Conjoint Professor Jarad Martin
Conjoint Professor
School of Medicine and Public Health
An integrated approach to cancer treatment
Associate Professor Jarad Martin is a Radiation Oncologist with a dual focus on research and clinical practice.
Radiation oncologists apply radiation therapy to a broad range of conditions and Jarad sub-specialise in anatomic sites such as genito-urinary (prostate, bladders, penis, and urinary), and gastrointestinal (from the oesophagus via the pancreas and liver, and the bowel). While this work is very specialised, Jarad says that there are a range of conditions involved in the treatment which allows for opportunities and challenges for practitioners and researchers.
“When it comes to treating bowel cancer or colorectal cancer we need to work with medical oncologists, colorectal surgeons, radiologists, physios and other professionals to get the right outcomes for the patient,” Jarad says.
Working closely with other specialists to achieve optimal patient outcome, Jarad says that it’s important to consider a whole suite of research approaches, including retrospective reviews, technical sub-studies and behavioural change. “We’ve been working with Laureate Professor Rob Sanson-Fisher’s group to help clinicians integrate research findings into their everyday practice, and we really do try to collaborate as much as we can with the other areas of excellence in this town.”
“We interact with dietitians, physios and other allied health professionals,” Jarad adds. “A lot of these groups have strong community bases, so there are many opportunities to engage with people through speaking at meetings. It’s a great way to interact at the ‘coal-face’ with people.”
A long road to Newcastle
The decision to specialize as a Radiation Oncologist has seen Jarad forge a career in the Hunter after travelling the world studying and specialising. After graduating as a medical practitioner in New Zealand, Jarad spent time in England and then Melbourne training at Australia’s largest cancer hospital. This gave Jarad insight into the challenges that researchers face when integrating practice. He then did some advanced training Toronto, Canada, prior to spending nearly six years in Queensland working in a regional setting and in private clinical practice. This range of work settings places Jarad well to have formed numerous networks, and gained valuable perspective on the diversity of issues which arise in different environments.
His move to Newcastle has placed Jarad in an epicentre of cancer research. The Hunter region has a strong network of cancer researchers, with a diverse range of specialists collaborating to achieve a positive outcome for this pernicious disease. As the leading cause of death in Australia, there is a justifiable focus on diagnosis, treatment and options for cure for cancer with researchers drawn to solving one of the world’s greatest health problems.
Jarad is also involved in TROG Cancer Research group, which is based in Newcastle, and working across Australia and New Zealand to improve the way that radiotherapy is delivered to cancer patients. “With the TROG group we have almost 30 years of history and are the epicentre for a lot of research and practice. We’re also integrated with a range of other groups involved in research into different forms of cancer.”
However, Jarad’s quick to point out that while the Hunter is a hub for specialists in the field, collaborating further afield is not only desirable, it’s essential. “It’s a little bit challenging, but because a lot of the networks are dispersed it means that you could end up collaborating with someone from Canada just easily as you would with someone from down the corridor.”
The challenges of juggling clinical work and research isn’t lost on Jarad who acknowledges that a heavy workload just comes with the territory. “It would be just about impossible to be a really relevant clinical researcher unless you’re a relatively busy clinician – because then you’re aware of what the pertinent questions are and what’s really relevant,” Jarad states.
“With research you’ve got to be pretty clear-eyed about why you’re getting into it,” Jarad explains. “It’s a way of keeping your practice connected with an always changing standard of care, as well as offering your patients access to novel approaches.”
A mathematical angle
Jarad’s early interest in maths and physics has stood him in a positive stead for this career. “On a day-to-day basis we’re really creating virtual patients and using super-computers to model the way photon interact within them and coming up with all sorts of ways to predict toxicity and effectiveness,” he explains. “Unless you have a fairly deep understanding of the mathematics behind the practice you’re potentially going to end up an uninformed end user fairly quickly.”
Radiation therapy is complex because you’re treating a moving target, using something invisible that doesn’t leave a footprint, and that’s why quality assurance has become a really big part of the speciality. Jarad is working with a team led by Professor Peter Greer on a new system called ‘Watchdog’ which aims to verify that the patient is receiving the correct dose during radiation therapy treatment.
“You could describe it as a practical way of doing quality control, but it’s a lot deeper than that in that it tries to confirm that what we predict will happen is actually occurring,” Jarad says. With radiotherapy it’s important to not only identify where a tumour is located, but to look at how it can move, rotate or change shape.
Jarad and his team are also looking at how you can change the amount of radiation given, so that it can make treatment more accessible to patients by giving people larger doses over a shorter time period. Having recently led the Australian arm of a clinical trial with prostate cancer patients, published in the Journal of Clinical Oncology where patients were given shorter treatments, using higher doses of radiation. The study showed that the and 4 week version stacked up very well against the previously standard 8 week approach. “It’s a month’s less treatment for exactly the same cure rates,” Jarad affirms.
Challenges of Clinical Oncology
Dealing with patients and their families who are facing deeply emotional issues around their health can be taxing, “When you’re dealing with cancer there’s a lot of information that you’re trying to convey,” Jarad explains. “We’re trying to guide people through a fairly difficult time in their life, and that’s our most important role as clinicians in oncology.”
“It’s important to remember that there’s no right or wrong answer when it comes to treatment options, all you can really do is break up the information into bite-sized chunks and then try to figure out what will lead to the best outcome for all. You need to have an open conversation with the patients and come up with a decision that everyone’s comfortable with.”
An integrated approach to cancer treatment
Associate Professor Jarad Martin is a Radiation Oncologist with a dual focus on research and clinical practice.
Career Summary
Biography
Conjoint Professor Jarad Martin (MB ChB BSc DMed PhD, FRANZCR GAustMS ) is the Director of Research (Department of Radiation Oncology) and Radiation Oncologist at the Calvary Mater Newcastle, and Visiting Medical Officer at Genesis Cancer Care, Lake Macquarie Private Hospital.
With strong research interests in the areas of gastrointestinal and genitourinary oncology, Prof Martin has attracted over $10 million in competitive grant funding and has over 85 peer-reviewed publications to date. He is also Senior author on the Australasian guidelines for prostate cancer radiotherapy.
Prof Martin's professional leadership roles have included: Faculty of Radiation Oncology; Chairperson Research Committee, Faculty of Radiation Oncology, Royal Australian and New Zealand College of Radiologists; Australia New Zealand Urological and Prostate Cancer Trials Group Scientific Advisory Committee; Trans-Tasman Radiation Oncology Group (TROG) Clinical Liason Leader; and Deputy Chairperson, Hunter Cancer Research Alliance (HCRA) Implementation Science Flagship Committee.
Qualifications
- Doctor of Philosophy, University of Queensland
- Doctor of Medicine, University of Queensland
Keywords
- Bladder Cancer
- Diagnostics
- Gastrointestinal Cancer
- Magnetic Resonance Imaging
- Mathematics
- Oesophageal Cancer
- Prostate Cancer
- Radiation Oncology
- Radiotherapy
- Rectal Cancer
- Screening
- Stereotactic Body Radiotherapy
- Therapy and Treatment
Languages
- English (Mother)
Professional Experience
Professional appointment
Dates | Title | Organisation / Department |
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12/11/2014 - |
Visiting Radiation Oncologist A/Prof Martin is engaged with Australia's largest provider of radiotherapy services with over 25 campuses. |
Genesis Cancer Care, Lake Macquarie Private Hospital Australia |
7/5/2012 - |
Director of Research (Department of Radiation Oncology), Radiation Oncologist A/Prof Martin is a clinician who also helps shape research strategy within the field of Radiation Oncology. |
Calvary Mater Newcastle Australia |
30/4/2007 - 30/4/2012 | Radiation Oncologist | Radiation Oncology Queensland, Toowoomba, Queensland Australia |
1/7/2006 - 27/4/2007 | Locum Radiation Oncologist | Royal Brisbane and Women's Hospital Australia |
1/7/2005 - 30/6/2006 |
Fellow in Radiation Oncology A/Prof Martin did his advanced fellowship training at the Princess Margaret Hospital, one of the world's largest and most respected radiotherapy centres. |
University of Toronto Canada |
23/7/2001 - 30/6/2005 |
Registrar in Radiation Oncology A/Prof Martin did his clinical training at the Peter Mac - Australia's largest cancer hospital. |
Peter MacCallum Cancer Centre Australia |
Publications
For publications that are currently unpublished or in-press, details are shown in italics.
Chapter (1 outputs)
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2009 |
Fay MF, Martin JM, Porceddu SV, O'Sullivan B, 'Acute and Late Radiation Therapy Effects', When Cancer Crosses Disciplines, World Scientific, London 179-200 (2009)
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Journal article (139 outputs)
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2024 |
Roberts MJ, Conduit C, Davis ID, Effeney RM, Williams S, Martin JM, et al., 'The Dedicated Imaging Post-Prostatectomy for Enhanced Radiotherapy outcomes (DIPPER) trial protocol: a multicentre, randomised trial of salvage radiotherapy versus surveillance for low-risk biochemical recurrence after radical prostatectomy', BJU INTERNATIONAL, 133 39-47 (2024)
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2024 |
Wegener E, Sidhom M, Pryor D, Bucci J, Yeoh K, Richardson M, et al., 'Prostate Virtual High-dose-rate Brachytherapy Boost: 5-Year Results from the PROMETHEUS Prospective Multicentre Trial.', Eur Urol Oncol, (2024) [C1]
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2023 |
Kaur G, Lehmann J, Greer PB, Martin J, Simpson J, 'Clinical validation of the Varian Truebeam intra-fraction motion review (IMR) system for prostate treatment guidance.', Phys Eng Sci Med, 46 131-140 (2023) [C1]
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2023 |
Wegener E, Samuels J, Sidhom M, Trada Y, Sridharan S, Dickson S, et al., 'Virtual HDR Boost for Prostate Cancer: Rebooting a Classic Treatment Using Modern Tech.', Cancers (Basel), 15 (2023) [C1]
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2023 |
Sengupta C, Skouboe S, Ravkilde T, Poulsen PR, Nguyen DT, Greer PB, et al., 'The dosimetric error due to uncorrected tumor rotation during real-time adaptive prostate stereotactic body radiation therapy.', Med Phys, 50 20-29 (2023) [C1]
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2023 |
Nikitas J, Ong WL, Carrier N, Romero T, Millar J, Steinberg ML, et al., 'Prostate-Specific Antigen Response to Androgen Deprivation Therapy in the Neoadjuvant Setting for High-Risk Prostate Adenocarcinoma (PIRANHA): Pooled Analysis of Two Randomized Clinical Trials.', Int J Radiat Oncol Biol Phys, (2023) [C1]
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2023 |
Chrystall D, Mylonas A, Hewson E, Martin J, Keall P, Booth J, Nguyen DT, 'Deep learning enables MV-based real-time image guided radiation therapy for prostate cancer patients.', Phys Med Biol, 68 (2023) [C1]
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2023 |
Richardson M, Sidhom M, Keall P, Leigh L, Ball H, Bucci J, et al., 'Genitourinary Quality-of-Life Comparison Between Urethral Sparing Prostate Stereotactic Body Radiation Therapy Monotherapy and Virtual High-Dose-Rate Brachytherapy Boost.', Int J Radiat Oncol Biol Phys, 116 1069-1078 (2023) [C1]
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2023 |
Phonlakrai M, Ramadan S, Simpson J, Gholizadeh N, Arm J, Skehan K, et al., 'Determination of hepatic extraction fraction with gadoxetate low-temporal resolution DCE-MRI-based deconvolution analysis: validation with ALBI score and Child-Pugh class.', Journal of medical radiation sciences, 70 Suppl 2 48-58 (2023) [C1]
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2023 |
O'Connor LM, Quinn A, Denley S, Leigh L, Martin J, Dowling JA, et al., 'Cone beam computed tomography image guidance within a magnetic resonance imaging-only planning workflow', Physics and Imaging in Radiation Oncology, 27 100472-100472 (2023) [C1]
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2023 |
Phonlakrai M, Ramadan S, Simpson J, Skehan K, Goodwin J, Trada Y, et al., 'Non-contrast based approach for liver function quantification using Bayesian-based intravoxel incoherent motion diffusion weighted imaging: A pilot study.', J Appl Clin Med Phys, 24 e14178 (2023) [C1]
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2023 |
Min H, Dowling J, Jameson MG, Cloak K, Faustino J, Sidhom M, et al., 'Clinical target volume delineation quality assurance for MRI-guided prostate radiotherapy using deep learning with uncertainty estimation.', Radiother Oncol, 186 109794 (2023) [C1]
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2023 |
M Naeini M, Newell F, Aoude LG, Bonazzi VF, Patel K, Lampe G, et al., 'Multi-omic features of oesophageal adenocarcinoma in patients treated with preoperative neoadjuvant therapy', Nature Communications, 14 (2023) [C1] Oesophageal adenocarcinoma is a poor prognosis cancer and the molecular features underpinning response to treatment remain unclear. We investigate whole genome, transcriptomic and... [more] Oesophageal adenocarcinoma is a poor prognosis cancer and the molecular features underpinning response to treatment remain unclear. We investigate whole genome, transcriptomic and methylation data from 115 oesophageal adenocarcinoma patients mostly from the DOCTOR phase II clinical trial (Australian New Zealand Clinical Trials Registry-ACTRN12609000665235), with exploratory analysis pre-specified in the study protocol of the trial. We report genomic features associated with poorer overall survival, such as the APOBEC mutational and RS3-like rearrangement signatures. We also show that positron emission tomography non-responders have more sub-clonal genomic copy number alterations. Transcriptomic analysis categorises patients into four immune clusters correlated with survival. The immune suppressed cluster is associated with worse survival, enriched with myeloid-derived cells, and an epithelial-mesenchymal transition signature. The immune hot cluster is associated with better survival, enriched with lymphocytes, myeloid-derived cells, and an immune signature including CCL5, CD8A, and NKG7. The immune clusters highlight patients who may respond to immunotherapy and thus may guide future clinical trials.
