Sciences Incorporated (PSI) (Albuquerque, NM) and was tested for its suitability in brachytherapy applications in comparison with a similar device by the Photoelectron Corporation. The depth dose profiles were also compared with those of two common brachytherapy sources (125I and 192Ir). The depth dose characteristics of the radiation were comparable with the two brachytherapy sources with a slightly reduced attenuation gradient. The dose rate from the x-ray needle tip was relatively isotropic at the needle tip and was continuously adjustable over the range of 0 cGy min(-1) to upwards of 62 cGy min(-1) at a reference distance of 1 cm in air. We detected a significant proportion of x-rays generated along the needle shaft, and not at the needle tip, as intended. The energy spectrum emitted from this device had a peak intensity at 21 keV and an average energy of 28 keV. The beam was attenuated in both aluminium (the first half-value layer being less than 0.1 mm) and in water (50% dose at approximately 2 mm). These studies confirm that although there is potential for a system similar to this one for clinical applications, the simplistic electron guidance used in this particular prototype device limits it to research applications. Further optimization is required in focusing and steering the electron beam to the target, improving x-ray production efficiency and using x-ray target cooling to achieve higher dose rates.
2001-01-01T08:00:00Z
article
https://ir.lib.uwo.ca/biophysicspub/8
info:doi/10.1088/0031-9155/46/1/307
http://www.iop.org/EJ/abstract/0031-9155/46/1/307
Medical Biophysics Publications
Scholarship@Western
Aluminum
Brachytherapy
Dose-Response Relationship
Radiation
Iodine Radioisotopes
Iridium Radioisotopes
Water
X-Rays
Dose-Response Relationship, Radiation
Medical Biophysics
Oncology
oai:ir.lib.uwo.ca:biophysicspub-1008
2009-11-22T04:49:49Z
publication:physics
publication:biophysicspub
publication:oncpub
publication:pmid
publication:faculties
publication:physicspub
publication:biophysics
publication:onc
Optimal Photon Energies for IUdR K-edge Radiosensitization with Filtered X-ray and Radioisotope Sources
Karnas, S. J.
Yu, E.
McGarry, R. C.
Battista, J. J.
The purpose of this work is to determine the most physically effective radiation energy for K-edge absorption of x- or gamma-rays by iododeoxyuridine (IUdR) on Chinese hamster ovary (CHO) cells. Brachytherapy sources (Sm-145, I-125, Yb-169 and Am-241) and x-ray beams (30 kVp, 100 kVp and 100 kVp with gold, gadolinium, lead or tungsten filtration) were investigated for their preferential absorption qualities by IUdR sensitized DNA. The 30 kVp, 100 kVp and 100 kVp with tungsten filtration were then used to irradiate CHO cells, with or without IUdR incorporation (i.e. 10(-5) M of IUdR for 3 days). Radiation absorption calculations were performed to determine the increase in energy absorption in DNA with and without IUdR incorporated. In order to measure the in vitro biological effects of K-edge absorption, cell survival experiments were performed. The radiation physics calculations yielded an iodine dose enhancement ratio (DER) of 1.4+/-0.15. 1.8+/-0.15 and 2.7+/-0.15 for the 30 kVp, 100 kVp and tungsten filtered 100 kVp respectively, for 18% IUdR replacement of thymidine in DNA. The corresponding cell sensitization enhancement ratios (SER), determined from the cell survival assay, were determined to be 1.24+/-0.2, 1.8+/-0.2 and 2.3+/-0.3 for the 30 kVp, 100 kVp and tungsten filtered 100 kVp respectively, for cells with 18+/-2% IUdR incorporation. These SER values are in reasonable agreement with the DER values of 1.4, 1.8 and 2.7. From these radiation calculations and radiobiology experiments we confirm that using x-radiation energies above the K-edge of iodine (33.2 keV) can have a significant effect on cell survival. This effect is due mainly to the increase in the local dose to the DNA for IUdR-sensitized cells compared with the normal DNA which lacks the iodine contrast agent. Our results support the clinical application of IUdR and low-energy brachytherapy, perhaps using new technologies such as the x-ray needle or new isotopes such as Yb-169.
1999-10-01T07:00:00Z
article
https://ir.lib.uwo.ca/biophysicspub/9
info:doi/10.1088/0031-9155/44/10/312
http://www.iop.org/EJ/abstract/0031-9155/44/10/312
Medical Biophysics Publications
Scholarship@Western
Americium
Animals
Brachytherapy
CHO Cells
Cricetinae
DNA
Dose-Response Relationship
Radiation
Gamma Rays
Idoxuridine
Iodine Radioisotopes
Photons
Radiation-Sensitizing Agents
Radioisotopes
Samarium
X-Rays
Ytterbium
Dose-Response Relationship, Radiation
Medical Biophysics
Oncology
oai:ir.lib.uwo.ca:oncpub-1053
2009-11-23T00:23:24Z
publication:biophysicspub
publication:oncpub
publication:pmid
publication:faculties
publication:biophysics
publication:onc
Functional Infrared Imaging of the Breast
Keyserlingk, J. R.
Ahlgren, P. D.
Yu, E.
Belliveau, N.
Yassa, M.
In order to re-assess the potential contribution of infrared (IR) imaging as a first-line component of a multi-imaging strategy using currently available technology, we first review the history of its introduction and clinical application, including the results of the Breast Cancer Detection Demonstration Projects (BCDDP). We then discuss experiments with a new high-resolution, computerized IR station and software program acquired by the Ville Marie Breast Center to assess IR imaging's ability to complement clinical examination and mammography in the early detection of breast cancer. Our goal is to show that high-resolution IR imaging provides additional safe, practical, and objective information when produced and interpreted by sufficiently trained breast physicians.
2000-05-01T07:00:00Z
article
https://ir.lib.uwo.ca/oncpub/53
info:doi/10.1109/51.844378
http://ieeexplore.ieee.org/xpl/freeabs_all.jsp?isnumber=18309&arnumber=844378&count=16&index=0
Oncology Publications
Scholarship@Western
Breast
Breast Neoplasms
Diagnostic Imaging
Female
History
20th Century
Humans
Infrared Rays
Mammography
History, 20th Century
Bioimaging and Biomedical Optics
Oncology
oai:ir.lib.uwo.ca:oncpub-1054
2009-11-23T00:37:47Z
publication:physics
publication:biophysicspub
publication:oncpub
publication:pmid
publication:faculties
publication:physicspub
publication:biophysics
publication:epidem
publication:onc
publication:epidempub
Radiation Treatment for Cervical Esophagus: Patterns of Practice Study in Canada, 1996
Tai, Patricia
Van Dyk, Jake
Yu, Edward
Battista, Jerry
Schmid, Matthew
Stitt, Larry
Tonita, Jon
Coad, Terry
PURPOSE: To assess the patterns of practice among Canadian radiation oncologists who treat esophageal cancers, using a trans-Canada survey, completed at the end of 1996.
METHODS AND MATERIALS: One of 3 case presentations of different stages of cervical esophageal cancer was randomly assigned and sent to participating radiation oncologists by mail. Respondents were asked to fill in questionnaires regarding treatment techniques and to outline target volumes for the boost phase of radiotherapy. Radiation oncologists from 26 of 27 (96%) of all Canadian centers participated.
RESULTS: High-energy X-rays (>/= 10 MV) were employed by 68% of the respondents in part of the treatment course. The majority (83%) of the radiation oncologists used at least two phases of treatment. Very few, 10 of 59 (17%), responses started with multifield treatment. The most frequently used prescription dose was 60 Gy/30 fractions/6 weeks, given with concurrent chemotherapy. Dose prescriptions were to the isocenter in 39 of 48 (81%) or to a particular isodose line in 9 of 48 (19%) of respondents.
CONCLUSION: There was a variety of radiation treatment techniques in this trans-Canada survey. The majority of the patients had combined cisplatin-based chemoradiation. The isocenter was not used consistently as a dose prescription point.
2000-06-01T07:00:00Z
article
https://ir.lib.uwo.ca/oncpub/54
info:doi/10.1016/S0360-3016(00)00484-3
http://dx.doi.org/10.1016/S0360-3016(00)00484-3
Oncology Publications
Scholarship@Western
Aged
Antineoplastic Combined Chemotherapy Protocols
Canada
Cancer Care Facilities
Combined Modality Therapy
Esophageal Neoplasms
Health Care Surveys
Humans
Male
Physician's Practice Patterns
Radiation Oncology
Radiotherapy Dosage
Epidemiology
Medical Biophysics
Oncology
oai:ir.lib.uwo.ca:oncpub-1056
2009-11-23T01:02:06Z
publication:biophysicspub
publication:oncpub
publication:pmid
publication:faculties
publication:biophysics
publication:epidem
publication:onc
publication:epidempub
Does Delay in Breast Irradiation Following Conservative Breast Surgery in Node-Negative Breast Cancer Patients Have an Impact on Risk of Recurrence?
Vujovic, Olga
Perera, Francisco
Dar, A. Rashid
Stitt, Larry
Yu, Edward
Voruganti, Sachi M.
Truong, Pauline T.
PURPOSE: This retrospective review was conducted to determine if delay in the start of radiotherapy after definitive breast surgery had any detrimental effect on local recurrence or disease-free survival in node-negative breast cancer patients.
