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[14th Congress European Association of Urology, Stockholm, Sweden. Therapy of advanced cancer of the bladder]

https://arctichealth.org/en/permalink/ahliterature20778
Source
Urologe A. 1999 Sep;38(5 Suppl):1-8
Publication Type
Conference/Meeting Material
Date
Sep-1999

Accrual rate-limiting factors in a Swedish randomised ductal carcinoma in situ (DCIS) trial - a demographic study.

https://arctichealth.org/en/permalink/ahliterature20554
Source
Eur J Cancer. 2000 Mar;36(4):483-8
Publication Type
Article
Date
Mar-2000
Author
A. Ringberg
T. Möller
Author Affiliation
Department of Plastic and Reconstructive Surgery, Malmö University Hospital, SE-205 02, Malmö, Sweden. anita.ringberg@plastsurg.mas.lu.se
Source
Eur J Cancer. 2000 Mar;36(4):483-8
Date
Mar-2000
Language
English
Publication Type
Article
Keywords
Breast Neoplasms - radiotherapy - surgery - therapy
Carcinoma in Situ - radiotherapy - surgery - therapy
Carcinoma, Ductal, Breast - radiotherapy - surgery - therapy
Female
Humans
Patient Selection
Radiotherapy, Adjuvant
Randomized Controlled Trials - methods
Research Support, Non-U.S. Gov't
Retrospective Studies
Abstract
In the last two decades the introduction of mammographic screening in the Western world has increased the number of diagnosed ductal carcinomas in situ (DCIS) considerably. In situ carcinoma of the breast is considered a heterogeneous disease, the natural history of which is not well known. Thus, appropriate treatment needs to be established. For this reason, a randomised trial studying the effect of breast conserving operation with or without postoperative radiotherapy was instituted in Southern Sweden in 1987. The aim of the present study was to assess patient accrual, identify limiting factors, and evaluate possible ways to influence these factors in order to increase patient accrual. Between 1987 and 1992, 331 patients had been registered with DCIS in the Regional Tumour Registry, 96 of which had been randomised. All 331 were subjected to chart review studying clinical data, mammography reports, cytology and pathology reports to identify inclusion and exclusion criteria according to the design of the trial. It was found that 5% (18/331) had an incorrect diagnosis of DCIS. According to the trial protocol 52% were not eligible (162/313). Fifty-eight per cent (n=88) of the 151 eligible patients had been correctly randomised. The most common reason for exclusion was lesion size. In 21% (66/313) the lesion was 'too large'. Several other limiting factors were identified such as in cytological and pathological definitions and reports, lack of information/awareness in certain physicians, patient reluctance to participate, which in turn may be influenced by the previous factor. With increased information to participating hospitals and considering the above given facts it should be possible to increase accrual from the 28% noted in the present consecutive demographic study to at least one-third of the diagnosed cases of DCIS.
PubMed ID
10717524 View in PubMed
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[Acute lymphoblastic leukaemia in Danish children and young people 10 to 19 years of age. Should young adults with acute lymphoblastic leukaemia be treated in the same way as children?]