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2022 |
O'Connor LM, Choi JH, Dowling JA, Warren-Forward H, Martin J, Greer PB, 'Comparison of Synthetic Computed Tomography Generation Methods, Incorporating Male and Female Anatomical Differences, for Magnetic Resonance Imaging-Only Definitive Pelvic Radiotherapy', FRONTIERS IN ONCOLOGY, 12 (2022) [C1]
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2022 |
Lockhart K, Martin J, White M, Raman A, Grant A, Chong P, 'Fusion versus cognitive MRI-guided prostate biopsies in diagnosing clinically significant prostate cancer', Journal of Clinical Urology, (2022) [C1] Objective: This study assesses whether fusion or cognitive magnetic resonance imaging (MRI)-guided prostate targeted and systematic transperineal biopsies (TPB) increase detection... [more] Objective: This study assesses whether fusion or cognitive magnetic resonance imaging (MRI)-guided prostate targeted and systematic transperineal biopsies (TPB) increase detection of clinically significant prostate cancer (csPCa). Materials and Methods: A retrospective analysis was completed of patients (2018¿2020) undergoing 3-Tesla multiparametric prostate MRI informing targeted (either cognitive or MIM software fusion approach) and systematic TPB. ISUP (International Society of Urological Pathology) grade group ¿ 2 was considered csPCa. Results: A total of 355 cases from 4 urologists were included; 131 were fusion and 224 were cognitive MRI-guided biopsies. Of all csPCa found, 86.8% (n = 171) of cases were confirmed to be at the MRI-indicated location and 11.6% were found as part of active surveillance. In all, 45.0% of the fusion group were found to have csPCa, compared to 62.05% (n = 139) in the cognitive group (p = 0.002). csPCa detection rates varied between urologists (41% to 78%, p < 0.001), so a subgroup analysis was performed on Urologist A; 45.0% of fusion and 41.3% of cognitive biopsies had csPCa (p = 0.644). Multinomial logistic regression analysis showed that biopsy type, being on active surveillance, number of biopsy cores, iPSA (initial Prostate Specific Antigen) value or PIRADS (Prostate Imaging-Reporting and Data System) score made no significant difference in whether csPCa was found. Conclusion: Cognitive and fusion targeting had similar csPCa detection rates. Further prospective studies would be beneficial to validate these findings. Level of evidence: 2b (according to Oxford Centre for Evidence-Based Medicine)
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2022 |
Sridharan S, Day F, Loh J, Lynam J, Smart J, Holt B, et al., 'Phase I trial of hypofractionated chemoradiotherapy in the palliative management of esophageal and gastro-esophageal cancer', RADIATION ONCOLOGY, 17 (2022) [C1]
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2022 |
Martin JM, Richardson M, Siva S, Cardoso M, Handmer M, Sidhom M, 'Mechanisms, mitigation, and management of urinary toxicity from prostate radiotherapy', The Lancet Oncology, 23 e534-e543 (2022) [C1] Urinary toxicity is common following pelvic radiotherapy and can have a substantial negative effect on survivorship. Due to its prevalence and the increasing number of related cli... [more] Urinary toxicity is common following pelvic radiotherapy and can have a substantial negative effect on survivorship. Due to its prevalence and the increasing number of related clinical trials, localised prostate cancer radiotherapy is a useful illustrative tool to explore urinary toxicity. A good understanding of the interplay between anatomy, radiation-sensitive cell populations, and treatment sequencing is necessary for optimal outcomes. Emerging evidence suggests that the prostatic urethra is a radiation-sensitive structure, not only for stricture development, but also chronic irritative symptoms. Tools now exist not only to identify the urethra, but also to direct radiation dose away from the urethra, with early data suggesting that this reduces moderate-to-severe late urinary toxicity. Coupled with new evidence supporting dominant nodule microboosting and ultrahypofractionation as emerging standards of care, urethral sparing radiotherapy is a powerful tool against radiation induced urinary toxicity while also maximising disease control.
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2022 |
O'Connor LM, Dowling JA, Choi JH, Martin J, Warren-Forward H, Richardson H, et al., 'Validation of an MRI-only planning workflow for definitive pelvic radiotherapy', RADIATION ONCOLOGY, 17 (2022) [C1]
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2022 |
Zhou K, Renouf M, Perrocheau G, Magné N, Latorzeff I, Pommier P, et al., 'Cost-effectiveness of hypofractionated versus conventional radiotherapy in patients with intermediate-risk prostate cancer: An ancillary study of the PROstate fractionated irradiation trial - PROFIT.', Radiother Oncol, 173 306-312 (2022) [C1]
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2021 |
Min H, Dowling J, Jameson MG, Cloak K, Faustino J, Sidhom M, et al., 'Automatic radiotherapy delineation quality assurance on prostate MRI with deep learning in a multicentre clinical trial', Physics in Medicine and Biology, 66 (2021) [C1] Volume delineation quality assurance (QA) is particularly important in clinical trial settings where consistent protocol implementation is required, as outcomes will affect future... [more] Volume delineation quality assurance (QA) is particularly important in clinical trial settings where consistent protocol implementation is required, as outcomes will affect future as well current patients. Currently, where feasible, this is conducted manually, which is time consuming and resource intensive. Although previous studies mostly focused on automating delineation QA on CT, magnetic resonance imaging (MRI) is being increasingly used in radiotherapy treatment. In this work, we propose to perform automatic delineation QA on prostate MRI for both the clinical target volume (CTV) and organs-at-risk (OARs) by using delineations generated by 3D Unet variants as benchmarks for QA. These networks were trained on a small gold standard atlas set and applied on a multicentre radiotherapy clinical trial dataset to generate benchmark delineations. Then, a QA stage was designed to recommend 'pass', 'minor correction' and 'major correction' for each manual delineation in the trial set by thresholding its Dice similarity coefficient to the network generated delineation. Among all 3D Unet variants explored, the Unet with anatomical gates in an AtlasNet architecture performed the best in delineation QA, achieving an area under the receiver operating characteristics curve of 0.97, 0.92, 0.89 and 0.97 for identifying unacceptable (major correction) delineations with a sensitivity of 0.93, 0.73, 0.74 and 0.90 at a specificity of 0.93, 0.86, 0.86 and 0.95 for bladder, prostate CTV, rectum and gel spacer respectively. To the best of our knowledge, this is the first study to propose automated delineation QA for a multicentre radiotherapy clinical trial with treatment planning MRI. The methods proposed in this work can potentially improve the accuracy and consistency of CTV and OAR delineation in radiotherapy treatment planning.
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2021 |
Nithiyananthan K, Creighton N, Currow D, Martin JM, 'Population-Level Uptake of Moderately Hypofractionated Definitive Radiation Therapy in the Treatment of Prostate Cancer', International Journal of Radiation Oncology Biology Physics, 111 417-423 (2021) [C1] Purpose: Recent evidence shows the noninferiority of hypofractionated radiation therapy regimens compared with conventional regimens in the treatment of prostate cancer (PCa). Hyp... [more] Purpose: Recent evidence shows the noninferiority of hypofractionated radiation therapy regimens compared with conventional regimens in the treatment of prostate cancer (PCa). Hypofractionation has benefits for both the patient and health care system, because of the shorter treatment duration. Despite this advantage, the uptake of hypofractionation can be slow. Here we investigate the factors influencing the changing use of moderate hypofractionation (HypoRT) for the treatment of PCa. Methods and Materials: We conducted a population-based, retrospective, consecutive cohort study using the 2014 to 2018 Outpatient Radiation Oncology Data from public and private treatment facilities in New South Wales, Australia. Included participants had a PCa diagnosis of any risk, and they completed curative-intent external beam radiation therapy without treatment to lymph nodes. Factors potentially affecting use of HypoRT were examined using a 3-level hierarchical logistic regression model. The effects were reported using adjusted, median, or interval odds ratios. Results: The study included 4915 patients. Of these, 4053 patients (82.5%) received conventional fractionation, and 862 patients (17.5%) received HypoRT. HypoRT utilization increased from 5.2% in 2014 to 40.3% in 2018. The treating radiation oncologist, treatment facility, and increasing distance to treatment centers had the greatest influence on HypoRT uptake. The main limitation was the lack of stratification by PCa risk categorization. Conclusions: Although HypoRT uptake has considerably increased between 2014 and 2018, it remains variable among facilities and treating radiation oncologists. Strategies are being explored to reduce inter-clinician variability.
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2021 |
Ell P, Martin JM, Cehic DA, Ngo DTM, Sverdlov AL, 'Cardiotoxicity of Radiation Therapy: Mechanisms, Management, and Mitigation', Current Treatment Options in Oncology, 22 (2021) [C1] Radiation therapy is a key component of modern-day cancer therapy and can reduce the rates of recurrence and death from cancer. However, it can increase risk of cardiovascular (CV... [more] Radiation therapy is a key component of modern-day cancer therapy and can reduce the rates of recurrence and death from cancer. However, it can increase risk of cardiovascular (CV) events, and our understanding of the timeline associated with that risk is shorter than previously thought. Risk mitigation strategies, such as different positioning techniques, and breath hold acquisitions as well as baseline cardiovascular risk stratification that can be undertaken at the time of radiotherapy planning should be implemented, particularly for patients receiving chest radiation therapy. Primary and secondary prevention of cardiovascular disease (CVD), as appropriate, should be used before, during, and after radiation treatment in order to minimize the risks. Opportunistic screening for subclinical coronary disease provides an attractive possibility for primary/secondary CVD prevention and thus mitigation of long-term CV risk. More data on long-term clinical usefulness of this strategy and development of appropriate management pathways would further strengthen the evidence for the implementation of such screening. Clear guidelines in initial cardiovascular screening and cardiac aftercare following radiotherapy need to be formulated in order to integrate these measures into everyday clinical practice and policy and subsequently improve post-treatment morbidity and mortality for these patients.