METHODS AND MATERIALS: A total of 568 patients with T1-T2, N0 breast cancer were treated with breast-conserving surgery and breast irradiation, without adjuvant systemic therapy between January 1, 1985 and December 31, 1992, at the London Regional Cancer Centre. Adjuvant breast irradiation consisted either of 50 Gy in 25 fractions or 40 Gy in 15 or 16 fractions, followed by a boost of 10 Gy or 12.5 Gy to the lumpectomy site. The time intervals from definitive breast surgery to breast irradiation used for analysis were 0-8 weeks (201 patients), > 8-12 weeks (235 patients), > 1216 weeks (91 patients), and > 16 weeks (41 patients). The time intervals of 0-12 weeks (436 patients) and > 12 weeks (132 patients) were also analyzed. Kaplan-Meier estimates of time to local recurrence and disease-free survival rates were calculated. The association between surgery-radiotherapy interval, age (< or = 40, > 40 years), tumor size (< or = 2, > 2cm), Scharf-Bloom-Richardson (SBR) grade, resection margins, lymphatic vessel invasion, extensive intraductal component, and local recurrence and disease-free survival were investigated using Cox regression techniques.
RESULTS: Median follow-up was 63.5 months. Patients in all 4 time intervals were similar in terms of age and pathologic features. There was no statistically significant difference between the 4 groups in local recurrence or disease-free survival with surgery-radiotherapy interval (p = 0.189 and p = 0.413, respectively). The 5-year freedom from local relapse was 95.4%. The crude local recurrence rate was 6.9% (7.8% for 436 patients treated within 12 weeks (median follow-up 67 months) and 3.8% for 132 patients treated > 12 weeks from surgery (median follow-up 52 months). In a stepwise multivariable Cox regression model for disease-free survival, allowing for entry of known risk factors, tumour size (p < 0.001), grade (p < 0.001), and age (p = 0.048) entered the model, but the surgery-radiotherapy interval did not enter the model.
CONCLUSION: This retrospective study suggests that delay in start of breast irradiation beyond 12 and up to 16 weeks does not increase the risk of recurrence in node-negative breast cancer patients. The certainty of these results are limited by the retrospective nature of this analysis and the lack of information concerning the late local failure rate.
1998-03-01T08:00:00Z
article
https://ir.lib.uwo.ca/oncpub/56
info:doi/10.1016/S0360-3016(97)00922-X
http://dx.doi.org/10.1016/S0360-3016(97)00922-X
Oncology Publications
Scholarship@Western
Adult
Analysis of Variance
Breast Neoplasms
Carcinoma
Ductal
Breast
Carcinoma
Lobular
Combined Modality Therapy
Disease-Free Survival
Female
Humans
Middle Aged
Neoplasm Recurrence
Local
Radiotherapy Dosage
Retrospective Studies
Time Factors
Carcinoma, Ductal, Breast
Carcinoma, Lobular
Neoplasm Recurrence, Local
Epidemiology
Oncology
oai:ir.lib.uwo.ca:oncpub-1055
2009-11-23T00:47:11Z
publication:physics
publication:biophysicspub
publication:oncpub
publication:pmid
publication:medimaging
publication:faculties
publication:physicspub
publication:biophysics
publication:epidem
publication:medimagingpub
publication:onc
publication:epidempub
Variability of Target Volume Delineation in Cervical Esophageal Cancer
Tai, Patricia
Van Dyk, Jake
Yu, Edward
Battista, Jerry
Stitt, Larry
Coad, Terry
PURPOSE: Three-dimensional (3D) conformal radiation therapy (CRT) assumes and requires the precise delineation of the target volume. To assess the consistency of target volume delineation by radiation oncologists, who treat esophageal cancers, we have performed a transCanada survey.
MATERIALS AND METHODS: One of three case presentations, including CT scan images, of different stages of cervical esophageal cancer was randomly chosen and sent by mail. Respondents were asked to fill in questionnaires regarding treatment techniques and to outline boost target volumes for the primary tumor on CT scans, using ICRU-50 definitions.
RESULTS: Of 58 radiation oncologists who agreed to participate, 48 (83%) responded. The external beam techniques used were mostly anterior-posterior fields, followed by a multifield boost technique. Brachytherapy was employed by 21% of the oncologists, and concurrent chemotherapy by 88%. For a given case, and the three volumes defined by ICRU-50 (i.e., gross tumor volume [GTV], clinical target volume [CTV], and planning target volume [PTV]) we determined: 1. The total length in the cranio-caudal dimension; 2. the mean diameter in the transverse slice that was located in a CT slice that was common to all participants; 3. the total volume for each ICRU volume; and 4. the (5, 95) percentiles for each parameter. The PTV showed a mean length of 14.4 (9.6, 18.0) cm for Case A, 9.4 (5.0, 15.0) cm for Case B, 11.8 (6.0, 16.0) cm for Case C, a mean diameter of 6.4 (5.0, 9.4) cm for Case A, 4.4 (0.0, 7.3) cm for Case B, 5.2 (3.9, 7.3) cm for Case C, and a mean volume of 320 (167, 840) cm3 for Case A and 176 (60, 362) cm3 for Case C. The results indicate variability factors (95 percentile divided by 5 percentile values) in target diameters of 1.5 to 2.6, and in target lengths of 1.9 to 5.0.
CONCLUSION: There was a substantial inconsistency in defining the planning target volume, both transversely and longitudinally, among radiation oncologists. The potential benefits of 3D treatment planning with high-precision dose delivery could be offset by this inconsistency in target-volume delineation by radiation oncologists. This may be particularly important for multicenter clinical trials, for which quality assurance of this step will be essential to the interpretation of results.
1998-09-01T07:00:00Z
article
https://ir.lib.uwo.ca/oncpub/55
info:doi/10.1016/S0360-3016(98)00216-8
http://dx.doi.org/10.1016/S0360-3016(98)00216-8
Oncology Publications
Scholarship@Western
Aged
Analysis of Variance
Canada
Esophageal Neoplasms
Health Care Surveys
Humans
Male
Medical Oncology
Observer Variation
Radiotherapy Dosage
Radiotherapy Planning
Computer-Assisted
Radiotherapy
Conformal
Radiotherapy Planning, Computer-Assisted
Radiotherapy, Conformal
Epidemiology
Medical Biophysics
Oncology
oai:ir.lib.uwo.ca:oncpub-1057
2009-11-23T01:17:23Z
publication:biophysicspub
publication:oncpub
publication:pmid
publication:faculties
publication:biophysics
publication:epidem
publication:onc
publication:epidempub
Superior Vena Cava Obstruction in Small-cell Lung Cancer
Chan, Roscoe H.
Dar, A. Rashid
Yu, Edward
Stitt, Larry W.
Whiston, Francis
Truong, Pauline
Vincent, Mark D.
Kocha, Walter I.
PURPOSE: To identify prognostic or treatment factors influencing the response of superior vena cava obstruction (SVCO), time to SVCO recurrence, and overall survival of SCLC patients with SVCO at presentation; and to assess the role of retreatment in patients with SVCO at recurrent or persistent disease.
METHODS AND MATERIALS: Between January 1983 and November 1993, 76 consecutive patients who had small-cell lung cancer (SCLC) with SVCO were treated in our institution. Analysis was done according to the disease status at diagnosis of SVCO. The first analysis concerned a group of 50 patients who had SVCO at initial presentation. The second analysis concerned a group who had SVCO as a manifestation of persistent or recurrent disease.
RESULTS: In the first analysis, 93% had significant improvement in symptoms of SVCO after chemotherapy and 94% after mediastinal radiation. Response is almost universal despite a wide range of radiation fractionation and total dose used. Seventy percent remained SVCO-free before death. Thirty percent developed recurrence of SVCO symptoms 1-16 months (median 8) after the start of initial treatment. Those who received combined chemotherapy and radiation had a longer time to SVCO recurrence (p = 0.018) compared to those who received chemotherapy alone. This effect is mainly seen in limited-stage patients. The presence of SVCO recurrence tends to have an adverse effect on the overall survival (p = 0.077) irrespective of the time when the recurrences occurred (p = 0.296). The median survival of this whole group of 50 patients in the first analysis was 9.5 months, and the 2-year survival was 10%. Stage was strongly predictive of survival (p < 0.001). Sixteen percent (3 of 19) of the patients with limited-stage diseases were long-term survivors (two patients survived 35 months and one survived 70 months). The early mortality from SVCO was 2%. In the second analysis, 85% had previously been treated with chemotherapy alone. The response rate of SVCO in the analysable patients (n = 39) was 77%. There was no significant difference in the response rate of SVCO to treatment comparing patients treated by chemotherapy first or mediastinal radiation first (p = 0.653), but most patients [82% (32 of 39)] received radiation as the initially treatment of SVCO. Ninety-three percent (38 of 41) received mediastinal radiation as a part of their ultimate retreatment regimen, and 68% (28 of 41) received mediastinal radiation as their sole retreatment regimen. Thirty-two percent (13 of 41) received chemotherapy as a part of their ultimate retreatment regimen, and only 7% received chemotherapy alone as their sole retreatment regimen. Eighty-three percent (25 of 30) of those whose SVCO responded remained free of SVCO before death, with a median survival of 3 months after recurrent or persistent disease documented.
