Epworth Collection:
http://hdl.handle.net/11434/125
2024-03-28T15:09:19ZFocal low dose rate brachytherapy for unifocal low intermediate prostate cancer – preliminary experience.
http://hdl.handle.net/11434/1871
Title: Focal low dose rate brachytherapy for unifocal low intermediate prostate cancer – preliminary experience.
Epworth Authors: See, Andrew; Grummet, Jeremy2020-10-01T00:00:00ZOC-0277 Interim safety analysis of RAPPORT trial - SABR with pembrolizumab in oligometastatic RCC.
http://hdl.handle.net/11434/1671
Title: OC-0277 Interim safety analysis of RAPPORT trial - SABR with pembrolizumab in oligometastatic RCC.
Epworth Authors: Moon, Daniel; Sandhu, Suneet; Tran, Ben; Goad, Jeremy; Lawrentschuk, Nathan; Murphy, Declan
Abstract: SABR is a locally effective modality for metastatic renal cell carcinoma (RCC) (1, 2). Preclinical data in RCC has demonstrated improved disease control in both irradiated and unirradiated sites with single fraction SABR and anti-PD1 checkpoint blockade (3), although prospective clinical trials with this combination have not yet been reported. RAPPORT is a multi-institutional, single arm, phase 1b/II clinical trial (NCT02855203). Patients with 1-5 oligometastases from clear cell RCC were eligible. They received a single fraction SABR of 18-20Gy to all metastases (or 30Gy in 10 fractions of conventional radiotherapy if SABR was not feasible) followed by 8 x 3 weekly cycles of 200mg intravenous pembrolizumab. This is a preplanned interim safety analysis of the first 12 patients who completed SABR and 12 weeks of pembrolizumab. Adverse events were graded using CTCAE v4.0.2019-04-01T00:00:00ZLong-term survival after surgery and radiotherapy for recurrent or persistent ovarian and tubal cancer
http://hdl.handle.net/11434/1555
Title: Long-term survival after surgery and radiotherapy for recurrent or persistent ovarian and tubal cancer
Epworth Authors: Rome, Robert; Leung, Samuel
Abstract: OBJECTIVE:
This study examines the factors associated with long-term disease-specific survival (DSS) and complications after radiotherapy (RT) for recurrent or persistent ovarian and tubal cancer.
METHODS/MATERIALS:
Between 1980 and 2015, 65 women with ovarian (57), tubal (3), or co-existent ovarian/endometrial carcinoma (5) received RT (>45 Gy) with curative intent for recurrent (45) or persistent cancer (20) found at second-look surgery. Surgery to debulk (± restage) was integrated into the management of all but 7 cases.
RESULTS:
Twenty-two women had no evidence of disease at last contact after a median of 15.6 years (range = 1.0-35.8 years). Of the 53 patients treated more than 10 years ago, 18 (34%) are in this long-term no evidence of disease group. Univariate analysis showed that the following factors were significantly associated with longer DSS (P < 0.05): initial stage I, II (vs III, IV); endometrioid histology (vs serous and other); no or 1 previous chemotherapy (vs ≥2); no macroscopic tumor before RT (vs macroscopic); localized tumor encompassed by a limited-volume RT field (vs more widespread tumor), and chemotherapy and RT (vs RT only). Multivariate analysis showed that endometrioid (vs other histology HR = 4.37, P = 0.017) and localized tumor (vs more widespread tumor, HR = 2.43, P = 0.017) were significantly associated with longer DSS.After RT to the pelvis and/or abdomen, 13 (21.7%) of 60 patients developed G3 or 4 bowel complications requiring surgery. In 10, these occurred in the presence of tumor, RT changes, and adhesions, and in 3, there was no sign of cancer. Six patients (9.2%) developed a subsequent malignancy.
CONCLUSIONS:
We conclude that there is a role for the use of RT in selected cases of localized recurrent or persistent ovarian cancer and may confer long-term survival. Surgery is useful to debulk and define the extent of tumor to be irradiated but may confer an increased risk of severe bowel complications.2018-07-01T00:00:00ZA software platform for statistical evaluation of patient respiratory patterns in radiation therapy.
http://hdl.handle.net/11434/1284
Title: A software platform for statistical evaluation of patient respiratory patterns in radiation therapy.
Epworth Authors: Dunn, Leon; Kenny, John
Abstract: AIM:
The aim of this work was to design and evaluate a software tool for analysis of a patient's respiration, with the goal of optimizing the effectiveness of motion management techniques during radiotherapy imaging and treatment.
MATERIALS AND METHODS:
A software tool which analyses patient respiratory data files (.vxp files) created by the Varian Real-Time Position Management System (RPM) was developed to analyse patient respiratory data. The software, called RespAnalysis, was created in MATLAB and provides four modules, one each for determining respiration characteristics, providing breathing coaching (biofeedback training), comparing pre and post-training characteristics and performing a fraction-by-fraction assessment. The modules analyse respiratory traces to determine signal characteristics and specifically use a Sample Entropy algorithm as the key means to quantify breathing irregularity. Simulated respiratory signals, as well as 91 patient RPM traces were analysed with RespAnalysis to test the viability of using the Sample Entropy for predicting breathing regularity.
RESULTS:
Retrospective assessment of patient data demonstrated that the Sample Entropy metric was a predictor of periodic irregularity in respiration data, however, it was found to be insensitive to amplitude variation. Additional waveform statistics assessing the distribution of signal amplitudes over time coupled with Sample Entropy method were found to be useful in assessing breathing regularity.
CONCLUSIONS:
The RespAnalysis software tool presented in this work uses the Sample Entropy method to analyse patient respiratory data recorded for motion management purposes in radiation therapy. This is applicable during treatment simulation and during subsequent treatment fractions, providing a way to quantify breathing irregularity, as well as assess the need for breathing coaching. It was demonstrated that the Sample Entropy metric was correlated to the irregularity of the patient's respiratory motion in terms of periodicity, whilst other metrics, such as percentage deviation of inhale/exhale peak positions provided insight into respiratory amplitude regularity.2017-10-01T00:00:00Z