Supplementary appendix
|
|
- Virginia Hall
- 6 years ago
- Views:
Transcription
1 Supplementary appendix This appendix formed part of the original submission and has been peer reviewed. We post it as supplied by the authors. Supplement to: James RD, Glynne-Jones R, Meadows HM, et al. Mitomycin or cisplatin chemoradiation with or without maintenance chemotherapy for treatment of squamous-cell carcinoma of the anus (ACT II): a randomised, phase 3, open-label, 2 2 factorial trial. Lancet Oncol 2013; published online April 9.
2 ACT II: A randomised trial of chemoradiation with or without maintenance chemotherapy in squamous cell carcinoma of the anus. Online tables and Figures RD James*, R Glynne-Jones*, HM Meadows, D Cunningham, A Sun Myint, MP Saunders, T Maughan, A MacDonald, S Essapen, M Leslie, S Falk, C Wilson, S Gollins, R Begum, J Ledermann, L Kadalayil, D Sebag-Montefiore. *Joint first authors 1
3 Online Table 1. Compliance to radiotherapy MMC (N=472) CisP (N=468) No Maintenance* (N=446) Maintenance* (N=448) % (n) Full dose received 92 (435) 91 (424) 91 (406) 91 (408) Full dose no delay/reduction 78 (370) 75 (352) 79 (353) 74 (332) Phase 1 completed as per protocol 99 (465) 99 (461) 98 (436) 99 (444) Dose or fraction not reported 1 (6) <1 (3) 1 (7) <1 (2) Modifications Interruptions 15 (70) 15 (79) 14 (61) 18 (80) Due to toxicity 68 (48/71) 65 (51/79) 74 (45/61) 60 (49/81) Due to other reasons # 27 (19/71) 27 (21/79) 23 (14/61) 28 (23/81) Stopped early 3 (13) 5 (23) 4 (19) 4 (16) Due to toxicity 85 (11/13) 65 (15/23) 68 (13/19) 75 (12/16) Death <1 (1/13) <1 (1/23) <1 (1/19) <1 (1/16) Due to other reasons 8 (1/13) 26 (6/23) 21 (4/19) 19 (3/16) Interruptions 7 days Median (range), days Interruptions >7 days Median (range), days 13 (59) 2 (1 to 7) 2 (9) 12 (8 to 31) 14 (67) 2 (1 to 7) 2 (9) 9 (8 to 25) 11 (47) 2 (1 to 7) 3 (13) 10 (8 to 16) 939 patients started RT. One patient (MMC/No-maint) died before treatment commenced. *46 patients randomised to MMC (n=23) or CisP (n=23) were not randomised to maintenance therapy 50.4 Gy in 28 fractions with or without interruptions Patients can have more than one reason for interruptions # 22 interrupted due to weather, transport machine breakdown etc (9 MMC & 13 CisP) 16 (71) 2 (1 to 7) 1 (5) 22 (8 to 31) 2
4 Online Table 2. Compliance to chemotherapy during chemoradiation* MMC (N=472) CisP (N=468) % (n) Weeks 1 and 5 Completed both weeks as per protocol 77 (365) 72 (338) Any delay, dose reduction or both 21 (100) 26 (122) No chemotherapy during CRT 0 <1 (2) # Insufficient data 1 (7) 1 (6) Week 1 Completed week1 as per protocol 92 (433) 92 (429) Any delay, dose reduction or both 7 (32) 7 (33) No chemotherapy 0 <1 (2) # Insufficient data 1 (7) <1 (4) Week 5 Completed week5 as per protocol 82 (388) 75 (349) Any delay, dose reduction or both 14 (68) 21 (96) No chemotherapy 3 (15) 4 (20) Insufficient data <1 (1) <1 (3) *4 patients randomised to CisP were given MMC. The reasons were low GFR post-randomisation (n=1), treated off study (n=1), patient withdrew from trial schedule (n=1) and administrative error (n=1). 2 patients were randomised to MMC but were given CisP during week 5 (one on clinician s advice and the other due to toxicity from 5FU during week 5). includes n=8 with confirmed overdose of MMC ranging from 21 to 27 mg/day patients counted only once # death (n=1); treated off trial (n=1) includes death (n=2), treated off trial (n=1) and patient withdrew (n=1) 3
5 Online Table 3. Compliance to chemotherapy during maintenance therapy* # Prior MMC (N=226) Prior CisP (N=222) % (n) Courses 1 and 2 Completed both courses as per protocol 46 (105) 41 (91) Any delay, dose reduction or both 36 (82) 35 (78) No chemotherapy 17 (38) 24 (53) Insufficient data <1 (1) 0 Course 1 Completed course1 as per protocol 68 (153) 60 (133) Any delay, dose reduction or both 15 (34) 16 (36) No chemotherapy 17 (38) 24 (53) Insufficient data <1 (1) 0 Course 2 Completed course2 as per protocol 48 (109) 44 (97) Any delay, dose reduction or both 25 (56) 25 (55) No chemotherapy 27 (60) 32 (70) Insufficient data <1 (1) 0 *Those randomised to maintenance alone (n=448) included in the analysis # 91 patients did not receive maintenance therapy, 41 patient decision, 15 pt unwell, 7 clinical decision, 1 death, 1 APER, 26 not known. Includes n=4 overdose of CisP Patients counted only once 4