CONCLUSION: Chemotherapy or mediastinal radiation is very effective as an initial treatment in SCLC patients with SVCO at presentation and at recurrent or persistent disease. There is no obvious need to use big radiation fraction sizes for the first few radiation treatment as was previously believed. In patients with recurrent or persistent SCLC with SVCO, especially in those who previously received chemotherapy only, we have more experience in incorporating mediastinal radiation as a major component of the palliative regimen with highly effective and durable palliation achieved.
1997-06-01T07:00:00Z
article
https://ir.lib.uwo.ca/oncpub/57
info:doi/10.1016/S0360-3016(97)00094-1
http://dx.doi.org/10.1016/S0360-3016(97)00094-1
Oncology Publications
Scholarship@Western
Adult
Aged
Aged
80 and over
Carcinoma
Small Cell
Female
Humans
Lung Neoplasms
Male
Middle Aged
Radiotherapy Dosage
Recurrence
Retrospective Studies
Superior Vena Cava Syndrome
Aged, 80 and over
Carcinoma, Small Cell
Epidemiology
Oncology
oai:ir.lib.uwo.ca:oncpub-1058
2009-11-24T08:23:34Z
publication:biophysicspub
publication:oncpub
publication:faculties
publication:biophysics
publication:onc
Infrared Imaging of the Breast: Initial Reappraisal Using High-Resolution Digital Technology in 100 Successive Cases of Stage I and II Breast Cancer
Keyserlingk, J. R.
Ahlgren, P. D.
Yu, E.
Belliveau, N.
There is a general consensus that earlier detection of breast cancer should result in improved survival. Current breast imaging relies primarily on mammography. Despite better equipement and regulation, variability in interpretation and tissue density still affect accuracy. A number of adjuvant imaging techniques are currently being used, including doppler ultrasound and gadolinium-enhanced MRI, which can detect cancer-induced neovascularity. In order to assess the potential contribution of currently available high-resolution digital infrared technology capable of recognizing minute regional vascular flow related temperature variation, we retrospecitively reviewed the relative ability of our preoperative clinical exam, mammography, and infrared imaging to detect 100 new cases of ductal carcinoma in situ, stage I and II breast cancer. While the false-negative rate of infrared imaging was 17%, at least one abnormal infrared sign was detected in the remaining 83 cases, including 10 of the 15 patients, a slightly younger cohort, who had nonspecific mammograms. The 85% sensitivity rate of mammography alone thus increased to 95% when combining both imaging modalities. Access to infrared information was also pertinent when confronted with the relatively frequent contributory but equivocal clinical exam (34%) and mammography (19%). The average size of those tumors undetected by mammography or infrared imaging was 1.66 cm and 1.28 cm, respectively, while the false-positive rate of infrared imaging in a concurrent series of 100 successive benign open breast biopsies was 19%. Our initial experience would suggest that, when done concomitantly with clinical exam and mammography, high-resolution digital infrared imaging can provide additional safe, practical, and objective information. Further evaluation, preferably in controlled prospective multicenter trials, would provide valuable data.
1998-07-01T07:00:00Z
article
https://ir.lib.uwo.ca/oncpub/58
info:doi/10.1046/j.1524-4741.1998.440245.x
http://www3.interscience.wiley.com/journal/119133173/abstract
Oncology Publications
Scholarship@Western
breast
cancer
detection
imaging
infrared
Oncology
oai:ir.lib.uwo.ca:oncpub-1059
2009-12-06T13:38:05Z
publication:biophysicspub
publication:oncpub
publication:pmid
publication:faculties
publication:biophysics
publication:onc
Vitamin D and Parotid Gland Function in the Rat
Peterfy, C.
Tenenhouse, A.
Yu, E.
1. We previously reported that parotid gland secretion is decreased in rats deprived of vitamin D (Glijer, Peterfy & Tenenhouse, 1985). In the present study we examine whether this effect is a direct result of the absence of vitamin D or due to the secondary systemic effects of vitamin D deficiency. 2. Offspring of rats maintained on a calcium-supplemented (1.2%), vitamin-D-deficient diet were weaned onto the same diet and examined after 8 weeks. Using this method it was possible to maintain serum calcium and parathyroid hormone concentrations within normal limits. Serum 25-hydroxyvitamin D (25(OH)D3) was not detectable, but 1,25-dihydroxyvitamin D (1,25(OH)2D3) concentrations were normal. 3. Pilocarpine-stimulated flow of parotid saliva was reduced 57% in vitamin-D-deprived animals, but amylase secretion was unchanged. Treatment with vitamin D3 returned flow rates to normal. 4. The concentration of calcium in parotid saliva was normal in vitamin-D-deprived rats, although total parotid calcium output was reduced 57%. 5. Pilocarpine-stimulated salivary flow from submandibular gland, a tissue which does not possess 1,25(OH)2D3 receptors, was normal in vitamin-D-deprived rats. 6. Heart rate and arterial blood pressure changes in response to I.V. pilocarpine administration were identical in normal and vitamin-D-deficient rats. 7. Auriculotemporal nerve-stimulated flow of parotid saliva was also reduced by 50% and administration of vitamin D3 to these rats corrected this abnormality. 8. It is concluded that fluid and electrolyte secretion from parotid gland is directly dependent on vitamin D; abnormal parotid gland function seen in vitamin-D-deficient rats is not due to secondary hypocalcaemia or hyperparathyroidism, nor can it be explained by haemodynamic changes evoked during systemic administration of pilocarpine. We further conclude that the metabolite of vitamin D responsible for this effect is not 1,25(OH)2D3.
1988-04-01T08:00:00Z
article
https://ir.lib.uwo.ca/oncpub/59
http://jp.physoc.org/content/398/1/1.abstract
Oncology Publications
Scholarship@Western
Animals
Calcium
Diet
Female
Hemodynamics
Parotid Gland
Pilocarpine
Rats
Rats
Inbred Strains
Salivation
Vitamin D
Rats, Inbred Strains
Medical Physiology
Oncology
oai:ir.lib.uwo.ca:oncpub-1060
2009-11-25T08:42:45Z
publication:biophysicspub
publication:oncpub
publication:pmid
publication:faculties
publication:biophysics
publication:onc
Uptake, Storage and Secretion of 5-hydroxytryptamine and Its Amino Acid Precursor by Dispersed Rat Pancreas Acinar Cells
Stern, Ligia
Tenenhouse, A.
Yu, E. W.-T.
Rat pancreas acinar cells contain 5-hydroxytryptamine (5-HT; 10.86 +/- 2.52 ng/i.u. amylase), all of which can be accounted for by the 5-HT recovered from the zymogen granule fraction of these cells (10.70 +/- 3.06 ng/i.u. amylase). When incubated with [14C]5-HT dispersed acinar cells take up the amine and concentrate it in zymogen granules. These cells will also take up [14C]5-HTP (5-hydroxytryptophan), decarboxylate it and store the [14C]5-HT so produced in zymogen granules. 5-HTP itself is not taken up by the granules. 5-HT is incorporated into zymogen granules early in their formation; no amine is accumulated by mature zymogen granules and the amine within the mature granule is not exchangeable with extragranular amine. When dispersed acinar cells pre-labelled with [14C]5-HT and [3H]leucine are stimulated with caerulein, there is a synchronous increase in amylase activity and secretion of [14C]5-HT and [3H]protein; the ratios of [3H]protein/[14C]5-HT in zymogen granules and in the secretory products are identical. Pancreas acinar cells take up L-DOPA, decarboxylate it and store the dopamine produced in zymogen granules but the dopamine is not retained by the granules (t1/2 approximately equal to 90 min) and dopamine secretion from cells exposed to caerulein could not be demonstrated. It is concluded that 5-HT is a normal component of rat pancreas acinar cell zymogen granule. The granular amine has a turnover rate similar to that of granular protein and is released when the cells are stimulated to secrete protein. All the 5-HT released from the cell originates in zymogen granules.
1983-07-01T07:00:00Z
article
https://ir.lib.uwo.ca/oncpub/60
http://jp.physoc.org/content/340/1/555.abstract
Oncology Publications
Scholarship@Western
5-Hydroxytryptophan
Amylases
Animals
Caerulein
Cytoplasmic Granules
Dopamine
Enzyme Precursors
Pancreas
Proteins
Rats
Rats
Inbred Strains
Serotonin
Subcellular Fractions
Time Factors
Rats, Inbred Strains
Medical Physiology
Oncology
oai:ir.lib.uwo.ca:oncpub-1061
2009-12-21T00:38:45Z
publication:physics
publication:biophysicspub
publication:oncpub
publication:pmid
publication:medimaging
publication:faculties
publication:physicspub
publication:biophysics
publication:epidem
publication:medimagingpub
publication:onc
publication:epidempub
Variability of Target Volume Delineation in Cervical Esophageal Cancer
Tai, Patricia
Van Dyk, Jake
Yu, Edward
Battista, Jerry
Stitt, Larry
Coad, Terry
1999-01-01T08:00:00Z
book_contribution
https://ir.lib.uwo.ca/oncpub/61
Oncology Publications
Scholarship@Western
Aged
Analysis of Variance
Canada
Esophageal Neoplasms
Health Care Surveys
Humans
Male
Medical Oncology
Observer Variation
Radiotherapy Dosage
Radiotherapy Planning
Computer-Assisted
Radiotherapy
Conformal
Radiotherapy Planning, Computer-Assisted
Radiotherapy, Conformal
Oncology
oai:ir.lib.uwo.ca:oncpub-1062
2009-12-21T00:49:04Z
publication:biophysicspub
publication:oncpub
publication:faculties
publication:biophysics
publication:onc
Esophageal Cancer
Yu, Edward
2007-01-01T08:00:00Z
book_contribution
application/pdf
https://ir.lib.uwo.ca/oncpub/62
https://ir.lib.uwo.ca/context/oncpub/article/1062/viewcontent/Esophageal.pdf
Oncology Publications
Scholarship@Western
esophageal cancer
Oncology
oai:ir.lib.uwo.ca:oncpub-1063
2009-11-28T06:53:58Z
publication:robartspub
publication:biophysicspub
publication:oncpub
publication:surgerypub
publication:faculties
publication:electricalpub
publication:biophysics
publication:epidem
publication:electrical
publication:robarts
publication:surgery
publication:institutes
publication:onc
publication:epidempub
MIRA V: An Integrated System for Minimally Invasive Robot-assisted Lung Brachytherapy
Trejos, A. L.