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2021 |
Pryor DI, Martin JM, Millar JL, Day H, Ong WL, Skala M, et al., 'Evaluation of Hypofractionated Radiation Therapy Use and Patient-Reported Outcomes in Men with Nonmetastatic Prostate Cancer in Australia and New Zealand', JAMA Network Open, (2021) [C1] Importance: Randomized clinical trials in prostate cancer have reported noninferior outcomes for hypofractionated radiation therapy (HRT) compared with conventional RT (CRT); howe... [more] Importance: Randomized clinical trials in prostate cancer have reported noninferior outcomes for hypofractionated radiation therapy (HRT) compared with conventional RT (CRT); however, uptake of HRT across jurisdictions is variable. Objective: To evaluate the use of HRT vs CRT in men with nonmetastatic prostate cancer and compare patient-reported outcomes (PROs) at a population level. Design, Setting, and Participants: Registry-based cohort study from the Australian and New Zealand Prostate Cancer Outcomes Registry (PCOR-ANZ). Participants were men with nonmetastatic prostate cancer treated with primary RT (excluding brachytherapy) from January 2016 to December 2019. Data were analyzed in March 2021. Exposures: HRT defined as 2.5 to 3.3 Gy and CRT defined as 1.7 to 2.3 Gy per fraction. Main Outcomes and Measures: Temporal trends and institutional, clinicopathological, and sociodemographic factors associated with use of HRT were analyzed. PROs were assessed 12 months following RT using the Expanded Prostate Cancer Index Composite (EPIC)-26 Short Form questionnaire. Differences in PROs were analyzed by adjusting for age and National Comprehensive Cancer Network risk category. Results: Of 8305 men identified as receiving primary RT, 6368 met the inclusion criteria for CRT (n = 4482) and HRT (n = 1886). The median age was 73.1 years (IQR, 68.2-77.3 years), 2.6% (168) had low risk, 45.7% (2911) had intermediate risk, 44.5% (2836) had high-/very high-risk, and 7.1% (453) had regional nodal disease. Use of HRT increased from 2.1% (9 of 435) in the first half of 2016 to 52.7% (539 of 1023) in the second half of 2019, with lower uptake in the high-/very high-risk (1.9% [4 of 215] to 42.4% [181 of 427]) compared with the intermediate-risk group (2.2% [4 of 185] to 67.6% [325 of 481]) (odds ratio, 0.26; 95% CI, 0.15-0.45). Substantial variability in the use of HRT for intermediate-risk disease remained at the institutional level (median 53.3%; range, 0%-100%) and clinician level (median 57.9%; range, 0%-100%) in the last 2 years of the study period. There were no clinically significant differences across EPIC-26 urinary and bowel functional domains or bother scores. Conclusions and Relevance: In this cohort study, use of HRT for prostate cancer increased substantially from 2016. This population-level data demonstrated clinically equivalent PROs and supports the continued implementation of HRT into routine practice. The wide variation in practice observed at the jurisdictional, institutional, and clinician level provides stakeholders with information that may be useful in targeting implementation strategies and benchmarking services.
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2021 |
O'Connor LM, Skehan K, Choi JH, Simpson J, Martin J, Warren-Forward H, et al., 'Optimisation and validation of an integrated magnetic resonance imaging-only radiotherapy planning solution', Physics and Imaging in Radiation Oncology, 20 34-39 (2021) [C1] Background and purpose: Magnetic resonance imaging (MRI)-only treatment planning is gaining in popularity in radiation oncology, with various methods available to generate a synth... [more] Background and purpose: Magnetic resonance imaging (MRI)-only treatment planning is gaining in popularity in radiation oncology, with various methods available to generate a synthetic computed tomography (sCT) for this purpose. The aim of this study was to validate a sCT generation software for MRI-only radiotherapy planning of male and female pelvic cancers. The secondary aim of this study was to improve dose agreement by applying a derived relative electron and mass density (RED) curve to the sCT. Method and materials: Computed tomography (CT) and MRI scans of forty patients with pelvic neoplasms were used in the study. Treatment plans were copied from the CT scan to the sCT scan for dose comparison. Dose difference at reference point, 3D gamma comparison and dose volume histogram analysis was used to validate the dose impact of the sCT. The RED values were optimised to improve dose agreement by using a linear plot. Results: The average percentage dose difference at isocentre was 1.2% and the mean 3D gamma comparison with a criteria of 1%/1 mm was 84.0% ± 9.7%. The results indicate an inherent systematic difference in the dosimetry of the sCT plans, deriving from the tissue densities. With the adapted REDmod table, the average percentage dose difference was reduced to -0.1% and the mean 3D gamma analysis improved to 92.9% ± 5.7% at 1%/1 mm. Conclusions: CT generation software is a viable solution for MRI-only radiotherapy planning. The option makes it relatively easy for departments to implement a MRI-only planning workflow for cancers of male and female pelvic anatomy.
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2021 |
Richardson M, Skehan K, Wilton L, Sams J, Samuels J, Goodwin J, et al., 'Visualising the urethra for prostate radiotherapy planning', Journal of Medical Radiation Sciences, 68 282-288 (2021) [C1] Introduction: The prostatic urethra is an organ at risk for prostate radiotherapy with genitourinary toxicities a common side effect. Many external beam radiation therapy protocol... [more] Introduction: The prostatic urethra is an organ at risk for prostate radiotherapy with genitourinary toxicities a common side effect. Many external beam radiation therapy protocols call for urethral sparing, and with modulated radiotherapy techniques, the radiation dose distribution can be controlled so that maximum doses do not fall within the prostatic urethral volume. Whilst traditional diagnostic MRI sequences provide excellent delineation of the prostate, uncertainty often remains as to the true path of the urethra within the gland. This study aims to assess if a high-resolution isotropic 3D T2 MRI series can reduce inter-observer variability in urethral delineation for radiotherapy planning. Methods: Five independent observers contoured the prostatic urethra for ten patients on three data sets; a 2¿mm axial CT, a diagnostic 3¿mm axial T2 TSE MRI and a 0.9¿mm isotropic 3D T2 SPACE MRI. The observers were blinded from each other¿s contours. A Dice Similarity Coefficient (DSC) score was calculated using the intersection and union of the five observer contours vs an expert reference contour for each data set. Results: The mean DSC of the observer vs reference contours was 0.47 for CT, 0.62 for T2 TSE and 0.78 for T2 SPACE (P¿<¿0.001). Conclusions: The introduction of a 0.9¿mm isotropic 3D T2 SPACE MRI for treatment planning provides improved urethral visualisation and can lead to a significant reduction in inter-observer variation in prostatic urethral contouring.
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2020 |
Kneebone A, Fraser-Browne C, Duchesne GM, Fisher R, Frydenberg M, Herschtal A, et al., 'Adjuvant radiotherapy versus early salvage radiotherapy following radical prostatectomy (TROG 08.03/ANZUP RAVES): a randomised, controlled, phase 3, non-inferiority trial', The Lancet Oncology, 21 1331-1340 (2020) [C1]
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2020 |
Handmer M, Martin J, Tiu A, 'Costing Urologic Complications Following Pelvic Radiation Therapy.', Urology, 140 64-69 (2020) [C1]
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2020 |
Barbour AP, Walpole ET, Mai GT, Barnes EH, Watson DI, Ackland SP, et al., 'Preoperative cisplatin, fluorouracil, and docetaxel with or without radiotherapy after poor early response to cisplatin and fluorouracil for resectable oesophageal adenocarcinoma (AGITG DOCTOR): results from a multicentre, randomised controlled phase II trial', Annals of Oncology, 31 236-245 (2020) [C1] Background: Patients with oesophageal/gastro-oesophageal junction adenocarcinoma (EAC) not showing early metabolic response (EMR) to chemotherapy have poorer survival and histolog... [more] Background: Patients with oesophageal/gastro-oesophageal junction adenocarcinoma (EAC) not showing early metabolic response (EMR) to chemotherapy have poorer survival and histological response rates <5%. We investigated whether tailoring neoadjuvant therapy can improve outcomes in these patients. Patients and methods: Patients with resectable EAC were enrolled and randomised into two single-arm, multicentre phase II trials. After induction cisplatin and 5-fluorouracil (CF), all were assessed by day 15 positron emission tomography (PET). Patients with an EMR [maximum standardised uptake values (SUVmax) =35% reduction from baseline to day 15 PET] received a second CF cycle then oesophagectomy. Non-responders were randomised 1: 1 to two cycles of CF and docetaxel (DCF, n = 31) or DCF + 45 Gy radiotherapy (DCFRT, n = 35) then oesophagectomy. The primary end point was major histological response (<10% residual tumour) in the oesophagectomy specimen; secondary end points were overall survival (OS), progression-free survival (PFS), and locoregional recurrence (LR). Results: Of 124 patients recruited, major histological response was achieved in 3/45 (7%) with EMR, 6/30 (20%) DCF, and 22/35 (63%) DCFRT patients. Grade 3/4 toxicities occurred in 12/45 (27%) EMR (CF), 13/31 (42%) DCF, and 25/35 (71%) DCFRT patients. No treatment-related deaths occurred. LR by 3 years was seen in 5/45 (11%) EMR, 10/31 (32%) DCF, and 4/35 (11%) DCFRT patients. PFS [95% confidence interval (CI)] at 36 months was 47% (31% to 61%) for EMR, 29% (15% to 45%) for DCF, and 46% (29% to 61%) for DCFRT patients. OS (95% CI) at 60 months was 53% (37% to 67%) for EMR, 31% (16% to 48%) for DCF, and 46% (29% to 61%) for DCFRT patients. Conclusions: EMR is associated with favourable OS, PFS, and low LR. For non-responders, the addition of docetaxel augmented histological response rates, but OS, PFS, and LR remained inferior compared with responders. DCFRT improved histological response and PFS/LR outcomes, matching the EMR group. Early PET/CT has the potential to tailor therapy for patients not showing an early response to chemotherapy. Trial registration: ACTRN12609000665235.
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2020 |
Keall P, Nguyen DT, O'Brien R, Hewson E, Ball H, Poulsen P, et al., 'Real-Time Image Guided Ablative Prostate Cancer Radiation Therapy: Results From the TROG 15.01 SPARK Trial', International Journal of Radiation Oncology Biology Physics, 107 530-538 (2020) [C1] Purpose: Kilovoltage intrafraction monitoring (KIM) is a novel software platform implemented on standard radiation therapy systems and enabling real-time image guided radiation th... [more] Purpose: Kilovoltage intrafraction monitoring (KIM) is a novel software platform implemented on standard radiation therapy systems and enabling real-time image guided radiation therapy (IGRT). In a multi-institutional prospective trial, we investigated whether real-time IGRT improved the accuracy of the dose patients with prostate cancer received during radiation therapy. Methods and Materials: Forty-eight patients with prostate cancer were treated with KIM-guided SABR with 36.25 Gy in 5 fractions. During KIM-guided treatment, the prostate motion was corrected for by either beam gating with couch shifts or multileaf collimator tracking. A dose reconstruction method was used to evaluate the dose delivered to the target and organs at risk with and without real-time IGRT. Primary outcome was the effect of real-time IGRT on dose distributions. Secondary outcomes included patient-reported outcomes and toxicity. Results: Motion correction occurred in =1 treatment for 88% of patients (42 of 48) and 51% of treatments (121 of 235). With real-time IGRT, no treatments had prostate clinical target volume (CTV) D98% dose 5% less than planned. Without real-time IGRT, 13 treatments (5.5%) had prostate CTV D98% doses 5% less than planned. The prostate CTV D98% dose with real-time IGRT was closer to the plan by an average of 1.0% (range, ¿2.8% to 20.3%). Patient outcomes showed no change in the 12-month patient-reported outcomes compared with baseline and no grade =3 genitourinary or gastrointestinal toxicities. Conclusions: Real-time IGRT is clinically effective for prostate cancer SABR.