6 Online Table 4: Reasons for exclusion from the response analysis of week 26 Reasons N Death 23 Progression / salvage surgery before assessment 8 Too unwell to be assessed 5 Assessment inconclusive 2 Did not attend 12 Not assessed 25 Not known 2 Total not assessed 77 5
7 Online Table 5. Reported colostomy $ Colostomy MMC/ No-maint (N=246) CisP/ No-maint (N=246) MMC/ Maint (N=226) CisP/ Maint (N=222) Evaluable* % (n) Pre-treatment colostomy Absent 88% (203) 85% (196) 84% (179) 88% (185) Present 12% (27) 15% (34) 16% (33) 11% (24) reversed # 22% (6/27) 21% (7/34) 9% (3/33) 17% (4/24) not reversed 78% (21/27) 79% (27/34) 91% (30/33) 83% (20/24) Not known <1% (2) 0 0 <1% (1) Post-treatment colostomy 16% (33/203) 17%(34/196) 11% (19/179) 14% (26/185) Due to disease** 30/33 32/34 15/19 21/26 Due to morbidity^ 3/30 2/31 4/21 5/27 *56 patients did not have follow-up data. Reasons were death before 6 months (n=23), too ill to attend follow-up (n=27), withdrawal from the trial (n=2), ineligibility (n=2), lost to follow-up (n=1), data missing (n=1) within 8 months from start of treatment ie first follow up # 4 of these patients had a subsequent colostomy during follow up due to disease 13/112 of the post-treatment colostomies were reversed later on, but 4/13 had a subsequent colostomy **includes one patient with no disease detected on histology report ^ 3 for necrosis/ulceration 5, fistula, 4 faecal incontinence and 1 other 6
8 Online Table 6. Comparison of ACT II results with recently reported Phase III trials Trial No Design Primary Endpoint RTOG cycles CisP/5FU then concurrent DFS CisP/5FU RT vs Concurrent MMC/5FU RT RT schedule 5 yr DFS/PFS* 5 yr CFS* 5 yr OS* 45Gy / 25F T3/4 N+ or residual T2 boost to 54Gy 67.8% MMC 57.8% CisP p= % MMC 65% CisP p= % MMC 70.7% CisP p=0.026 ACCORD Factorial 2x2 design concurrent CisP/5FU RT +/- neoadjuvant CisP/5FU low or high dose boost CFS 45Gy / 25F 3 wk gap boost 15 Gy vs 20-25Gy 70% NACT /LD 78% NACT/HD 67% CRT / LD 68% CRT /HD 69.9% NACT /LD 82.4% NACT/HD 77% CRT / LD 72.7% CRT /HD 74.5% neoadjuvant 71% no neoadjuvant NS ACT Factorial 2x2 design -concurrent MMC/5FU vs CisP/5FU RT +/- maintenance chemo CR (MMC /CisP) PFS (Maint /no maint) 50.4Gy / 28F Phase I 30.6Gy; Phase II 19.8 Gy; No gap 69% MMC 69% CisP 70% m aint 69% no maint p=0.63 p=0.7 68% MMC 67% CisP 69% maint 66% no maint p=0.94 p= % MMC 77% CisP 76% maint 79% no maint p=0.7 p=0.65 DFS = disease free survival, PFS = progression free survival, CFS + Colostomy free survival, OS = Overall survival, RT = radiotherapy, CRT = chemoradiation, 5FU =5- Fluorouracil, CisP = Cisplatinum, MMC = Mitomycin C, NACT= neoadjuvant chemotherapy, NS = not significant, HD = high-dose radiotherapy, CR complete response*all p- values relate to Hazard Ratios 7
9 Online Figure 1. Progression-free survival for CisP vs MMC. The 3-year PFS rates for CisP and MMC were 74% (95% CI: 69 to 77) and 73% (95% CI: 69 to 77) respectively 8
10 Online Figure 2. Overall survival CisP vs MMC (upper figure), Maint vs No-maint (middle figure) and all four arms of the trial (lower figure). 3-year OS rates were 82% MMC/Maint, 83% CisP/Maint, 86% MMC/No-maint, 84% CisP/No-Maint 9
11 Online Figure 3. Anal cancer mortality CisP vs MMC (upper figure), Maint vs No-maint (middle figure) and all four arms of the trial (lower figure). 3-year survival rates were 87% MMC/Maint, 86% CisP/Maint, 88% MMC/No-maint, 87% CisP/No-Maint 10
12 Online Figure 4. Colostomy-free survival For patients who had complete colostomy data during follow-up (n=884), CisP vs. MMC (upper figure), Maint vs. Nomaint (middle figure), and all four arms of the trial (lower figure). For the Maint vs. No-maint comparison, patients not randomised to maintenance therapy (n=42) were excluded from the 884 patients. The 3-year rates were 73% MMC/Maint, 75% CisP/Maint, 75% MMC/No-maint, 72% CisP/No-Maint 11
13 Online Figure 5. Forest plot for progression-free survival: CisP vs. MMC (left) and Maint vs. No-maint (right) 12
Carcinoma del Canale Anale. Approcci RadioChemioterapici. Antonino De Paoli.. Oncologia Radioterapica, CRO Aviano.
