2023 |
Cicchetti A, Fiorino C, Ebert MA, Iacovacci J, Kennedy A, Joseph DJ, et al., 'Validation of prediction models for radiation-induced late rectal bleeding: Evidence from a large pooled population of prostate cancer patients', RADIOTHERAPY AND ONCOLOGY, 183 (2023) [C1]
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Nova |
2022 |
Kishan AU, Wang X, Sun Y, Romero T, Michalski JM, Ma TM, et al., 'High-dose Radiotherapy or Androgen Deprivation Therapy (HEAT) as Treatment Intensification for Localized Prostate Cancer: An Individual Patient-data Network Meta-analysis from the MARCAP Consortium.', Eur Urol, 82 106-114 (2022) [C1]
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Nova |
2022 |
Kishan AU, Steigler A, Denham JW, Zapatero A, Guerrero A, Joseph D, et al., 'Interplay Between Duration of Androgen Deprivation Therapy and External Beam Radiotherapy With or Without a Brachytherapy Boost for Optimal Treatment of High-risk Prostate Cancer A Patient-Level Data Analysis of 3 Cohorts', JAMA ONCOLOGY, 8 (2022) [C1]
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Nova |
2022 |
Delahunt B, Steigler A, Atkinson C, Christie D, Duchesne G, Egevad L, et al., 'Percentage grade 4 tumour predicts outcome for prostate adenocarcinoma in needle biopsies from patients with advanced disease: 10-year data from the TROG 03.04 RADAR trial', Pathology, 54 49-54 (2022) [C1]
Previous reports have shown that quantification of high tumour grade is of prognostic significance for patients with prostate cancer. In particular, percent Gleason pattern 4 (GP4... [more]
Previous reports have shown that quantification of high tumour grade is of prognostic significance for patients with prostate cancer. In particular, percent Gleason pattern 4 (GP4) has been shown to predict outcome in several studies, although conflicting results have also been reported. A major issue with these studies is that they rely on surrogate markers of outcome rather than patient survival. We have investigated the prognostic predictive value of quantifying GP4 in a series of prostatic biopsies containing Gleason score 3+4=7 and 4+3=7 tumours. It was found that the length of GP4 tumour determined from the measurement of all biopsy cores from a single patient, percent GP4 present and absolute GP4 were all significantly associated with distant progression of tumour, all-cause mortality and cancer-specific mortality over a 10-year follow-up period. Assessment of the relative prognostic significance showed that these parameters outperformed division of cases according to Gleason score (3+4=7 versus 4+3=7). International Society of Urological Pathology (ISUP) Grade Groups currently divide these tumours, according to Gleason grading guidelines, into grade 2 (3+4=7) and grade 3 (4+3=7). Our results indicate that this simple classification results in the loss of important prognostic information. In view of this we would recommend that ISUP Grade Groups 2 and 3 be amalgamated as grade 2 tumour with the percentage of GP4 carcinoma being appended to the final grade, e.g., 3+4=7 carcinoma with 40% pattern 4 tumour would be classified as ISUP Grade Group 2 (40%).
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Nova |
2022 |
Kishan AU, Sun Y, Hartman H, Pisansky TM, Bolla M, Neven A, et al., 'Androgen deprivation therapy use and duration with definitive radiotherapy for localised prostate cancer: an individual patient data meta-analysis', The Lancet Oncology, 23 304-316 (2022) [C1]
Background: Randomised trials have investigated various androgen deprivation therapy (ADT) intensification strategies in men receiving radiotherapy for the treatment of prostate c... [more]
Background: Randomised trials have investigated various androgen deprivation therapy (ADT) intensification strategies in men receiving radiotherapy for the treatment of prostate cancer. This individual patient data meta-analysis of relevant randomised trials aimed to quantify the benefit of these interventions in aggregate and in clinically relevant subgroups. Methods: For this meta-analysis, we performed a systematic literature search in MEDLINE, Embase, trial registries, the Web of Science, Scopus, and conference proceedings to identify trials with results published in English between Jan 1, 1962, and Dec 30, 2020. Multicentre randomised trials were eligible if they evaluated the use or prolongation of ADT (or both) in men with localised prostate cancer receiving definitive radiotherapy, reported or collected distant metastasis and survival data, and used ADT for a protocol-defined finite duration. The Meta-Analysis of Randomized trials in Cancer of the Prostate (MARCAP) Consortium was accessed to obtain individual patient data from randomised trials. The primary outcome was metastasis-free survival. Hazard ratios (HRs) were obtained through stratified Cox models for ADT use (radiotherapy alone vs radiotherapy plus ADT), neoadjuvant ADT extension (ie, extension of total ADT duration in the neoadjuvant setting from 3¿4 months to 6¿9 months), and adjuvant ADT prolongation (ie, prolongation of total ADT duration in the adjuvant setting from 4¿6 months to 18¿36 months). Formal interaction tests between interventions and metastasis-free survival were done for prespecified subgroups defined by age, National Comprehensive Cancer Network (NCCN) risk group, and radiotherapy dose. This meta-analysis is registered with PROSPERO, CRD42021236855. Findings: Our search returned 12 eligible trials that provided individual patient data (10 853 patients) with a median follow-up of 11·4 years (IQR 9·0¿15·0). The addition of ADT to radiotherapy significantly improved metastasis-free survival (HR 0·83 [95% CI 0·77¿0·89], p<0·0001), as did adjuvant ADT prolongation (0·84 [0·78¿0·91], p<0·0001), but neoadjuvant ADT extension did not (0·95 [0·83¿1·09], p=0·50). Treatment effects were similar irrespective of radiotherapy dose, patient age, or NCCN risk group. Interpretation: Our findings provide the strongest level of evidence so far to the magnitude of the benefit of ADT treatment intensification with radiotherapy for men with localised prostate cancer. Adding ADT and prolonging the portion of ADT that follows radiotherapy is associated with improved metastasis-free survival in men, regardless of risk group, age, and radiotherapy dose delivered; however, the magnitude of the benefit could vary and shared decision making with patients is recommended. Funding: University Hospitals Seidman Cancer Center, Prostate Cancer Foundation, and the American Society for Radiation Oncology.
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Nova |
2022 |
Ma TM, Chu F-I, Sandler H, Feng FY, Efstathiou JA, Jones CU, et al., 'Local Failure Events in Prostate Cancer Treated with Radiotherapy: A Pooled Analysis of 18 Randomized Trials from the Meta-analysis of Randomized Trials in Cancer of the Prostate Consortium (LEVIATHAN).', Eur Urol, 82 487-498 (2022) [C1]
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Nova |
2021 |
McGovern JA, Bock N, Shafiee A, Martine LC, Wagner F, Baldwin JG, et al., 'A humanized orthotopic tumor microenvironment alters the bone metastatic tropism of prostate cancer cells', COMMUNICATIONS BIOLOGY, 4 (2021) [C1]
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Nova |
2021 |
D Amico AV, Xie W, McMahon E, Loffredo M, Medeiros S, Joseph D, et al., 'Radiation and Androgen Deprivation Therapy With or Without Docetaxel in the Management of Nonmetastatic Unfavorable-Risk Prostate Cancer: A Prospective Randomized Trial', Journal of Clinical Oncology, 39 2938-2947 (2021) [C1]
PURPOSE Although docetaxel is not recommended when managing men with unfavorable-risk prostate cancer (PC) given negative or inconclusive results from previous randomized trials, ... [more]
PURPOSE Although docetaxel is not recommended when managing men with unfavorable-risk prostate cancer (PC) given negative or inconclusive results from previous randomized trials, unstudied benefits may exist. METHODS Between September 21, 2005, and January 13, 2015, we randomly assigned 350 men 1:1 with T1c-4N0M0 unfavorable-risk PC to receive radiation therapy (RT) and androgen deprivation therapy (ADT) plus docetaxel (60 mg/m2 once every 3 weeks for three cycles before RT and 20 mg/m2 once weekly during RT) versus ADT 1 RT. We evaluated the treatment effect of adding docetaxel to ADT 1 RT on the primary end point of overall survival (OS) and the incidence of RT-induced cancers and explored whether the impact of the treatment effect on OS differed within prostate-specific antigen (PSA) subgroups (, 4, . 20 v 4-20 ng/mL) using the interaction test for heterogeneity adjusted for age and PC prognostic factors. RESULTS After a median follow-up of 10.2 years, 89 men died (25.43%); of these, 42 from PC (47.19%). Although OS was not significantly increased in the docetaxel arm (the restricted mean survival time over 10 years was 9.11 v 8.82 years; P 5 .22), significantly fewer RT-induced cancers were observed (10-year estimates: 0.61% v 4.90%; age-adjusted hazard ratio of 0.13; 95% CI, 0.02 to 0.97; P 5 .046). The treatment effect of adding docetaxel to ADT 1 RT on OS significantly differed in men with a PSA, 4 ng/mL versus 4-20 ng/mL (adjusted hazard ratio: 0.27 and 1.51, respectively) because of less PC-specific mortality on the docetaxel arm (0.00% v 28.57%) among men with PSA, 4 ng/mL. CONCLUSION Adding docetaxel to ADT 1 RT did not prolong OS in men with unfavorable-risk PC, but decreased RT-induced cancer incidence, and may prolong OS in the subgroup of men with a PSA, 4 ng/mL by reducing PC-specific mortality.
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2021 |
Ferdoushi A, Griffin N, Marsland M, Xu X, Faulkner S, Gao F, et al., 'Tumor innervation and clinical outcome in pancreatic cancer', SCIENTIFIC REPORTS, 11 (2021) [C1]
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Nova |
2021 |
Kishan AU, Sun Y, Pisansky TM, Bolla M, Steigler A, Denham JW, et al., 'Individual Patient Data Meta-Analysis of Randomized Trials in Cancer of the Prostate (MARCAP) Consortium: Impact of Androgen Deprivation Therapy Use and Duration With Definitive Radiotherapy for Localized Prostate Cancer', INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS, 111 S5-S6 (2021)
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2021 |
Kishan AU, Romero T, Wang X, Pisansky TM, Roach M, Bolla M, et al., 'Impact of High DosE rAdioTherapy (HEAT) in Localized Prostate Cancer: An Individual Patient Data (IPD) Meta-Analysis of 15 Randomized Trials', INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS, 111 S78-S79 (2021)
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2021 |
Petit C, Lacas B, Pignon JP, Le QT, Grégoire V, Grau C, et al., 'Chemotherapy and radiotherapy in locally advanced head and neck cancer: an individual patient data network meta-analysis', The Lancet Oncology, 22 727-736 (2021) [C1]
Background: Randomised, controlled trials and meta-analyses have shown the survival benefit of concomitant chemoradiotherapy or hyperfractionated radiotherapy in the treatment of ... [more]
Background: Randomised, controlled trials and meta-analyses have shown the survival benefit of concomitant chemoradiotherapy or hyperfractionated radiotherapy in the treatment of locally advanced head and neck cancer. However, the relative efficacy of these treatments is unknown. We aimed to determine whether one treatment was superior to the other. Methods: We did a frequentist network meta-analysis based on individual patient data of meta-analyses evaluating the role of chemotherapy (Meta-Analysis of Chemotherapy in Head and Neck Cancer [MACH-NC]) and of altered fractionation radiotherapy (Meta-Analysis of Radiotherapy in Carcinomas of Head and Neck [MARCH]). Randomised, controlled trials that enrolled patients with non-metastatic head and neck squamous cell cancer between Jan 1, 1980, and Dec 31, 2016, were included. We used a two-step random-effects approach, and the log-rank test, stratified by trial to compare treatments, with locoregional therapy as the reference. Overall survival was the primary endpoint. The global Cochran Q statistic was used to assess homogeneity and consistency and P score to rank treatments (higher scores indicate more effective therapies). Findings: 115 randomised, controlled trials, which enrolled patients between Jan 1, 1980, and April 30, 2012, yielded 154 comparisons (28 978 patients with 19 253 deaths and 20 579 progression events). Treatments were grouped into 16 modalities, for which 35 types of direct comparisons were available. Median follow-up based on all trials was 6·6 years (IQR 5·0¿9·4). Hyperfractionated radiotherapy with concomitant chemotherapy (HFCRT) was ranked as the best treatment for overall survival (P score 97%; hazard ratio 0·63 [95% CI 0·51¿0·77] compared with locoregional therapy). The hazard ratio of HFCRT compared with locoregional therapy with concomitant chemoradiotherapy with platinum-based chemotherapy (CLRTP) was 0·82 (95% CI 0·66¿1·01) for overall survival. The superiority of HFCRT was robust to sensitivity analyses. Three other modalities of treatment had a better P score, but not a significantly better HR, for overall survival than CLRTP (P score 78%): induction chemotherapy with taxane, cisplatin, and fluorouracil followed by locoregional therapy (ICTaxPF-LRT; 89%), accelerated radiotherapy with concomitant chemotherapy (82%), and ICTaxPF followed by CLRT (80%). Interpretation: The results of this network meta-analysis suggest that further intensifying chemoradiotherapy, using HFCRT or ICTaxPF-CLRT, could improve outcomes over chemoradiotherapy for the treatment of locally advanced head and neck cancer. Fundings: French Institut National du Cancer, French Ligue Nationale Contre le Cancer, and Fondation ARC.
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2020 |
Taneja SS, 'Re: Radiation Dose Escalation or Longer Androgen Suppression to Prevent Distant Progression in Men with Locally Advanced Prostate Cancer: 10-Year Data from the TROG 03.04 RADAR Trial', JOURNAL OF UROLOGY, 204 879-880 (2020)
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2020 |
Mylona E, Ebert M, Kennedy A, Joseph D, Denham J, Steigler A, et al., 'Rectal and Urethro-Vesical Subregions for Toxicity Prediction After Prostate Cancer Radiation Therapy: Validation of Voxel-Based Models in an Independent Population', International Journal of Radiation Oncology Biology Physics, 108 1189-1195 (2020) [C1]
Purpose: Recent voxel-based studies have shown that the dose to specific rectal and urethro-vesical subregions is predictive of toxicities after prostate cancer intensity modulate... [more]
Purpose: Recent voxel-based studies have shown that the dose to specific rectal and urethro-vesical subregions is predictive of toxicities after prostate cancer intensity modulated radiation therapy. The objective of this study was to validate the discriminatory power of these subregions with respect to the whole organs in a large independent population. Methods and Materials: The validation cohort consisted of 450 patients from the TROG03.04-RADAR trial treated with 3-dimensional conformal radiation therapy at 66 to 74 Gy. Previous voxel-based analyses identified an inferoanterior rectal subregion as predictive of rectal bleeding and 5 subregions in the urethra and the posterior and superior part of the bladder as predictive of urinary incontinence, dysuria, retention, and hematuria. In the validation cohort, these subregions were segmented in each patient's anatomy. Dose-volume histograms (DVHs) of the whole organs and the 6 subregions were compared bin-wise between patients with and without toxicities. The discriminatory power of DVHs for grade =2 toxicity endpoints was assessed using the area under the receiver operating characteristic curve (AUC). Results: Subregion DVHs were significantly different between patients with and without toxicities for late rectal bleeding (V44-V74), acute urinary incontinence (V68-V72), late dysuria (V56-V68), and late retention (V14-V64). The dose to the rectal subregion and the whole rectum were equally predictive of rectal bleeding (V68; AUC = 0.61). The doses to 3 out of the 5 urethro-vesical subregions were found to be more predictive than the dose to the whole bladder: in the urethra for acute incontinence (V71 AUC = 0.69 vs V71 AUC = 0.66), in the posterior part of the bladder for late dysuria (V65 AUC = 0.66 vs V68 AUC = 0.59), and late retention (V39 AUC = 0.74 vs no significant AUC). Conclusions: Three subregions located in the urethra and the bladder were successfully validated as more predictive of urinary toxicity than the whole bladder for urinary incontinence, retention, and dysuria. Sparing the posterior part of the bladder in particular in treatment planning may reduce the risk of late urinary retention.