Lin, A. W.
Mohan, S.
Bassan, H.
Edirisinghe, C.
Patel, R. V.
Lewis, C.
Yu, E.
Fenster, A.
Malthaner, R. A.
An integrated system for minimally invasive robot-assisted image-guided lung brachytherapy has been developed. The system incorporates an experimental setup for accurate radioactive seed placement with commercially available dosimetry planning software. The end result is a complete system that allows planning and executing a brachytherapy procedure with increased accuracy. The results of the in vitro seed placement evaluation show that seed misplacement has a significant effect on the volume receiving more than 200% of the dose (V200), and the minimum dosage received by 90% of the volume (D90).
2008-05-01T07:00:00Z
conference
https://ir.lib.uwo.ca/oncpub/63
info:doi/10.1109/ROBOT.2008.4543663
http://ieeexplore.ieee.org/xpl/freeabs_all.jsp?isnumber=4543169&arnumber=4543663&count=669&index=492
Oncology Publications
Scholarship@Western
lung brachytherapy
lung cancer
robotics
Electrical and Computer Engineering
Oncology
Surgery
oai:ir.lib.uwo.ca:oncpub-1064
2009-12-05T02:01:21Z
publication:biophysicspub
publication:oncpub
publication:pmid
publication:faculties
publication:biophysics
publication:onc
The Management of Thymoma: A Systematic Review and Practice Guideline
Falkson, Conrad B.
Bezjak, Andrea
Darling, Gail
Gregg, Richard
Malthaner, Richard
Maziak, Donna E.
Yu, Edward
Smith, Christopher A.
McNair, Sheila
Ung, Yee C.
Evans, William K.
Lung Cancer Disease Site Group of Cancer Care Ontario's Program in Evidence-Based Care
INTRODUCTION: Thymoma is a rare tumor for which there is little randomized evidence to guide treatment. Because of the lack of high-quality evidence, a formal consensus-based approach was used to develop recommendations on treatment.
METHODS: A systematic refview of the literature was performed. Recommendations were formed from available evidence and developed through a two-round modified Delphi consensus approach.
RESULTS: The treatment recommendations are summarized as follows: Stage I--complete resection of the entire thymus without neoadjuvant or adjuvant therapy. Stage II--complete resection of the entire thymus with consideration of adjuvant radiation for high-risk tumors. Stage IIIA--surgery either initially or after neoadjuvant therapy, or surgery followed by adjuvant therapy. Stage IIIB--treatment may include a combination of chemotherapy, radiation, and/or surgery, or if technically possible, surgery in combination with chemoradiotherapy (concurrent cisplatin based). For bulky tumors, consideration should be given to sequential chemotherapy followed by radiation. Stage IVA--as per stage III, with surgery only if metastases can be resected. Stage IVB--treatment on an individual case basis (no generic recommendations). Recurrent disease--consider surgery, radiation, and/or chemoradiation. Chemoradiation should be considered in all medically inoperable and technically inoperable patients.
CONCLUSION: Consensus was achieved on these recommendations, which serve to provide practical guidance to the physician treating this rare disease.
2009-07-01T07:00:00Z
article
https://ir.lib.uwo.ca/oncpub/64
info:doi/10.1097/JTO.0b013e3181a4b8e0
http://journals.lww.com/jto/Abstract/2009/07000/The_Management_of_Thymoma__A_Systematic_Review_and.22.aspx
Oncology Publications
Scholarship@Western
Combined Modality Therapy
Delphi Technique
Humans
Neoplasm Metastasis
Neoplasm Staging
Thymoma
Thymus Neoplasms
Oncology
oai:ir.lib.uwo.ca:biochempub-1041
2009-12-19T01:52:14Z
publication:oncpub
publication:paed
publication:pmid
publication:faculties
publication:biochempub
publication:biochem
publication:onc
publication:paedpub
Smoking and the Risk of Breast Cancer in BRCA1 and BRCA2 Carriers: An Update
Ginsburg, Ophira
Ghadirian, Parviz
Lubinski, Jan
Cybulski, Cezary
Lynch, Henry
Neuhausen, Susan
Kim-Sing, Charmaine
Robson, Mark
Domchek, Susan
Isaacs, Claudine
Klijn, Jan
Armel, Susan
Foulkes, William D.
Tung, Nadine
Moller, Pal
Sun, Ping
Narod, Steven A.
Hereditary Breast Cancer Clinical Study Group, Toronto, ON
Among women with a mutation in BRCA1 or BRCA2, the risk of breast cancer is high, but it may be modified by exogenous and endogenous factors. There is concern that exposure to carcinogens in cigarette smoke may increase the risk of cancer in mutation carriers. We conducted a matched case-control study of 2,538 cases of breast cancer among women with a BRCA1 (n = 1,920) or a BRCA2 (n = 618) mutation. One non-affected mutation carrier control was selected for each case, matched on mutation, country of birth, and year of birth. Odds ratios were calculated using conditional logistic regression, adjusted for oral contraceptive use and parity. Ever-smoking was not associated with an increased breast cancer risk among BRCA1 carriers (OR = 1.09; 95% CI 0.95-1.24) or among BRCA2 carriers (OR = 0.81; 95% CI 0.63-1.05). The result did not differ when cases were restricted to women who completed the questionnaire within two years of diagnosis. A modest, but significant increase in risk was seen among BRCA1 carriers with a past history of smoking (OR = 1.27; 95% CI 1.06-1.50), but not among current smokers (OR = 0.95; 0.81-1.12). There appears to be no increase in the risk of breast cancer associated with current smoking in BRCA1 or BRCA2 carriers. There is a possibility of an increased risk of breast cancer among BRCA1 carriers associated with past smoking. There may be different effects of carcinogens in BRCA mutation carriers, depending upon the timing of exposure.
2009-03-01T08:00:00Z
article
https://ir.lib.uwo.ca/biochempub/39
info:doi/10.1007/s10549-008-9977-5
http://www.springerlink.com/content/y62843458100j737/?p=05d3fcb4379d451590cb02ebcbeec606π=14
Biochemistry Publications
Scholarship@Western
Adolescent
Adult
Aged
Aged
80 and over
Breast Neoplasms
Case-Control Studies
Female
Genes
BRCA1
Genes
BRCA2
Heterozygote
Humans
Middle Aged
Mutation
Risk Factors
Smoking
Young Adult
Aged, 80 and over
Genes, BRCA1
Genes, BRCA2
Biochemistry
Epidemiology
Oncology
oai:ir.lib.uwo.ca:biochempub-1042
2010-09-21T06:49:25Z
publication:oncpub
publication:pmid
publication:faculties
publication:biochempub
publication:biochem
publication:onc
Estrogen Receptor β Is Required for Optimal cAMP Production in Mouse Granulosa Cells
Deroo, Bonnie J.
Rodriguez, Karina F.
Couse, John F.
Hamilton, Katherine J.
Collins, Jennifer B.
Grissom, Sherry F.
Korach, Kenneth S.
Granulosa cells of preovulatory follicles differentiate in response to FSH, and this differentiation is augmented by estradiol. We have previously shown that FSH-mediated granulosa cell differentiation requires functional estrogen receptor-β (ERβ) by demonstrating that the granulosa cells of ERβ–/– FSH-treated mice are unable to maximally induce expression of the LH receptor (an indicator of granulosa cell differentiation) compared with ERβ+/+ controls. As a result, FSH-primed ERβ–/– granulosa cells exhibit a reduced response to a subsequent ovulatory dose of LH. In this study, we further characterized the attenuated response of ERβ–/– granulosa cells to stimulation by LH and FSH using isolated mouse granulosa cells and primary granulosa cell cultures. We observed a 50% reduction in cAMP levels in cultured ERβ–/– granulosa cells exposed to LH compared with ERβ+/+ controls. We also observed an attenuated genomic response in granulosa cells isolated from FSH-primed ERβ–/– mice compared with ERβ+/+ controls. Our data indicate that this attenuated response may result from inadequate levels of cAMP, because cAMP levels in cultured ERβ–/– granulosa cells exposed to forskolin were approximately 50% lower than in ERβ+/+ granulosa cells. Phosphorylation of cAMP regulatory element binding protein, an indicator of protein kinase A activity, was also reduced in FSH-treated ERβ–/– granulosa cells compared with ERβ+/+ controls. These are the first data to indicate that ERβ plays a role in the induction of the cAMP pathway in mouse granulosa cells and that disruption of proper ERβ signaling associated with this pathway may cause negative effects on ovulation and fertility.