Carcinoma del Canale Anale Approcci RadioChemioterapici Antonino De Paoli.. Oncologia Radioterapica, CRO Aviano. Anal Cancer Epidemiology and Risk Factors Uncommon Disease; 2-4% of all GI Tumors Increasing
More informationRob Glynne-Jones Mount Vernon Cancer Centre
ESMO Preceptorship Programme Colorectal Cancer Prague July 2016 State of the art: Standard of care for anal squamous cancer Rob Glynne-Jones Mount Vernon Cancer Centre Aim to discuss Background The trials
More informationThe optimum time to assess complete clinical response (CR)
The optimum time to assess complete clinical response (CR) following chemoradiation (CRT) using mitomycin C (MMC) or Cisplatin (CisP) with or without Maintenance CisP/5FU in squamous cell carcinoma of
More informationESMO Preceptorship Programme, Colorectal Cancer, Vienna
State of the art multimodal treatment of anal cancer ESMO Preceptorship Programme, Colorectal Cancer, Vienna Rob Glynne-Jones Mount Vernon Centre for Cancer Treatment Disclosures: last 5 years Speaker:
More informationDr Mark Saunders Christie Hospital and Paterson Institute of Cancer Research. Anal cancer chemoradiotherapy
Dr Mark Saunders Christie Hospital and Paterson Institute of Cancer Research Anal cancer chemoradiotherapy No disclosures to declare Anal tumours - pathology SCC Basaloid* Cloacogenic (transitional)* Adenocarcinoma
More informationRob Glynne-Jones Mount Vernon Cancer Centre
ESMO Preceptorship Programme Anal Cancer Valencia May 2018 Standard of care for anal squamous cancer Rob Glynne-Jones Mount Vernon Cancer Centre My Disclosures: last 5 years Speaker: Roche, Merck Serono,
More information3/8/2014. Case Presentation. Primary Treatment of Anal Cancer. Anatomy. Overview. March 6, 2014
Case Presentation Primary Treatment of Anal Cancer 65 year old female presents with perianal pain, lower GI bleeding, and anemia with Hb of 7. On exam 6 cm mass protruding through the anus with bulky R
More informationRadical Chemo-Radiotherapy for Oesophageal Cancer: An audit of dose-fractionation schedules and timeliness of treatment
Radical Chemo-Radiotherapy for Oesophageal Cancer: An audit of dose-fractionation schedules and timeliness of treatment Dr L Dixon and Dr J Wadsley Department of Clinical Oncology, Weston Park Hospital,
More informationLocally advanced disease & challenges in management
Gynecologic Cancer InterGroup Cervix Cancer Research Network Cervix Cancer Education Symposium, February 2018 Locally advanced disease & challenges in management Carien Creutzberg Radiation Oncology, Leiden
More informationManagement of Squamous Cell Cancer of the Esophagus: Surgery Should Follow Chemo + RT
Management of Squamous Cell Cancer of the Esophagus: Surgery Should Follow Chemo + RT David H. Ilson, MD, PhD Gastrointestinal Oncology Service Memorial Sloan Kettering Cancer Center Disclosure Consulting
More informationANAL CANCER Updated May 2016 by Dr. Daniel Yokom (PGY-5 Medical Oncology Resident, University of Toronto)
ANAL CANCER Updated May 2016 by Dr. Daniel Yokom (PGY-5 Medical Oncology Resident, University of Toronto) Reviewed by Dr. Lee-Ying (Staff Medical Oncologist, University of Calgary), Dr. Kzyzanowska (Staff
More informationRadiotherapy for rectal cancer. Karin Haustermans Department of Radiation Oncology
Radiotherapy for rectal cancer Karin Haustermans Department of Radiation Oncology O U T L I N E RT with TME surgery? Neoadjuvant or adjuvant RT? 5 x 5 Gy or long-course CRT? RT with new drugs? Selection
More informationThe following slides are provided as presented by the author during the live educa7onal ac7vity and are intended for reference purposes only.
The following slides are provided as presented by the author during the live educa7onal ac7vity and are intended for reference purposes only. If you have any ques7ons, please contact Imedex via email at:
More informationThe PARADIGM Study: A Phase III Study Comparing Sequential Therapy (ST) to Concurrent Chemoradiotherapy (CRT) in Locally Advanced Head and Neck Cancer
The PARADIGM Study: A Phase III Study Comparing Sequential Therapy (ST) to Concurrent Chemoradiotherapy (CRT) in Locally Advanced Head and Neck Cancer Robert I. Haddad, Guilherme Rabinowits, Roy B. Tishler,
More informationNon-small Cell Lung Cancer: Multidisciplinary Role: Role of Medical Oncologist
Non-small Cell Lung Cancer: Multidisciplinary Role: Role of Medical Oncologist Vichien Srimuninnimit, MD. Medical Oncology Division Faculty of Medicine, Siriraj Hospital Outline Resectable NSCLC stage
More informationThe International Federation of Head and Neck Oncologic Societies. Current Concepts in Head and Neck Surgery and Oncology
The International Federation of Head and Neck Oncologic Societies Current Concepts in Head and Neck Surgery and Oncology www.ifhnos.net The International Federation of Head and Neck Oncologic Societies
More informationCombined Modality Therapy State of the Art. Everett E. Vokes The University of Chicago
Combined Modality Therapy State of the Art Everett E. Vokes The University of Chicago What we Know Some patients are cured (20%) Induction and concurrent chemoradiotherapy are each superior to radiotherapy
More informationLung Cancer Non-small Cell Local, Regional, Small Cell, Other Thoracic Cancers: The Question Isn t Can We, but Should We
Lung Cancer Non-small Cell Local, Regional, Small Cell, Other Thoracic Cancers: The Question Isn t Can We, but Should We Edward Garon, MD, MS Associate Professor Director- Thoracic Oncology Program David
More informationUpdate on Neoadjuvant Chemotherapy (NACT) in Cervical Cancer
Update on Neoadjuvant Chemotherapy (NACT) in Cervical Cancer Nicoletta Colombo, MD University of Milan-Bicocca European Institute of Oncology Milan, Italy NACT in Cervical Cancer NACT Stage -IB2 -IIA>4cm
More informationOptimal Management of Isolated HER2+ve Brain Metastases
Optimal Management of Isolated HER2+ve Brain Metastases Eliot Sims November 2013 Background Her2+ve patients 15% of all breast cancer Even with adjuvant trastuzumab 10-15% relapse Trastuzumab does not
More informationChemoradiation (CRT) Safety Analysis of ACOSOG Z6041: A Phase II Trial of Neoadjuvant CRT followed by Local Excision in ut2 Rectal Cancer
Chemoradiation (CRT) Safety Analysis of ACOSOG Z6041: A Phase II Trial of Neoadjuvant CRT followed by Local Excision in ut2 Rectal Cancer Emily Chan, Qian Shi, Julio Garcia-Aguilar, Peter Cataldo, Jorge
More informationNewly Diagnosed Cases Cancer Related Death NCI 2006 Data
Multi-Disciplinary Management of Esophageal Cancer: Surgical and Medical Steps Forward Alarming Thoracic Twin Towers 200000 150000 UCSF UCD Thoracic Oncology Conference November 21, 2009 100000 50000 0
More informationMedicinae Doctoris. One university. Many futures.