https://arctichealth.org/en/permalink/ahliterature81544
Source
Ugeskr Laeger. 2006 Jun 26;168(26-32):2554-8
Publication Type
Article
Date
Jun-26-2006
Author
Schrøder Henrik
Kjeldstad Marthe
Boesen Anne Marie
Nielsen Ove Juul
Schmidt Kai Gjerløff
Johnsen Hans Erik
Gregersen Henrik
Gustafsson Göran
Author Affiliation
Arhus Universitetshospital, Skejby Sygehus, Børneafdelingen, DK-8200 Arhus. hsa@sks.aaa.dk
Source
Ugeskr Laeger. 2006 Jun 26;168(26-32):2554-8
Date
Jun-26-2006
Language
Danish
Publication Type
Article
Keywords
Adolescent
Adult
Antineoplastic Combined Chemotherapy Protocols - administration & dosage
Child
Cyclophosphamide - administration & dosage
Daunorubicin - administration & dosage
Doxorubicin - administration & dosage
Female
Humans
Leukemia, Lymphocytic, Acute - drug therapy - mortality - radiotherapy
Male
Methotrexate - administration & dosage
Neoplasm Recurrence, Local
Prednisone - administration & dosage
Prognosis
Radiotherapy, Adjuvant
Retrospective Studies
Stem Cell Transplantation
Treatment Outcome
Vincristine - administration & dosage
Abstract
INTRODUCTION: Data seem to indicate that young adults with acute lymphoblastic leukemia (ALL) have a better survival rate when treated with paediatric protocols than with adult ALL protocols. The purpose of this study was to report the clinical characteristics and outcome of all children and young adults 10-19 years of age diagnosed with ALL in Denmark between 1992 and 2001. MATERIALS AND METHODS: The study included 99 patients 10-19 years of age with ALL in Denmark during a 10-year period found in the complete NOPHO (Nordic Society of Pediatric Hematology and Oncology) registry and through the Danish Cancer Registry and local pathology databases. Data were retrieved by reviewing patients' medical charts. 61 children (10-14 years) were treated on paediatric protocols, and 38 young adults (15-19 years) were diagnosed with ALL. Data were reported as of 1 January 2005. RESULTS: There were no differences between the two groups with respect to the distribution of T-ALL, CNS leukemia, total WBC and high-risk chromosomal abnormalities. There was a statistically significant lower event-free survival rate (EFS) (p
PubMed ID
16824410 View in PubMed
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Adherence to treatment guidelines in stage II/III rectal cancer in Alberta, Canada.

https://arctichealth.org/en/permalink/ahliterature132600
Source
Clin Oncol (R Coll Radiol). 2012 Feb;24(1):e9-17
Publication Type
Article
Date
Feb-2012
Author
N Sharaf Eldin
Y. Yasui
A. Scarfe
M. Winget
Author Affiliation
School of Public Health, University of Alberta, Alberta, Canada. marcy.winget@albertahealthservices.ca
Source
Clin Oncol (R Coll Radiol). 2012 Feb;24(1):e9-17
Date
Feb-2012
Language
English
Publication Type
Article
Keywords
Adenocarcinoma - pathology - therapy
Aged
Alberta
Antineoplastic Agents - therapeutic use
Chemotherapy, Adjuvant
Digestive System Surgical Procedures
Female
Guideline Adherence - statistics & numerical data
Humans
Male
Medical Oncology - standards - statistics & numerical data
Middle Aged
Neoadjuvant Therapy
Neoplasm Grading
Neoplasm Staging
Practice Guidelines as Topic - standards
Radiotherapy
Radiotherapy, Adjuvant
Rectal Neoplasms - pathology - therapy
Referral and Consultation
Socioeconomic Factors
Abstract
Evidence suggests that pre- and/or postoperative treatment benefits patients with stage II/III rectal cancer. This study aimed to quantify treatment patterns and adherence to treatment guidelines, and to identify barriers to having a consultation with an oncologist and barriers to receiving treatment in stage II/III rectal cancer, in a publicly funded medical care system.
Patients with surgically treated stage II/III rectal adenocarcinoma, diagnosed from 2002 to 2005 in Alberta, a Canadian province with a population of 3 million, were included. Demographic and treatment information from the Alberta Cancer Registry were linked to data from electronic medical records, hospital discharge data and the 2001 Canadian Census. The study outcomes were 'not having an oncologist consultation' and 'not receiving guideline-based treatment'. The relative risks of the two outcomes in association with patient characteristics were estimated using multivariable log-binomial regression.
Of a total of 910 surgically treated stage II/III rectal adenocarcinoma patients, 748 (82%) had a consultation with an oncologist and 414 (45.5%) received treatment. Pre-/post-surgical treatment modalities and timing varied; 96 (10.5%) received neoadjuvant treatment only, 389 (42.7%) received adjuvant treatment only, 119 (13.1%) received both, and 306 (33.6%) had surgery alone. Factors related to not having a consultation with an oncologist included older age, co-morbidities, cancer stage II and region of residence. Older age was the most significantly associated factor with not receiving treatment (relative risk=2.23; 95% confidence interval: 1.89, 2.64).
Disparities exist in the receipt of treatment in stage II/III rectal cancer. Factors such as age, region of residence and stage should not be barriers to consulting an oncologist to discuss or receive treatment. The reasons for these disparities need to be identified and addressed.
PubMed ID
21802914 View in PubMed
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Adjuvant external beam radiotherapy in the treatment of endometrial cancer (MRC ASTEC and NCIC CTG EN.5 randomised trials): pooled trial results, systematic review, and meta-analysis.