2009-07-01T07:00:00Z
article
https://ir.lib.uwo.ca/biochempub/40
info:doi/10.1210/me.2008-0213
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2703605/
Biochemistry Publications
Scholarship@Western
Animals
Cells
Cultured
Cyclic AMP
Down-Regulation
Estrogen Receptor beta
Female
Fertility
Forskolin
Granulosa Cells
Luteinizing Hormone
Mice
Mice
Knockout
Ovulation
Receptors
LH
Cells, Cultured
Mice, Knockout
Receptors, LH
Biochemistry
oai:ir.lib.uwo.ca:oncpub-1065
2009-12-19T06:34:31Z
publication:oncpub
publication:pmid
publication:faculties
publication:biochempub
publication:biochem
publication:onc
Multipotent Stromal Cells Are Activated to Reduce Apoptosis in Part by Upregulation and Secretion of Stanniocalcin-1
Block, Gregory J.
Ohkouchi, Shinya
Fung, France
Frenkel, Joshua
Gregory, Carl
Pochampally, Radhika
DiMattia, Gabriel
Sullivan, Deborah E.
Prockop, Darwin J.
Multipotent stromal cells (MSCs) have been shown to reduce apoptosis in injured cells by secretion of paracrine factors, but these factors were not fully defined. We observed that coculture of MSCs with previously UV-irradiated fibroblasts reduced apoptosis of the irradiated cells, but fresh MSC conditioned medium was unable reproduce the effect. Comparative microarray analysis of MSCs grown in the presence or absence of UV-irradiated fibroblasts demonstrated that the MSCs were activated by the apoptotic cells to increase synthesis and secretion of stanniocalcin-1 (STC-1), a peptide hormone that modulates mineral metabolism and has pleiotrophic effects that have not been fully characterized. We showed that STC-1 was required but not sufficient for reduction of apoptosis of UV-irradiated fibroblasts. In contrast, we demonstrated that MSC-derived STC-1 was both required and sufficient for reduction of apoptosis of lung cancer epithelial cells made apoptotic by incubation at low pH in hypoxia. Our data demonstrate that STC-1 mediates the antiapoptotic effects of MSCs in two distinct models of apoptosis in vitro.
2009-03-01T08:00:00Z
article
https://ir.lib.uwo.ca/oncpub/65
info:doi/10.1634/stemcells.2008-0742
http://www3.interscience.wiley.com/journal/122229323/abstract
Oncology Publications
Scholarship@Western
Animals
Apoptosis
Blotting
Western
Cell Line
Cell Survival
Cells
Cultured
Culture Media
Conditioned
Fibroblasts
Glycoproteins
Humans
Hydrogen-Ion Concentration
Mice
Microscopy
Fluorescence
Oligonucleotide Array Sequence Analysis
Reverse Transcriptase Polymerase Chain Reaction
Stromal Cells
Transfection
Ultraviolet Rays
Up-Regulation
Blotting, Western
Cells, Cultured
Culture Media, Conditioned
Microscopy, Fluorescence
Medical Biochemistry
Oncology
oai:ir.lib.uwo.ca:biochempub-1046
2009-12-22T00:05:23Z
publication:oncpub
publication:pmid
publication:faculties
publication:biochempub
publication:biochem
publication:onc
Evidence for Regulation of Mitotic Progression through Temporal Phosphorylation and Dephosphorylation of CK2{alpha}
St-Denis, Nicole A.
Derksen, D. Richard
Litchfield, David W.
Proper mitotic progression is crucial for maintenance of genomic integrity in proliferating cells and is regulated through an intricate series of events, including protein phosphorylation governed by a complex network of protein kinases. One kinase family implicated in the regulation of mitotic progression is protein kinase CK2, a small family of enzymes that is overexpressed in cancer and induces transformation in mice and cultured fibroblasts. CK2alpha, one isoform of the catalytic subunits of CK2, is maximally phosphorylated at four sites in nocodazole-treated cells. To investigate the effects of CK2alpha phosphorylation on mitotic progression, we generated phosphospecific antibodies against its mitotic phosphorylation sites. In U2OS cells released from S-phase arrest, these antibodies reveal that CK2alpha is most highly phosphorylated in prophase and metaphase. Phosphorylation gradually decreases during anaphase and becomes undetectable during telophase and cytokinesis. Stable expression of phosphomimetic CK2alpha (CK2alpha-4D, CK2alpha-4E) results in aberrant centrosome amplification and chromosomal segregation defects and loss of mitotic cells through mitotic catastrophe. Conversely, cells expressing nonphosphorylatable CK2alpha (CK2alpha-4A) show a decreased ability to arrest in mitosis following nocodazole treatment, suggesting involvement in the spindle assembly checkpoint. Collectively, these studies indicate that reversible phosphorylation of CK2alpha requires precise regulation to allow proper mitotic progression.
2009-04-01T07:00:00Z
article
https://ir.lib.uwo.ca/biochempub/44
info:doi/10.1128/MCB.01563-08
http://mcb.asm.org/cgi/content/abstract/29/8/2068
Biochemistry Publications
Scholarship@Western
Animals
Binding Sites
Casein Kinase II
Cell Line
Cell Nucleus Division
Centrosome
Chromosome Segregation
Cytokinesis
Mice
Mitosis
Mitotic Spindle Apparatus
Phosphorylation
Biochemistry
oai:ir.lib.uwo.ca:biochempub-1048
2009-12-23T20:23:47Z
publication:oncpub
publication:pmid
publication:faculties
publication:biochempub
publication:biochem
publication:onc
Protein Kinase CK2 in Health and Disease: From Birth to Death: The Role of Protein Kinase CK2 in the Regulation of Cell Proliferation and Survival
St-Denis, N. A.
Litchfield, D. W.
Protein kinase CK2 is a serine/threonine kinase with a multitude of protein substrates. The enzyme is ubiquitously expressed in mammalian cells, where it functions in a variety of cellular processes, including cell cycle progression, apoptosis, transcription, and viral infection. While the importance of CK2 in the mammalian life cycle is undisputed, the regulatory mechanisms coordinating its numerous functions remain elusive. In this review, we focus on the various roles of CK2 in the mammalian cell, with particular attention on its functions through the stages of the cell cycle and during the decision to undergo cell death. We highlight how these roles are controlled in part through direct transcriptional regulation by CK2, and how the constitutive activity of CK2 can be hijacked in the case of viral infection. Finally, we discuss possible ways in which these functions are integrated to allow the cell to respond appropriately in the presence of multiple signals.
2009-06-01T07:00:00Z
article
https://ir.lib.uwo.ca/biochempub/46
info:doi/10.1007/s00018-009-9150-2
http://www.springerlink.com/content/t72132g44h20851n/?p=2d93be6c97254f1a8d01b3329ec62448π=3
Biochemistry Publications
Scholarship@Western
Animals
Apoptosis
Casein Kinase II
Cell Cycle
Cell Proliferation
Cell Survival
Humans
Phosphorylation
Signal Transduction
Virus Diseases
Virus Replication
Biochemistry
Oncology
oai:ir.lib.uwo.ca:biochempub-1050
2009-12-27T16:28:12Z
publication:oncpub
publication:paed
publication:pmid
publication:faculties
publication:biochempub
publication:biochem
publication:onc
publication:paedpub
Epigenetic Contributions to Cancer Metastasis
Rodenhiser, David I.
The molecular basis of cancer encompasses both genetic and epigenetic alterations. These epigenetic changes primarily involve global DNA methylation changes in the form of widespread loss of methylation along with concurrent hypermethylation events in gene regulatory regions that can repress tissue-specific gene expression. Increasingly, the importance of these epigenetic changes to the metastatic process is being realized. Cells may acquire an epi-genotype that permits their dissemination from the primary tumour mass or the ability to survive and proliferate at a secondary tissue site. These epigenetic changes may be cancer-type specific, or in some cases may involve a common target gene providing a selective advantage to multiple metastatic cell types. In this review, I examine the growing volume of literature related to the epigenetic contributions to cancer metastasis. I discuss the functional importance of these epigenetic phenomena and how new epigenetic biomarkers may permit the identification of diagnostic signatures of metastasis and the development of new cancer therapies.
2009-01-01T08:00:00Z
article
https://ir.lib.uwo.ca/biochempub/48
info:doi/10.1007/s10585-008-9166-2
http://www.springerlink.com/content/87006261t004036w/?p=b993b0601e4e45c8b8737bc8e05cc503π=2
Biochemistry Publications
Scholarship@Western
DNA Methylation
Epigenesis
Genetic
Gene Expression Profiling
Humans
Neoplasm Metastasis
Promoter Regions
Genetic
Epigenesis, Genetic
Promoter Regions, Genetic
Biochemistry
Oncology
Pediatrics
oai:ir.lib.uwo.ca:oncpub-1066
2009-12-27T23:37:06Z
publication:oncpub
publication:pmid
publication:faculties
publication:biochempub
publication:biochem
publication:onc
Anti-Inflammatory and Renal Protective Actions of Stanniocalcin-1 in a Model of Anti-Glomerular Basement Membrane Glomerulonephritis
Huang, Luping
Garcia, Gabriela
Lou, Yahuan
Zhou, Qin
Truong, Luan D.