Medicinae Doctoris The Before and The After: Can chemotherapy revise the trajectory of gastric and esophageal cancers? Dr. David Dawe MD, FRCPC Medical Oncologist Assistant Professor Disclosures None All
More informationTHE ROLE OF RADIATION THERAPY IN MANAGEMENT OF PANCREATIC ADENOCARCINOMA. TIMUR MITIN, MD, PhD
THE ROLE OF RADIATION THERAPY IN MANAGEMENT OF PANCREATIC ADENOCARCINOMA TIMUR MITIN, MD, PhD RESECTABLE DISEASE MANAGEMENT: RESECTABLE DISEASE Resection offers the only possibility of long term survival
More informationTratamiento Multidisciplinar de Estadios Localmente Avanzados en Cáncer de Pulmón
Tratamiento Multidisciplinar de Estadios Localmente Avanzados en Cáncer de Pulmón Santiago Ponce Aix Servicio Oncología Médica Hospital Universitario 12 de Octubre Madrid Stage III: heterogenous disease
More informationWhich Treatment Approach is Most Appropriate for Primary Therapy of Gastric Cancer: Neoadjuvant Chemotherapy
Which Treatment Approach is Most Appropriate for Primary Therapy of Gastric Cancer: Neoadjuvant Chemotherapy Joseph Chao, M.D. Assistant Clinical Professor Department of Medical Oncology & Therapeutics
More informationDepartment of Radiotherapy, Pt. BDS PGIMS, Rohtak, Haryana, India
Bharti et al., IJPSR, 2010; Vol. 1 (11): 169-173 ISSN: 0975-8232 IJPSR (2010), Vol. 1, Issue 11 (Research Article) Received on 29 September, 2010; received in revised form 21 October, 2010; accepted 26
More informationPrognostic factors in squamous cell anal cancers
Prognostic factors in squamous cell anal cancers Zainul Abedin Kapacee Year 4-5 Intercalating Medical Student, University of Manchester Dr. Shabbir Susnerwala, Mr. Nigel Scott Dr. Falalu Danwata, Dr. Marcus
More informationBladder Preservation Strategies for Muscle Invasive Bladder Cancer
Bladder Preservation Strategies for Muscle Invasive Bladder Cancer Jeff M. Michalski, MD, MBA, FACR, FASTRO The Carlos A. Perez Distinguished Professor of Radiation Oncology Department of Radiation Oncology
More informationSeptember 10, Dear Dr. Clark,
September 10, 2015 Peter E. Clark, MD Chair, NCCN Bladder Cancer Guidelines (Version 2.2015) Associate Professor of Urologic Surgery Vanderbilt Ingram Cancer Center Nashville, TN 37232 Dear Dr. Clark,
More informationLaryngeal Preservation Using Radiation Therapy. Chemotherapy and Organ Preservation
1 Laryngeal Preservation Using Radiation Therapy 1903: Schepegrell was the first to perform radiation therapy for the treatment of laryngeal cancer Conventional external beam radiation produced disappointing
More informationTwo Cycles of Chemoradiation: 2 Cycles is Enough. Concurrent Chemotherapy / RT Regimens
1 Two Cycles of Chemoradiation: 2 Cycles is Enough Heather Wakelee, M.D. Assistant Professor of Medicine, Oncology Stanford University Concurrent Chemotherapy / RT Regimens Cisplatin 50 mg/m 2 on days
More informationSome Seminal Studies. Chemotherapy Alone is Inadequate. Bladder Cancer Role of Radiation in Bladder Sparing. Primary Radiation for Bladder Cancer
Bladder Cancer Role of Radiation in Bladder Sparing David C. Beyer M.D., FACR, FACRO, FASTRO Arizona Oncology Services Phoenix, Arizona Primary Radiation for Bladder Cancer No modern surgery / XRT randomized
More informationHPV VACCINE AND AIN Palefsky NEJM 2011 n=602 MSM 16-26y qhpv = vaccine against HPV 6, 11, 16 and 18 vs placebo They analyzed ITT and per protocol.