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Nova |
2020 |
Delahunt B, Murray JD, Steigler A, Atkinson C, Christie D, Duchesne G, et al., 'Perineural invasion by prostate adenocarcinoma in needle biopsies predicts bone metastasis: Ten year data from the TROG 03.04 RADAR Trial', Histopathology, 77 284-292 (2020) [C1]
Aims: Perineural invasion (PNI) by prostatic adenocarcinoma is debated as a prognostic parameter. This study investigates the prognostic predictive value of PNI in a series of pat... [more]
Aims: Perineural invasion (PNI) by prostatic adenocarcinoma is debated as a prognostic parameter. This study investigates the prognostic predictive value of PNI in a series of patients with locally advanced prostate cancer treated with radiotherapy and androgen deprivation using 10¿years outcome data from the TROG 03.04 RADAR trial. Methods: Diagnostic prostate biopsies from 976 patients were reviewed and the presence of PNI noted. Patients were followed for 10¿years according to the trial protocol or until death. The primary endpoint for the study was time to bone metastasis. Secondary endpoints included time to soft tissue metastasis, transition to castration resistance, prostate cancer-specific mortality and all-cause mortality. Results: PNI was detected in 449 cases (46%), with 234 cases (24%) having PNI in more than one core. The presence of PNI was significantly associated with higher ISUP grade, clinical T staging category, National Comprehensive Cancer Network risk group, and percent positive biopsy cores. The cumulative probability of bone metastases according to PNI status was significant over the 10¿years follow-up interval of the study (log-rank test P¿<¿0.0001). PNI was associated with all endpoints on univariable analysis. After adjusting for baseline clinicopathological and treatment factors, bone metastasis was the only endpoint in which PNI retained its prognostic significance (hazard ratio 1.42, 95% confidence interval 1.05¿1.92, P¿=¿0.021). Conclusions: The association between PNI and the development of bone metastases supports the inclusion of this parameter as a component of the routine histology report. Further this association suggests that evaluation of PNI may assist in selecting those patients who should be monitored more closely during follow-up.
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Nova |
2020 |
Marcello M, Denham JW, Kennedy A, Haworth A, Steigler A, Greer PB, et al., 'Reduced Dose Posterior to Prostate Correlates With Increased PSA Progression in Voxel-Based Analysis of 3 Randomized Phase 3 Trials', International Journal of Radiation Oncology Biology Physics, 108 1304-1318 (2020) [C1]
Purpose: Reducing margins during treatment planning to decrease dose to healthy organs surrounding the prostate can risk inadequate treatment of subclinical disease. This study ai... [more]
Purpose: Reducing margins during treatment planning to decrease dose to healthy organs surrounding the prostate can risk inadequate treatment of subclinical disease. This study aimed to investigate whether lack of dose to subclinical disease is associated with increased disease progression by using high-quality prostate radiation therapy clinical trial data to identify anatomically localized regions where dose variation is associated with prostate-specific antigen progression (PSAP). Methods and Materials: Planned dose distributions for 683 patients of the Trans-Tasman Radiation Oncology Group 03.04 Randomized Androgen Deprivation and Radiotherapy (RADAR) trial were deformably registered onto a single exemplar computed tomography data set. These were divided into high-risk and intermediate-risk subgroups for analysis. Three independent voxel-based statistical tests, using permutation testing, Cox regression modeling, and least absolute shrinkage selection operator feature selection, were applied to identify regions where dose variation was associated with PSAP. Results from the intermediate-risk RADAR subgroup were externally validated by registering dose distributions from the RT01 (n = 388) and Conventional or Hypofractionated High Dose Intensity Modulated Radiotherapy for Prostate Cancer Trial (CHHiP) (n = 253) trials onto the same exemplar and repeating the tests on each of these data sets. Results: Voxel-based Cox regression revealed regions where reduced dose was correlated with increased prostate-specific androgen progression. Reduced dose in regions associated with coverage at the posterior prostate, in the immediate periphery of the posterior prostate, and in regions corresponding to the posterior oblique beams or posterior lateral beam boundary, was associated with increased PSAP for RADAR and RT01 patients, but not for CHHiP patients. Reduced dose to the seminal vesicle region was also associated with increased PSAP for RADAR intermediate-risk patients. Conclusions: Ensuring adequate dose coverage at the posterior prostate and immediately surrounding posterior region (including the seminal vesicles), where aggressive cancer spread may be occurring, may improve tumor control. It is recommended that particular care be taken when defining margins at the prostate posterior, acknowledging the trade-off between quality of life due to rectal dose and the preferences of clinicians and patients.
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Nova |
2020 |
Gao F, Griffin N, Faulkner S, Li X, King SJ, Jobling P, et al., 'The Membrane Protein Sortilin Can Be Targeted to Inhibit Pancreatic Cancer Cell Invasion.', The American journal of pathology, 190 (2020) [C1]
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Nova |
2020 |
Marcello M, Denham JW, Kennedy A, Haworth A, Steigler A, Greer PB, et al., 'Relationships between rectal and perirectal doses and rectal bleeding or tenesmus in pooled voxel-based analysis of 3 randomised phase III trials.', Radiotherapy and Oncology, 150 (2020) [C1]
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Nova |
2020 |
Marcello M, Denham JW, Kennedy A, Haworth A, Steigler A, Greer PB, et al., 'Increased Dose to Organs in Urinary Tract Associates With Measures of Genitourinary Toxicity in Pooled Voxel-Based Analysis of 3 Randomized Phase III Trials', Frontiers in Oncology, 10 (2020) [C1]
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Nova |
2020 |
Samaratunga H, Delahunt B, Egevad L, Srigley JR, Billis A, Bostwick DG, et al., 'Intraductal carcinoma of the prostate is an aggressive form of invasive carcinoma and should be graded', Pathology, 52 192-196 (2020) [C1]
Infiltration of the prostatic ducts by prostatic adenocarcinoma occurs relatively frequently, being most commonly associated with high grade disease. It is now recognised that int... [more]
Infiltration of the prostatic ducts by prostatic adenocarcinoma occurs relatively frequently, being most commonly associated with high grade disease. It is now recognised that intraductal carcinoma of the prostate (IDCP) has an associated poor prognosis and this is reflected in its histological, molecular and immunohistochemical features. The current recommendation of the World Health Organization is that IDCP not be taken into consideration when grading prostate adenocarcinoma. It is apparent that Gleason did not differentiate between IDCP and stromal invasive carcinoma when developing and validating his grading system, and recent studies suggest that the incorporation of IDCP grading into the overall grading of the specimen provides additional prognostic information.
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Nova |
2020 |
Panettieri V, Rancati T, Onjukka E, Ebert MA, Joseph DJ, Denham JW, et al., 'External Validation of a Predictive Model of Urethral Strictures for Prostate Patients Treated With HDR Brachytherapy Boost', FRONTIERS IN ONCOLOGY, 10 (2020) [C1]
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Nova |
2020 |
Joseph D, Denham JW, Steigler A, Lamb DS, Spry NA, Stanley J, et al., 'Radiation Dose Escalation or Longer Androgen Suppression to Prevent Distant Progression in Men With Locally Advanced Prostate Cancer: 10-Year Data From the TROG 03.04 RADAR Trial', International Journal of Radiation Oncology Biology Physics, 106 693-702 (2020) [C1]
Purpose: To clarify the relative effects of duration of androgen suppression (AS) and radiation dose escalation (RDE) on distant progression (DP) in men with locally advanced pros... [more]
Purpose: To clarify the relative effects of duration of androgen suppression (AS) and radiation dose escalation (RDE) on distant progression (DP) in men with locally advanced prostate cancer. Methods and Materials: Participants with locally advanced prostate cancer in the TROG 03.04 RADAR trial were randomized to 6 or 18 months AS ± 18 months zoledronic acid (Z). The trial incorporated a RDE program by stratification at randomization and dosing options were 66, 70, or 74 Gy external beam radiation therapy (EBRT), or 46 Gy EBRT plus high-dose-rate brachytherapy boost (HDRB). The primary endpoint for this study was distant progression (DP). Secondary endpoints included local progression, bone progression, prostate cancer-specific mortality and all-cause mortality. Effect estimates for AS duration and RDE were derived using Fine and Gray competing risk models adjusting for use of Z, age, tumor stage, Gleason grade group, prostate-specific antigen, and treatment center. Cumulative incidence at 10 years was estimated for each RDE group. Results: A total of 1051 out of 1071 randomized subjects were eligible for inclusion in this analysis. Compared with 6 months AS, 18 months AS significantly reduced DP independently of radiation dose (subhazard ratio 0.70; 95% confidence interval [CI], 0.56-0.87; P =.002). No statistically significant interaction between effect of AS duration and RT dose was observed (Wald test P =.76). In subgroup analyses, DP was significantly reduced by the longer duration of AS in the 70 Gy and HDRB groups but not in the 66 Gy and 74 Gy. Compared with 70 Gy, HDRB significantly reduced DP (subhazard ratio 0.68 [95% CI, 0.57-0.80]; P <.0001) independently of AS duration. At 10 years, adjusted cumulative incidences were 26.1% (95% CI, 18.9%-33.2%), 26.7% (22.9%-30.6%), 24.9% (20.0%-29.8%) and 19.7% (15.5%-23.8%) for DPs in the respective radiation dose groups. Conclusions: Compared with 6 months AS, 18 months AS reduced DP independently of radiation dose. Men treated with HDRB gained a significant benefit from a longer duration of AS. Evidence of improved oncologic outcomes for HDRB compared with dose-escalated EBRT needs to be confirmed in a randomized trial.
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Nova |
2020 |
Gholizadeh N, Simpson J, Ramadan S, Denham J, Lau P, Siddique S, et al., 'Voxel-based supervised machine learning of peripheral zone prostate cancer using noncontrast multiparametric MRI', Journal of Applied Clinical Medical Physics, 21 179-191 (2020) [C1]
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Nova |
2020 |
March B, Faulkner S, Jobling P, Steigler A, Blatt A, Denham J, Hondermarck H, 'Tumour innervation and neurosignalling in prostate cancer', Nature Reviews Urology, 17 119-130 (2020) [C1]
Prostate cancer progression has been shown to be dependent on the development of autonomic nerves into the tumour microenvironment. Sympathetic nerves activate adrenergic neurosig... [more]
Prostate cancer progression has been shown to be dependent on the development of autonomic nerves into the tumour microenvironment. Sympathetic nerves activate adrenergic neurosignalling that is necessary in early stages of tumour progression and for initiating an angiogenic switch, whereas parasympathetic nerves activate cholinergic neurosignalling resulting in tumour dissemination and metastasis. The innervation of prostate cancer seems to be initiated by neurotrophic growth factors, such as the precursor to nerve growth factor secreted by tumour cells, and the contribution of brain-derived neural progenitor cells has also been reported. Current experimental, epidemiological and clinical evidence shows the stimulatory effect of tumour innervation and neurosignalling in prostate cancer. Using nerves and neurosignalling could have value in the management of prostate cancer by predicting aggressive disease, treating localized disease through denervation and relieving cancer-associated pain in bone metastases.
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Nova |
2019 |
Denham JW, Joseph D, Lamb DS, Spry NA, Duchesne G, Matthews J, et al., 'Short-term androgen suppression and radiotherapy versus intermediate-term androgen suppression and radiotherapy, with or without zoledronic acid, in men with locally advanced prostate cancer (TROG 03.04 RADAR): 10-year results from a randomised, phase 3, factorial trial', The Lancet Oncology, 20 267-281 (2019) [C1]
Background: The optimal duration of androgen suppression for men with locally advanced prostate cancer receiving radiotherapy with curative intent is yet to be defined. Zoledronic... [more]
Background: The optimal duration of androgen suppression for men with locally advanced prostate cancer receiving radiotherapy with curative intent is yet to be defined. Zoledronic acid is effective in preventing androgen suppression-induced bone loss, but its role in preventing castration-sensitive bone metastases in locally advanced prostate cancer is unclear. The RADAR trial assessed whether the addition of 12 months of adjuvant androgen suppression, 18 months of zoledronic acid, or both, can improve outcomes in men with locally advanced prostate cancer who receive 6 months of androgen suppression and prostatic radiotherapy. This report presents 10-year outcomes from this trial. Methods: For this randomised, phase 3, 2 × 2 factorial trial, eligible men were 18 years or older with locally advanced prostate cancer (either T2b-4, N0 M0 tumours or T2a, N0 M0 tumours provided Gleason score was =7 and baseline prostate-specific antigen [PSA] concentration was =10 µg/L). We randomly allocated participants in a 2 × 2 factorial design by computer-generated randomisation (using the minimisation technique, and stratified by centre, baseline PSA concentration, clinical tumour stage, Gleason score, and use of a brachytherapy boost) in a 1:1:1:1 ratio to four treatment groups. Patients in the control group received 6 months of neoadjuvant androgen suppression with leuprorelin (22·5 mg every 3 months, intramuscularly) and radiotherapy alone (short-term androgen suppression [STAS]); this treatment was either followed by another 12 months of adjuvant androgen suppression with leuprorelin (22·5 mg every 3 months, intramuscularly; intermediate-term androgen suppression [ITAS]), or accompanied by 18 months of zoledronic acid (4 mg every 3 months, intravenously) starting at randomisation (STAS plus zoledronic acid), or both (ITAS plus zoledronic acid). All patients received radiotherapy to the prostate and seminal vesicles, starting from the end of the fifth month of androgen suppression; dosing options were 66, 70, and 74 Gy in 2-Gy fractions per day, or 46 Gy in 2-Gy fractions followed by a high-dose-rate brachytherapy boost dose of 19·5 Gy in 6·5-Gy fractions. Treatment allocation was open label. The primary endpoint was prostate cancer-specific mortality and was analysed according to intention-to-treat using competing-risks methods. The trial is closed to follow-up and this is the final report of the main endpoints. This trial is registered with ClinicalTrials.gov, number NCT00193856. Findings: Between Oct 20, 2003, and Aug 15, 2007, 1071 men were enrolled and randomly assigned to STAS (n=268), ITAS (n=268), STAS plus zoledronic acid (n=268), and ITAS plus zoledronic acid (n=267). Median follow-up was 10·4 years (IQR 7·9¿11·7). At this 10-year follow-up, no interactions were observed between androgen suppression and zoledronic acid so the treatment groups were collapsed to compare treatments according to duration of androgen suppression: 6 months of androgen suppression plus radiotherapy (6AS+RT) versus 18 months of androgen suppression plus radiotherapy (18AS+RT) and to compare treatments according to whether or not patients received zoledronic acid. The total number of deaths was 375 (200 men receiving 6AS+RT and 175 men receiving 18AS+RT), of which 143 (38%) were attributable to prostate cancer (81 men receiving 6AS+RT and 62 men receiving 18AS+RT). When analysed by duration of androgen suppression, the adjusted cumulative incidence of prostate cancer-specific mortality was 13·3% (95% CI 10·3¿16·0) for 6AS+RT versus 9·7% (7·3¿12·0) for 18AS+RT, representing an absolute difference of 3·7% (95% CI 0·3¿7·1; sub-hazard ratio [sHR] 0·70 [95% CI 0·50¿0·98], adjusted p=0·035). The addition of zoledronic acid did not affect prostate cancer-specific mortality; the adjusted cumulative incidence of prostate cancer-specific mortality was 11·2% (95% CI 8·7¿13·7) with zoledronic acid vs 11·7% (9·2¿14·1) without, representing an absolute difference o...