DiMattia, Gabriel
Lan, Xia Ru
Lan, Hui Y.
Wang, Yanlin
Sheikh-Hamad, David
We have previously shown that stanniocalcin-1 (STC1) inhibits the transendothelial migration of macrophages and T cells, suppresses superoxide generation in macrophages, and attenuates macrophage responses to chemoattractants. To study the effects of STC1 on inflammation, in this study we induced a macrophage- and T-cell-mediated model of anti-glomerular basement membrane disease in STC1 transgenic mice, which display elevated serum STC1 levels and preferentially express STC1 in both endothelial cells and macrophages. We examined the following parameters both at baseline and after anti-glomerular basement membrane antibody treatment: blood pressure; C(3a) levels; urine output; proteinuria; blood urea nitrogen; and kidney C(3) deposition, fibrosis, histological changes, cytokine expression, and number of T cells and macrophages. Compared with wild-type mice, after anti-glomerular basement membrane treatment STC1 transgenic mice exhibited: i) diminished infiltration of inflammatory macrophages in the glomeruli; ii) marked reduction in crescent formation and sclerotic glomeruli; iii) decreased interstitial fibrosis; iv) preservation of kidney function and lower blood pressure; v) diminished C(3) deposition in the glomeruli; and vi) reduced expression of macrophage inhibitory protein-2 and transforming growth factor-beta2 in the kidney. Compared with baseline, wild-type mice, but not STC1 transgenic mice, had higher proteinuria and a marked reduction in urine output. STC1 had minimal effects, however, on both T-cell number in the glomeruli and interstitium and on cytokine expression characteristic of either TH1 or TH2 activation. These data suggest that STC1 is a potent anti-inflammatory and renal protective protein.
2009-04-01T07:00:00Z
article
https://ir.lib.uwo.ca/oncpub/66
info:doi/10.2353/ajpath.2009.080476
http://ajp.amjpathol.org/cgi/content/abstract/174/4/1368
Oncology Publications
Scholarship@Western
Animals
Anti-Glomerular Basement Membrane Disease
Autoantibodies
Autoantigens
Blotting
Western
Cytokines
Disease Models
Animal
Glomerular Basement Membrane
Glycoproteins
Immunohistochemistry
Inflammation
Inflammation Mediators
Kidney Function Tests
Mice
Mice
Transgenic
Blotting, Western
Disease Models, Animal
Mice, Transgenic
Medical Biochemistry
Oncology
oai:ir.lib.uwo.ca:oncpub-1067
2010-01-03T03:59:33Z
publication:anatomy
publication:patholpub
publication:biophysicspub
publication:oncpub
publication:pmid
publication:faculties
publication:anatomypub
publication:pathol
publication:biophysics
publication:biochempub
publication:biochem
publication:onc
Lymphatic Metastasis of Breast Cancer Cells Is Associated with Differential Gene Expression Profiles that Predict Cancer Stem Cell-like Properties and the Ability to Survive, Establish and Grow in a Foreign Environment
Pandit, Terlika S.
Kennette, Wendy
Mackenzie, Lisa
Zhang, Guihua
Al-Katib, Waleed
Andrews, Joseph
Vantyghem, Sharon A.
Ormond, D. George
Allan, Alison L.
Rodenhiser, David I.
Chambers, Ann F.
Tuck, Alan B.
Although lymphatic dissemination is a major route for breast cancer metastasis, there has been little work to determine what factors control the ability of tumor cells to survive, establish and show progressive growth in a lymph node environment. This information is of particular relevance now, in the era of sentinel lymph node biopsy, where smaller intranodal tumor deposits are being detected earlier in the course of disease, the clinical relevance of which is uncertain. In this study, we compared differentially expressed genes in cell lines of high (468LN) vs. low (468GFP) lymphatic metastatic ability, and related these to clinical literature on genes associated with lymphatic metastatic ability and prognosis, to identify genes of potential clinical relevance. This approach revealed differential expression of a set of genes associated with 'cancer stem cell-like' properties, as well as networks of genes potentially associated with survival and autonomous growth. We explored these differences functionally and found that 468LN cells have a higher proportion of cells with a cancer stem cell-like (CD44+/CD24-) phenotype, have a higher clonogenic potential and a greater ability to survive, establish and grow in a foreign (lymph node and 3D Matrigel) microenvironment, relative to 468GFP cells. Differentially expressed genes which reflect these functions provide candidates for investigation as potential targets for therapy directed against early lymphatic metastasis.
2009-08-01T07:00:00Z
article
https://ir.lib.uwo.ca/oncpub/67
http://www.spandidos-publications.com/ijo/35/2/297
Oncology Publications
Scholarship@Western
Animals
Antigens
CD24
Antigens
CD44
Breast Neoplasms
Cell Proliferation
Cell Survival
Female
Flow Cytometry
Gene Expression Profiling
Humans
Lymphatic Metastasis
Mice
Neoplastic Stem Cells
Antigens, CD24
Antigens, CD44
Medical Anatomy
Medical Biochemistry
Medical Biophysics
Medical Pathology
Oncology
oai:ir.lib.uwo.ca:oncpub-1068
2010-01-04T00:01:56Z
publication:oncpub
publication:pmid
publication:faculties
publication:biochempub
publication:biochem
publication:onc
Melanoma Proteoglycan Modifies Gene Expression to Stimulate Tumor Cell Motility, Growth, and Epithelial-to-Mesenchymal Transition
Yang, Jianbo
Price, Matthew A.
Li, Gui Yuan
Bar-Eli, Menashe
Salgia, Ravi
Jagedeeswaran, Ramasamy
Carlson, Jennifer H.
Ferrone, Soldano
Turley, Eva A.
McCarthy, James B.
Melanoma chondroitin sulfate proteoglycan (MCSP) is a plasma membrane-associated proteoglycan that facilitates the growth, motility, and invasion of tumor cells. MCSP expression in melanoma cells enhances integrin function and constitutive activation of Erk1,2. The current studies were performed to determine the mechanism by which MCSP expression promotes tumor growth and motility. The results show that MCSP expression in radial growth phase, vertical growth phase, or metastatic cell lines causes sustained activation of Erk1,2, enhanced growth, and motility which all require the cytoplasmic domain of the MCSP core protein. MCSP expression in a radial growth phase cell line also promotes an epithelial-to-mesenchymal transition based on changes in cell morphology and the expression of several epithelial-to-mesenchymal transition markers. Finally, MCSP enhances the expression of c-Met and hepatocyte growth factor, and inhibiting c-Met expression or activation limits the increased growth and motility of multiple melanoma cell lines. The studies collectively show the importance of MCSP in promoting progression by an epigenetic mechanism and they indicate that MCSP could be targeted to delay or inhibit tumor progression in patients.
2009-10-01T07:00:00Z
article
https://ir.lib.uwo.ca/oncpub/68
info:doi/10.1158/0008-5472.CAN-08-4626
http://cancerres.aacrjournals.org/cgi/content/abstract/69/19/7538
Oncology Publications
Scholarship@Western
Animals
Cell Growth Processes
Cell Line
Tumor
Cell Movement
Enzyme Activation
Epithelial Cells
Female
Gene Expression Regulation
Neoplastic
Humans
MAP Kinase Signaling System
Melanoma
Mesoderm
Mice
Mice
Inbred NOD
Mice
SCID
Mitogen-Activated Protein Kinase 1
Mitogen-Activated Protein Kinase 3
Proteochondroitin Sulfates
Cell Line, Tumor
Gene Expression Regulation, Neoplastic
Mice, Inbred NOD
Mice, SCID
Medical Biochemistry
Oncology
oai:ir.lib.uwo.ca:biochempub-1073
2010-01-11T02:15:26Z
publication:oncpub
publication:pmid
publication:faculties
publication:biochempub
publication:biochem
publication:onc
EGF-Induced ERK Activation Promotes CK2-Mediated Disassociation of α-Catenin from β-Catenin and Transactivation of β-Catenin
Ji, Haitao
Wang, Ji
Nika, Heinz
Hawke, David
Keezer, Susan
Ge, Qingyuan
Fang, Bingliang
Fang, Xuexun
Fang, Dexing
Litchfield, David W.
Aldape, Kenneth
Lu, Zhimin
Increased transcriptional activity of beta-catenin resulting from Wnt/Wingless-dependent or -independent signaling has been detected in many types of human cancer, but the underlying mechanism of Wnt-independent regulation remains unclear. We demonstrate here that EGFR activation results in disruption of the complex of beta-catenin and alpha-catenin, thereby abrogating the inhibitory effect of alpha-catenin on beta-catenin transactivation via CK2alpha-dependent phosphorylation of alpha-catenin at S641. ERK2, which is activated by EGFR signaling, directly binds to CK2alpha via the ERK2 docking groove and phosphorylates CK2alpha primarily at T360/S362, subsequently enhancing CK2alpha activity toward alpha-catenin phosphorylation. In addition, levels of alpha-catenin S641 phosphorylation correlate with levels of ERK1/2 activity in human glioblastoma specimens and with grades of glioma malignancy. This EGFR-ERK-CK2-mediated phosphorylation of alpha-catenin promotes beta-catenin transactivation and tumor cell invasion. These findings highlight the importance of the crosstalk between EGFR and Wnt pathways in tumor development.