ANAL CANCER Updated Mar 2017 by Doreen Ezeife, PGY-5 resident University of Calgary Reviewed by Dr. Lee-Ying (Staff Medical Oncologist, University of Calgary), Dr. Kzyzanowska (Staff Medical Oncologist,
More informationFoROMe Lausanne 6 février Anita Wolfer MD-PhD Cheffe de clinique Département d Oncologie, CHUV
FoROMe Lausanne 6 février 2014 Anita Wolfer MD-PhD Cheffe de clinique Département d Oncologie, CHUV Epithelial Ovarian Cancer (EOC) Epidemiology Fifth most common cancer in women and forth most common
More informationTristate Lung Meeting 2014 Pro-Con Debate: Surgery has no role in the management of certain subsets of N2 disease
Tristate Lung Meeting 2014 Pro-Con Debate: Surgery has no role in the management of certain subsets of N2 disease Jennifer E. Tseng, MD UFHealth Cancer Center-Orlando Health Sep 12, 2014 Background Approximately
More informationCHEMO-RADIOTHERAPY FOR BLADDER CANCER. Dr Darren Mitchell Consultant Clinical Oncologist Northern Ireland Cancer Centre
CHEMO-RADIOTHERAPY FOR BLADDER CANCER Dr Darren Mitchell Consultant Clinical Oncologist Northern Ireland Cancer Centre AIMS Muscle invasive disease Current Gold-Standard Rationale behind Chemo-Radiotherapy
More informationChemo-radiotherapy in muscle invasive bladder cancer. Dr Paula Wells St Bartholomew s Hospital London
Chemo-radiotherapy in muscle invasive bladder cancer Dr Paula Wells St Bartholomew s Hospital London Overview Evidence base for cystectomy vs bladder preservation Chemo-radiotherapy vs radiotherapy alone
More informationLocal excision for patients with stage I anal canal squamous cell carcinoma can be curative
Original Article Local excision for patients with stage I anal canal squamous cell carcinoma can be curative Sakti Chakrabarti 1, Zhaohui Jin 1, Brandon M. Huffman 1, Siddhartha Yadav 1, Rondell P. Graham
More informationCombined modality treatment for N2 disease
Combined modality treatment for N2 disease Dr Clara Chan Consultant in Clinical Oncology 3 rd March 2017 Overview Background The evidence base Systemic treatment Radiotherapy Future directions/clinical
More informationWhere are we with radiotherapy for biliary tract cancers?
Where are we with radiotherapy for biliary tract cancers? Professor Maria A. Hawkins Associate Professor in Clinical Oncology MRC Group Leader/Honorary Consultant Clinical Oncologist CRUK MRC Oxford Institute
More informationCombined Modality Treatment of Anal Carcinoma
Combined Modality Treatment of Anal Carcinoma F. ROELOFSEN, a H. BARTELINK b a Bethesda Krankenhaus, Essen, Germany; b The Netherlands Cancer Institute/Antoni van Leeuwenhoek Ziekenhuis, Amsterdam, The
More informationSan Antonio Breast Cancer Symposium 2010 Highlights Radiotherapy
San Antonio Breast Cancer Symposium 2010 Highlights Radiotherapy Kathleen C. Horst, M.D. Assistant Professor Department of Radiation Oncology Stanford University The Optimal SEquencing of Adjuvant Chemotherapy
More informationGastroesophag Gastroesopha eal Junction Adenocarcinoma: What is the best adjuvant regimen? Michael G. G. H addock Haddock M.D.
Gastroesophageal Junction Adenocarcinoma: What is the best adjuvant regimen? Michael G. Haddock M.D. Mayo Clinic Rochester, MN Locally Advanced GE Junction ACA CT S CT or CT S CT/RT Proposition Chemoradiation
More informationMini J.Elnaggar M.D. Radiation Oncology Ochsner Medical Center 9/23/2016. Background
Mini J.Elnaggar M.D. Radiation Oncology Ochsner Medical Center 9/23/2016 Background Mostly adenocarcinoma (scc possible, but treated like anal cancer) 39, 220 cases annually Primary treatment: surgery
More informationAdvances in gastric cancer: How to approach localised disease?
Advances in gastric cancer: How to approach localised disease? Andrés Cervantes Professor of Medicine Classical approach to localised gastric cancer Surgical resection Pathology assessment and estimation
More informationPERIOPERATIVE TREATMENT OF NON SMALL CELL LUNG CANCER. Virginie Westeel Chest Disease Department University Hospital Besançon, France
PERIOPERATIVE TREATMENT OF NON SMALL CELL LUNG CANCER Virginie Westeel Chest Disease Department University Hospital Besançon, France LEARNING OBJECTIVES 1. To understand the potential of perioperative
More informationConcurrent chemoradiation with volumetric modulated Arc therapy of patients treated for anal cancer acute toxicity and treatment outcome
Original Article Concurrent chemoradiation with volumetric modulated Arc therapy of patients treated for anal cancer acute toxicity and treatment outcome Kaloyan Yordanov, Simona Cima, Antonella Richetti,
More informationGynecologic Cancer InterGroup Cervix Cancer Research Network. Management of Cervical Cancer in Resource Limited Settings.