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Nova |
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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Nova |
2019 |
Roach D, Holloway LC, Jameson MG, Dowling JA, Kennedy A, Greer PB, et al., 'Multi-observer contouring of male pelvic anatomy: Highly variable agreement across conventional and emerging structures of interest', JOURNAL OF MEDICAL IMAGING AND RADIATION ONCOLOGY, 63 264-271 (2019) [C1]
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Nova |
2019 |
Gholizadeh N, Greer PB, Simpson J, Denham J, Lau P, Dowling J, et al., 'Characterization of prostate cancer using diffusion tensor imaging: a new perspective', European Journal of Radiology, 110 112-120 (2019) [C1]
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Nova |
2018 |
Taaffe DR, Buffart LM, Newton RU, Spry N, Denham J, Joseph D, et al., 'Time on androgen deprivation therapy and adaptations to exercise: secondary analysis from a 12-month randomized controlled trial in men with prostate cancer', BJU International, 121 194-202 (2018) [C1]
Objectives: To explore if duration of previous exposure to androgen deprivation therapy (ADT) in men with prostate cancer (PCa) undertaking a year-long exercise programme moderate... [more]
Objectives: To explore if duration of previous exposure to androgen deprivation therapy (ADT) in men with prostate cancer (PCa) undertaking a year-long exercise programme moderates the exercise response with regard to body composition and muscle performance, and also to explore the moderator effects of baseline testosterone, time since ADT, and baseline value of the outcome. Patients and Methods: In a multicentre randomized controlled trial, 100 men who had previously undergone either 6 months (short-term) or 18 months (long-term) of ADT in combination with radiotherapy, as part of the TROG 03.04 RADAR trial, were randomized to 6 months supervised exercise, followed by a 6-month home-based maintenance programme, or to printed physical activity educational material for 12 months across 13 university-affiliated exercise clinics in Australia and New Zealand. The participants were long-term survivors of PCa with a mean age of 71.7 ± 6.4 years, and were assessed for lower extremity performance (repeated chair rise), with a subset of men (n = 57) undergoing additional measures for upper and lower body muscle strength and body composition (lean mass, fat mass, appendicular skeletal muscle [ASM]) by dual X-ray absorptiometry. Data were analysed using generalized estimating equations. Results: Time on ADT significantly moderated the exercise effects on chair rise (ßinteraction = -1.3 s, 95% confidence interval [CI] -2.6 to 0.0), whole-body lean mass (ßinteraction = 1194 g, 95% CI 234 to 2153) and ASM mass (ßinteraction = 562 g, 95% CI 49 to 1075), and approached significance for fat mass (ßinteraction = -1107 g, 95% CI -2346 to 132), with greater benefits for men previously on long-term ADT. At 6 months, the intervention effects on chair rise time -1.5 s (95% CI -2.5 to -0.5), whole-body lean mass 824 g (95% CI 8 to 1640), ASM mass 709 g (95% CI 260 to 1158), and fat mass -1377 g (95% CI -2156 to -598) were significant for men previously on long-term ADT, but not for men on short-term ADT. At 12 months, the intervention effects for men on long-term ADT remained significant for the chair rise, with improved performance (-2.0 s, 95% CI -3.0 to -1.0) and increased ASM (537 g, 95% CI 153 to 921). Time on ADT did not moderate the exercise effects on muscle strength, nor did time since ADT cessation moderate any intervention effects. Similarly, testosterone and baseline values of the outcome had negligible moderator effects. Conclusions: Men with PCa previously treated long-term with ADT respond more favourably to exercise in terms of lower body muscle performance and body composition (lean and fat mass, and ASM) than those with short-term ADT exposure. As a result, men who were formerly on long-term androgen suppression regimens should be especially prescribed exercise medicine interventions to alleviate residual treatment-related adverse effects.
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Nova |
2018 |
Marcello M, Ebert M, Haworth A, Steigler A, Kennedy A, Joseph D, Denham J, 'Association between treatment planning and delivery factors and disease progression in prostate cancer radiotherapy: Results from the TROG 03.04 RADAR trial', Radiotherapy and Oncology, 126 249-256 (2018) [C1]
Background and purpose: To evaluate the impact of treatment planning and delivery factors on treatment outcome as measured by post-treatment disease progression. Materials and met... [more]
Background and purpose: To evaluate the impact of treatment planning and delivery factors on treatment outcome as measured by post-treatment disease progression. Materials and methods: Accruing 813 external beam radiotherapy participants during 2003¿2007, the RADAR trial collected a comprehensive range of clinical treatment factor data for each participant. Both the Fine and Gray competing risks modelling and the Kaplan¿Meier (KM) analysis were undertaken to determine the impact of these factors on local-composite progression (LCP), with 709 participants available for analysis. Results: Participants with treatments involving 7 or more beams experienced significantly higher incidence of LCP, with a sub-hazard ratio (relative to 3-beam participants) of 3.056 (CI: 1.446¿6.458, p < 0.0034). Participants treated with a more rigorous dose calculation algorithm also displayed significantly higher incidence of LCP, with a sub-hazard ratio of 1.686 (CI: 1.334¿2.132, p < 0.0001). The KM analysis resulted in the same groups showing a higher incidence of LCP, with log-rank test results of p = 0.0005 and p = 0.0008 respectively. Conclusions: The RADAR dataset has enabled a successful secondary analysis in which the impact of technical modifications has been assessed, challenging several established hypotheses. Increasingly precise treatments should be complemented with increasing accuracy to avoid potential geometric miss.
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Nova |
2018 |
Marcello M, Ebert MA, Haworth A, Steigler A, Kennedy A, Bulsara M, et al., 'Association between measures of treatment quality and disease progression in prostate cancer radiotherapy: An exploratory analysis from the TROG 03.04 RADAR trial', Journal of Medical Imaging and Radiation Oncology, 62 248-255 (2018) [C1]
Introduction: Quality assurance methods are incorporated into multicentre radiotherapy clinical trials for ensuring consistent application of trial protocol and quantifying treatm... [more]
Introduction: Quality assurance methods are incorporated into multicentre radiotherapy clinical trials for ensuring consistent application of trial protocol and quantifying treatment uncertainties. The study's purpose was to determine whether post-treatment disease progression is associated with measures of the quality of radiotherapy treatment. Methods: The TROG 03.04 RADAR trial tested the impact of androgen deprivation on prostate cancer patients receiving dose-escalated external beam radiation therapy. The trial incorporated a plan-review process and Level III dosimetric intercomparison at each centre, from which variables suggestive of treatment quality were collected. Kaplan¿Meier statistics and Fine and Gray competing risk modelling were employed to test for associations between quality-related variables and the participant outcome local composite progression. Results: Increased ¿dose-difference¿ at the prostatic apex and at the anterior rectal wall, between planned and measured dose, was associated with reduced progression. Participants whose treatment plans included clinical target volume (CTV) to planning target volume (PTV) margins exceeding protocol requirements also experienced reduced progression. Other quality-related variables, including total accrual from participating centres, measures of target coverage and other variations from protocol, were not significantly associated with progression. Conclusions: This analysis has revealed the association of several treatment quality factors with disease progression. Increased dose and dose margin coverage in the prostate region can reduce disease progression. Extensive and rigorous monitoring has helped to maximise treatment quality, reducing the incidence of quality-indicator outliers, and thus reduce the chance of observing significant associations with progression rates.
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Nova |
2018 |
Galvão DA, Taaffe DR, Spry N, Cormie P, Joseph D, Chambers SK, et al., 'Exercise Preserves Physical Function in Prostate Cancer Patients with Bone Metastases', Medicine and Science in Sports and Exercise, 50 393-399 (2018) [C1]
Purpose The presence of bone metastases has excluded participation of cancer patients in exercise interventions and is a relative contraindication to supervised exercise in the co... [more]
Purpose The presence of bone metastases has excluded participation of cancer patients in exercise interventions and is a relative contraindication to supervised exercise in the community setting because of concerns of fragility fracture. We examined the efficacy and safety of a modular multimodal exercise program in prostate cancer patients with bone metastases. Methods Between 2012 and 2015, 57 prostate cancer patients (70.0 ± 8.4 yr; body mass index, 28.7 ± 4.0 kg·m -2) with bone metastases (pelvis, 75.4%; femur, 40.4%; rib/thoracic spine, 66.7%; lumbar spine, 43.9%; humerus, 24.6%; other sites, 70.2%) were randomized to multimodal supervised aerobic, resistance, and flexibility exercises undertaken thrice weekly (EX; n = 28) or usual care (CON; n = 29) for 3 months. Physical function subscale of the Medical Outcomes Study Short-Form 36 was the primary end point as an indicator of patient-rated physical functioning. Secondary end points included objective measures of physical function, lower body muscle strength, body composition, and fatigue. Safety was assessed by recording the incidence and severity of any adverse events, skeletal complications, and bone pain throughout the intervention. Results There was a significant difference between groups for self-reported physical functioning (3.2 points; 95% confidence interval, 0.4-6.0 points; P = 0.028) and lower body muscle strength (6.6 kg; 95% confidence interval, 0.6-12.7; P = 0.033) at 3 months favoring EX. However, there was no difference between groups for lean mass (P = 0.584), fat mass (P = 0.598), or fatigue (P = 0.964). There were no exercise-related adverse events or skeletal fractures and no differences in bone pain between EX and CON (P = 0.507). Conclusions Multimodal modular exercise in prostate cancer patients with bone metastases led to self-reported improvements in physical function and objectively measured lower body muscle strength with no skeletal complications or increased bone pain.
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Nova |
2018 |
Newton RU, Jeffery E, Galvão DA, Peddle-McIntyre CJ, Spry N, Joseph D, et al., 'Body composition, fatigue and exercise in patients with prostate cancer undergoing androgen-deprivation therapy', BJU International, 122 986-993 (2018) [C1]
Objectives: To investigate the association between lean mass (LM) and fat mass (FM) with fatigue and vitality before and after exercise in patients with prostate cancer already un... [more]
Objectives: To investigate the association between lean mass (LM) and fat mass (FM) with fatigue and vitality before and after exercise in patients with prostate cancer already undergoing androgen-deprivation therapy (ADT). Subjects and Methods: Cross-sectional associations between LM and FM with fatigue and/or vitality measures were examined in 229 patients (aged 43¿90 years). Prospective analysis was undertaken in 129 patients who underwent a supervised 3¿6 months exercise programme (predominantly resistance + aerobic). Whole body and appendicular LM, and total and trunk FM were assessed by dual X-ray absorptiometry. Fatigue was assessed using the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30 (EORTC QLQ-30) and vitality using the Short Form-36. Results: Based on the EORTC QLQ-30, 19% of patients had clinically relevant fatigue. There was no association between LM and fatigue; however, total (P = 0.013), trunk (P = 0.015) and percentage (P = 0.008) FM were higher in fatigued than not fatigued patients, with total and trunk FM 5.0 and 2.6 kg higher, respectively. For quartiles of vitality, a similar pattern emerged for FM with those in the lowest quartile of vitality having the highest FM values (P = 0.014¿0.034). In contrast, following supervised exercise, change in fatigue and vitality were associated with change in total LM (r = -0.182, P = 0.042 and r = 0.309, P = 0.001, respectively) but not FM. Patients fatigued at baseline but not fatigued following the exercise programme gained a median (interquartile range) of 2.1 (0.7¿3.2) kg LM. Conclusion: In patients with prostate cancer treated with ADT, body composition is associated with fatigue, with higher total and trunk FM in those with clinically relevant fatigue. However, following exercise those no longer fatigued had an accompanying substantial increase in LM. Modifying body composition, both LM and FM, in patients with prostate cancer may favourably alter cancer-related fatigue levels and should be a target of exercise medicine in this population.
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Nova |
2017 |
Yahya N, Ebert MA, House MJ, Kennedy A, Matthews J, Joseph DJ, Denham JW, 'Modeling Urinary Dysfunction After External Beam Radiation Therapy of the Prostate Using Bladder Dose-Surface Maps: Evidence of Spatially Variable Response of the Bladder Surface', International Journal of Radiation Oncology Biology Physics, 97 420-426 (2017) [C1]
Purpose We assessed the association of the spatial distribution of dose to the bladder surface, described using dose-surface maps, with the risk of urinary dysfunction. Methods an... [more]
Purpose We assessed the association of the spatial distribution of dose to the bladder surface, described using dose-surface maps, with the risk of urinary dysfunction. Methods and Materials The bladder dose-surface maps of 754 participants from the TROG 03.04-RADAR trial were generated from the volumetric data by virtually cutting the bladder at the sagittal slice, intersecting the bladder center-of-mass through to the bladder posterior and projecting the dose information on a 2-dimensional plane. Pixelwise dose comparisons were performed between patients with and without symptoms (dysuria, hematuria, incontinence, and an International Prostate Symptom Score increase of =10 [¿IPSS10]). The results with and without permutation-based multiple-comparison adjustments are reported. The pixelwise multivariate analysis findings (peak-event model for dysuria, hematuria, and ¿IPSS10; event-count model for incontinence), with adjustments for clinical factors, are also reported. Results The associations of the spatially specific dose measures to urinary dysfunction were dependent on the presence of specific symptoms. The doses received by the anteroinferior and, to lesser extent, posterosuperior surface of the bladder had the strongest relationship with the incidence of dysuria, hematuria, and ¿IPSS10, both with and without adjustment for clinical factors. For the doses to the posteroinferior region corresponding to the area of the trigone, the only symptom with significance was incontinence. Conclusions A spatially variable response of the bladder surface to the dose was found for symptoms of urinary dysfunction. Limiting the dose extending anteriorly might help reduce the risk of urinary dysfunction.
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Nova |
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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Nova |
2017 |
Sharpley CF, Bitsika V, Christie DRH, Bradford R, Steigler A, Denham JW, 'Psychological resilience aspects that mediate the depressive effects of urinary incontinence in prostate cancer survivors 10 years after treatment with radiation and hormone ablation', Journal of Psychosocial Oncology, 35 438-450 (2017) [C1]
Repeated surveys of prostate cancer (PCa) patients indicate that their prevalence of depression is well above that for their non-PCa peers. Although standard first-line treatments... [more]
Repeated surveys of prostate cancer (PCa) patients indicate that their prevalence of depression is well above that for their non-PCa peers. Although standard first-line treatments for depression are only about 35% effective, some recent comments have suggested that a focus upon the possible correlates (factors that aggravate or mediate depression) might help improve treatment efficacy. To investigate this issue, 144 10 year PCa survivors were asked about the frequency of urinary incontinence, a common side effect of some PCa treatments. The 53 patients who suffered urinary incontinence had significantly higher depression scores on the Zung Self-rating Depression Scale than those patients who did not report urinary incontinence. Using mediation analysis, patients' psychological resilience (PR) significantly mediated the depressive effects of urinary incontinence, but those effects were confined to just one of the five components of PR¿a sense of control over the things that happen to oneself. Implications for treatment models of psychosocial oncology support for PCa survivors are discussed.