2009-11-25T08:00:00Z
article
https://ir.lib.uwo.ca/biochempub/72
info:doi/10.1016/j.molcel.2009.09.034
http://www.cell.com/molecular-cell/abstract/S1097-2765%2809%2900694-7
Biochemistry Publications
Scholarship@Western
Amino Acid Sequence
Binding Sites
Casein Kinase II
Enzyme Activation
Epidermal Growth Factor
Extracellular Signal-Regulated MAP Kinases
Glioblastoma
Humans
Molecular Sequence Data
Neoplasm Invasiveness
Phosphorylation
Phosphoserine
Protein Binding
Receptor
Epidermal Growth Factor
Transcriptional Activation
alpha Catenin
beta Catenin
Receptor, Epidermal Growth Factor
Biochemistry
Oncology
oai:ir.lib.uwo.ca:biochempub-1076
2010-01-28T06:51:09Z
publication:patholpub
publication:rwkex_researcharticles
publication:oncpub
publication:paed
publication:pmid
publication:faculties
publication:rwkex
publication:pathol
publication:biochempub
publication:biochem
publication:onc
publication:paedpub
Multi-Platform Whole-Genome Microarray Analyses Refine the Epigenetic Signature of Breast Cancer Metastasis with Gene Expression and Copy Number
Andrews, Joseph
Kennette, Wendy
Pilon, Jenna
Hodgson, Alexandra
Tuck, Alan B.
Chambers, Ann F.
Rodenhiser, David I.
BACKGROUND: We have previously identified genome-wide DNA methylation changes in a cell line model of breast cancer metastasis. These complex epigenetic changes that we observed, along with concurrent karyotype analyses, have led us to hypothesize that complex genomic alterations in cancer cells (deletions, translocations and ploidy) are superimposed over promoter-specific methylation events that are responsible for gene-specific expression changes observed in breast cancer metastasis.
METHODOLOGY/PRINCIPAL FINDINGS: We undertook simultaneous high-resolution, whole-genome analyses of MDA-MB-468GFP and MDA-MB-468GFP-LN human breast cancer cell lines (an isogenic, paired lymphatic metastasis cell line model) using Affymetrix gene expression (U133), promoter (1.0R), and SNP/CNV (SNP 6.0) microarray platforms to correlate data from gene expression, epigenetic (DNA methylation), and combination copy number variant/single nucleotide polymorphism microarrays. Using Partek Software and Ingenuity Pathway Analysis we integrated datasets from these three platforms and detected multiple hypomethylation and hypermethylation events. Many of these epigenetic alterations correlated with gene expression changes. In addition, gene dosage events correlated with the karyotypic differences observed between the cell lines and were reflected in specific promoter methylation patterns. Gene subsets were identified that correlated hyper (and hypo) methylation with the loss (or gain) of gene expression and in parallel, with gene dosage losses and gains, respectively. Individual gene targets from these subsets were also validated for their methylation, expression and copy number status, and susceptible gene pathways were identified that may indicate how selective advantage drives the processes of tumourigenesis and metastasis.
CONCLUSIONS/SIGNIFICANCE: Our approach allows more precisely profiling of functionally relevant epigenetic signatures that are associated with cancer progression and metastasis.
2010-01-13T08:00:00Z
article
https://ir.lib.uwo.ca/biochempub/75
info:doi/10.1371/journal.pone.0008665
http://dx.doi.org/10.1371/journal.pone.0008665
Biochemistry Publications
Scholarship@Western
genome
microarray analysis
breast cancer
gene expression
Biochemistry
Oncology
Pathology
Pediatrics
oai:ir.lib.uwo.ca:oncpub-1069
2010-02-04T04:06:01Z
publication:oncpub
publication:pmid
publication:faculties
publication:onc
Repressive and Non-repressive Chromatin at Native Telomeres in Saccharomyces Cerevisiae
Loney, Esther R.
Inglis, Peter W.
Sharp, Sarah
Pryde, Fiona E.
Kent, Nicholas A.
Mellor, Jane
Louis, Edward J.
BACKGROUND: In Saccharomyces cerevisiae genes that are located close to a telomere can become transcriptionally repressed by an epigenetic process known as telomere position effect. There is large variation in the level of the telomere position effect among telomeres, with many native ends exhibiting little repression.
RESULTS: Chromatin analysis, using microccocal nuclease and indirect end labelling, reveals distinct patterns for ends with different silencing states. Differences were observed in the promoter accessibility of a subtelomeric reporter gene and a characteristic array of phased nucleosomes was observed on the centromere proximal side of core X at a repressive end. The silent information regulator proteins 2 - 4, the yKu heterodimer and the subtelomeric core X element are all required for the maintenance of the chromatin structure of repressive ends. However, gene deletions of particular histone modification proteins can eliminate the silencing without the disruption of this chromatin structure.
CONCLUSION: Our data identifies chromatin features that correlate with the silencing state and indicate that an array of phased nucleosomes is not sufficient for full repression.
2009-12-02T08:00:00Z
article
https://ir.lib.uwo.ca/oncpub/69
info:doi/10.1186/1756-8935-2-18
http://www.epigeneticsandchromatin.com/content/2/1/18
Oncology Publications
Scholarship@Western
chromatin
telomere
Saccharomyces cerevisiae
Medical Biochemistry
Medical Genetics
Oncology
oai:ir.lib.uwo.ca:biochempub-1081
2010-11-04T02:31:20Z
publication:oncpub
publication:pmid
publication:faculties
publication:biochempub
publication:biochem
publication:onc
Polycomb-like 2 Associates with PRC2 and Regulates Transcriptional Networks during Mouse Embryonic Stem Cell Self-Renewal and Differentiation.
Walker, Emily
Chang, Wing Y.
Hunkapiller, Julie
Cagney, Gerard
Garcha, Kamal
Torchia, Joseph
Krogan, Nevan J.
Reiter, Jeremy F.
Stanford, William L.
Polycomb group (PcG) proteins are conserved epigenetic transcriptional repressors that control numerous developmental gene expression programs and have recently been implicated in modulating embryonic stem cell (ESC) fate. We identified the PcG protein PCL2 (polycomb-like 2) in a genome-wide screen for regulators of self-renewal and pluripotency and predicted that it would play an important role in mouse ESC-fate determination. Using multiple biochemical strategies, we provide evidence that PCL2 is a Polycomb Repressive Complex 2 (PRC2)-associated protein in mouse ESCs. Knockdown of Pcl2 in ESCs resulted in heightened self-renewal characteristics, defects in differentiation, and altered patterns of histone methylation. Integration of global gene expression and promoter occupancy analyses allowed us to identify PCL2 and PRC2 transcriptional targets and draft regulatory networks. We describe the role of PCL2 in both modulating transcription of ESC self-renewal genes in undifferentiated ESCs as well as developmental regulators during early commitment and differentiation.
2010-02-05T08:00:00Z
article
https://ir.lib.uwo.ca/biochempub/80
info:doi/10.1016/j.stem.2009.12.014
http://dx.doi.org/10.1016/j.stem.2009.12.014
Biochemistry Publications
Scholarship@Western
Embryonic Stem Cell
Self-Renewal
Differentiation
Transcriptional Network
Polycomb Repressive Complex 2
PRC2
Biochemistry
Oncology
oai:ir.lib.uwo.ca:biochempub-1082
2010-02-28T05:49:11Z
publication:oncpub
publication:pmid
publication:faculties
publication:biochempub
publication:biochem
publication:onc
Regulation of Cell Proliferation and Survival: Convergence of Protein Kinases and Caspases
Duncan, James S.
Turowec, Jacob P.
Vilk, Greg
Li, Shawn S. C.
Gloor, Gregory B.
Litchfield, David W.
Intricate networks of protein kinases are intimately involved in the regulation of cellular events related to cell proliferation and survival. In addition to protein kinases, cells also contain networks of proteases including aspartic-acid directed caspases organized in cascades that play a major role in the regulation of cell survival through their involvement in the initiation and execution phases of apoptosis. Perturbations in regulatory protein kinase and caspase networks induce alterations in cell survival and frequently accompany transformation and tumorigenesis. Furthermore, recent studies have documented that caspases or their substrates are subject to phosphorylation in cells illustrating a potential convergence of protein kinase and caspase signaling pathways. Interestingly, a number of caspase substrates are protected from cleavage when they are phosphorylated at sites that are adjacent to caspase cleavage sites. While it is theoretically possible that many distinct protein kinases could protect proteins from caspase-mediated cleavage, protein kinase CK2 is of particular interest because acidic amino acids, including aspartic acid residues that are recognized by caspases, are its dominant specificity determinants.