Management of Cervical Cancer in Resource Limited Settings Linus Chuang MD Conflict of Interests None Cervical cancer is the fourth most common malignancy in women worldwide 530,000 new cases per year
More informationRadiotherapy & Cervical Cancer Dr Mary McCormack Consultant Clinical Oncologist University College Hospital, London,UK
Lead Group Log Radiotherapy & Cervical Cancer Dr Mary McCormack Consultant Clinical Oncologist University College Hospital, London,UK Cervical Cancer treatment Treatment planning should be made on a multidisciplinary
More informationAre we making progress? Marked reduction in operative morbidity and mortality
Are we making progress? Surgical Progress Marked reduction in operative morbidity and mortality Introduction of Minimal-Access approaches for complex esophageal cancer resections Significantly better functional
More informationHPV INDUCED OROPHARYNGEAL CARCINOMA radiation-oncologist point of view. Prof. dr. Sandra Nuyts Dep. Radiation-Oncology UH Leuven Belgium
HPV INDUCED OROPHARYNGEAL CARCINOMA radiation-oncologist point of view Prof. dr. Sandra Nuyts Dep. Radiation-Oncology UH Leuven Belgium DISCLOSURE OF INTEREST Nothing to declare HEAD AND NECK CANCER -HPV
More informationBCCA Protocol Summary for Curative Combined Modality Therapy for Carcinoma of the Anal Canal Using Mitomycin, Capecitabine and Radiation Therapy
BCCA Protocol Summary for Curative Combined Modality Therapy for Carcinoma of the Anal Canal Using Mitomycin, and Radiation Therapy Protocol Code: Tumour Group: Contact Physician: GICART Gastrointestinal
More informationClinical experience of SIB-IMRT in anal cancer and selective literature review
Janssen et al. Radiation Oncology 2014, 9:199 RESEARCH Open Access Clinical experience of SIB-IMRT in anal cancer and selective literature review Stefan Janssen 1, Christoph Glanzmann 1, Peter Bauerfeind
More informationHeterogeneity of N2 disease
Locally Advanced NSCLC Surgery? No. Ramaswamy Govindan M.D Co-Director, Section of Medical Oncology Alvin J Siteman Cancer Center at Washington University School of Medicine St. Louis, Missouri Heterogeneity
More informationRole of Prophylactic Cranial Irradiation in Small Cell Lung Cancer
Role of Prophylactic Cranial Irradiation in Small Cell Lung Cancer Kazi S. Manir MD,DNB,ECMO,PDCR Clinical Tutor Department of Radiotherapy R. G. Kar Medical College and Hospital, Kolkata SCLC 15% of lung
More informationCurrent Approaches for Limited Small Cell Lung Cancer. Laurie E Gaspar MD, MBA Prof/Chair Radiation Oncology University of Colorado Denver
Current Approaches for Limited Small Cell Lung Cancer Laurie Gaspar MD, MBA Prof/Chair Radiation Oncology University of Colorado Denver Can we improve or personalize treatment? Limited Histology/molecular
More information5/20/ ) Haffty GB: Concurrent chemoradiation in the treatment of head and neck cancer. Hematol. Oncol. Clin: North Am.
Prague, 24-25 25 April 29 ALTERNATING CHEMORADIATION: FOR WHOM? M. Merlano MD Holy Cross Gen. Hospital Cuneo - Italy ALTERNATING CHEMORADIATION: FOR WHOM? Definition of alternating chemoradiation Targets
More informationHypofractionated RT in Cervix Cancer. Anuja Jhingran, MD
Hypofractionated RT in Cervix Cancer Anuja Jhingran, MD Hypofractionated RT in Cervix Cancer: Clinicaltrials.gov 919 cervix trials 134 hypofractionated RT trials Prostate, breast, NSCLC, GBM 0 cervix trials
More informationProphylactic Cranial Irradiation and Thoracic Radiotherapy in Extensive Stage Small-Cell Lung Cancer
Prophylactic Cranial Irradiation and Thoracic Radiotherapy in Extensive Stage Small-Cell Lung Cancer Dr Neil Bayman Consultant Clinical Oncology ESMO-Christie Preceptorship Programme in Lung Cancer, March
More informationEffective treatment of anal cancer in the elderly with low-dose chemoradiotherapy
British Journal of Cancer (2005) 92, 1221 1225 All rights reserved 0007 0920/05 $30.00 www.bjcancer.com Effective treatment of anal cancer in the elderly with low-dose chemoradiotherapy N Charnley 1, A
More informationLarynx Hypopharynx. Therapy algorithms. Why larynx preservation at all? State of the art Jean Louis Lefebvre,Lille Jan Klozar,Prague
Larynx Hypopharynx Moderation Rainald Knecht,Hamburg State of the art Jean Louis Lefebvre,Lille Debate pro CRT Jan Klozar,Prague contra CRT Marshall Posner,Boston Clinical cases all Therapy algorithms
More informationUpper Gastrointestinal Cancers in the Elderly. Choo Su Pin Senior Consultant Medical Oncology National Cancer Centre Singapore
Upper Gastrointestinal Cancers in the Elderly Choo Su Pin Senior Consultant Medical Oncology National Cancer Centre Singapore Gastric Cancer --High Global Burden Global Cancer Deaths % of all cancer (2008)
More informationPre- Versus Post-operative Radiotherapy
Postoperative Radiation and Chemoradiation: Indications and Optimization of Practice Dislosures Clinical trial support from Genentech Inc. Sue S. Yom, MD, PhD Associate Professor UCSF Radiation Oncology
More informationCALGB Thoracic Radiotherapy for Limited Stage Small Cell Lung Cancer
CALGB 30610 Thoracic Radiotherapy for Limited Stage Small Cell Lung Cancer Jeffrey A. Bogart Department of Radiation Oncology Upstate Medical University Syracuse, NY Small Cell Lung Cancer Estimated 33,000
More informationHYPERTHERMIA in CERVIX and VAGINA CANCER. J. van der Zee
HYPERTHERMIA in CERVIX and VAGINA CANCER J. van der Zee ESTRO 2006 Deep hyperthermia in Rotterdam HYPERTHERMIA in CERVIX and VAGINA CANCER ESTRO 2006 Hyperthermia and radiotherapy in primary advanced cervix
More informationRT +/- Surgery. Concurrent ChemoRT +/- Surgery
Molecular targeted approaches to head and neck cancer Lillian L. Siu Department of Medical Oncology & Hematology Princess Margaret Hospital, University of Toronto Locally Advanced HNSCC Locally Advanced
More informationINTRODUCTION. Jpn J Clin Oncol 2011;41(5) doi: /jjco/hyr028 Advance Access Publication 5 April 2011
Jpn J Clin Oncol 2011;41(5)713 717 doi:10.1093/jjco/hyr028 Advance Access Publication 5 April 2011 A Phase I/II Trial of Chemoradiotherapy Concurrent with S-1 plus Mitomycin C in Patients with Clinical
More informationCarcinoma del retto: Highlights
Carcinoma del retto: Highlights Stefano Cordio Struttura Complessa di Oncologia Medica ARNAS Garibaldi Catania Roma 17 Febbraio 2018 Disclosures Advisory Committee, research funding and speakers bureau
More informationArticles. Funding Cancer Research UK. Copyright The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY license.