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2020 |
Jones M, Hruby G, Coolens C, Driscoll B, Stanwell P, Kumar M, et al., 'A prospective, multi-centre trial of multi-parametric MRI as a biomarker in anal carcinoma', RADIOTHERAPY AND ONCOLOGY, 144 7-12 (2020) [C1]
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2020 |
Hofman MS, Lawrentschuk N, Francis RJ, Tang C, Vela I, Thomas P, et al., 'Prostate-specific membrane antigen PET-CT in patients with high-risk prostate cancer before curative-intent surgery or radiotherapy (proPSMA): a prospective, randomised, multicentre study', LANCET, 395 1208-1216 (2020) [C1]
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2019 |
Greer P, Martin J, Sidhom M, Hunter P, Pichler P, Choi JH, et al., 'A Multi-center Prospective Study for Implementation of an MRI-Only Prostate Treatment Planning Workflow', FRONTIERS IN ONCOLOGY, 9 (2019) [C1]
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2019 |
Jones MP, Hruby G, Metser U, Sridharan S, Capp A, Kumar M, et al., 'FDG-PET parameters predict for recurrence in anal cancer - results from a prospective, multicentre clinical trial', RADIATION ONCOLOGY, 14 (2019) [C1]
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2019 |
De Leon J, Jameson MG, Rivest-henault D, Keats S, Rai R, Arumugam S, et al., 'Reduced motion and improved rectal dosimetry through endorectal immobilization for prostate stereotactic body radiotherapy', BRITISH JOURNAL OF RADIOLOGY, 92 (2019) [C1]
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2019 |
Hewson EA, Nguyen DT, O Brien R, Kim JH, Montanaro T, Moodie T, et al., 'The accuracy and precision of the KIM motion monitoring system used in the multi-institutional TROG 15.01 Stereotactic Prostate Ablative Radiotherapy with KIM (SPARK) trial', Medical Physics, 46 4725-4737 (2019) [C1] Purpose: Kilovoltage intrafraction monitoring (KIM) allows for real-time image guidance for tracking tumor motion in six-degrees-of-freedom (6DoF) on a standard linear accelerator... [more] Purpose: Kilovoltage intrafraction monitoring (KIM) allows for real-time image guidance for tracking tumor motion in six-degrees-of-freedom (6DoF) on a standard linear accelerator. This study assessed the geometric accuracy and precision of KIM used to guide patient treatments in the TROG 15.01 multi-institutional Stereotactic Prostate Ablative Radiotherapy¿with KIM trial and investigated factors affecting accuracy and precision. Methods: Fractions from 44 patients with prostate cancer treated using KIM-guided SBRT were analyzed across four institutions, on two different linear accelerator models and two different beam models (6 MV¿and 10¿MV FFF). The geometric accuracy and precision of KIM was assessed from over 33¿000¿images (translation) and over 9000 images (rotation) by comparing the real-time measured motion to retrospective kV/MV triangulation. Factors potentially affecting accuracy, including contrast-to-noise ratio (CNR) of kV images and incorrect marker segmentation, were also investigated. Results: The geometric accuracy and precision did not depend on treatment institution, beam model or motion magnitude, but was correlated with gantry angle. The centroid geometric accuracy and precision of the KIM system for SABR prostate treatments was 0.0¿±¿0.5, 0.0¿±¿0.4 and 0.1¿±¿0.3¿mm for translation, and¿-0.1¿±¿0.6°, -0.1¿±¿1.4° and¿-0.1¿±¿1.0° for rotation in the AP, LR and SI directions respectively. Centroid geometric error exceeded 2¿mm for 0.05% of this dataset. No significant relationship was found between large geometric error and CNR or marker segmentation correlation. Conclusions: This study demonstrated the ability of KIM to locate the prostate with accuracy below other uncertainties in radiotherapy treatments, and the feasibility for KIM to be implemented across multiple institutions.
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2019 |
Bandara V, Capp A, Ahmed G, Arm J, Martin J, 'Assessment and predictors of fatigue in men with prostate cancer receiving radiotherapy and androgen deprivation therapy.', Journal of medical imaging and radiation oncology, 63 683-690 (2019) [C1]
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2019 |
Pryor D, Sidhom M, Arumugam S, Bucci J, Gallagher S, Smart J, et al., 'Phase 2 Multicenter Study of Gantry-Based Stereotactic Radiotherapy Boost for Intermediate and High Risk Prostate Cancer (PROMETHEUS)', FRONTIERS IN ONCOLOGY, 9 (2019) [C1]
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2018 |
Hanlon MC, Ludbrook J, Jovanovic K, Greer P, Martin JM, 'Fostering a culture of research within a clinical radiation oncology department', Journal of Medical Imaging and Radiation Oncology, 62 102-108 (2018) [C1] Introduction: Support and investment in increasing a research-active culture in clinical practice needs to be translated at the department and hospital levels as well as regional,... [more] Introduction: Support and investment in increasing a research-active culture in clinical practice needs to be translated at the department and hospital levels as well as regional, state and national levels. We aimed to improve the research culture of our department, to enable more clinical staff to become more research competent and research active. Methods: We describe and discuss the appointment of a Director of Research and a Research Coordinator into our already-research-active department and the interactions at the research¿clinical interface. By identifying barriers and instituting enablers which ameliorate their effect, we explore how a clinical department can utilize the resources already available with the goal of developing a more confident and competent clinician-researcher culture as measured by a range of research metrics. Results: We observed an improved research culture within our department. Our department's improved research culture was reflected by increased numbers of peer-reviewed publications (of 30%), research students/supervisions (of 60%) and engagement of external speakers. We also observed double the number of first-authored peer-reviewed articles and a growth in conference presentations, posters and speaker invitations/awards. In the majority of the research performance metrics tracked, there was a steady improvement noted over the four years monitored. Conclusions: By responding to the barriers of staff (such as time, expertise and ideas) with structural and personal enablers, as well as funded resources, it is possible to develop research capacity and confidence in a clinical setting.
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2018 |
Pryor DI, Turner SL, Tai KH, Tang C, Sasso G, Dreosti M, et al., 'Moderate hypofractionation for prostate cancer: A user's guide', Journal of Medical Imaging and Radiation Oncology, 62 232-239 (2018) [C1] Three large randomised controlled trials have been published in the last year demonstrating the non-inferiority of moderate hypofractionation compared to conventional fractionatio... [more] Three large randomised controlled trials have been published in the last year demonstrating the non-inferiority of moderate hypofractionation compared to conventional fractionation for localised prostate cancer with respect to both disease control and late toxicity at 5¿years. Furthermore, no clinically significant differences in patient-reported outcomes have emerged. More mature follow-up data are now also available from phase 2 studies confirming that moderate hypofractionation is associated with low rates of significant toxicity at 10¿years. Moving forward it is likely that appropriate patient selection, integration of androgen deprivation and attention to optimising technique will play a more important role than modest differences in dose-fractionation schedules. Here we briefly review the evidence, discuss issues of patient selection and provide an approach to implementing moderately hypofractionated radiation therapy for prostate cancer in clinical practice.
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2018 |
Catton CN, Lukka H, Martin J, 'Prostate cancer radiotherapy: An evolving paradigm', Journal of Clinical Oncology, 36 2909-2913 (2018) [C1] A urologist referred a 69-year-old man for a radiotherapy opinion regarding a recently diagnosed adenocarcinoma of the prostate. Annual serum prostate-specific antigen (PSA) testi... [more] A urologist referred a 69-year-old man for a radiotherapy opinion regarding a recently diagnosed adenocarcinoma of the prostate. Annual serum prostate-specific antigen (PSA) testing over 7 years demonstrated a rise in PSA from 1.36 ng/mL to 5.8 ng/mL, prompting a transrectal ultrasound that revealed a heterogeneous 37-mL gland containing no visualized hypoechoic nodules. Biopsy disclosed a Gleason score 314 (grade group 2) adenocarcinoma of the prostate. The synoptic report stated that six of 14 cores and 17% of the tissue were involved, with the greatest core involvement being 80% at the right apex. Perineural invasion was present without lymphovascular invasion. Disease was present bilaterally at the base, midgland, and apex.His medical history was significant only for treated peptic ulcer disease and he was taking no medication. His International Prostate Symptom Score was six of 35, and he reported being sexually active with good erectile function. There was no family history of prostate cancer. He is retired. Digital rectal examination revealed moderate benign prostatic hypertrophy with no suspicious nodules. A staging computerized tomography (CT) scan of the abdomen and pelvis and a whole-body bone scan ordered by his referring urologist reported no evidence of metastatic disease. The patient had discussed surgical options with his urologist and now wished to consider radiotherapy approaches.
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2018 |
Rutledge AB, McLeod N, Mehan N, Regan TW, Ainsworth P, Chong P, et al., 'A clinician-centred programme for behaviour change in the optimal use of staging investigations for newly diagnosed prostate cancer', BJU International, 121 22-27 (2018) [C1] Objectives: To improve imaging utilisation and reduce the widespread overuse of staging investigations, in the form of computed tomography (CT) and whole-body bone scans for men w... [more] Objectives: To improve imaging utilisation and reduce the widespread overuse of staging investigations, in the form of computed tomography (CT) and whole-body bone scans for men with newly diagnosed prostate cancer in the Hunter region of NSW, Australia, by implementation of a multifaceted clinician-centred behaviour change programme. Patients and Methods: Records of all patients with a new diagnosis of prostate cancer were reviewed prior to the intervention (July 2014 to July 2015), and the results of this audit were presented to participating urologists by a clinical champion. Urologists then underwent focused education based on current guidelines. Patterns of imaging use for staging were then re-evaluated (November 2015 to July 2016). Patients were stratified into low-, intermediate- and high-risk groups as described by the D'Amico classification system. Results: A total of 144 patients were retrospectively enrolled into the study cohort. The use of diagnostic imaging for staging purposes significantly decreased in men with low- and intermediate-risk disease post intervention. In low-risk patients, the use of CT decreased from 43% to 0% (P = 0.01). A total of 21% of patients underwent bone scans in the pre-intervention group compared with18% in the post-intervention group (P = 0.84). In intermediate-risk patients, the use of CT decreased from 89% to 34% (P < 0.001), whilst the use of bone scan decreased from 63% to 37% (P = 0.02). In high-risk patients, the appropriate use of imaging was maintained, with CT performed in 87% compared with 85% and bone scan in 87% compared with 65% (P = 0.07). Conclusion: Our results show that a focused, clinician-centred education programme can lead to improved guideline adherence at a regional level. The assessment of trends and application of such a programme at a state-based or national level could be further assessed in the future with the help of registry data. This will be particularly important in future with the advent of advanced imaging, such as prostate-specific membrane antigen positron-emission tomography.
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2018 |
Jones MP, Martin J, Foo K, Estoesta P, Holloway L, Jameson M, 'The impact of contour variation on tumour control probability in anal cancer', Radiation Oncology, 13 1-7 (2018) [C1]
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2018 |
Martin JM, Supiot S, Keall PJ, Catton CN, 'Moderately hypofractionated prostate external-beam radiotherapy: an emerging standard.', The British journal of radiology, 91 20170807 (2018) [C1]
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2018 |
Day FL, Sherwood E, Chen TY, Barbouttis M, Varlow M, Martin J, et al., 'Oncologist provision of smoking cessation support: A national survey of Australian medical and radiation oncologists', Asia-Pacific Journal of Clinical Oncology, 14 431-438 (2018) [C1] Aim: Continued smoking in patients diagnosed with cancer affects treatment outcomes and overall survival. With national surveys of Australian medical oncologists (MO) and radiatio... [more] Aim: Continued smoking in patients diagnosed with cancer affects treatment outcomes and overall survival. With national surveys of Australian medical oncologists (MO) and radiation oncologists (RO) we sought to determine current clinical practices, preferences and barriers in providing patient smoking cessation support. Methods: Oncologist members of the Medical Oncology Group of Australia (n¿=¿452) and Trans-Tasman Radiation Oncology Group (n¿=¿230) were invited to participate in a multiple choice survey exploring smoking cessation practices and beliefs. Results: The survey response rate was 43%. At first consultations more than 90% of MO and RO regularly asked patients if they smoke or use tobacco products, closely followed by documentation of duration of smoking history and current level of consumption. Less common was asking the patient if they intended to quit (MO 63%, RO 53%) and advising cessation (MO 70%, RO 72%). Less than 50% of oncologists regularly asked about current smoking in follow-up consultations. Although a range of referral options for smoking cessation care were used by oncologists, only 2% of MO and 3% of RO actively managed the patients¿ smoking cessation themselves and this was the least preferred option. The majority believed they require more training in cessation interventions (67% MO, 57% RO) and cited multiple additional barriers to providing cessation care. Conclusions: Oncologists strongly prefer smoking cessation interventions to be managed by other health workers. A collaborative approach with other health professionals is needed to aid the provision of comprehensive smoking cessation care tailored to patients with cancer.