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Nova |
2017 |
Sharpley CF, Bitsika V, Christie DRH, Bradford R, Steigler A, Denham JW, 'Total depression and subtypes in prostate cancer survivors 10 years after treatment', European Journal of Cancer Care, 26 e12630-e12630 (2017) [C1]
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Nova |
2017 |
Moulton CR, House MJ, Lye V, Tang CI, Krawiec M, Joseph DJ, et al., 'Spatial features of dose-surface maps from deformably-registered plans correlate with late gastrointestinal complications', Physics in Medicine and Biology, 62 4118-4139 (2017) [C1]
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Nova |
2017 |
Gulliford SL, Ghose S, Ebert MA, Kennedy A, Dowling J, Mitra J, et al., 'Radiotherapy dose-distribution to the perirectal fat space (PRS) is related to gastrointestinal control-related complications.', Clin Transl Radiat Oncol, 7 62-70 (2017) [C1]
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Nova |
2017 |
Xie W, Regan MM, Buyse M, Halabi S, Kantoff PW, Sartor O, et al., 'Metastasis-Free Survival Is a Strong Surrogate of Overall Survival in Localized Prostate Cancer', JOURNAL OF CLINICAL ONCOLOGY, 35 3097-3104 (2017)
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2017 |
Rutledge A, Jobling P, Walker MM, Denham JW, Hondermarck H, 'Spinal Cord Injuries and Nerve Dependence in Prostate Cancer', Trends in Cancer, 3 812-815 (2017) [C1]
Nerves are emerging as drivers of tumorigenesis, as demonstrated in the mouse where denervation suppresses prostate cancer; however, clinical evidence is needed. Patients with spi... [more]
Nerves are emerging as drivers of tumorigenesis, as demonstrated in the mouse where denervation suppresses prostate cancer; however, clinical evidence is needed. Patients with spinal cord injuries (SCIs) resulting in functional denervation of the prostate have a lower incidence of prostate cancer. This may constitute a clinical evidence for nerve dependence in human prostate tumorigenesis.
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Nova |
2017 |
Lamb DS, Sondhauss S, Dunne JC, Woods L, Delahunt B, Ferguson P, et al., 'Proteins annexin A2 and PSA in prostate cancer biopsies do not predict biochemical failure', Anticancer Research, 37 6943-6946 (2017) [C1]
Background/Aim: We previously reported the use of mass spectrometry and western blotting to identify proteins from tumour regions of formalin-fixed paraffin-embedded biopsies from... [more]
Background/Aim: We previously reported the use of mass spectrometry and western blotting to identify proteins from tumour regions of formalin-fixed paraffin-embedded biopsies from 16 men who presented with apparently localized prostate cancer, and found that annexin A2 (ANXA2) appeared to be a better predictor of subsequent biochemical failure than prostate-specific antigen (PSA). Materials and Methods: In this follow-up study, ANXA2 and PSA were measured using western blotting of proteins extracted from biopsies from 37 men from a subsequent prostate cancer trial. Results: No significant differences in ANXA2 and PSA levels were observed between men with and without biochemical failure. The statistical effect sizes were small, d=0.116 for ANXA2, and 0.266 for PSA. Conclusion: ANXA2 and PSA proteins measured from biopsy tumour regions are unlikely to be good biomarkers for prediction of the clinical outcome of prostate cancer presenting with apparently localized disease.
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Nova |
2017 |
Moulton CR, House MJ, Lye V, Tang CI, Krawiec M, Joseph DJ, et al., 'Accumulation of rectum dose-volume metrics for prostate external beam radiotherapy combined with brachytherapy: Evaluating deformably registered dose distribution addition using parameter-based addition', Journal of Medical Imaging and Radiation Oncology, 61 534-542 (2017) [C1]
Introduction: To investigate the accuracy of deriving dose-volume histogram (DVH) parameters from deformably registered data by comparing values with the simple addition of DVHs f... [more]
Introduction: To investigate the accuracy of deriving dose-volume histogram (DVH) parameters from deformably registered data by comparing values with the simple addition of DVHs from each phase of a combined external beam radiotherapy (EBRT)/high-dose-rate (HDR-BT) brachytherapy prostate treatment. Methods: Eighty-two patients received EBRT in 23 fractions of 2¿Gy and HDR-BT TG43 in three fractions of 6.5¿Gy. The HDR-BT CT was deformably registered to the EBRT CT. The rectum D0.1cc, D1cc, D2cc and D10cc were calculated in two ways. (i) Parameter-adding: the EBRT DVH parameters (or the EBRT prescription dose) were added to the unregistered HDR-BT DVH parameters. (ii) Distribution-adding: the parameters were extracted after the EBRT doses were 3D-summed with the registered HDR-BT doses. Resulting differences between the parameters were investigated. Results: The D0.1cc, D1cc and D2cc from parameter-adding were 21.3% (P¿<¿0.001), 6.3% (P¿<¿0.001) and 3.5% (P¿<¿0.001) smaller than those from distribution-adding. The D10cc was 2.2% (P¿=¿0.015) larger for distribution-adding. Conclusion: Distribution-adding was confounded by unsystematic inter/intra-observer rectum-contouring errors and registration accuracy near the anterior rectal wall. Consequently, clinical use of distribution-adding to assess rectal doses requires careful contour and registration evaluation.
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Nova |
2017 |
Lacas B, Bourhis J, Overgaard J, Zhang Q, Grégoire V, Nankivell M, et al., 'Role of radiotherapy fractionation in head and neck cancers (MARCH): an updated meta-analysis', The Lancet Oncology, 18 1221-1237 (2017) [C1]
Background The Meta-Analysis of Radiotherapy in squamous cell Carcinomas of Head and neck (MARCH) showed that altered fractionation radiotherapy is associated with improved overal... [more]
Background The Meta-Analysis of Radiotherapy in squamous cell Carcinomas of Head and neck (MARCH) showed that altered fractionation radiotherapy is associated with improved overall and progression-free survival compared with conventional radiotherapy, with hyperfractionated radiotherapy showing the greatest benefit. This update aims to confirm and explain the superiority of hyperfractionated radiotherapy over other altered fractionation radiotherapy regimens and to assess the benefit of altered fractionation within the context of concomitant chemotherapy with the inclusion of new trials. Methods For this updated meta-analysis, we searched bibliography databases, trials registries, and meeting proceedings for published or unpublished randomised trials done between Jan 1, 2009, and July 15, 2015, comparing primary or postoperative conventional fractionation radiotherapy versus altered fractionation radiotherapy (comparison 1) or conventional fractionation radiotherapy plus concomitant chemotherapy versus altered fractionation radiotherapy alone (comparison 2). Eligible trials had to start randomisation on or after Jan 1, 1970, and completed accrual before Dec 31, 2010; had to have been randomised in a way that precluded prior knowledge of treatment assignment; and had to include patients with non-metastatic squamous cell carcinoma of the oral cavity, oropharynx, hypopharynx, or larynx undergoing first-line curative treatment. Trials including a non-conventional radiotherapy control group, investigating hypofractionated radiotherapy, or including mostly nasopharyngeal carcinomas were excluded. Trials were grouped in three types of altered fractionation: hyperfractionated, moderately accelerated, and very accelerated. Individual patient data were collected and combined with a fixed-effects model based on the intention-to-treat principle. The primary endpoint was overall survival. Findings Comparison 1 (conventional fractionation radiotherapy vs altered fractionation radiotherapy) included 33 trials and 11 423 patients. Altered fractionation radiotherapy was associated with a significant benefit on overall survival (hazard ratio [HR] 0·94, 95% CI 0·90¿0·98; p=0·0033), with an absolute difference at 5 years of 3·1% (95% CI 1·3¿4·9) and at 10 years of 1·2% (-0·8 to 3·2). We found a significant interaction (p=0·051) between type of fractionation and treatment effect, the overall survival benefit being restricted to the hyperfractionated group (HR 0·83, 0·74¿0·92), with absolute differences at 5 years of 8·1% (3·4 to 12·8) and at 10 years of 3·9% (-0·6 to 8·4). Comparison 2 (conventional fractionation radiotherapy plus concomitant chemotherapy versus altered fractionation radiotherapy alone) included five trials and 986 patients. Overall survival was significantly worse with altered fractionation radiotherapy compared with concomitant chemoradiotherapy (HR 1·22, 1·05¿1·42; p=0·0098), with absolute differences at 5 years of -5·8% (-11·9 to 0·3) and at 10 years of -5·1% (-13·0 to 2·8). Interpretation This update confirms, with more patients and a longer follow-up than the first version of MARCH, that hyperfractionated radiotherapy is, along with concomitant chemoradiotherapy, a standard of care for the treatment of locally advanced head and neck squamous cell cancers. The comparison between hyperfractionated radiotherapy and concomitant chemoradiotherapy remains to be specifically tested. Funding Institut National du Cancer; and Ligue Nationale Contre le Cancer.
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Nova |
2017 |
Bitsika V, Sharpley CF, Christie DRH, Bradford R, Steigler A, Denham JW, 'Measuring personal and functional changes in prostate cancer survivors: development and validation of the FADE: data from the TROG 03.04 RADAR trial', Psycho-Oncology, 26 553-555 (2017) [C1]
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Nova |
2016 |
Sridharan S, Steigler A, Spry NA, Joseph D, Lamb DS, Matthews JH, et al., 'Oligometastatic bone disease in prostate cancer patients treated on the TROG 03.04 RADAR trial', Radiotherapy and Oncology, 121 98-102 (2016) [C1]
Background It remains unclear whether eradication of oligometastases by stereotactic body radiation therapy or other means will result in cure or prolongation of survival in some ... [more]
Background It remains unclear whether eradication of oligometastases by stereotactic body radiation therapy or other means will result in cure or prolongation of survival in some cases, or merely provide palliation. We address this issue with prospectively collected progression and treatment data from the TROG 03.04 RADAR randomised controlled trial for men with locally advanced prostate cancer (PC). Methods Three Fine and Gray competing risk survival models with time-dependent covariates were used to determine whether metastatic progression status at first diagnosis of bony metastases, i.e. number of bony sites involved and presence of prior or simultaneous other sites of progression, impacts on prostate cancer-specific mortality (PCSM) when adjusted for baseline prognostic factors and allocated primary treatment. Results Between 2003 and 2014, 176 of the 1071 subjects developed bone metastases, 152 developed other sites of progression and 91 died of PC. All subjects received secondary treatment using androgen suppression but none received extirpative treatments. The three models found evidence: 1 ¿ of a clear prognostic gradient according to number of bony metastatic sites; 2 ¿ that other sites of progression contributed to PCSM to a lesser extent than bone progression; and 3 ¿ that further bony metastatic progression in men with up to 3 bony metastases had a major impact on PCSM. Conclusion Randomised trials are essential to determine the value of extirpative treatment for oligometastatic bony metastases due to PC.
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Nova |
2016 |
Yahya N, Ebert MA, Bulsara M, House MJ, Kennedy A, Joseph DJ, Denham JW, 'Statistical-learning strategies generate only modestly performing predictive models for urinary symptoms following external beam radiotherapy of the prostate: A comparison of conventional and machine-learning methods', Medical Physics, 43 2040-2052 (2016) [C1]
Purpose: Given the paucity of available data concerning radiotherapy-induced urinary toxicity, it is important to ensure derivation of the most robust models with superior predict... [more]
Purpose: Given the paucity of available data concerning radiotherapy-induced urinary toxicity, it is important to ensure derivation of the most robust models with superior predictive performance. This work explores multiple statistical-learning strategies for prediction of urinary symptoms following external beam radiotherapy of the prostate. Methods: The performance of logistic regression, elastic-net, support-vector machine, random forest, neural network, and multivariate adaptive regression splines (MARS) to predict urinary symptoms was analyzed using data from 754 participants accrued by TROG03.04-RADAR. Predictive features included dose-surface data, comorbidities, and medication-intake. Four symptoms were analyzed: dysuria, haematuria, incontinence, and frequency, each with three definitions (grade = 1, grade = 2 and longitudinal) with event rate between 2.3% and 76.1%. Repeated cross-validations producing matched models were implemented. A synthetic minority oversampling technique was utilized in endpoints with rare events. Parameter optimization was performed on the training data. Area under the receiver operating characteristic curve (AUROC) was used to compare performance using sample size to detect differences of =0.05 at the 95% confidence level. Results: Logistic regression, elastic-net, random forest, MARS, and support-vector machine were the highest-performing statistical-learning strategies in 3, 3, 3, 2, and 1 endpoints, respectively. Logistic regression, MARS, elastic-net, random forest, neural network, and support-vector machine were the best, or were not significantly worse than the best, in 7, 7, 5, 5, 3, and 1 endpoints. The best-performing statistical model was for dysuria grade = 1 with AUROC ± standard deviation of 0.649 ± 0.074 using MARS. For longitudinal frequency and dysuria grade = 1, all strategies produced AUROC>0.6 while all haematuria endpoints and longitudinal incontinence models produced AUROC<0.6. Conclusions: Logistic regression and MARS were most likely to be the best-performing strategy for the prediction of urinary symptoms with elastic-net and random forest producing competitive results. The predictive power of the models was modest and endpoint-dependent. New features, including spatial dose maps, may be necessary to achieve better models.
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Nova |
2016 |
Moulton CR, House MJ, Lye V, Tang CI, Krawiec M, Joseph DJ, et al., 'Prostate external beam radiotherapy combined with high-dose-rate brachytherapy: dose-volume parameters from deformably-registered plans correlate with late gastrointestinal complications', RADIATION ONCOLOGY, 11 (2016) [C1]
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Nova |
2016 |
Holzapfel BM, Wagner F, Martine LC, Reppenhagen S, Rudert M, Schuetz M, et al., 'Tissue engineering and regenerative medicine in musculoskeletal oncology', Cancer and Metastasis Reviews, 35 475-487 (2016) [C1]
Currently used surgical techniques to reconstruct tissue defects after resection of musculoskeletal tumours are associated with high complication rates. This drives a strong deman... [more]
Currently used surgical techniques to reconstruct tissue defects after resection of musculoskeletal tumours are associated with high complication rates. This drives a strong demand for innovative therapeutic concepts that are able to improve the clinical outcomes of patients suffering from bone and soft tissue tumours. Tissue engineering and regenerative medicine (TE&RM) provides a technology platform based on biochemical, molecular, cellular and biomaterials modules to selectively direct tissue healing processes for improved defect regeneration. At the same time, precautionary measures have to be taken when these instruments are used in cancer patients to prevent any promotion of tumour growth or metastatic spread. On the other hand, several innovative TE&RM tools are being developed such as multi-functionalized biomaterials, drug-delivering nanomaterials or genetically engineered stem cells that per se have the potential to mediate anti-cancer effects, act synergistically with currently used chemotherapeutics and/or radiotherapy regimens and reduce their side effects. Recently, scientists became conscious that TE&RM strategies may not only be utilized to advance contemporary tissue reconstruction techniques but also to develop personalized diagnostic tools and clinically relevant disease models for cancer patients. Eventually, prospective randomized clinical trials combined with comparative outcome analyses are a conditio sine qua non to shape the benefits of personalized regenerative therapies for the standardized management of patients with musculoskeletal tumours.