Best time to assess complete clinical response after chemoradiotherapy in squamous cell carcinoma of the anus (ACT II): a post-hoc analysis of randomised controlled phase 3 trial Robert Glynne-Jones, David
More informationSanguineti s (2)Comment: When it was initially published in 2003 with a median follow-up of 3.8 years (4), the RTOG study led to a change in
Commento di due Soci AIRO pubblicati su due prestigiose riviste internazionali al Trial della forastiere et al. Long term results of RTOG:91-11 (a cura di Dr. Russi e Dr. Testolin )! Forastiere)et)al.)Long/Term)Results)of)RTOG)91/11:)A)Comparison)of)
More informationRadiotherapy Management of Breast Cancer Treated with Neoadjuvant Chemotherapy. Julia White MD Professor, Radiation Oncology
Radiotherapy Management of Breast Cancer Treated with Neoadjuvant Chemotherapy Julia White MD Professor, Radiation Oncology Agenda Efficacy of radiotherapy in the management of breast cancer in the Adjuvant
More informationIs the Neo-adjuvant Approach Better than Adjuvant Approach? Comparative Levels of Evidence: Randomized Trials
Is the Neo-adjuvant Approach Better than Approach? Virginie Westeel University Hospital Besançon, France Perspectives in Lung Cancer Amsterdam, 5-6 March 2010 Comparative Levels of Evidence: Randomized
More informationGCIG Rare Tumour Brainstorming Day
GCIG Rare Tumour Brainstorming Day Relatively (Not So) Rare Tumours Adenocarcinoma of Cervix Keiichi Fujiwara, Ros Glasspool Benedicte Votan, Jim Paul Aim of the Day To develop at least one clinical trial
More informationManagement of Cervical Cancer in Resource Limited Settings
Management of Cervical Cancer in Resource Limited Settings Linus Chuang MD MPH MS Professor, Gynecologic Oncology Icahn School of Medicine at Mount Sinai New York NY 84% of incidence and death occur in
More informationDe-Escalate Trial for the Head and neck NSSG. Dr Eleanor Aynsley Consultant Clinical Oncologist
De-Escalate Trial for the Head and neck NSSG Dr Eleanor Aynsley Consultant Clinical Oncologist 3 HPV+ H&N A distinct disease entity Leemans et al., Nature Reviews, 2011 4 Good news Improved response to
More informationDr Roopinder Gillmore July 2017
Dr Roopinder Gillmore July 2017 Resectable Borderline / locally advanced Metastatic 15-20% 15-20% 60-70% 22-28 months 9-15 months 6-12 months Does the patient have resectable disease?? Definitely not
More informationRECTAL CANCER APPARENT COMPLETE RESPONSE (acr) AFTER LONG COURSE CHEMORADIOTHERAPY
COLORECTAL CLINICAL SUBGROUP RECTAL CANCER APPARENT COMPLETE RESPONSE (acr) AFTER LONG COURSE CHEMORADIOTHERAPY Finalised by: Dr Simon Gollins Mr Andrew Renehan Dr Mark Saunders Mr Nigel Scott Dr Shabbir
More informationThe role of chemoradiotherapy in GE junction and gastric cancer. Karin Haustermans
The role of chemoradiotherapy in GE junction and gastric cancer Karin Haustermans Overview Postoperative chemoradiotherapy Preoperative chemoradiotherapy Palliative radiation Technical aspects Overview
More informationNeo- and adjuvant treatment for gastric cancer: The role of chemotherapy
Neo- and adjuvant treatment for gastric cancer: The role of chemotherapy Priv. Doz. Dr. Dr. med. T.O. Götze Institute of Clinical Cancer Research Director: Prof. Dr. S.-E. Al- Batran University Cancer
More informationComparing simultaneous integrated boost vs sequential boost in anal cancer patients: results of a retrospective observational study
Franco et al. Radiation Oncology (2018) 13:172 https://doi.org/10.1186/s13014-018-1124-9 RESEARCH Comparing simultaneous integrated boost vs sequential boost in anal cancer patients: results of a retrospective
More informationLocally advanced head and neck cancer
Locally advanced head and neck cancer Radiation Oncology Perspective Petek Erpolat, MD Gazi University, Turkey Definition and Management of LAHNC Stage III or IV cancers generally include larger primary
More informationUpdate on Limited Small Cell Lung Cancer. Laurie E Gaspar MD, MBA Prof/Chair Radiation Oncology University of Colorado Denver
Update on Limited Small Cell Lung Cancer Laurie E Gaspar MD, MBA Prof/Chair Radiation Oncology University of Colorado Denver Objectives - Limited Radiation Dose Radiation Timing Radiation Volume PCI Neurotoxicity
More informationADJUVANT CHEMOTHERAPY FOR RECTAL CANCER
ESMO Preceptorship Programme Colorectal Cancer Barcelona November, 25-26, 2016 ADJUVANT CHEMOTHERAPY FOR RECTAL CANCER Andrés Cervantes Professor of Medicine OLD APPROACH TO RECTAL CANCER Surgical resection
More informationGASTRIC & PANCREATIC CANCER