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2017 |
Gupta SK, Watson T, Denham J, Shakespeare TP, Rutherford N, McLeod N, et al., 'Prostate-Specific Membrane Antigen Positron Emission Tomography Computed Tomography for Prostate Cancer: Distribution of Disease and Implications for Radiation Therapy Planning', International Journal of Radiation Oncology Biology Physics, 99 701-709 (2017) [C1] Purpose To explore the prostate-specific membrane antigen (PSMA)¿avid distribution of prostate cancer (PC) on positron emission tomography (PET), both at the time of initial diagn... [more] Purpose To explore the prostate-specific membrane antigen (PSMA)¿avid distribution of prostate cancer (PC) on positron emission tomography (PET), both at the time of initial diagnosis and at the time of relapse after definitive local treatment. Methods and Materials A total of 179 PSMA PET scans in patients with nil or =3 lesions on conventional imaging were retrospectively categorized into 3 subgroups: group A, high-risk PC with no prior definitive therapy (n=34); group B, prior prostatectomy (n=75); and group C, prior radiation therapy (n=70). The numbers and locations of the PSMA-avid lesions were mapped. The PSMA-positive lesions were identified subjectively by a nuclear medicine physician on the basis of clinical experience and taking into account the recent literature and artefacts. Results A total of 893 PSMA-avid lesions were identified; at least 1 lesion was detected in 80% of all scans. A high detection rate was present even at very low serum PSA levels (eg, at PSA =0.20 ng/mL in group B, the detection rate was 46%). Thirty-eight percent of studies revealed extrapelvic disease (41%, 31%, and 46% in groups A, B, and C, respectively). Almost one-third of all studies showed only oligometastases (24%, 36%, and 31% in groups A, B, and C, respectively). A large proportion of these (40%) were a solitary lesion. Conclusions Prostate-specific membrane antigen PET demonstrated a large number of otherwise unknown metastatic lesions. Therefore we recommend PSMA PET for more accurate assessment of disease burden in initial staging of high-risk PC, as well as for restaging in patients with prostate-specific antigen relapse after primary therapies. Furthermore, a high proportion of oligometastases on PSMA PET provides a prime opportunity to investigate the role of targeted local therapies for oligometastatic PCs.
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2017 |
Wilton L, Richardson M, Keats S, Legge K, Hanlon MC, Arumugam S, et al., 'Rectal protection in prostate stereotactic radiotherapy: a retrospective exploratory analysis of two rectal displacement devices', Journal of Medical Radiation Sciences, 64 266-273 (2017) [C1] Introduction: High rectal doses are associated with increased toxicity. A rectal displacement device (RDD) reduces rectal dose in prostate stereotactic body radiation therapy (SBR... [more] Introduction: High rectal doses are associated with increased toxicity. A rectal displacement device (RDD) reduces rectal dose in prostate stereotactic body radiation therapy (SBRT). This study investigates any dosimetric difference between two methods of rectal displacement (Rectafix and SpaceOAR) for prostate SBRT. Methods: Rectal dosimetry of 45 men who received SBRT within the PROMETHEUS trial was retrospectively examined, across two radiation therapy centres using the two RDD's. Men received a total dose (TD) of 19 or 20 Gy in two fractions followed by 46 Gy in 23 fractions. Centre 1 contributed 16 Rectafix and 10 SpaceOAR patients. Centre 2 contributed 19 Rectafix patients. Rectal dose volume histogram (DVH) data were recorded as a TD percentage at the following volume intervals; V1%, V2%, V5%, V10% and then 10% increments to V80%. As only one centre employed both RDD's, three sequential rectal dosimetry comparisons were performed; (1) centre 1 Rectafix versus centre 1 SpaceOAR; (2) centre 1 Rectafix versus centre 2 Rectafix and (3) centre 1+ centre 2 Rectafix versus centre 1 SpaceOAR. Results: In comparison (1) Rectafix demonstrated lower mean doses at 9 out of 11 measured intervals (P = 0.0012). Comparison (2) demonstrated a moderate difference with centre 2 plans producing slightly lower rectal doses (P = 0.013). Comparison (3) further demonstrated that Rectafix returned lower mean doses than SpaceOAR (P < 0.001). Although all dose levels were in favour of Rectafix, in absolute terms differences were small (2.6¿9.0%). Conclusions: In well-selected prostate SBRT patients, Rectafix and SpaceOAR RDD's provide approximately equivalent rectal sparing.
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2017 |
Catton CN, Lukka H, Gu CS, Martin JM, Supiot S, Chung PWM, et al., 'Randomized trial of a hypofractionated radiation regimen for the treatment of localized prostate cancer', Journal of Clinical Oncology, 35 1884-1890 (2017) [C1] Purpose: Men with localized prostate cancer often are treated with external radiotherapy (RT) over 8 to 9 weeks. Hypofractionated RT is given over a shorter time with larger doses... [more] Purpose: Men with localized prostate cancer often are treated with external radiotherapy (RT) over 8 to 9 weeks. Hypofractionated RT is given over a shorter time with larger doses per treatment than standard RT. We hypothesized that hypofractionation versus conventional fractionation is similar in efficacy without increased toxicity. Patients and Methods: We conducted a multicenter randomized noninferiority trial in intermediate-risk prostate cancer (T1 to 2a, Gleason score # 6, and prostate-specific antigen [PSA] 10.1 to 20 ng/mL; T2b to 2c, Gleason # 6, and PSA # 20 ng/mL; or T1 to 2, Gleason = 7, and PSA # 20 ng/mL). Patients were allocated to conventional RT of 78 Gy in 39 fractions over 8 weeks or to hypofractionated RT of 60 Gy in 20 fractions over 4 weeks. Androgen deprivation was not permitted with therapy. The primary outcome was biochemical-clinical failure (BCF) defined by any of the following: PSA failure (nadir + 2), hormonal intervention, clinical local or distant failure, or death as a result of prostate cancer. The noninferiority margin was 7.5% (hazard ratio,, 1.32). Results: Median follow-up was 6.0 years. One hundred nine of 608 patients in the hypofractionated arm versus 117 of 598 in the standard arm experienced BCF. Most of the events were PSA failures. The 5-year BCF disease-free survival was 85% in both arms (hazard ratio [short v standard], 0.96; 90% CI, 0.77 to 1.2). Ten deaths as a result of prostate cancer occurred in the short arm and 12 in the standard arm. No significant differences were detected between arms for grade = 3 late genitourinary and GI toxicity. Conclusion: The hypofractionated RT regimen used in this trial was not inferior to conventional RT and was not associated with increased late toxicity. Hypofractionated RT is more convenient for patients and should be considered for intermediate-risk prostate cancer.
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2017 |
Ghose S, Greer PB, Sun J, Pichler P, Rivest-Henault D, Mitra J, et al., 'Regression and statistical shape model based substitute CT generation for MRI alone external beam radiation therapy from standard clinical MRI sequences.', Phys Med Biol, 62 8566-8580 (2017) [C1]
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2017 |
Legge K, Nguyen D, Ng JA, Wilton L, Richardson M, Booth J, et al., 'Real-time intrafraction prostate motion during linac based stereotactic radiotherapy with rectal displacement.', Journal of applied clinical medical physics, 18 130-136 (2017) [C1]
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2017 |
Nguyen DT, O'Brien R, Kim J-H, Huang C-Y, Wilton L, Greer P, et al., 'The first clinical implementation of a real-time six degree of freedom target tracking system during radiation therapy based on Kilovoltage Intrafraction Monitoring (KIM)', RADIOTHERAPY AND ONCOLOGY, 123 37-42 (2017) [C1]
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2017 |
Martin J, Arm J, Smart J, Palazzi K, Capp A, Ainsworth P, Cowin G, 'Spinal multiparametric MRI and DEXA changes over time in men with prostate cancer treated with androgen deprivation therapy: a potential imaging biomarker of treatment toxicity', European Radiology, 27 995-1003 (2017) [C1] Objectives: To explore changes in bone mineral density (BMD) measured by DEXA and MRS fat fraction (FF), Dixon FF, and ADC in lower spinal vertebral bodies in men with prostate ca... [more] Objectives: To explore changes in bone mineral density (BMD) measured by DEXA and MRS fat fraction (FF), Dixon FF, and ADC in lower spinal vertebral bodies in men with prostate cancer treated with androgen deprivation therapy (ADT). Methods: Twenty-eight men were enrolled onto a clinical trial. All received ADT. DEXA imaging was performed at baseline and 12¿months. L-spine MRI was done at baseline and 6¿months. Results: The number of patients who underwent DEXA, Dixon, ADC, and MRS at baseline/follow-up were 28/27, 28/26, 28/26, and 22/20. An increase in FF was observed from T11 to S2 (average 1¿%/vertebra). There was a positive correlation between baseline MRS FF and Dixon FF (r = 0.85, p < 0.0001) and a negative correlation between MRS FF and ADC (r = -0.56, p = 0.036). Over 6¿months, MRS FF increased by a median of 25¿% in relative values (p = 0.0003), Dixon FF increased (p < 0.0001) and ADC values decreased (p = 0.0014). Men with >5¿% BMD loss after 1¿year had triple the percentage increase in MRS FF at 6¿months (61.1¿% vs. 20.9¿%, p = 0.19). Conclusions: Changes are observed on L-spine MRI after 6¿months of ADT. Further investigation is warranted of MRS change as a potential predictive biomarker for later BMD loss. Key Points: ¿ Spinal marrow fat fraction increases after 6¿months of androgen deprivation therapy. ¿ More inferior vertebral bodies tend to have higher fat fractions. ¿ MRS fat fraction changes were associated with later changes in DEXA BMD.
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2017 |
Legge K, Greer PB, Keall PJ, Booth JT, Arumugam S, Moodie T, et al., 'Technical note: TROG 15.01 SPARK trial multi-institutional imaging dose measurement', Journal of Applied Clinical Medical Physics, 18 358-363 (2017) [C1]
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2017 |
Legge K, Greer PB, O'Connor DJ, Wilton L, Richardson M, Hunter P, et al., 'Real-time in vivo rectal wall dosimetry using MOSkin detectors during linac based stereotactic radiotherapy with rectal displacement', RADIATION ONCOLOGY, 12 (2017) [C1]
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2017 |
Jones MP, Carroll S, Martin J, Hillman R, Grulich A, O Connell D, et al., 'Management of early anal cancer: need for guidelines and standardisation', International Journal of Colorectal Disease, 32 1719-1724 (2017) [C1] Purpose: The optimal management of early squamous cell carcinoma of the anal canal (AC) is yet to be determined. This study investigated current practice in the management of earl... [more] Purpose: The optimal management of early squamous cell carcinoma of the anal canal (AC) is yet to be determined. This study investigated current practice in the management of early AC. Methods: A patterns of care survey was completed by Australian surgeons and radiation oncologists. Specific topics addressed were as follows: geographical location of practice, staging of disease, treatment approaches to T1N0 tumours and grade 3 anal intra-epithelial neoplasia (AIN3) lesions, radiotherapy planning, toxicities, follow-up and clinical trial involvement. Results: Sixty-four responses were obtained. For the management of T1N0 disease, half the respondents recommended standard dose chemo-radiotherapy (CRT) and one third recommended wide local excision (WLE). For the management of AIN3, half recommended WLE while a quarter advocated observation. Conclusions: This study reveals a significant variation in the management of early AC. The development of guidelines specific to the treatment of early AC could standardise treatment while further research is required to define the optimal management of T1N0 AC and AIN.