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Nova |
2016 |
Yahya N, Ebert MA, Bulsara M, Kennedy A, Joseph DJ, Denham JW, 'Independent external validation of predictive models for urinary dysfunction following external beam radiotherapy of the prostate: Issues in model development and reporting.', Radiother Oncol, 120 339-345 (2016) [C1]
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Nova |
2016 |
Ghose S, Denham JW, Ebert MA, Kennedy A, Mitra J, Dowling JA, 'Multi-atlas and unsupervised learning approach to perirectal space segmentation in CT images', Australasian Physical and Engineering Sciences in Medicine, 39 933-941 (2016) [C1]
Perirectal space segmentation in computed tomography images aids in quantifying radiation dose received by healthy tissues and toxicity during the course of radiation therapy trea... [more]
Perirectal space segmentation in computed tomography images aids in quantifying radiation dose received by healthy tissues and toxicity during the course of radiation therapy treatment of the prostate. Radiation dose normalised by tissue volume facilitates predicting outcomes or possible harmful side effects of radiation therapy treatment. Manual segmentation of the perirectal space is time consuming and challenging in the presence of inter-patient anatomical variability and may suffer from inter- and intra-observer variabilities. However automatic or semi-automatic segmentation of the perirectal space in CT images is a challenging task due to inter patient anatomical variability, contrast variability and imaging artifacts. In the model presented here, a volume of interest is obtained in a multi-atlas based segmentation approach. Un-supervised learning in the volume of interest with a Gaussian-mixture-modeling based clustering approach is adopted to achieve a soft segmentation of the perirectal space. Probabilities from soft clustering are further refined by rigid registration of the multi-atlas mask in a probabilistic domain. A maximum a posteriori approach is adopted to achieve a binary segmentation from the refined probabilities. A mean volume similarity value of 97% and a mean surface difference of 3.06¿±¿0.51¿mm is achieved in a leave-one-patient-out validation framework with a subset of a clinical trial dataset. Qualitative results show a good approximation of the perirectal space volume compared to the ground truth.
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Nova |
2016 |
Moulton CR, House MJ, Lye V, Tang CI, Krawiec M, Joseph DJ, et al., 'Prostate external beam radiotherapy combined with high-dose-rate brachytherapy: dose-volume parameters from deformably-registered plans correlate with late gastrointestinal complications', REPRODUCTIVE HEALTH, 13 (2016)
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2016 |
Warren LEG, Chen M-H, Denham JW, Steigler AB, Renshaw AA, Loffredo M, et al., 'Gleason score and the risk of cause-specific and all-cause mortality following radiation with or without 6 months of androgen deprivation therapy for men with unfavorable-risk prostate cancer', JOURNAL OF RADIATION ONCOLOGY, 5 301-308 (2016) [C1]
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Nova |
2016 |
Cicchetti A, Rancati T, Ebert M, Fiorino C, Palorini F, Kennedy A, et al., 'Modelling late stool frequency and rectal pain after radical radiotherapy in prostate cancer patients: Results from a large pooled population.', Phys Med, 32 1690-1697 (2016) [C1]
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Nova |
2015 |
Buffart LM, Newton RU, Chinapaw MJ, Taaffe DR, Spry NA, Denham JW, et al., 'Erratum: The effect, moderators, and mediators of resistance and aerobic exercise on health-related quality of life in older long-term survivors of prostate cancer (Cancer DOI: 10.1002/cncr.29406)', Cancer, 121 3367-3368 (2015)
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2015 |
Yahya N, Ebert MA, Bulsara M, House MJ, Kennedy A, Joseph DJ, Denham JW, 'Urinary symptoms following external beam radiotherapy of the prostate: Dose-symptom correlates with multiple-event and event-count models', Radiotherapy and Oncology, 117 277-282 (2015) [C1]
Background and purpose This study aimed to compare urinary dose-symptom correlates after external beam radiotherapy of the prostate using commonly utilised peak-symptom models to ... [more]
Background and purpose This study aimed to compare urinary dose-symptom correlates after external beam radiotherapy of the prostate using commonly utilised peak-symptom models to multiple-event and event-count models which account for repeated events. Materials and methods Urinary symptoms (dysuria, haematuria, incontinence and frequency) from 754 participants from TROG 03.04-RADAR trial were analysed. Relative (R1-R75 Gy) and absolute (A60-A75 Gy) bladder dose-surface area receiving more than a threshold dose and equivalent uniform dose using exponent a (range: aâ [1 ... 100]) were derived. The dose-symptom correlates were analysed using; peak-symptom (logistic), multiple-event (generalised estimating equation) and event-count (negative binomial regression) models. Results Stronger dose-symptom correlates were found for incontinence and frequency using multiple-event and/or event-count models. For dysuria and haematuria, similar or better relationships were found using peak-symptom models. Dysuria, haematuria and high grade (=2) incontinence were associated to high dose (R61-R71 Gy). Frequency and low grade (=1) incontinence were associated to low and intermediate dose-surface parameters (R13-R41 Gy). Frequency showed a parallel behaviour (a = 1) while dysuria, haematuria and incontinence showed a more serial behaviour (a = 4 to a = 100). Relative dose-surface showed stronger dose-symptom associations. Conclusions For certain endpoints, the multiple-event and event-count models provide stronger correlates over peak-symptom models. Accounting for multiple events may be advantageous for a more complete understanding of urinary dose-symptom relationships.
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Nova |
2015 |
Buffart LM, Newton RU, Chinapaw MJ, Taaffe DR, Spry NA, Denham JW, et al., 'The effect, moderators, and mediators of resistance and aerobic exercise on health-related quality of life in older long-term survivors of prostate cancer', Cancer, (2015) [C1]
BACKGROUND: The current study examined effects, moderators (for whom), and mediators (working mechanisms) of 12 months of exercise on health-related quality of life (HRQoL) in old... [more]
BACKGROUND: The current study examined effects, moderators (for whom), and mediators (working mechanisms) of 12 months of exercise on health-related quality of life (HRQoL) in older long-term survivors of prostate cancer. METHODS: In total, 100 men aged 71.7 years (standard deviation, 6.4 years) were randomly assigned to 6 months of supervised aerobic and resistance exercise followed by 6 months of a home-based exercise maintenance program (EX group) or printed education material regarding physical activity for 12 months (PA group). Assessments took place at baseline and after 6 and 12 months. Generalized estimating equations were used to study the effects of EX versus PA on HRQoL at 6 and 12 months, adjusting for baseline HRQoL. The authors examined potential sociodemographic and clinical moderators by adding interaction terms, and potential physical and psychological mediators using the product-of-coefficients test. RESULTS: At 6 months, significant beneficial effects were found for global QoL, physical function, and social function in the EX group compared with the PA group. For physical function, beneficial effects were sustained at 12 months. Moderation analyses demonstrated larger effects of EX versus PA for patients who were married, started exercising sooner after their diagnosis, and previously used bisphosphonates. Changes in lower body functional performance significantly mediated the effect of EX on global QoL, physical function, and social function. No mediating effects on HRQoL were found for aerobic fitness, physical activity, fatigue, distress, or falls self-efficacy. CONCLUSIONS: Aerobic and resistance exercise appears to have beneficial effects on HRQoL among older, long-term survivors of prostate cancer. Effects were moderated by marital status, time since diagnosis, and use of bisphosphonates, and were mediated by lower body functional performance.
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Nova |
2015 |
Ebert MA, Foo K, Haworth A, Gulliford SL, Kennedy A, Joseph DJ, Denham JW, 'Gastrointestinal dose-histogram effects in the context of dose-volume-constrained prostate radiation therapy: Analysis of data from the radar prostate radiation therapy trial', International Journal of Radiation Oncology Biology Physics, 91 595-603 (2015) [C1]
Purpose To use a high-quality multicenter trial dataset to determine dose-volume effects for gastrointestinal (GI) toxicity following radiation therapy for prostate carcinoma. Inf... [more]
Purpose To use a high-quality multicenter trial dataset to determine dose-volume effects for gastrointestinal (GI) toxicity following radiation therapy for prostate carcinoma. Influential dose-volume histogram regions were to be determined as functions of dose, anatomical location, toxicity, and clinical endpoint. Methods and Materials Planning datasets for 754 participants in the TROG 03.04 RADAR trial were available, with Late Effects of Normal Tissues (LENT) Subjective, Objective, Management, and Analytic (SOMA) toxicity assessment to a median of 72 months. A rank sum method was used to define dose-volume cut-points as near-continuous functions of dose to 3 GI anatomical regions, together with a comprehensive assessment of significance. Univariate and multivariate ordinal regression was used to assess the importance of cut-points at each dose. Results Dose ranges providing significant cut-points tended to be consistent with those showing significant univariate regression odds-ratios (representing the probability of a unitary increase in toxicity grade per percent relative volume). Ranges of significant cut-points for rectal bleeding validated previously published results. Separation of the lower GI anatomy into complete anorectum, rectum, and anal canal showed the impact of mid-low doses to the anal canal on urgency and tenesmus, completeness of evacuation and stool frequency, and mid-high doses to the anorectum on bleeding and stool frequency. Derived multivariate models emphasized the importance of the high-dose region of the anorectum and rectum for rectal bleeding and mid- to low-dose regions for diarrhea and urgency and tenesmus, and low-to-mid doses to the anal canal for stool frequency, diarrhea, evacuation, and bleeding. Conclusions Results confirm anatomical dependence of specific GI toxicities. They provide an atlas summarizing dose-histogram effects and derived constraints as functions of anatomical region, dose, toxicity, and endpoint for informing future radiation therapy planning.
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Nova |
2015 |
Delahunt B, Egevad L, Srigley JR, Steigler A, Murray JD, Atkinson C, et al., 'Validation of International Society of Urological Pathology (ISUP) grading for prostatic adenocarcinoma in thin core biopsies using TROG 03.04 'RADAR' trial clinical data', Pathology, 47 520-525 (2015) [C1]
In 2014 a consensus conference convened by the International Society of Urological Pathology (ISUP) adopted amendments to the criteria for Gleason grading and scoring (GS) for pro... [more]
In 2014 a consensus conference convened by the International Society of Urological Pathology (ISUP) adopted amendments to the criteria for Gleason grading and scoring (GS) for prostatic adenocarcinoma. The meeting defined a modified grading system based on 5 grading categories (grade 1, GS 3+3; grade 2, GS 3+4; grade 3, GS 4+3; grade 4, GS 8; grade 5, GS 9-10). In this study we have evaluated the prognostic significance of ISUP grading in 496 patients enrolled in the TROG 03.04 RADAR Trial. There were 19 grade 1, 118 grade 2, 193 grade 3, 88 grade 4 and 79 grade 5 tumours in the series, with follow-up for a minimum of 6.5 years. On follow-up 76 patients experienced distant progression of disease, 171 prostate specific antigen (PSA) progression and 39 prostate cancer deaths. In contrast to the 2005 modified Gleason system (MGS), the hazards of the distant and PSA progression endpoints, relative to grade 2, were significantly greater for grades 3, 4 and 5 of the 2014 ISUP grading scheme. Comparison of predictive ability utilising Harrell's concordance index, showed 2014 ISUP grading to significantly out-perform 2005 MGS grading for each of the three clinical endpoints.
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Nova |
2015 |
Moulton CR, House MJ, Lye V, Tang CI, Krawiec M, Joseph DJ, et al., 'Registering prostate external beam radiotherapy with a boost from high-dose-rate brachytherapy: A comparative evaluation of deformable registration algorithms', Radiation Oncology, 10 (2015) [C1]
Background: Registering CTs for patients receiving external beam radiotherapy (EBRT) with a boost dose from high-dose-rate brachytherapy (HDR) can be challenging due to considerab... [more]
Background: Registering CTs for patients receiving external beam radiotherapy (EBRT) with a boost dose from high-dose-rate brachytherapy (HDR) can be challenging due to considerable image discrepancies (e.g. rectal fillings, HDR needles, HDR artefacts and HDR rectal packing materials). This study is the first to comparatively evaluate image processing and registration methods used to register the rectums in EBRT and HDR CTs of prostate cancer patients. The focus is on the rectum due to planned future analysis of rectal dose-volume response. Methods: For 64 patients, the EBRT CT was retrospectively registered to the HDR CT with rigid registration and non-rigid registration methods in VelocityAI. Image processing was undertaken on the HDR CT and the rigidly-registered EBRT CT to reduce the impact of discriminating features on alternative non-rigid registration methods applied in the software suite for Deformable Image Registration and Adaptive Radiotherapy Research (DIRART) using the Horn-Schunck optical flow and Demons algorithms. The propagated EBRT-rectum structures were compared with the HDR structure using the Dice similarity coefficient (DSC), Hausdorff distance (HD) and average surface distance (ASD). The image similarity was compared using mutual information (MI) and root mean squared error (MSE). The displacement vector field was assessed via the Jacobian determinant (JAC). The post-registration alignments of rectums for 21 patients were visually assessed. Results: The greatest improvement in the median DSC relative to the rigid registration result was 35 % for the Horn-Schunck algorithm with image processing. This algorithm also provided the best ASD results. The VelocityAI algorithms provided superior HD, MI, MSE and JAC results. The visual assessment indicated that the rigid plus deformable multi-pass method within VelocityAI resulted in the best rectum alignment. Conclusions: The DSC, ASD and HD improved significantly relative to the rigid registration result if image processing was applied prior to DIRART non-rigid registrations, whereas VelocityAI without image processing provided significant improvements. Reliance on a single rectum structure-correspondence metric would have been misleading as the metrics were inconsistent with one another and visual assessments. It was important to calculate metrics for a restricted region covering the organ of interest. Overall, VelocityAI generated the best registrations for the rectum according to the visual assessment, HD, MI, MSE and JAC results.
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Nova |
2015 |
Andren O, Armstrong J, Berry D, Bolla M, Buyse M, Chowdhury S, et al., 'The Development of Intermediate Clinical Endpoints in Cancer of the Prostate (ICECaP)', Journal of the National Cancer Institute, 107 (2015)
New systemic therapies have prolonged the lives of men with metastatic castration-resistant prostate cancer (mCRPC). Use of these therapies in the adjuvant setting when the diseas... [more]
New systemic therapies have prolonged the lives of men with metastatic castration-resistant prostate cancer (mCRPC). Use of these therapies in the adjuvant setting when the disease may be micrometastatic and potentially more sensitive to therapies may decrease mortality from prostate cancer. However, the conduct of adjuvant prostate cancer clinical trials is hampered by taking longer than a decade to reach the meaningful endpoint of overall survival (OS) and the fact that many men never die from prostate cancer, even if they relapse. A validated intermediate clinical endpoint (ICE) in prostate cancer that is a robust surrogate for OS has yet to be defined. This paper details the plans, process, and progress of the international Intermediate Clinical Endpoints in Cancer of the Prostate (ICECaP) working group to pool individual patient data from all available clinical trials of radiation or prostatectomy for localized disease and conduct the requisite analyses to determine whether an ICE can be identified. This paper further details the challenges and the a priori statistical analytical plans and strategies to define an ICE for adjuvant prostate cancer clinical trials. In addition, a brief review of the health economic analyses to model the benefits to patients, society and manufacturers is detailed. If successful, the results from this work will provide a robust surrogate for OS that will expedite the design and conduct of future adjuvant therapy trials using new agents that have proven activity in mCRPC. Moreover, it will also define the health economic benefits to patients and societies.