GASTRIC & PANCREATIC CANCER ASCO HIGHLIGHTS 2005 Fadi Sami Farhat, MD Head of Hematology Oncology Division Hammoud Hospital University Medical Center Saida Lebanon Tel: +961 3 753 155 E-Mail: drfadi@drfadi.org
More informationThe Evolution of SBRT and Hypofractionation in Thoracic Radiation Oncology
The Evolution of SBRT and Hypofractionation in Thoracic Radiation Oncology (specifically, lung cancer) 2/10/18 Jeffrey Kittel, MD Radiation Oncology, Aurora St. Luke s Medical Center Outline The history
More informationTargeted Agents as Maintenance Therapy. Karen Kelly, MD Professor of Medicine UC Davis Cancer Center
Targeted Agents as Maintenance Therapy Karen Kelly, MD Professor of Medicine UC Davis Cancer Center Disclosures Genentech Advisory Board Maintenance Therapy Defined Treatment Non-Progressing Patients Drug
More informationAdjuvant Therapies in Endometrial Cancer. Emma Hudson
Adjuvant Therapies in Endometrial Cancer Emma Hudson Endometrial Cancer Most common gynaecological cancer Incidence increasing in Western world 1-2% cancer deaths 75% patients postmenopausal 97% epithelial
More informationES-SCLC Joint Case Conference. Anthony Paravati Adam Yock
ES-SCLC Joint Case Conference Anthony Paravati Adam Yock Case 57 yo woman with 35 pack year smoking history presented with persistent cough and rash Chest x-ray showed a large left upper lobe/left hilar
More informationAdjuvant Chemotherapy for Rectal Cancer: Are we making progress?
Adjuvant Chemotherapy for Rectal Cancer: Are we making progress? Hagen Kennecke, MD, MHA, FRCPC Division Of Medical Oncology British Columbia Cancer Agency October 25, 2008 Objectives Review milestones
More informationStrategies of Radiotherapy for Intermediate- to High-Risk Prostate Cancer
Strategies of Radiotherapy for Intermediate- to High-Risk Prostate Cancer Daisaku Hirano, MD Department of Urology Higashi- matsuyama Municipal Hospital, Higashi- matsuyama- city, Saitama- prefecture,
More informationAdvanced Stage of Anal Squamous Cell Carcinoma. A Case Report
Advanced Stage of Anal Squamous Cell Carcinoma. A Case Report Anamaria Rusu 1, Tănase Timiş 2, Raluca Popiţă 3, Gabriel Kacsó 4,5 Institute of Oncology Ion Chiricuta, Departments of 1) Radiation Oncology;
More informationStage III Non-Small Cell Lung Cancer, Is There Any Progress? HARMESH R NAIK, MD. KARMANOS CANCER INSTITUTE 2/24/99
Stage III Non-Small Cell Lung Cancer, Is There Any Progress? HARMESH R NAIK, MD. KARMANOS CANCER INSTITUTE 2/24/99 Introduction 1/3 of the total lung cancer cases few patients are cured with single modality
More informationEGFR inhibitors in NSCLC
Suresh S. Ramalingam, MD Associate Professor Director of Medical Oncology Emory University i Winship Cancer Institute EGFR inhibitors in NSCLC Role in 2nd/3 rd line setting Role in first-line and maintenance
More informationDebate: Whole pelvic RT for high risk prostate cancer??
Debate: Whole pelvic RT for high risk prostate cancer?? WPRT well, at least it ll get the job done.or will it? Andrew K. Lee, MD, MPH Associate Professor Department of Radiation Oncology Using T-stage,
More informationLocoregional treatment Session Oral Abstract Presentation Saulo Brito Silva
Locoregional treatment Session Oral Abstract Presentation Saulo Brito Silva Background Post-operative radiotherapy (PORT) improves disease free and overall suvivallin selected patients with breast cancer
More informationHow can we Personalize RT as part of Breast-Conserving Therapy?
How can we Personalize RT as part of Breast-Conserving Therapy? Jay R. Harris Dana-Farber Cancer Institute (DFCI) Brigham and Women s Hospital (BWH) Harvard Medical School Disclosures I have no COI disclosures
More informationSequencing Chemo with Radiation therapy Locally Advanced Head and Neck Cancer. Dr P Vijay Anand Reddy Director Apollo Cancer Hospital
Sequencing Chemo with Radiation therapy Locally Advanced Head and Neck Cancer Dr P Vijay Anand Reddy Director Apollo Cancer Hospital H&N Ca - Disease Burden 15-20% of all cancers in India, 8% worldwide
More informationSimultaneous Integrated Boost or Sequential Boost in the Setting of Standard Dose or Dose De-escalation for HPV- Associated Oropharyngeal Cancer
Simultaneous Integrated Boost or Sequential Boost in the Setting of Standard Dose or Dose De-escalation for HPV- Associated Oropharyngeal Cancer Dawn Gintz, CMD, RTT Dosimetry Coordinator of Research and
More informationPractice changing studies in lung cancer 2017
1 Practice changing studies in lung cancer 2017 Rolf Stahel University Hospital of Zürich Cape Town, February 16, 2018 DISCLOSURE OF INTEREST Consultant or Advisory Role in the last two years I have received
More information