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2017 |
Forshaw K, Hall AE, Boyes AW, Carey ML, Martin J, 'Patients' experiences of preparation for radiation therapy: A qualitative study', Oncology Nursing Forum, 44 E1-E9 (2017) [C1] Purpose/Objectives: To explore patients' experiences of and preferences for preparation for radiation therapy. Research Approach: Qualitative study. Participants: 26 individu... [more] Purpose/Objectives: To explore patients' experiences of and preferences for preparation for radiation therapy. Research Approach: Qualitative study. Participants: 26 individuals who recently received radiation therapy for cancer. Setting: One Australian radiation oncology clinic located within a tertiary referral hospital in New South Wales. Methodologic Approach: Semistructured interviews were conducted and analyzed based on a qualitative descriptive approach and content analysis of the transcribed interviews. Findings: Four main themes related to preparation techniques were identified: (a) psychological preparation (frame of mind, downward comparison, coping mechanisms, and reassurance); (b) information preparation (format, content, and knowledge from patients' own or others' experiences); (c) quality of health care; and (d) social support. Two themes related to outcomes of preparation were identified: feeling psychologically prepared and knowing what to expect. Overall, participants' accounts of preparation for radiation therapy revealed that provision of information was satisfactory. Some participants would have liked more information and support primarily in relation to side effects and the practicalities of what would happen during treatment. Conclusions: The information gained in this study indicates what strategies may best prepare patients for radiation therapy. Interpretation: Providing patients with information that creates a realistic expectation of what radiation therapy involves both before and after treatment seems particularly important in helping them feel prepared.
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2016 |
Chandra SS, Dowling JA, Greer PB, Martin J, Wratten C, Pichler P, et al., 'Fast automated segmentation of multiple objects via spatially weighted shape learning', Physics in Medicine and Biology, 61 8070-8084 (2016) [C1] Active shape models (ASMs) have proved successful in automatic segmentation by using shape and appearance priors in a number of areas such as prostate segmentation, where accurate... [more] Active shape models (ASMs) have proved successful in automatic segmentation by using shape and appearance priors in a number of areas such as prostate segmentation, where accurate contouring is important in treatment planning for prostate cancer. The ASM approach however, is heavily reliant on a good initialisation for achieving high segmentation quality. This initialisation often requires algorithms with high computational complexity, such as three dimensional (3D) image registration. In this work, we present a fast, self-initialised ASM approach that simultaneously fits multiple objects hierarchically controlled by spatially weighted shape learning. Prominent objects are targeted initially and spatial weights are progressively adjusted so that the next (more difficult, less visible) object is simultaneously initialised using a series of weighted shape models. The scheme was validated and compared to a multi-atlas approach on 3D magnetic resonance (MR) images of 38 cancer patients and had the same (mean, median, inter-rater) Dice's similarity coefficients of (0.79, 0.81, 0.85), while having no registration error and a computational time of 12-15 min, nearly an order of magnitude faster than the multi-atlas approach.
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2016 |
Barbour A, Walpole E, Mai GT, Chan H, Barnes E, Watson D, et al., 'An AGITG trial A randomised phase II study of pre-operative cisplatin, fluorouracil and DOCetaxel +/-radioTherapy based on poOR early response to cisplatin and fluorouracil for resectable esophageal adenocarcinoma', Annals of Oncology, 27 vi207 (2016)
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2015 |
Schmidt C, Martin JM, Khoo E, Plank A, Grigg R, 'Outcomes of nodal metastatic cutaneous squamous cell carcinoma of the head and neck treated in a regional center', HEAD AND NECK-JOURNAL FOR THE SCIENCES AND SPECIALTIES OF THE HEAD AND NECK, 37 1808-1815 (2015) [C1]
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2015 |
Loh J, Baker K, Sridharan S, Greer P, Wratten C, Capp A, et al., 'Infections after fiducial marker implantation for prostate radiotherapy: are we underestimating the risks?', RADIATION ONCOLOGY, 10 (2015) [C1]
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2015 |
Dowling JA, Sun J, Pichler P, Rivest-Hénault D, Ghose S, Richardson H, et al., 'Automatic substitute computed tomography generation and contouring for magnetic resonance imaging (MRI)-alone external beam radiation therapy from standard MRI sequences', International Journal of Radiation Oncology Biology Physics, 93 1144-1153 (2015) [C1] Purpose To validate automatic substitute computed tomography CT (sCT) scans generated from standard T2-weighted (T2w) magnetic resonance (MR) pelvic scans for MR-Sim prostate trea... [more] Purpose To validate automatic substitute computed tomography CT (sCT) scans generated from standard T2-weighted (T2w) magnetic resonance (MR) pelvic scans for MR-Sim prostate treatment planning. Patients and Methods A Siemens Skyra 3T MR imaging (MRI) scanner with laser bridge, flat couch, and pelvic coil mounts was used to scan 39 patients scheduled for external beam radiation therapy for localized prostate cancer. For sCT generation a whole-pelvis MRI scan (1.6 mm 3-dimensional isotropic T2w SPACE [Sampling Perfection with Application optimized Contrasts using different flip angle Evolution] sequence) was acquired. Three additional small field of view scans were acquired: T2w, T2*w, and T1w flip angle 80° for gold fiducials. Patients received a routine planning CT scan. Manual contouring of the prostate, rectum, bladder, and bones was performed independently on the CT and MR scans. Three experienced observers contoured each organ on MRI, allowing interobserver quantification. To generate a training database, each patient CT scan was coregistered to their whole-pelvis T2w using symmetric rigid registration and structure-guided deformable registration. A new multi-atlas local weighted voting method was used to generate automatic contours and sCT results. Results The mean error in Hounsfield units between the sCT and corresponding patient CT (within the body contour) was 0.6 ± 14.7 (mean ± 1 SD), with a mean absolute error of 40.5 ± 8.2 Hounsfield units. Automatic contouring results were very close to the expert interobserver level (Dice similarity coefficient): prostate 0.80 ± 0.08, bladder 0.86 ± 0.12, rectum 0.84 ± 0.06, bones 0.91 ± 0.03, and body 1.00 ± 0.003. The change in monitor units between the sCT-based plans relative to the gold standard CT plan for the same dose prescription was found to be 0.3% ± 0.8%. The 3-dimensional ¿ pass rate was 1.00 ± 0.00 (2 mm/2%). Conclusions The MR-Sim setup and automatic sCT generation methods using standard MR sequences generates realistic contours and electron densities for prostate cancer radiation therapy dose planning and digitally reconstructed radiograph generation.
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2015 |
Trada Y, Kneebone A, Paneghel A, Pearse M, Sidhom M, Tang C, et al., 'Optimizing radiation therapy quality assurance in clinical trials: A TROG 08.03 RAVES substudy', International Journal of Radiation Oncology Biology Physics, 93 1045-1051 (2015) [C1] Purpose To explore site- and clinician-level factors associated with protocol violations requiring real-time-review (RTR) resubmission in a multicenter clinical trial to help tail... [more] Purpose To explore site- and clinician-level factors associated with protocol violations requiring real-time-review (RTR) resubmission in a multicenter clinical trial to help tailor future quality assurance (QA) protocols. Methods and Materials RAVES (Radiation Therapy-Adjuvant vs Early Salvage) (Trans-Tasman Radiation Oncology Group 08.03) is a randomized trial comparing adjuvant with early salvage radiation therapy in men with positive surgical margins or pT3 disease after prostatectomy. Quality assurance in RAVES required each clinician and site to submit a credentialing dummy run (DR) and for each patient's radiation therapy plan to undergo external RTR before treatment. Prospectively defined major violations from trial protocol required remedy and resubmission. Site and clinician factors associated with RTR resubmission were examined using hierarchical modeling. Results Data were collected from 171 consecutive patients, treated by 46 clinicians at 32 hospitals. There were 47 RTR resubmissions (27%) due to 65 major violations. The relative rate of resubmission decreased by 29% per year as the study progressed (odds ratio OR. 0.71, P=.02). The majority of resubmissions were due to contouring violations (39 of 65) and dosimetric violations (22 of 65). For each additional patient accrued, significant decreases in RTR resubmission were seen at both clinician level (OR 0.75, P=.02) and site level (OR 0.72, P=.01). The rate of resubmission due to dosimetric violations was only 1.6% after the first 5 patients. Use of IMRT was associated with lower rates of resubmission compared with 3-dimensional conformal radiation therapy (OR 0.38, P=.05). Conclusion Several low- and high-risk factors that may assist with tailoring future clinical trial QA were identified. Because the real-time resubmission rate was largely independent of the credentialing exercise, some form of RTR QA is recommended. The greatest benefit from QA was derived early in trial activation and clinician experience.
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2015 |
Jones M, Hruby G, Stanwell P, Gallagher S, Wong K, Arm J, Martin J, 'Multiparametric MRI as an outcome predictor for anal canal cancer managed with chemoradiotherapy.', BMC Cancer, 15 281 (2015) [C3]
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2015 |
Sun J, Dowling JA, Pichler P, Parker J, Martin J, Stanwell P, et al., 'Investigation on the performance of dedicated radiotherapy positioning devices for MR scanning for prostate planning', Journal of Applied Clinical Medical Physics, 16 4-13 (2015) [C1] The purpose of this study was to investigate performance of the couch and coil mounts designed for MR-simulation prostate scanning using data from ten volunteers. Volunteers were ... [more] The purpose of this study was to investigate performance of the couch and coil mounts designed for MR-simulation prostate scanning using data from ten volunteers. Volunteers were scanned using the standard MR scanning protocol with the MR coil directly strapped on the external body and the volunteer lying on the original scanner table. They also were scanned using a MR-simulation table top and pelvic coil mounts. MR images from both setups were compared in terms of body contour variation and image quality effects within particular organs of interest. Six-field conformal plans were generated on the two images with assigned bulk density for dose calculation. With the MR-simulation devices, the anterior skin deformation was reduced by up to 1.7 cm. The hard tabletop minimizes the posterior body deformation which can be up to 2.3 cm on the standard table, depending on the weight of volunteer. The image signal-to-noise ratio reduced by 14% and 25% on large field of view (FOV) and small FOV images, respectively, after using the coil mount; the prostate volume contoured on two images showed difference of 1.05 ± 0.66 cm3. The external body deformation caused a mean dose reduction of 0.6 ± 0.3 Gy, while the coverage reduced by 22% ± 13% and 27% ± 6% in V
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2015 |
Sun J, Dowling J, Pichler P, Menk F, Rivest-Henault D, Lambert J, et al., 'MRI simulation: End-to-end testing for prostate radiation therapy using geometric pelvic MRI phantoms', Physics in Medicine and Biology, 60 3097-3109 (2015) [C1] To clinically implement MRI simulation or MRI-alone treatment planning requires comprehensive end-to-end testing to ensure an accurate process. The purpose of this study was to de... [more] To clinically implement MRI simulation or MRI-alone treatment planning requires comprehensive end-to-end testing to ensure an accurate process. The purpose of this study was to design and build a geometric phantom simulating a human male pelvis that is suitable for both CT and MRI scanning and use it to test geometric and dosimetric aspects of MRI simulation including treatment planning and digitally reconstructed radiograph (DRR) generation. A liquid filled pelvic shaped phantom with simulated pelvic organs was scanned in a 3T MRI simulator with dedicated radiotherapy couch-top, laser bridge and pelvic coil mounts. A second phantom with the same external shape but with an internal distortion grid was used to quantify the distortion of the MR image. Both phantoms were also CT scanned as the gold-standard for both geometry and dosimetry. Deformable image registration was used to quantify the MR distortion. Dose comparison was made using a seven-field IMRT plan developed on the CT scan with the fluences copied to the MR image and recalculated using bulk electron densities. Without correction the maximum distortion of the MR compared with the CT scan was 7.5 mm across the pelvis, while this was reduced to 2.6 and 1.7 mm by the vendor's 2D and 3D correction algorithms, respectively. Within the locations of the internal organs of interest, the distortion was <1.5 and <1 mm with 2D and 3D correction algorithms, respectively. The dose at the prostate isocentre calculated on CT and MRI images differed by 0.01% (1.1 cGy). Positioning shifts were within 1 mm when setup was performed using MRI generated DRRs compared to setup using CT DRRs. The MRI pelvic phantom allows end-to-end testing of the MRI simulation workflow with comparison to the gold-standard CT based process. MRI simulation was found to be geometrically accurate with organ dimensions, dose distributions and DRR based setup within acceptable limits compared to CT.