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2015 |
Denham JW, Steigler A, Joseph D, Lamb DS, Spry NA, Duchesne G, et al., 'Radiation dose escalation or longer androgen suppression for locally advanced prostate cancer? Data from the TROG 03.04 RADAR trial', Radiotherapy and Oncology, 115 301-307 (2015) [C1]
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Nova |
2015 |
Ebert MA, Bulsara M, Haworth A, Kearvell R, Richardson S, Kennedy A, et al., 'Technical quality assurance during the TROG 03.04 RADAR prostate radiotherapy trial: Are the results reflected in observed toxicity rates?', Journal of Medical Imaging and Radiation Oncology, 59 99-108 (2015) [C1]
Introduction Multicentre radiotherapy clinical trials can incorporate quality assurance (QA) procedures for ensuring consistent application of the trial protocol in the planning, ... [more]
Introduction Multicentre radiotherapy clinical trials can incorporate quality assurance (QA) procedures for ensuring consistent application of the trial protocol in the planning, delivery and reporting of participant treatments. Subsequently detected variations from trial protocol have previously been shown to reduce treatment efficacy, although little has been shown for toxicity rates. The purpose of this study was to investigate the association of QA measures and protocol variations on toxicity incidence in the context of a prostate radiotherapy trial. Methods Using QA records from the TROG 03.04 RADAR trial, the impact of variations on gastrointestinal (GI) and genito-urinary (GU) toxicities was investigated. Results Protocol variation rates were lower than reported in previous studies, and showed little correlation with GI toxicity outcomes. Variations classified as 'major' showed a non-significant trend for increased toxicity relative to those classified as 'minor'. Results from a Level III phantom-based dosimetry study showed some correlation with GI toxicity, whereas ranking on a set-up accuracy study did not impact on toxicity. Toxicity in general increased with the number of participants accrued per centre, at odds with previous reports relating to disease progression, with a potential link to increases in low-mid-range rectal doses in the cohort from higher-accruing centres. No QA-related variables correlated with GU toxicities. Conclusions Besides non-significant trends, minimal association was observed between QA variables and toxicity rates for the RADAR trial. The intention of the trial's QA programme was to reduce treatment variations and minimise toxicity in the context of a relevantly advanced treatment approach.
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Nova |
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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Nova |
2015 |
Yahya N, Ebert MA, Bulsara M, Haworth A, Kennedy A, Joseph DJ, Denham JW, 'Dosimetry, clinical factors and medication intake influencing urinary symptoms after prostate radiotherapy: An analysis of data from the RADAR prostate radiotherapy trial', Radiotherapy and Oncology, 116 112-118 (2015) [C1]
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Nova |
2015 |
Carter G, Clover K, Britton B, Mitchell AJ, White M, McLeod N, et al., 'Wellbeing during Active Surveillance for localised prostate cancer: A systematic review of psychological morbidity and quality of life', Cancer Treatment Reviews, 41 46-60 (2015) [C1]
Background: Active Surveillance (AS) is recommended for the treatment of localised prostate cancer; however this option may be under-used, at least in part because of expectations... [more]
Background: Active Surveillance (AS) is recommended for the treatment of localised prostate cancer; however this option may be under-used, at least in part because of expectations of psychological adverse events in those offered or accepting AS. Objective: (1) Determine the impact on psychological wellbeing when treated with AS (non-comparative studies). (2) Compare AS with active treatments for the impact on psychological wellbeing (comparative studies). Method: We used the PRISMA guidelines and searched Medline, PsychInfo, EMBASE, CINHAL, Web of Science, Cochrane Library and Scopus for articles published January 2000-2014. Eligible studies reported original quantitative data on any measures of psychological wellbeing. Results: We identified 34 eligible articles (. n=. 12,497 individuals); 24 observational, eight RCTs, and two other interventional studies. Studies came from North America (16), Europe (14) Australia (3) and North America/Europe (1). A minority (5/34) were rated as high quality. Most (26/34) used validated instruments, whilst a substantial minority (14/34) used watchful waiting or no active treatment rather than Active Surveillance. There was modest evidence of no adverse impact on psychological wellbeing associated with Active Surveillance; and no differences in psychological wellbeing compared to active treatments. Conclusion: Patients can be informed that Active Surveillance involves no greater threat to their psychological wellbeing as part of the informed consent process, and clinicians need not limit access to Active Surveillance based on an expectation of adverse impacts on psychological wellbeing.
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Nova |
2015 |
Denham JW, 'When to choose radiotherapy for prostate cancer, and what technique?', Cancer Forum, 39 183-188 (2015) [C1]
This review describes the present curative role of radiotherapy in men with localised prostate cancer, and the many technical innovations that have occurred over the last 20 years... [more]
This review describes the present curative role of radiotherapy in men with localised prostate cancer, and the many technical innovations that have occurred over the last 20 years that have improved its accuracy and safety. These have resulted in today's state of the art irradiation technique known as 'imaged guided intensity modulated radiotherapy'. Emerging changes in practice for men with good prognosis tumours, which include radiation dose escalation, and major reductions in the duration of radiotherapy treatment courses are outlined. Finally, the role of adjuvant treatments for men with poor prognosis, high risk locally advanced tumours, and new approaches to these initiatives are summarised.
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Nova |
2014 |
Ebert MA, Gulliford SL, Buettner F, Foo K, Haworth A, Kennedy A, et al., 'Two non-parametric methods for derivation of constraints from radiotherapy dose-histogram data', PHYSICS IN MEDICINE AND BIOLOGY, 59 N101-N111 (2014) [C1]
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Nova |
2014 |
Galvao DA, Spry N, Denham J, Taaffe DR, Cormie P, Joseph D, et al., 'A Multicentre Year-long Randomised Controlled Trial of Exercise Training Targeting Physical Functioning in Men with Prostate Cancer Previously Treated with Androgen Suppression and Radiation from TROG 03.04 RADAR', EUROPEAN UROLOGY, 65 856-864 (2014) [C1]
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Nova |
2014 |
Yahya N, Ebert MA, Bulsara M, Haworth A, Kearvell R, Foo K, et al., 'Impact of treatment planning and delivery factors on gastrointestinal toxicity: An analysis of data from the RADAR prostate radiotherapy trial', Radiation Oncology, 9 (2014) [C1]
Background: To assess the impact of incremental modifications of treatment planning and delivery technique, as well as patient anatomical factors, on late gastrointestinal toxicit... [more]
Background: To assess the impact of incremental modifications of treatment planning and delivery technique, as well as patient anatomical factors, on late gastrointestinal toxicity using data from the TROG 03.04 RADAR prostate radiotherapy trial. Methods: The RADAR trial accrued 813 external beam radiotherapy participants during 2003-2008 from 23 centres. Following review and archive to a query-able database, digital treatment plans and data describing treatment technique for 754 patients were available for analysis. Treatment demographics, together with anatomical features, were assessed using uni- and multivariate regression models against late gastrointestinal toxicity at 18-, 36- and 54-month follow-up. Regression analyses were reviewed in the context of dose-volume data for the rectum and anal canal. Results: A multivariate analysis at 36-month follow-up shows that patients planned using a more rigorous dose calculation algorithm (DCA) was associated with a lower risk of stool frequency (OR: 0.435, CI: 0.242-0.783, corrected p = 0.04). Patients using laxative as a method of bowel preparation had higher risk of having increased stool frequency compared to patients with no dietary intervention (OR: 3.639, CI: 1.502-8.818, corrected p = 0.04). Despite higher risks of toxicities, the anorectum, anal canal and rectum dose-volume histograms (DVH) indicate patients using laxative had unremarkably different planned dose distributions. Patients planned with a more rigorous DCA had lower median DVH values between EQD23 = 15 Gy and EQD23 = 35 Gy. Planning target volume (PTV), conformity index, rectal width and prescription dose were not significant when adjusted for false discovery rate. Number of beams, beam energy, treatment beam definition, positioning orientation, rectum-PTV separation, rectal length and mean cross sectional area did not affect the risk of toxicities. Conclusions: The RADAR study dataset has allowed an assessment of technical modifications on gastrointestinal toxicity. A number of interesting associations were subsequently found and some factors, previously hypothesised to influence toxicity, did not demonstrate any significant impact. We recommend trial registries be encouraged to record technical modifications introduced during the trial in order for more powerful evidence to be gathered regarding the impact of the interventions.
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Nova |
2014 |
Sharpley CF, Bitsika V, Denham JW, 'Factors associated with feelings of loss of masculinity in men with prostate cancer in the RADAR trial', Psycho-Oncology, 23 524-530 (2014) [C1]
Objectives To identify the factors underlying prostate cancer (PCa) patients' depression-anxiety, sexual problems, urinary dysfunction and androgen deprivation therapy (ADT)-... [more]
Objectives To identify the factors underlying prostate cancer (PCa) patients' depression-anxiety, sexual problems, urinary dysfunction and androgen deprivation therapy (ADT)-linked breast changes and hot flushes, and test these as predictors of loss of masculinity (LoM) over 36months following diagnosis. Methods One thousand seventy patients from the TROG 03.04 (RADAR) trial the EORTC QLQ C-30 and PR 25 questionnaires, and the International Prostate Cancer Symptom Score of the American Urological Association at baseline, 3, 7, 12, 18, 24 and 36months. Selected items from these scales were factor-analysed to identify a four-component solution for responses at 18 and 36months, and these components were regressed against a single-item measuring LoM. Results Depression-anxiety factor was the most powerful predictor of LoM at both time points, followed by sexual problems of ADT side effects (breast changes and hot flushes). Urinary dysfunction was not a consistent predictor of LoM. Depression-anxiety was also the most significant factor distinguishing between those men who reported LoM and those who did not. Conclusions Although LoM is often reported as arising from ADT, the relative power of depression-anxiety in predicting LoM, both at the selected time points and using a time-lagged analysis, plus the finding that depression-anxiety was the most consistent difference between men who reported LoM and those who did not, argues for the presence of adverse mood states as being the key ingredient in deciding if PCa patients experience loss of their feelings of masculinity. Copyright © 2013 John Wiley & Sons, Ltd. Copyright © 2013 John Wiley & Sons, Ltd.
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Nova |
2014 |
Denham JW, Nowitz M, Joseph D, Duchesne G, Spry NA, Lamb DS, et al., 'Impact of androgen suppression and zoledronic acid on bone mineral density and fractures in the Trans-Tasman Radiation Oncology Group (TROG) 03.04 Randomised Androgen Deprivation and Radiotherapy (RADAR) randomized controlled trial for locally advanced prostate cancer', BJU International, 114 344-353 (2014) [C1]
Objective To study the influence of adjuvant androgen suppression and bisphosphonates on incident vertebral and non-spinal fracture rates and bone mineral density (BMD) in men wit... [more]
Objective To study the influence of adjuvant androgen suppression and bisphosphonates on incident vertebral and non-spinal fracture rates and bone mineral density (BMD) in men with locally advanced prostate cancer. Patients and Methods Between 2003 and 2007, 1071 men with locally advanced prostate cancer were randomly allocated, using a 2 × 2 trial design, to 6 months i.m. leuprorelin (androgen suppression [AS]) before radiotherapy alone ± 12 months additional leuprorelin ± 18 months zoledronic acid (ZdA), commencing at randomization. The main endpoint was incident thoraco-lumbar vertebral fractures, which were assessed radiographically at randomization and at 3 years, then reassessed by centralized review. Subsidiary endpoints included incident non-spinal fractures, which were documented throughout follow-up, and BMD, which was measured in 222 subjects at baseline, 2 years and 4 years. Results Incident vertebral fractures at 3 years were observed in 132 subjects. Their occurrence was not increased by 18 months' AS, nor reduced by ZdA. Incident non-spinal fractures occurred in 72 subjects and were significantly related to AS duration but not to ZdA. Osteopenia and osteoporosis prevalence rates at baseline were 23.4 and 1.4%, respectively, at the hip. Treatment for 6 and 18 months with AS caused significant reductions in hip BMD at 2 and 4 years (P < 0.01) and ZdA prevented these losses at both time points. Conclusion In an AS-naïve population, 18 months of ZdA treatment prevented the sustained BMD losses caused by 18 months of AS treatment; however, the study power was insufficient to show that AS duration or ZdA influenced vertebral fracture rates. © 2013 The Authors. BJU International © 2013 BJU International.
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2014 |
Denham JW, Joseph D, Lamb DS, Spry NA, Duchesne G, Matthews J, et al., 'Short-term androgen suppression and radiotherapy versus intermediate-term androgen suppression and radiotherapy, with or without zoledronic acid, in men with locally advanced prostate cancer (TROG 03.04 RADAR): an open-label, randomised, phase 3 factorial trial', LANCET ONCOLOGY, 15 1076-1089 (2014) [C1]
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2014 |
Chang D, Joseph DJ, Ebert MA, Galvão DA, Taaffe DR, Denham JW, et al., 'Effect of androgen deprivation therapy on muscle attenuation in men with prostate cancer', Journal of Medical Imaging and Radiation Oncology, 58 223-228 (2014) [C1]
Introduction Aging skeletal muscle is associated with not only a reduction in muscle size and strength but also in muscle quality which reflects an increase in fatty infiltration ... [more]
Introduction Aging skeletal muscle is associated with not only a reduction in muscle size and strength but also in muscle quality which reflects an increase in fatty infiltration of muscle. In men with prostate cancer, androgen deprivation therapy (ADT) accelerates this loss of muscle size and strength, but it is unknown if muscle quality is also adversely affected. Therefore, we examined the effects of ADT on muscle attenuation, an indirect measure of intramuscular lipid content, as well as the muscle cross-sectional area (CSA) in men with prostate cancer. Methods Pre- and post-CT scans of the pelvis in 39 men aged 49-78 years receiving leuprorelin were examined. The time between baseline and follow-up scans was 14.6-20 weeks after the commencement of ADT. Changes in skeletal muscle attenuation in Hounsfield units of the rectus femoris and the CSA of the rectus femoris, sartorius and quadricep muscles were assessed. Results Muscle attenuation of the rectus femoris muscle was significantly reduced following the initiation of ADT by 18.9% (P < 0.001). In addition, there was a significant decrease (P < 0.001) in the CSA for the sartorius, quadriceps and rectus femoris muscles. There was no effect of Zometa on muscle attenuation or muscle CSA. Conclusions Our results indicate that not only muscle size but also muscle quality may be adversely affected by the undertaking of ADT in men with prostate cancer. Consequently, interventions to counteract deteriorations to both muscle mass and possibly muscle quality should be considered in men receiving ADT. © 2013 The Royal Australian and New Zealand College of Radiologists.