https://arctichealth.org/en/permalink/ahliterature90870
Source
Lancet. 2009 Jan 10;373(9658):137-46
Publication Type
Article
Date
Jan-10-2009
Author
Blake P.
Swart Ann Marie
Orton J.
Kitchener H.
Whelan T.
Lukka H.
Eisenhauer E.
Bacon M.
Tu D.
Parmar M K B
Amos C.
Murray C.
Qian W.
Source
Lancet. 2009 Jan 10;373(9658):137-46
Date
Jan-10-2009
Language
English
Publication Type
Article
Keywords
Brachytherapy - adverse effects - methods
Endometrial Neoplasms - mortality - pathology - radiotherapy
Female
Humans
Kaplan-Meiers Estimate
Multicenter Studies as Topic
Neoplasm Recurrence, Local
Postoperative Period
Radiotherapy, Adjuvant - adverse effects
Randomized Controlled Trials as Topic
Abstract
BACKGROUND: Early endometrial cancer with low-risk pathological features can be successfully treated by surgery alone. External beam radiotherapy added to surgery has been investigated in several small trials, which have mainly included women at intermediate risk of recurrence. In these trials, postoperative radiotherapy has been shown to reduce the risk of isolated local recurrence but there is no evidence that it improves recurrence-free or overall survival. We report the findings from the ASTEC and EN.5 trials, which investigated adjuvant external beam radiotherapy in women with early-stage disease and pathological features suggestive of intermediate or high risk of recurrence and death from endometrial cancer. METHODS: Between July, 1996, and March, 2005, 905 (789 ASTEC, 116 EN.5) women with intermediate-risk or high-risk early-stage disease from 112 centres in seven countries (UK, Canada, Poland, Norway, New Zealand, Australia, USA) were randomly assigned after surgery to observation (453) or to external beam radiotherapy (452). A target dose of 40-46 Gy in 20-25 daily fractions to the pelvis, treating five times a week, was specified. Primary outcome measure was overall survival, and all analyses were by intention to treat. These trials were registered ISRCTN 16571884 (ASTEC) and NCT 00002807 (EN.5). FINDINGS: After a median follow-up of 58 months, 135 women (68 observation, 67 external beam radiotherapy) had died. There was no evidence that overall survival with external beam radiotherapy was better than observation, hazard ratio 1.05 (95% CI 0.75-1.48; p=0.77). 5-year overall survival was 84% in both groups. Combining data from ASTEC and EN.5 in a meta-analysis of trials confirmed that there was no benefit in terms of overall survival (hazard ratio 1.04; 95% CI 0.84-1.29) and can reliably exclude an absolute benefit of external beam radiotherapy at 5 years of more than 3%. With brachytherapy used in 53% of women in ASTEC/EN.5, the local recurrence rate in the observation group at 5 years was 6.1%. INTERPRETATION: Adjuvant external beam radiotherapy cannot be recommended as part of routine treatment for women with intermediate-risk or high-risk early-stage endometrial cancer with the aim of improving survival. The absolute benefit of external beam radiotherapy in preventing isolated local recurrence is small and is not without toxicity.
Notes
Comment In: Lancet. 2009 Jan 10;373(9658):97-919070890
PubMed ID
19070891 View in PubMed
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Adjuvant high dose rate vaginal brachytherapy as treatment of stage I and II endometrial carcinoma.