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2015 |
Wu R, Woodford H, Capp A, Hunter P, Cowin G, Tai KH, et al., 'A prospective study of nomogram-based adaptation of prostate radiotherapy target volumes', Radiation Oncology, 10 (2015) [C1] Background: A prospective clinical trial was conducted to evaluate the feasibility of a novel approach to the treatment of patients with high risk prostate cancer (HRPC) through t... [more] Background: A prospective clinical trial was conducted to evaluate the feasibility of a novel approach to the treatment of patients with high risk prostate cancer (HRPC) through the use of a nomogram to tailor radiotherapy target volumes. Methods: Twenty seven subjects with HRPC were treated with a mildly hypofractionated radiotherapy regimen using image-guided IMRT technique between Jun/2013-Jan/2015. A set of validated prognostic factors were inputted into the Memorial-Sloan-Kettering Cancer Center (MSKCC) prostate cancer nomogram to estimate risk of loco-regional spread (LRS). The nomogram risk estimates for extra-capsular extension (ECE), seminal vesicles involvement (SVI), and pelvic lymph nodes involvement (LNI) were used to adapt radiotherapy treatment volumes based on a risk threshold of =15% in all cases. A planning guide was used to delineate target volumes and organs at risk (OAR). Up to three dose levels were administered over 28 fractions; 70Gy for gross disease in the prostate +/- seminal vesicles (2.5Gy/fraction), 61.6Gy for subclinical peri-prostatic disease (2.2Gy/fraction) and 50.4Gy to pelvic nodes (1.8Gy/fraction). Data regarding protocol adherence, nomogram use, radiotherapy dose distribution, and acute toxicity were collected. Results: Nomogram use 100% of patients were treated for ECE, 88.9% for SVI, and 70.4% for LNI. The three areas at risk of LRS were appropriately treated according to the study protocol in 98.8% cases. The MSKCC nomogram estimates for LRS differed significantly between the time of recruitment and analysis. Contouring protocol compliance Compliance with the trial contouring protocol for up to seven target volumes was 93.0% (159/171). Compliance with protocol for small bowel contouring was poor (59.3%). Dose constraints compliance Compliance with dose constraints for target volumes was 97.4% (191/196). Compliance with dose constraints for OAR was 88.2% (285/323). Acute toxicity There were no grade 3 acute toxicities observed. 20/27 (74.1%) and 6/27 (22.2%) patients experienced a grade 2 genitourinary and gastrointestinal toxicity respectively. Conclusions: We have demonstrated the feasibility of this novel risk-adapted radiation treatment protocol for HRPC. This study has identified key learning points regarding this approach, including the importance of standardization and updating of risk quantification tools, and the utility of an observer to verify their correct use. Trial registration: ClincialTrials.gov identifier NCT01418040. Hunter New England Human Research Ethics Committee (HNEHREC) reference number 12/08/15/4.02
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2015 |
Jones M, Hruby G, Solomon M, Rutherford N, Martin J, 'The Role of FDG-PET in the Initial Staging and Response Assessment of Anal Cancer: A Systematic Review and Meta-analysis', ANNALS OF SURGICAL ONCOLOGY, 22 3574-3581 (2015) [C1]
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2014 |
Loh J, Jovanovic L, Lehman M, Capp A, Pryor D, Harris M, et al., 'Circulating tumor cell detection in high-risk non-metastatic prostate cancer', Journal of Cancer Research and Clinical Oncology, 140 2157-2162 (2014) [C1] Results: The median age was 70¿years, median PSA was 14.1, and the median Gleason score was 9. The median 5-year risk of progression of disease using a validated nomogram was 39¿%... [more] Results: The median age was 70¿years, median PSA was 14.1, and the median Gleason score was 9. The median 5-year risk of progression of disease using a validated nomogram was 39¿%. Five out of 36 patients (14¿%, 95¿% CI 5¿30¿%) had CTCs detected in their circulation. Four patients had only 1 CTC per 7.5¿mL of blood detected. One patient had 3 CTCs per 7.5¿mL of blood detected, which included a circulating tumor microemboli. Both on univariate analysis and multivariate analysis, there were no correlations found between CTC positivity and the classic prognostic factors including PSA, Gleason score, T-stage and age.
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2014 |
Lehman M, Sidhom M, Kneebone AB, Hayden AJ, Martin JM, Christie D, et al., 'FROGG high-risk prostate cancer workshop: Patterns of practice and literature review. Part II post-radical prostatectomy', Journal of Medical Imaging and Radiation Oncology, 58 392-400 (2014) [C1] Australian and New Zealand radiation oncologists with an interest in uro-oncology were invited to undertake a pattern of practice survey dealing with issues encountered in the man... [more] Australian and New Zealand radiation oncologists with an interest in uro-oncology were invited to undertake a pattern of practice survey dealing with issues encountered in the management of high-risk prostate cancer in the post-prostatectomy setting. Responses from practitioners revealed a lack of consensus regarding the optimal timing of radiation therapy the use of whole pelvic radiation therapy and the use of androgen deprivation therapy. A review of the literature outlining the current body of knowledge and the clinical studies that will inform future practice is presented. © 2013 The Royal Australian and New Zealand College of Radiologists.
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2014 |
Loh J, Davis ID, Martin JM, Siva S, 'Extracranial oligometastatic renal cell carcinoma: current management and future directions', FUTURE ONCOLOGY, 10 761-774 (2014) [C1]
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2014 |
Ratnayake G, Martin J, Plank A, Wong W, 'Incremental changes verses a technological quantum leap: The additional value of intensity-modulated radiotherapy beyond image-guided radiotherapy for prostate irradiation', JOURNAL OF MEDICAL IMAGING AND RADIATION ONCOLOGY, 58 503-510 (2014) [C1]
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2014 |
Robson K, Alizart M, Martin J, Nagel R, 'Coeliac Patients Are Undiagnosed at Routine Upper Endoscopy', PLOS ONE, 9 (2014) [C1]
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2014 |
Lehman M, Hayden AJ, Martin JM, Christie D, Kneebone AB, Sidhom M, et al., 'FROGG high-risk prostate cancer workshop: Patterns of practice and literature review: Part I: Intact prostate', Journal of Medical Imaging and Radiation Oncology, 58 257-265 (2014) [C1] Australian and New Zealand radiation oncologists with an interest in uro-oncology were invited to participate in a pattern-of-practice survey dealing with the management of intact... [more] Australian and New Zealand radiation oncologists with an interest in uro-oncology were invited to participate in a pattern-of-practice survey dealing with the management of intact high-risk prostate cancer. Responses from 46 practitioners (representing 73% of all potential respondents) revealed that high-dose radiation therapy is the standard of care. However, there is variability in practice with regard to the methods used to achieve dose escalation, the use of whole-pelvic radiation therapy and the optimal duration of androgen deprivation therapy employed. A review of the literature outlining the current body of knowledge and the planned and ongoing studies in intact high-risk prostate cancer is presented. © 2013 The Authors. Journal of Medical Imaging and Radiation Oncology published by Wiley Publishing Asia Pty Ltd on behalf of Royal Australian and New Zealand College of Radiologists.
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2013 |
Izard MA, Morris LM, Wan W-Y, Martin J, 'Long-term outcome for prostate cancer using pseudo pulse-dosed rate brachytherapy, external beam radiotherapy, and hormones', BRACHYTHERAPY, 12 608-614 (2013) [C1]
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2013 |
Supiot S, Crehange G, Latorzeff I, Pommier P, Paumier A, Rio E, et al., 'Hypofractionated radiotherapy in prostate cancer', CANCER RADIOTHERAPIE, 17 349-354 (2013)
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2013 |
Grimison P, Houghton B, Chatfield M, Toner GC, Davis ID, Martin J, et al., 'Patterns of management and surveillance imaging amongst medical oncologists in Australia for stage i testicular cancer', BJU International, 112 (2013) [C1]
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Show 136 more journal articles |
Conference (48 outputs)
Year | Citation | Altmetrics | Link | |||||
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2023 | Niazi T, McBride SM, Williams S, Davis ID, Stockler MR, Martin AJ, et al., 'DASL-HiCaP: A randomized, phase 3, double-blind trial of darolutamide with androgen-deprivation therapy and definitive or salvage radiation for localized very high-risk prostate cancer.', JOURNAL OF CLINICAL ONCOLOGY, ELECTR NETWORK (2023) | |||||||
2023 | Day F, Sridharan S, Michael M, Christophersen L, Moore MM, Eastgate MA, et al., 'Chemoradiotherapy with concurrent durvalumab for the palliative treatment of oligometastatic esophageal and gastroesophageal carcinoma with dysphagia: A single arm phase 2 clinical trial, PALEO', JOURNAL OF CLINICAL ONCOLOGY, IL, Chicago (2023) | |||||||
2023 | Lange M, Ollivier L, Renouf M, Magne N, Latorzeff I, Pommier P, et al., 'Pattern of relapse following hypofractionated radiotherapy of IR prostate cancer in the PROFIT trial', RADIOTHERAPY AND ONCOLOGY, AUSTRIA, Vienna (2023) | |||||||
2023 | Hofman M, Kasivisvanathan V, Link E, Lawrentschuk N, O'Brien J, Buteau JP, et al., 'Baseline PSMA PET-CT is prognostic for treatment failure in men with intermediate-to-high risk prostate cancer: 54 months follow-up of the proPSMA randomised trial', EUROPEAN JOURNAL OF NUCLEAR MEDICINE AND MOLECULAR IMAGING, AUSTRIA, Vienna (2023) | |||||||
2017 |
Keall P, Booth J, Nguyen DT, O'Brien R, Poulsen PR, Caillet V, et al., 'The First Clinical Implementation of Real-time Adaptive Radiation Therapy Using a Standard Linear Accelerator', INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS, San Diego, CA (2017)
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Show 45 more conferences |
Thesis / Dissertation (1 outputs)
Year | Citation | Altmetrics | Link | ||
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2016 |
Martin JM, Imaging and Radiotherapy in Prostate Cancer: Advances in Biomarkers and Treatment, University of Queensland (2016)
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Grants and Funding
Summary
Number of grants | 24 |
---|---|
Total funding | $6,840,107 |
Click on a grant title below to expand the full details for that specific grant.