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Nova |
2014 |
Moseshvili E, Joseph DJ, Spry NA, Cohen RJ, Abreu A, Kautto A, Denham JW, 'Serum procollagen 1 amino-terminal propeptide (P1NP) in prostate cancer: Pitfalls of its use as an early surrogate marker for bone metastasis', Journal of Medical Imaging and Radiation Oncology, 58 497-502 (2014) [C1]
Introduction Procollagen 1 amino-terminal propeptide (P1NP) is a bone formation marker and has been shown to have a strong association with the extent of bone metastases (BM) in p... [more]
Introduction Procollagen 1 amino-terminal propeptide (P1NP) is a bone formation marker and has been shown to have a strong association with the extent of bone metastases (BM) in patients with advanced prostate cancer. More recently, its levels were found to be affected by androgen deprivation therapies and bisphosphonates. We investigated the role of P1NP as a surrogate marker of sub-radiological skeletal metastases in prostate cancer patients with biochemical failure (BF). Methods BePrepared is a prospective longitudinal substudy of RADAR trial in which serial P1NPs were collected at regular intervals for 123 patients who had completed RADAR protocol treatment. Results There was no trend identified in P1NP levels prior to diagnosis of BM. We found that there was no difference in P1NP concentrations at the time of diagnosis of BM in the group that developed BM compared with P1NP levels in groups with only nodal metastases or BF. In the group of patients who did not experience BF, P1NP was affected by previous luteinizing hormone-releasing hormone-agonist and bisphosphonate therapy. Hence, patients who received an 18-month course of androgen deprivation without bisphosphonates had significantly higher P1NP values than patients with shorter androgen deprivation therapy (ADT) course combined with a course of bisphosphonates. Conclusion P1NP is not a sensitive serum marker of early BM in high-risk prostate cancer patients with BF and low prostate-specific antigen levels as its levels are affected by prior history of bone remodelling therapies such as ADT and bisphosphonates. © 2014 The Royal Australian and New Zealand College of Radiologists.
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2014 |
Hauer-Jensen M, Denham JW, Andreyev HJN, 'Radiation enteropathy-Pathogenesis, treatment and prevention', Nature Reviews Gastroenterology and Hepatology, 11 470-479 (2014) [C1]
Changes in cancer incidence and mortality have been modest during the past several decades, but the number of cancer survivors has almost tripled during the same period. With an i... [more]
Changes in cancer incidence and mortality have been modest during the past several decades, but the number of cancer survivors has almost tripled during the same period. With an increasing cohort of cancer survivors, efforts to prevent, diagnose and manage adverse effects of cancer therapy, in general, and those of radiation therapy specifically, have intensified. Many cancer survivors have undergone radiation therapy of tumours in the pelvis or abdomen, thus rendering the bowel at risk of injury. In fact, the current prevalence of patients who have long-term radiation-induced intestinal adverse effects exceeds that of IBD. Considerable progress towards reducing toxicity of radiation therapy has been made by the introduction of so-called dose-sculpting treatment techniques, which enable precise delivery of the radiation beam. Moreover, new insights into the underlying pathophysiology have resulted in an improved understanding of mechanisms of radiation-induced bowel toxicity and in development of new diagnostic strategies and management opportunities. This Review discusses the pathogenesis of early and delayed radiation-induced bowel toxicity, presents current management options and outlines priorities for future research. By adding insight into molecular and cellular mechanisms of related bowel disorders, gastroenterologists can substantially strengthen these efforts. © 2014 Macmillan Publishers Limited. All rights reserved.
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2014 |
Sharpley CF, Bitsika V, Christie DRH, Denham JW, Duchesne GM, Couper JW, 'Researching depression in prostate cancer patients: Factors, timing, and measures', Journal of Men's Health, 11 145-156 (2014) [C1]
Background: Due to the pressing need to understand the causal and associative factors of depression among prostate cancer (PCa) patients, a comprehensive research protocol for inv... [more]
Background: Due to the pressing need to understand the causal and associative factors of depression among prostate cancer (PCa) patients, a comprehensive research protocol for investigating depression in prostate cancer patients is suggested as a way of furthering the collection of data in consistent and informative ways. Methods: A detailed review of a range of predictors of, and buffers against, depression, plus methods of assessing depressive symptomatology and optimum time to collect data were used to develop a model for a comprehensive research protocol. Results: A model protocol is described that includes socioeconomic, genetic, endocrinal, immunological, physiological, psychological, relationship, and socioeconomic pathways to depression. In addition, methods of assessing depressive symptomatology are described, plus comorbidity of anxiety with depression, male depression, and the construct of Individual Burden of Illness for Depression. The need to collect multiple measures over time in order to describe variability in symptoms and the relationships between symptoms and other variables is emphasized. Conclusion: This model protocol of research into depression in prostate cancer patients allows for a comprehensive approach that includes predictors, symptoms, and time for observation. Use of this protocol will enhance the understanding and treatment of depression in PCa patients from a "personalized medicine" perspective.
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2014 |
Hauer-Jensen M, Denham JW, Andreyev HJN, 'Radiation enteropathy-pathogenesis, treatment and prevention', Nature Reviews Gastroenterology and Hepatology, (2014)
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2013 |
Ghose S, Denham J, Ebert M, Kennedy A, Mitra J, Rose S, Dowling J, 'Multi-atlas and Gaussian Mixture Modeling Based Perirectal Fat Segmentation from CT Images', ABDOMINAL IMAGING: COMPUTATION AND CLINICAL APPLICATIONS, 8198 194-202 (2013)
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2013 |
Denham JW, Hauer-Jensen M, 'Radiation induced bowel injury: a neglected problem', The Lancet, (2013) [C3]
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2013 |
Denham JW, Hauer-Jensen M, 'Radiation induced bowel injury: A neglected problem', The Lancet, 382 2046-2047 (2013)
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2013 |
Denham JW, Steigler A, Tai K, Joseph D, Matthews J, Atkinson C, et al., 'Paradoxical metastatic progression following 3 months of neo-adjuvant androgen suppression in the TROG 96.01 trial for men with locally advanced prostate cancer', Radiotherapy and Oncology, 107 123-128 (2013) [C1]
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2013 |
Singh J, Greer PB, White MA, Parker J, Patterson J, Tang CI, et al., 'Treatment-Related Morbidity in Prostate Cancer: A Comparison of 3-Dimensional Conformal Radiation Therapy With and Without Image Guidance Using Implanted Fiducial Markers', INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS, 85 1018-1023 (2013) [C1]
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2013 |
Foo K, Ebert MA, Carolan MG, Haworth A, Bulsara M, Joseph D, Denham JW, 'TU-G-108-06: Anatomical Localization of Late Rectal Toxicity Predictors in Prostate Radiotherapy.', Med Phys, 40 454 (2013)
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2013 |
Denham JW, Steigler A, 'Picking the Optimal Duration of Hormonal Therapy in Men With High-Risk and Locally Advanced Prostate Cancer Treated With Radiotherapy', Seminars in Radiation Oncology, 23 206-214 (2013) [C1]
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2013 |
Kearvell R, Haworth A, Ebert MA, Murray J, Hooton B, Richardson S, et al., 'Quality improvements in prostate radiotherapy: Outcomes and impact of comprehensive quality assurance during the TROG 03.04 'RADAR' trial', Journal of Medical Imaging and Radiation Oncology, 57 247-257 (2013) [C1]
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2012 |
Wilcox C, Kautto AJ, Steigler A, Denham J, 'Androgen deprivation therapy for prostate cancer does not increase cardiovascular mortality in the long term', Oncology: International Journal of Cancer Research and Treatment, 82 56-58 (2012) [C1]
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Nova |
2012 |
Denham J, Wilcox C, Lamb DS, Spry NA, Duchesne G, Atkinson C, et al., 'Rectal and urinary dysfunction in the TROG 03.04 RADAR trial for locally advanced prostate cancer', Radiotherapy and Oncology, 105 184-192 (2012) [C1]
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Nova |
2012 |
Denham J, Wilcox C, Joseph D, Spry NA, Lamb DS, Tai K-H, et al., 'Quality of life in men with locally advanced prostate cancer treated with leuprorelin and radiotherapy with or without zoledronic acid (TROG 03.04 RADAR): Secondary endpoints from a randomised phase 3 factorial trial', Lancet Oncology, 13 1260-1270 (2012) [C1]
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2012 |
D'Amico AV, Chen M-H, De Castro M, De Castro M, Lamb DS, Steigler A, et al., 'Surrogate endpoints for prostate cancer-specific mortality after radiotherapy and androgen suppression therapy in men with localised or locally advanced prostate cancer: An analysis of two randomised trials', Lancet Oncology, 13 189-195 (2012) [C1]
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2012 |
Dowling JA, Lambert JA, Parker J, Salvado O, Fripp J, Capp A, et al., 'An atlas-based electron density mapping method for Magnetic Resonance Imaging (MRI)-Alone treatment planning and adaptive MRI-Based prostate radiation therapy', International Journal of Radiation Oncology Biology Physics, 83 E5-E11 (2012) [C1]
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2012 |
Steigler A, Denham J, Lamb DS, Spry NA, Joseph D, Matthews J, et al., 'Risk stratification after biochemical failure following curative treatment of locally advanced prostate cancer: Data from the TROG 96.01 trial', Prostate Cancer, 2012 1-11 (2012) [C1]
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2011 |
Galvao DA, Taaffe DR, Cormie P, Spry N, Chambers SK, Peddle-Mcintyre C, et al., 'Efficacy and safety of a modular multi-modal exercise program in prostate cancer patients with bone metastases: A randomized controlled trial', BMC Cancer, 11 517 (2011) [C3]
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2011 |
Denham J, 'An important piece of the localized prostate cancer puzzle?', Nature Reviews: Clinical Oncology, 8 573-574 (2011) [C3]
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2011 |
Dowling JA, Fripp J, Chandra S, Pluim JPW, Lambert JA, Parker J, et al., 'Fast automatic multi-atlas segmentation of the prostate from 3D MR images', International Workshop on Prostate Cancer Imaging: Image Analysis and Image-Guided Interventions Proceedings (LNCS 6963), 10-21 (2011) [E1]
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Nova |
2011 |
Dunstan RH, Sparkes DL, MacDonald MM, Roberts TK, Wratten C, Kumar M, et al., 'Altered amino acid homeostasis and the development of fatigue by breast cancer radiotherapy patients: A pilot study', Clinical Biochemistry, 44 208-215 (2011) [C1]
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2011 |
Greer PB, Dowling JA, Lambert JA, Fripp J, Parker J, Denham J, et al., 'A magnetic resonance imaging-based workflow for planning radiation therapy for prostate cancer', Medical Journal of Australia, 194 S24-S27 (2011) [C1]
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Nova |
2011 |
Andreyev HJN, Wotherspoon A, Denham J, Hauer-Jensen M, ''Pelvic radiation disease': New understanding and new solutions for a new disease in the era of cancer survivorship', Scandinavian Journal of Gastroenterology, 46 389-397 (2011) [C1]
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2011 |
Gustafsson H, Vial P, Kuncic Z, Baldock C, Denham J, Greer PB, 'Direct dose to water dosimetry for pretreatment IMRT verification using a modified EPID', Medical Physics, 38 6257-6264 (2011) [C1]
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2011 |
Harrison KM, Ebert MA, Kron T, Howlett SJ, Cornes D, Hamilton CS, Denham J, 'Design, manufacture, and evaluation of an anthropomorphic pelvic phantom purpose-built for radiotherapy dosimetric intercomparison', Medical Physics, 38 5330-5337 (2011) [C1]
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2011 |
Ebert MA, Harrison KM, Howlett SJ, Cornes D, Bulsara M, Hamilton CS, et al., 'Dosimetric intercomparison for multicenter clinical trials using a patient-based anatomic pelvic phantom', Medical Physics, 38 5167-5175 (2011) [C1]
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Nova |
2011 |
Hatton J, Greer PB, Tang C, Wright P, Capp A, Gupta S, et al., 'Does the planning dose-volume histogram represent treatment doses in image-guided prostate radiation therapy? Assessment with cone-beam computerised tomography scans', Radiotherapy and Oncology, 98 162-168 (2011) [C1]
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2011 |
Lambert JA, Greer PB, Menk FW, Patterson J, Parker J, Dahl K, et al., 'MRI-guided prostate radiation therapy planning: Investigation of dosimetric accuracy of MRI-based dose planning', Radiotherapy and Oncology, 98 330-334 (2011) [C1]
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Nova |
2011 |
Ebert MA, Lamb DS, Joseph DJ, Steigler A, Denham J, 'A methodology for the analysis of PSA response signatures', Radiotherapy and Oncology, 98 198-202 (2011) [C1]
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2011 |
Denham J, Lamb DS, Joseph D, Matthews J, Atkinson C, Spry NA, et al., 'Another form of subgroup to beware', Radiotherapy and Oncology, 101 525-526 (2011) [C3]
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2011 |
Lamb DS, Denham J, Joseph D, Matthews J, Atkinson C, Spry NA, et al., 'A comparison of the prognostic value of early PSA test-based variables following external beam radiotherapy, with or without preceding androgen deprivation: Analysis of data from the TROG 96.01 randomized trial', International Journal of Radiation Oncology Biology Physics, 79 385-391 (2011) [C1]
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Nova |
2011 |
D'Amico AV, Chen MH, Crook J, Armstrong JG, Malone S, Steigler A, et al., 'Duration of short-course androgen suppression therapy and the risk of death as a result of prostate cancer', Journal of Clinical Oncology, 29 4682-4687 (2011) [C1]
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Nova |
2011 |
Denham J, Steigler A, Lamb DS, Joseph D, Turner S, Matthews J, et al., 'Short-term neoadjuvant androgen deprivation and radiotherapy for locally advanced prostate cancer: 10-year data from the TROG 96.01 randomised trial', The Lancet Oncology, 12 451-459 (2011) [C1]
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2010 |
Baujat B, Bourhis J, Blanchard P, Overgaard J, Ang KK, Saunders M, et al., 'Hyperfractionated or accelerated radiotherapy for head and neck cancer', COCHRANE DATABASE OF SYSTEMATIC REVIEWS, (2010)
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2010 |
Dowling J, Lambert JA, Parker J, Greer PB, Fripp J, Denham J, et al., 'Automatic MRI atlas-based external beam radiation therapy treatment planning for prostate cancer', Prostate Cancer Imaging: Computer-Aided Diagnosis, Prognosis, and Intervention International Workshop, Held in Conjunction with MICCAI 2010, Beijing,China, September 24, 2010. Proceedings, 25-33 (2010) [E1]
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2010 |
Denham J, Bender R, Paradice WEJ, 'It's time to depolarise the unhelpful PSA-testing debate and put into practice lessons from the two major international screening trials', Medical Journal of Australia, 192 393-396 (2010) [C1]
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Nova |
2010 |
Delahunt B, Lamb DS, Srigley JR, Murray JD, Wilcox C, Samaratunga H, et al., 'Gleason scoring: A comparison of classical and modified (International Society of Urological Pathology) criteria using nadir PSA as a clinical end point', Pathology, 42 339-343 (2010) [C1]
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Nova |
2010 |