https://arctichealth.org/en/permalink/ahliterature19333
Source
Obstet Gynecol. 2002 Feb;99(2):235-40
Publication Type
Article
Date
Feb-2002
Author
Neil S Horowitz
William A Peters
Michael R Smith
Charles W Drescher
Mary Atwood
Timothy P Mate
Author Affiliation
The Swedish Medical Center, Seattle, Washington, USA. horowitzn@msnotes.wustl.edu
Source
Obstet Gynecol. 2002 Feb;99(2):235-40
Date
Feb-2002
Language
English
Publication Type
Article
Keywords
Adenocarcinoma - mortality - radiotherapy - secondary - surgery
Administration, Intravaginal
Aged
Brachytherapy - methods
Carcinoma, Adenosquamous - mortality - radiotherapy - secondary - surgery
Disease-Free Survival
Endometrial Neoplasms - mortality - pathology - radiotherapy - surgery
Female
Humans
Lymph Node Excision
Medical Records
Middle Aged
Neoplasm Recurrence, Local - mortality
Neoplasm Staging
Radiation Dosage
Radiotherapy, Adjuvant
Registries
Retrospective Studies
Survival Analysis
Sweden
Treatment Outcome
Abstract
OBJECTIVE: To evaluate the efficacy of high dose rate vaginal brachytherapy in the treatment of International Federation of Gynecology and Obstetrics stage IB, IC, and II endometrial carcinoma after surgical staging and complete lymphadenectomy. METHODS: All patients with stage IB, IC, or II adenocarcinoma or adenosquamous carcinoma of the endometrium who received postoperative high dose rate vaginal brachytherapy at our institution between June 1, 1989, and June 1, 1999, were eligible. High dose rate vaginal brachytherapy was delivered in three fractions of 700 cGy. Retrospective chart review was performed. Kaplan-Meier estimates were calculated for disease-free and overall survival. RESULTS: One hundred sixty-four women were identified. Fifty-six percent had stage IB disease, 30% had stage IC disease, and 14% had stage II disease. Approximately one third of patients had high-grade lesions and nearly 40% had deep myometrial invasion. Median follow-up was 65 months (range 6-142 months). To date, 14 patients have had recurrence; 2 at the vaginal apex, 9 at distant sites, 1 at the pelvic sidewall, 1 simultaneously in the pelvis and at a distant site, and 1 at an unknown site. Both patients with vaginal apex recurrences had salvage therapy and are now free of disease. The overall 5-year survival and disease-free survival rates were 87% and 90%, respectively. There were no Radiation Therapy Oncology Group grade 3 or 4 toxicities. High dose rate vaginal brachytherapy was approximately $1,000 less expensive than external-beam whole-pelvic radiation. CONCLUSIONS: Adjuvant high dose rate vaginal brachytherapy in thoroughly staged patients with intermediate-risk endometrial carcinoma provides excellent overall and disease-free survival with less toxicity and at less cost compared with whole-pelvic radiation.
PubMed ID
11814503 View in PubMed
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Adjuvant hypofractionated versus conventional whole breast radiation therapy for early-stage breast cancer: long-term hospital-related morbidity from cardiac causes.

https://arctichealth.org/en/permalink/ahliterature104800
Source
Int J Radiat Oncol Biol Phys. 2014 Mar 15;88(4):786-92
Publication Type
Article
Date
Mar-15-2014
Author
Elisa K Chan
Ryan Woods
Mary L McBride
Sean Virani
Alan Nichol
Caroline Speers
Elaine S Wai
Scott Tyldesley
Author Affiliation
Department of Oncology, Saint John Regional Hospital, Saint John, Canada.
Source
Int J Radiat Oncol Biol Phys. 2014 Mar 15;88(4):786-92
Date
Mar-15-2014
Language
English
Publication Type
Article
Keywords
Aged
Breast - pathology
Breast Neoplasms - pathology - radiotherapy - surgery
British Columbia
Dose Fractionation
Female
Follow-Up Studies
Heart - radiation effects
Hospitalization - statistics & numerical data
Humans
Mastectomy - utilization
Middle Aged
Neoplasm Staging
Organ Size
Organs at Risk - radiation effects
Radiation Injuries - complications
Radiotherapy, Adjuvant - adverse effects
Risk factors
Thoracic Wall
Abstract
The risk of cardiac injury with hypofractionated whole-breast/chest wall radiation therapy (HF-WBI) compared with conventional whole-breast/chest wall radiation therapy (CF-WBI) in women with left-sided breast cancer remains a concern. The purpose of this study was to determine if there is an increase in hospital-related morbidity from cardiac causes with HF-WBI relative to CF-WBI.
Between 1990 and 1998, 5334 women = 80 years of age with early-stage breast cancer were treated with postoperative radiation therapy to the breast or chest wall alone. A population-based database recorded baseline patient, tumor, and treatment factors. Hospital administrative records identified baseline cardiac risk factors and other comorbidities. Factors between radiation therapy groups were balanced using a propensity-score model. The first event of a hospital admission for cardiac causes after radiation therapy was determined from hospitalization records. Ten- and 15-year cumulative hospital-related cardiac morbidity after radiation therapy was estimated for left- and right-sided cases using a competing risk approach.
The median follow-up was 13.2 years. For left-sided cases, 485 women were treated with CF-WBI, and 2221 women were treated with HF-WBI. Mastectomy was more common in the HF-WBI group, whereas boost was more common in the CF-WBI group. The CF-WBI group had a higher prevalence of diabetes. The 15-year cumulative hospital-related morbidity from cardiac causes (95% confidence interval) was not different between the 2 radiation therapy regimens after propensity-score adjustment: 21% (19-22) with HF-WBI and 21% (17-25) with CF-WBI (P=.93). For right-sided cases, the 15-year cumulative hospital-related morbidity from cardiac causes was also similar between the radiation therapy groups (P=.76).
There is no difference in morbidity leading to hospitalization from cardiac causes among women with left-sided early-stage breast cancer treated with HF-WBI or CF-WBI at 15-year follow-up.
PubMed ID
24606848 View in PubMed
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Adjuvant radiation trials for high-risk breast cancer patients: adequacy of lymphadenectomy.