2010-03-01T08:00:00Z
article
https://ir.lib.uwo.ca/biochempub/81
info:doi/10.1016/j.bbapap.2009.11.001
http://dx.doi.org/10.1016/j.bbapap.2009.11.001
Biochemistry Publications
Scholarship@Western
Protein kinase
Caspase
Apoptosis
Protein kinase CK2
Phosphorylation-regulated cleavage
Biochemistry
Oncology
oai:ir.lib.uwo.ca:physpharmpub-1032
2010-03-09T01:51:48Z
publication:physpharmpub
publication:oncpub
publication:pmid
publication:faculties
publication:physpharm
publication:biochempub
publication:biochem
publication:onc
Opposing Regulatory Roles of Phosphorylation and Acetylation in DNA Mispair Processing by Thymine DNA Glycosylase
Mohan, Ryan D.
Litchfield, David W.
Torchia, Joseph
Tini, Marc
CpG dinucleotides are mutational hotspots associated with cancer and genetic diseases. Thymine DNA glycosylase (TDG) plays an integral role in CpG maintenance by excising mispaired thymine and uracil in a CpG context and also participates in transcriptional regulation via gene-specific CpG demethylation and functional interactions with the transcription machinery. Here, we report that protein kinase C alpha (PKCalpha) interacts with TDG and phosphorylates amino-terminal serine residues adjacent to lysines acetylated by CREB-binding protein (CBP) and p300 (CBP/p300). We establish that acetylation and phosphorylation are mutually exclusive, and their interplay dramatically alters the DNA mispair-processing functions of TDG. Remarkably, acetylation of the amino-terminal region abrogates high-affinity DNA binding and selectively prevents processing of G:T mispairs. In contrast, phosphorylation does not markedly alter DNA interactions, but may preserve G:T processing in vivo by preventing CBP-mediated acetylation. Mutational analysis suggests that the acetyl-acceptor lysines are not directly involved in contacting DNA, but may constitute a conformationally sensitive interface that modulates DNA interactions. These findings reveal opposing roles of CBP/p300 and PKCalpha in regulating the DNA repair functions of TDG and suggest that the interplay of these modifications in vivo may be critically important in the maintenance of CpG dinucleotides and epigenetic regulation.
2010-03-01T08:00:00Z
article
https://ir.lib.uwo.ca/physpharmpub/33
info:doi/10.1093/nar/gkp1097
http://nar.oxfordjournals.org/cgi/content/abstract/38/4/1135
Physiology and Pharmacology Publications
Scholarship@Western
phosphorylation
acetylation
DNA mispair processing
thymine DNA glycosylase
Medical Biochemistry
Medical Physiology
Oncology
oai:ir.lib.uwo.ca:surgerypub-1027
2010-03-26T21:19:32Z
publication:rwkex_researcharticles
publication:oncpub
publication:surgerypub
publication:pmid
publication:faculties
publication:stats
publication:rwkex
publication:epidem
publication:surgery
publication:statspub
publication:onc
publication:epidempub
Cyclosporin versus Tacrolimus for Liver Transplanted Patients
Haddad, Elizabeth
McAlister, Vivian
Renouf, Elizabeth
Malthaner, Richard
Kjaer, Mette S.
Gluud, Lise Lotte
A systematic review of randomized clinical trials (RCT) was undertaken to evaluate the beneficial and harmful effects of immunosuppression with cyclosporin versus tacrolimus for liver transplanted patients. MEDLINE, EMBASE, Cochrane Central and Hepato-Biliary Group Controlled Trials Registers were searched. Using fixed and random effects model, relative risk (RR), values <1 favoring>tacrolimus, with 95% confidence intervals (CI) were calculated. Of 717 potentially relevant references, 16 RCTs were eligible for inclusion. Mortality and graft loss at 1 year were significantly reduced in tacrolimus-treated recipients (Death: RR 0.85, 95% CI 0.73-0.99; graft loss: RR 0.73, 95% CI 0.61-0.86). Tacrolimus reduced the number of recipients with acute rejection (RR 0.81, 95% CI 0.75-0.88) and steroid-resistant rejection (RR 0.54, 95% CI 0.47-0.74) in the first year. Lymphoproliferative disorder or dialysis rates were not different but more de novo diabetes (RR 1.38, 95% CI 1.01-1.86) occurred with tacrolimus. More patients stopped cyclosporin than tacrolimus (RR 0.57, 95% CI 0.49-0.66). Treating 100 recipients with tacrolimus instead of cyclosporin would avoid rejection and steroid-resistant rejection in nine and seven patients respectively, graft loss and death in five and two patients respectively, but four additional patients would develop diabetes after liver transplantation.
2006-01-01T08:00:00Z
article
application/pdf
https://ir.lib.uwo.ca/surgerypub/29
info:doi/10.1002/14651858.CD005161.pub2
https://ir.lib.uwo.ca/context/surgerypub/article/1027/viewcontent/FK_CsA_meta.pdf
Surgery Publications
Scholarship@Western
Acute Disease
Cyclosporine
Follow-Up Studies
Graft Rejection
Humans
Immunosuppressive Agents
Liver Transplantation
Risk Factors
Tacrolimus
Epidemiology
Oncology
Statistics and Probability
Surgery
oai:ir.lib.uwo.ca:surgerypub-1028
2010-07-20T22:40:33Z
publication:oncpub
publication:surgerypub
publication:pmid
publication:faculties
publication:medpub
publication:med
publication:surgery
publication:onc
Use of Recombinant Activated Factor VII in Patients without Hemophilia: A Meta-Analysis of Randomized Control Trials
Hsia, Cyrus C.
Chin-Yee, Ian H.
McAlister, Vivian C.
CONTEXT: Benefits of recombinant activated factor VII (rFVIIa) in hemorrhage may be lost because of thromboembolic events (TAE).
METHOD: MEDLINE, EMBASE, BIOSIS, CINAHL, Science Citation Index Expanded, clinicaltrials.gov were searched for placebo controlled trials of rFVIIa in patients without hemophilia. Reports of 22 randomized controlled trials were selected for analysis. Results were pooled using random effects models to calculate the odds ratios (OR) with 95% confidence interval (CI). Subgroup analyses were predetermined.
RESULTS: Among 3184 participants, 478 (15.0%) died and 249 (7.8%) had TAE. Additional blood transfusion was required in 517 (41.2%) of 1256 subjects. Patients receiving rFVIIa were less likely to need additional blood transfusions (OR, 0.54; 95% CI, 0.34-0.86) than patients receiving placebo. Mortality was not increased but may be reduced (OR, 0.88; 95% CI, 0.71-1.09). Reduction in mortality was more likely if rFVIIa was given therapeutically (OR, 0.87; 95% CI, 0.70-1.09) rather than prophylactically (OR, 1.00; 95% CI, 0.37-2.68). Differences in the pooled analysis of TAE were not statistically significant (OR, 1.17; 95% CI, 0.87-1.58) but the incidence of arterial TAE was likely higher in patients receiving rFVIIa (OR, 1.50; 95% CI, 0.93-2.41) although no differences were seen with respect to venous TAE (OR, 0.76; 95% CI, 0.49-1.15).
CONCLUSIONS: Use of rFVIIa reduces the need for blood transfusion and it may reduce mortality, especially if the dose of rFVIIa is limited to therapeutic doses of 90 mug/kg. It does not increase the risk of venous thrombosis but it may increase the risk of arterial thrombosis.
2008-07-01T07:00:00Z
article
https://ir.lib.uwo.ca/surgerypub/26
info:doi/10.1097/SLA.0b013e318176c4ec
http://dx.doi.org/10.1097/SLA.0b013e318176c4ec
Surgery Publications
Scholarship@Western
Erythrocyte Transfusion
Factor VIIa
Hemorrhage
Hemostasis
Humans
Randomized Controlled Trials as Topic
Recombinant Proteins
Thromboembolism
Surgery
oai:ir.lib.uwo.ca:biochempub-1086
2010-04-05T06:50:21Z
publication:oncpub
publication:paed
publication:pmid
publication:faculties
publication:biochempub
publication:biochem
publication:onc
publication:paedpub
Numb: A New Player in EMT
Wang, Zezhou
Li, Shawn S.-C.
Epithelial to mesenchymal transition (EMT) is a critical event in embryogenesis and plays a fundamental role in cancer progression and metastasis1. Numb has been shown to play an important role in the proper functions of Par protein complex and in cell-cell junctions, both of which are associated with EMT. However, the role of Numb in EMT has not been fully elucidated. Recently, we showed that Numb is capable of binding to both Par3 and E-cadherin. Intriguingly, the interaction of Numb with E-cadherin or the Par protein complex is dynamically regulated by tyrosine phosphorylation induced by HGF or Src. Knockdown of Numb by shRNA in MDCK cells led to an lateral to apical translocation of E-cadherin and β-catenin, active F-actin polymerization, mis-localization of Par3 and aPKC, a decrease in cell-cell adhesion, and an increase in cell migration and proliferation. These data suggest a diverse role for Numb in regulating cell-cell adhesion, polarity and migration during EMT.
2010-04-16T07:00:00Z
article
https://ir.lib.uwo.ca/biochempub/84
http://www.landesbioscience.com/journals/celladhesion/article/10690/
Biochemistry Publications
Scholarship@Western
numb
EMT
epithelial to mesenchymal transition
Biochemistry
Oncology
834227/oai_dc/100//