20211 grants / $24,642
The PALEO Clinical Trial in Oesophageal Cancer$24,642
Funding body: Hunter Medical Research Institute
Funding body | Hunter Medical Research Institute |
---|---|
Project Team | Conjoint Associate Professor Fiona Day, Conjoint Professor Jarad Martin |
Scheme | Research Grant |
Role | Investigator |
Funding Start | 2021 |
Funding Finish | 2021 |
GNo | G2101129 |
Type Of Funding | C3300 – Aust Philanthropy |
Category | 3300 |
UON | Y |
20171 grants / $612,967
Improving patient safety in radiation therapy with the Watchdog real-time treatment delivery verification system$612,967
Funding body: NHMRC (National Health & Medical Research Council)
Funding body | NHMRC (National Health & Medical Research Council) |
---|---|
Project Team | Conjoint Professor Peter Greer, Emeritus Professor Rick Middleton, Conjoint Professor Jarad Martin, Dr Jeremy Booth, Dr Dale Lovelock, Dr Andrew Kneebone, Dr Boyd McCurdy |
Scheme | Project Grant |
Role | Investigator |
Funding Start | 2017 |
Funding Finish | 2020 |
GNo | G1600453 |
Type Of Funding | C1100 - Aust Competitive - NHMRC |
Category | 1100 |
UON | Y |
20163 grants / $3,941,667
Improving and maintaining holistic cancer survivor outcomes: A system-based program$2,234,525
Funding body: Cancer Council NSW
Funding body | Cancer Council NSW |
---|---|
Scheme | Project Grant |
Role | Investigator |
Funding Start | 2016 |
Funding Finish | 2020 |
GNo | |
Type Of Funding | Other Public Sector - State |
Category | 2OPS |
UON | N |
A prospective multicentre study of the impact of Ga-68 PSMA-PET/CT imaging in the management of prostate cancer (proPSMA study)$1,272,142
Funding body: Prostate Cancer Foundation of Australia
Funding body | Prostate Cancer Foundation of Australia |
---|---|
Scheme | Project Grant |
Role | Investigator |
Funding Start | 2016 |
Funding Finish | 2019 |
GNo | |
Type Of Funding | Aust Competitive - Non Commonwealth |
Category | 1NS |
UON | N |
A multistage multi centre international randomised trial of Conventional care Or Radioablation (stereotactic body radiotherapy) for Extra-cranial oligometastatic disease in lung, breast and prostate cancer (CORE).$435,000
Funding body: Cancer Australia
Funding body | Cancer Australia |
---|---|
Scheme | Priority-driven Collaborative Cancer Research Scheme |
Role | Investigator |
Funding Start | 2016 |
Funding Finish | 2018 |
GNo | |
Type Of Funding | Other Public Sector - Commonwealth |
Category | 2OPC |
UON | N |
20151 grants / $20,000
Neurotrophic growth factors as biomarkers and therapeutic targets in prostate cancer$20,000
Funding body: Hunter Cancer Research Alliance
Funding body | Hunter Cancer Research Alliance |
---|---|
Scheme | Biomarkers and Targeted Therapies Flagship Program: Pilot Project Grant |
Role | Investigator |
Funding Start | 2015 |
Funding Finish | 2016 |
GNo | |
Type Of Funding | Internal |
Category | INTE |
UON | N |
20144 grants / $640,000
SPARK: Stereotactic Prostate Adaptive Radiotherapy utilising Kilovoltage intrafraction monitoring$581,000
Funding body: Cancer Australia
Funding body | Cancer Australia |
---|---|
Scheme | Project Grant |
Role | Investigator |
Funding Start | 2014 |
Funding Finish | 2017 |
GNo | |
Type Of Funding | Not Known |
Category | UNKN |
UON | N |
Prostate Cancer: A new protein for improving diagnosis, prognosis and treatment$20,000
Funding body: Hunter Medical Research Institute (HMRI)
Funding body | Hunter Medical Research Institute (HMRI) |
---|---|
Scheme | Project Grant |
Role | Investigator |
Funding Start | 2014 |
Funding Finish | 2014 |
GNo | |
Type Of Funding | Grant - Aust Non Government |
Category | 3AFG |
UON | N |
Multiparametric MRI for Response Assessment of Anal Canal Squamous Cell Carcinoma$20,000
Funding body: Royal Australian and New Zealand College of Radiologists
Funding body | Royal Australian and New Zealand College of Radiologists |
---|---|
Scheme | Project grant |
Role | Investigator |
Funding Start | 2014 |
Funding Finish | 2015 |
GNo | |
Type Of Funding | Not Known |
Category | UNKN |
UON | N |
A prospective study of MRI based prostate treatment planning$19,000
Funding body: Calvary Mater Newcastle
Funding body | Calvary Mater Newcastle |
---|---|
Scheme | Jane Reid Harle Memorial Fund |
Role | Investigator |
Funding Start | 2014 |
Funding Finish | 2015 |
GNo | |
Type Of Funding | Not Known |
Category | UNKN |
UON | N |
20131 grants / $105,771
Advanced Radiation Oncology Clinical Trials: A Remotely Accessible Solution for Treatment Plan Review$105,771
Funding body: Cancer Instititue NSW
Funding body | Cancer Instititue NSW |
---|---|
Scheme | Research Equipment Grant |
Role | Lead |
Funding Start | 2013 |
Funding Finish | 2013 |
GNo | |
Type Of Funding | Other Public Sector - State |
Category | 2OPS |
UON | N |
20124 grants / $540,000
Enhancing Coordination of Complex Collaborative Clinical Trials in NSW: A TROG Initiative$300,000
Funding body: Cancer Instititue NSW
Funding body | Cancer Instititue NSW |
---|---|
Scheme | Cooperative Clinical Trials |
Role | Lead |
Funding Start | 2012 |
Funding Finish | 2012 |
GNo | |
Type Of Funding | Other Public Sector - State |
Category | 2OPS |
UON | N |
Safety and Quality IMRT Treatment Delivery Accuracy$200,000
Funding body: American Society for Therapeutic Radiation Oncology
Funding body | American Society for Therapeutic Radiation Oncology |
---|---|
Scheme | Research Grant |
Role | Investigator |
Funding Start | 2012 |
Funding Finish | 2013 |
GNo | |
Type Of Funding | Not Known |
Category | UNKN |
UON | N |
Multiparametric MRI for Response Assessment of Anal Canal Squamous Cell Carcinoma$20,000
Funding body: Hunter Translational Cancer Research Unit
Funding body | Hunter Translational Cancer Research Unit |
---|---|
Scheme | Seed Funding |
Role | Investigator |
Funding Start | 2012 |
Funding Finish | 2012 |
GNo | |
Type Of Funding | Internal |
Category | INTE |
UON | N |
Real Time Verification of Dynamic Radiotherapy$20,000
Funding body: Hunter Translational Cancer Research Unit
Funding body | Hunter Translational Cancer Research Unit |
---|---|
Scheme | Seed Funding |
Role | Investigator |
Funding Start | 2012 |
Funding Finish | 2012 |
GNo | |
Type Of Funding | Internal |
Category | INTE |
UON | N |
20112 grants / $158,800
Exploring Androgen Deprivation Therapy derived osteopaenia through MRI quantification of marrow, fat and bone composition$80,000
Funding body: Abbott Australasia Pty Ltd
Funding body | Abbott Australasia Pty Ltd |
---|---|
Scheme | Research Grant |
Role | Lead |
Funding Start | 2011 |
Funding Finish | 2011 |
GNo | |
Type Of Funding | Grant - Aust Non Government |
Category | 3AFG |
UON | N |
Gonadotrophin Releasing Hormone agonists and the metabolic syndrome – Pathophysiology and mitigation in a rat model$78,800
Funding body: Abbott Australasia Pty Ltd
Funding body | Abbott Australasia Pty Ltd |
---|---|
Scheme | Research Grant |
Role | Lead |
Funding Start | 2011 |
Funding Finish | 2011 |
GNo | |
Type Of Funding | Grant - Aust Non Government |
Category | 3AFG |
UON | N |
20091 grants / $176,260
Monitoring tumour Movement during Radiotherapy by 4D Ultrasound Imaging$176,260
Funding body: Cancer Australia
Funding body | Cancer Australia |
---|---|
Project Team | Christian Langton, QUT |
Scheme | Project Grant |
Role | Investigator |
Funding Start | 2009 |
Funding Finish | 2011 |
GNo | |
Type Of Funding | Not Known |
Category | UNKN |
UON | N |
20082 grants / $451,000
Phase III trial 'PROFIT: Prostate Fractionated Irradiation'$435,500
Funding body: Cancer Australia
Funding body | Cancer Australia |
---|---|
Scheme | Infrastructure support for clinical trials program |
Role | Lead |
Funding Start | 2008 |
Funding Finish | 2008 |
GNo | |
Type Of Funding | Aust Competitive - Commonwealth |
Category | 1CS |
UON | N |
PROFIT$15,500
Funding body: Queensland Clinical Oncology Group
Funding body | Queensland Clinical Oncology Group |
---|---|
Scheme | Research Grant |
Role | Lead |
Funding Start | 2008 |
Funding Finish | 2008 |
GNo | |
Type Of Funding | Grant - Aust Non Government |
Category | 3AFG |
UON | N |
20073 grants / $140,000
Phase III trial 'PROFIT: Prostate Fractionated Irradiation'$100,000
Funding body: Prostate Cancer Foundation of Australia
Funding body | Prostate Cancer Foundation of Australia |
---|---|
Scheme | Project Grant |
Role | Lead |
Funding Start | 2007 |
Funding Finish | 2007 |
GNo | |
Type Of Funding | Not Known |
Category | UNKN |
UON | N |
Phase III trial 'PROFIT: Prostate Fractionated Irradiation'$20,000
Funding body: Trans-Tasman Radiation Oncology Group
Funding body | Trans-Tasman Radiation Oncology Group |
---|---|
Scheme | Project grant |
Role | Lead |
Funding Start | 2007 |
Funding Finish | 2007 |
GNo | |
Type Of Funding | Not Known |
Category | UNKN |
UON | N |
FLT-PET for patients with Head and Neck Squamous Cell Carcinoma managed with chemoradiotherapy (CRT)$20,000
Funding body: Royal Brisbane and Women's Hospital
Funding body | Royal Brisbane and Women's Hospital |
---|---|
Scheme | Project Grant & New Investigator Grant |
Role | Lead |
Funding Start | 2007 |
Funding Finish | 2007 |
GNo | |
Type Of Funding | Not Known |
Category | UNKN |
UON | N |
20041 grants / $29,000
Phase II trial of whole abdominal radiotherapy for platinum resistant recurrent ovarian carcinoma$29,000
Funding body: Merck Medical School Grant
Funding body | Merck Medical School Grant |
---|---|
Scheme | Merck Medical School Grant |
Role | Lead |
Funding Start | 2004 |
Funding Finish | 2004 |
GNo | |
Type Of Funding | Not Known |
Category | UNKN |
UON | N |
Research Supervision
Number of supervisions
Current Supervision
Commenced | Level of Study | Research Title | Program | Supervisor Type |
---|---|---|---|---|
2022 | PhD | Development And Application Of Virtual HDR Boost Radiotherapy In Prostate Cancer | PhD (Medicine), College of Health, Medicine and Wellbeing, The University of Newcastle | Principal Supervisor |
Past Supervision
Year | Level of Study | Research Title | Program | Supervisor Type |
---|---|---|---|---|
2023 | PhD | Magnetic Resonance Imaging (MRI) only Radiation Therapy Treatment Planning for Complex Pelvic Cancers | PhD (Medical Radiation Sc), College of Health, Medicine and Wellbeing, The University of Newcastle | Co-Supervisor |
2021 | PhD | Anal Cancer: Radiotherapy and Imaging Biomarkers | PhD (Medicine), College of Health, Medicine and Wellbeing, The University of Newcastle | Principal Supervisor |
2017 | PhD | Hypofractionated Prostate Treatments: Dose, Motion Monitoring and Credentialling | PhD (Physics), College of Engineering, Science and Environment, The University of Newcastle | Co-Supervisor |
Research Collaborations
The map is a representation of a researchers co-authorship with collaborators across the globe. The map displays the number of publications against a country, where there is at least one co-author based in that country. Data is sourced from the University of Newcastle research publication management system (NURO) and may not fully represent the authors complete body of work.
Country | Count of Publications | |
---|---|---|
Australia | 180 | |
Canada | 37 | |
United Kingdom | 20 | |
Denmark | 14 | |
United States | 13 | |
More... |
Conjoint Professor Jarad Martin
Position
Conjoint Professor
School of Medicine and Public Health
College of Health, Medicine and Wellbeing
Contact Details
jarad.martin@newcastle.edu.au | |
Links |
Google+ Research Networks |
Office
Room | . |
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