https://arctichealth.org/en/permalink/ahliterature20381
Source
Ann Surg Oncol. 2000 Jun;7(5):357-60
Publication Type
Article
Date
Jun-2000
Author
A W Silberman
G P Sarna
D. Palmer
Author Affiliation
Division of Surgical Oncology, Cedars-Sinai Medical Center, Los Angeles, California, USA. aws222@aol.com
Source
Ann Surg Oncol. 2000 Jun;7(5):357-60
Date
Jun-2000
Language
English
Publication Type
Article
Keywords
Adult
Aged
Breast Neoplasms - pathology - radiotherapy - surgery
Clinical Trials
Female
Humans
Lymph Node Excision
Lymphatic Metastasis
Middle Aged
Neoplasm Recurrence, Local
Neoplasm, Residual
Radiotherapy, Adjuvant
Reproducibility of Results
Retrospective Studies
Risk factors
Abstract
BACKGROUND: The recently published, widely publicized adjuvant radiation trials from Denmark and Canada concluded that the addition of postoperative radiotherapy (XRT) to modified radical mastectomy (MRM) and adjuvant chemotherapy reduces locoregional recurrences and prolongs survival in high-risk premenopausal patients with breast cancer. Our thesis is that adequate lymphadenectomies were not performed in either study. Consequently, the conclusion to these studies is not applicable to those patients who have undergone adequate surgery. METHODS: To better assess adequate lymph node yield from an MRM, a retrospective review was performed on 215 consecutive patients treated surgically for invasive breast cancer. Data from this review were compared with the surgical data from the above-mentioned radiotherapy trials. RESULTS: In a group of 131 patients who had MRM, the average number of nodes removed was 26 (median, 25), and 75.5% of the specimens had 20 or more lymph nodes. In 73 patients who underwent segmental mastectomy with axillary lymph node dissection, both the average and the median number of lymph nodes removed were 24, and 68.9% had 20 or more nodes. These data compare to the Danish radiation trial in which a median of 7 lymph nodes were removed (with 76% of the patients having 9 or fewer lymph nodes in the specimen) and to the Canadian radiation trial in which a median of 11 lymph nodes were removed. In addition, in our breast cancer patients with positive nodes (84 of 204; 41.2%), 45.2.% (38 of 84) had more than three positive nodes compared with 29.8% in the Danish study and 35% in the Canadian study. CONCLUSIONS: Our surgical data are sufficiently different from those of the Danish and Canadian studies to indicate that, in those studies, incomplete lymph node dissections were performed and that residual disease was left behind in the axilla in some or all of the patients. The addition of XRT in the setting of residual axillary disease may compensate for an inadequate operation and yield an acceptable oncological result; however, these studies did not provide an adequate comparison with a well-performed MRM without XRT. In the absence of documented benefit, XRT should not be routinely added if a complete lymph node dissection has been performed.
PubMed ID
10864343 View in PubMed
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[Adjuvant radio-chemotherapy is effective in the treatment of Dukes B and C rectal cancer: results of a randomized controlled Norwegian trial]

https://arctichealth.org/en/permalink/ahliterature21437
Source
Strahlenther Onkol. 1998 Sep;174(9):490-1
Publication Type
Article
Date
Sep-1998

334 records – page 1 of 34.