Baumann M, Holscher T, Denham J, 'Fractionation in prostate cancer - Is it time after all?', Radiotherapy and Oncology, 96 1-5 (2010) [C3]
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2010 |
Kumar M, Denham J, Steigler A, 'Value of combined androgen blockade in the neoadjuvant treatment of localized prostate cancer: The jury must remain out', Journal of Clinical Oncology, 28 E445-E446 (2010) [C3]
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2010 |
Denham JW, Bender R, Paradice WEJ, 'It's time to depolarise the unhelpful PSA-testing debate and put into practice lessons from the two major international screening trials (Medical Journal of Australia (2010) 192, (393-396))', Medical Journal of Australia, 192 655 (2010)
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2010 |
Andreyev HJN, Wotherspoon A, Denham J, Hauer-Jensen M, 'Defining pelvic-radiation disease for the survivorship era', Lancet Oncology, 11 310-312 (2010) [C3]
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2009 |
Galvao DA, Spry NA, Taaffe DR, Denham J, Joseph D, Lamb DS, et al., 'A randomized controlled trial of an exercise intervention targeting cardiovascular and metabolic risk factors for prostate cancer patients from the RADAR trial', BMC Cancer, 9 1-7 (2009) [C1]
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Nova |
2009 |
Gupta SA, Wratten C, Kilmurray J, Nash S, Seldon M, O'Brien P, et al., 'Is there a relationship between skin erythema and fatigue in women undergoing irradiation after breast conserving surgery for early breast cancer? A prospective study', Asia-Pacific Journal of Clinical Oncology, 5 257-263 (2009) [C1]
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Nova |
2009 |
Ebert M, Harrison K, Cornes D, Howlett S, Joseph D, Kron T, et al., 'Comprehensive Australasian multicentre dosimetric intercomparison: Issues, logistics and recommendations', Journal of Medical Imaging and Radiation Oncology, 53 119-131 (2009) [C1]
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Nova |
2009 |
Tang C, Stanwell PT, Ourselin S, Salvado O, Dowling J, Bourgeat P, et al., 'Nonrigid correction of interleaving artefacts in pelvic MRI', Proceedings of SPIE Medical Imaging, 7259 1-10 (2009) [E1]
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2009 |
Denham J, Steigler A, Wilcox C, Lamb DS, Joseph D, Atkinson C, et al., 'Why are pretreatment prostate-specific antigen levels and biochemical recurrence poor predictors of prostate cancer survival?', Cancer, 115 4477-4487 (2009) [C1]
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Nova |
2009 |
Denham J, Lamb DS, Joseph D, Matthews J, Atkinson C, Spry NA, et al., 'PSA response signatures: A powerful new prognostic indicator after radiation for prostate cancer?', Radiotherapy and Oncology, 90 382-388 (2009) [C1]
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Nova |
2009 |
Haworth A, Kearvell R, Greer PB, Hooton B, Denham J, Lamb D, et al., 'Assuring high quality treatment delivery in clinical trials: Results from the Trans-Tasman Radiation Oncology Group (TROG) study 03.04 'RADAR' set-up accuracy study', Radiotherapy and Oncology, 90 299-306 (2009) [C1]
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Nova |
2009 |
Lincz L, Gupta SA, Wratten C, Kilmurray J, Nash S, Seldon M, et al., 'Thrombin generation as a predictor of radiotherapy induced skin erythema', Radiotherapy and Oncology, 90 136-140 (2009) [C1]
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Nova |
2009 |
Capp A, Inostroza-Ponta M, Bill D, Moscato PA, Lai C, Christie D, et al., 'Is there more than one proctitis syndrome? A revisitation using data from the TROG 96.01 trial', Radiotherapy and Oncology, 90 400-407 (2009) [C1]
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Nova |
2009 |
Denham J, Kumar M, Gleeson PS, Lamb DS, Joseph D, Atkinson C, et al., 'Recognizing false biochemical failure calls after radiation with or without neo-adjuvant androgen deprivation for prostate cancer', International Journal of Radiation Oncology Biology Physics, 74 404-411 (2009) [C1]
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Nova |
2009 |
Denham J, Steigler A, Kumar M, Lamb DS, Joseph D, Spry NA, et al., 'Measuring time to biochemical failure in the Trog 96.01 trial: When should the clock start ticking?', International Journal of Radiation Oncology Biology Physics, 75 1008-1012 (2009) [C1]
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Nova |
2009 |
Lamb DS, Delahunt B, Denham J, Slaney D, 'Survival benefit confirmed for prostate cancers diagnosed by PSA testing', New Zealand Medical Journal, 122 67-70 (2009) [C3] |
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Nova |
2008 |
Denham J, Steigler A, Wilcox C, Lamb DS, Joseph D, Atkinson C, et al., 'Time to biochemical failure and prostate-specific antigen doubling time as surrogates for prostate cancer-specific mortality: evidence from the TROG 96.01 randomised controlled trial', Lancet Oncology, 9 1058-1068 (2008) [C1]
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Nova |
2008 |
Gupta SA, Wratten C, Ludbrook JJ, O'Brien PC, Kumar MB, Denham JW, 'Hypofractionated versus standard fractionation radiotherapy in early glottic cancer: A retrospective review', Asia-Pacific Journal of Clinical Oncology, 4 239-243 (2008) [C1]
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Nova |
2008 |
Greer PB, Dahl K, Ebert MA, White M, Wratten C, Ostwald PM, et al., 'Assessment of a daily online implanted fiducial marker-guided prostate radiotherapy process', Journal of Medical Imaging and Radiation Oncology, 52 517-524 (2008) [C1]
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Nova |
2008 |
Greer PB, Dahl K, Ebert MA, Wratten C, White M, Denham J, 'Comparison of prostate set-up accuracy and margins with off-line bony anatomy corrections and online implanted fiducial-based corrections', Journal of Medical Imaging and Radiation Oncology, 52 511-516 (2008) [C1]
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Nova |
2008 |
Ebert MA, Howlett SJ, Harrison K, Cornes D, Hamilton CS, Denham J, 'Linear-accelerator X-ray output: A multicentre chamber-based intercomparison study in Australia and New Zealand', Australasian Physical & Engineering Sciences in Medicine, 31 268-279 (2008) [C1]
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Nova |
2007 |
Madjar I, Denham J, Rashid P, 'Do women have a role in early detection of prostate cancer? - Lessons from a qualitative study', Australian Family Physician, 36 375-377 (2007) [C1]
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2007 |
D'Amico AV, Denham J, Crook J, Chen MH, Goldhaber SZ, Lamb DS, et al., 'Influence of androgen suppression therapy for prostate cancer on the frequency and timing of fatal myocardial infarctions', Journal of Clinical Oncology, 25 2420-2425 (2007) [C1]
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2007 |
Hauer-Jensen M, Wang J, Boerma M, Fu Q, Denham J, 'Radiation damage to the gastrointestinal tract: Mechanisms, diagnosis, and management', Current Opinion in Supportive and Palliative Care, 1 23-29 (2007) [C1]
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2007 |
Wratten C, O'Brien PC, Hamilton CS, Bill D, Kilmurray J, Denham J, 'Breast edema in patients undergoing breast-conserving treatment for breast cancer: Assessment via high frequency ultrasound', Breast Journal, 13 266-273 (2007) [C1]
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2007 |
Madjar I, Kacen L, Ariad S, Denham J, 'Telling their stories, telling our stories: Physicians' experiences with patients who decide to forgo or stop treatment for cancer', Qualitative Health Research, 17 428-441 (2007) [C1]
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2007 |
D'Amico AV, Denham J, Bolla M, Collette L, Lamb DS, Tai KH, et al., 'Short- vs long-term androgen suppression plus external beam radiation therapy and survival in men of advanced age with node-negative high-risk adenocarcinoma of the prostate', Cancer, 109 2004-2010 (2007) [C1]
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2007 |
Denham J, 'MRC RT01: an important trial', Lancet Oncology, 8 459-460 (2007) [C3]
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2006 |
Dempsey CL, Duggan LJ, Bazley SG, Denham J, Kron T, 'Miniature LiF:Mg,Cu,P TLDs to study the effect of applicator material in 192-Ir brachytherapy', Australasian Physical & Engineering Sciences in Medicine, 29 300-302 (2006) [C1]
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2005 |
Christie D, Denham J, Steigler A, Lamb D, Turner S, Mameghan H, et al., 'Delayed rectal and urinary symptomatology in patients treated for prostate cancer by radiotherapy with or without short term neo-adjuvant androgen deprivation', Radiotherapy and oncology, 77 117-125 (2005) [C1]
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2005 |
Rischin D, Peters L, Fisher R, Macann A, Denham J, Poulsen M, et al., 'Tirapazamine, Cisplatin, and Radiation versus Fluorouracil, Cisplatin, and Radiation in patients with locally advanced head and neck cancer: a randomized phase II trial of the Trans-Tasman Radiation Oncology Group (TROG 98.02).', Journal of Clinical Oncology, 23 79-87 (2005) [C1]
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2005 |
Lamb DS, Denham JW, Delahunt B, 'Prostate cancer screening in Australasia', Clinical Oncology, 17 231-233 (2005) [C1]
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2005 |
Burmeister BH, Smithers BM, Gebski V, Fitzgerald L, Simes RJ, Devitt P, et al., 'Surgery alone versus chemoradiotherapy followed by surgery for resectable cancer of the oesophagus: A randomised controlled phase III trial', Lancet Oncology, 6 659-668 (2005) [C1]
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2005 |
Denham J, Steigler A, Lamb D, Joseph D, Mameghan H, Turner S, et al., 'Short-term androgen deprivation and radiotherapy for locally advanced prostate cancer : results from the Trans-Tasman Radiation Oncology Group 96.01 randomised controlled trial', The Lancet, 6 841-850 (2005) [C1]
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2004 |
Tsang G, O'Brien P, Robertson R, Hamilton C, Wratten C, Denham J, 'All Delays before radiotherapy risk progression of Merkel cell carcinoma', Australasian Radiology, 48 371-375 (2004) [C1]
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2004 |
Wratten C, Denham J, Kron T, O'Brien P, Hamilton C, ''When measurements mean action' decision models for portal image review to eliminate systematic set-up errors', Australasian Radiology, 48 272-279 (2004) [C1]
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2004 |
O'Brien P, Hamilton C, Denham J, Gourlay R, Franklin IV, 'Spontaneous improvement in late rectal mucosal changes after radiotherapy for prostate cancer', International Journal of Radiation: Oncology- Biology- Physics, 58 75-80 (2004) [C1]
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2004 |
Wratten C, Kilmurray J, Nash S, Seldon M, Hamilton C, O'Brien P, Denham J, 'Fatigue during breast radiotherapy and its relationship to biological factors', International Journal of Radiation: Oncology- Biology- Physics, 59 160-167 (2004) [C1]
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2003 |
Daly T, Poulsen MG, Denham JW, Peters LJ, Lamb DS, Krawitz H, et al., 'The effect of anaemia on efficacy and normal tissue toxicity following radiotherapy for locally advanced squamous cell carcinoma of the head and neck', RADIOTHERAPY AND ONCOLOGY, 68 113-122 (2003)
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2003 |
Lamb DS, Denham JW, Mameghan H, Joseph D, Turner S, Matthews J, et al., 'Acceptability of short term neo-adjuvant deprivation in patients with locally advanced prostate cancer', Radiotherapy and Oncology, 68 255-267 (2003) [C1]
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2003 |
Hauer-Jensen M, Wang J, Denham JW, 'Bowel injury: Current and evolving management strategies', Seminars in Radiation Oncology, 13 358-371 (2003)
The intestine is often dose limiting during abdominal and pelvic radiation therapy. Delayed bowel toxicity is difficult to manage and adversely impacts the quality of life of long... [more]
The intestine is often dose limiting during abdominal and pelvic radiation therapy. Delayed bowel toxicity is difficult to manage and adversely impacts the quality of life of long-term cancer survivors. Of the 8 to 9 million cancer survivors currently living in the United States, more than half have had abdominal or pelvic tumors, and about 60% of these patients have undergone or will undergo radiation therapy. Therefore, interventions that limit postradiation intestinal dysfunction would significantly improve outcomes in a large number of patients. Worthwhile steps toward reducing toxicity of treatments have been taken recently by introducing dose-sculpting treatment techniques. However, prophylactic or therapeutic approaches derived from an improved understanding of the pathophysiology of bowel injury will result in further advances. This article reviews current principles in the diagnosis and management of intestinal radiation injury. It also provides an overview of investigational strategies aimed at reducing radiation-induced bowel toxicity. These strategies include free radical scavengers, antioxidants, cytoprotective agents, cytokines, and enterotrophic interventions, as well as modulators of intraluminal factors, endothelial dysfunction, and neuroimmune interactions. Preclinical testing in clinically relevant animal models will facilitate translation of these strategies into the clinic and contribute to improving cancer cure rates and quality of life in cancer survivors. © 2003 Elsevier Inc. All rights reserved.
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2003 |
Denham J, Steigler A, Kilmurray J, Wratten C, Burmeister B, Lam D, et al., 'Relapse patterns after chemo-radiation for carcinoma of the oesophagus', Clinical Oncology, 15 98-108 (2003) [C1]
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Nova |
2003 |
Denham JW, 'Clinical implications of mucosal regeneration', INTERNATIONAL JOURNAL OF RADIATION BIOLOGY, 79 511-512 (2003)
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2003 |
Denham JW, 'Clinical implications of mucosal regeneration', International Journal of Radiation Biology, 79 1-2 (2003) [C1] |
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2003 |
Bentzen SM, D Rr W, Anscher MS, Denham J, Hauer-Jensen M, Marks LB, Williams J, 'Normal tissue effects: Reporting and analysis', Seminars in Radiation Oncology, 13 189-202 (2003) [C1]
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2003 |
Hauer-Jensen M, Wang J, Denham J, 'Bowel injury: Current and evolving management strategies', Seminars in Radiation Oncology, 13 358-371 (2003) [C1]
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2002 |
Hood C, Duggan L, Bazley SG, Denham J, Budzanowski M, Kron T, 'LiF: Mg, Cu, P 'Pin Worms': Miniature Detectors for Brachytherapy Dosimetry', Radiation Protection Dosimetry, 101(1-4) 407-410 (2002) [C1]
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2002 |
Denham J, Hauer-Jensen M, 'The radiotherapeutic injury - a complex 'wound'', Radiotherapy and Oncology, 63 129-145 (2002) [C1]
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Nova |
2002 |
Denham JW, Hauer-Jensen M, Peters LJ, 'In regard to Denham et al., Is it time for a new formalism to categorize normal tissue radiation injury? IJROBP 2001;50 : 1105-1106 - Response', INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS, 52 1148-1148 (2002)
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2002 |
Denham JW, 'In response to Seymour and colleagues (Letter)', Int. J. Radiat. Oncol. Biol. Phys., 52 (2002) [C3] |
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2002 |
Denham J, 'Prostate Cancer: Low the only consideration? In regard to Fowler, Chappell, and Ritter: The prospects for new treatments for prostate cancer', Int. J. Radiation Oncology Biol. Phys., 53(5) 1394-1395 (2002) [C3]
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2002 |
Denham JW, 'Prostate cancer: low alpha/beta the only consideration? (Letter to the Editor)', Int.J.Radiat.Onco.Biol.Phys., 52 3-5 (2002) [C3] |
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2002 |
Kron T, Hamilton C, Roff M, Denham J, 'Dosimetric Intercomparison for Two Australasian Clinical Trials Using an Anthropomorphic Phantom', International Journal of Radiation: Oncology - Biology - Physics, 52(2) 566-579 (2002) [C1]
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2002 |
O'Brien P, Franklin C, Poulsen M, Joseph D, Spry N, Denham J, 'Acute Symptoms, Not Rectally Administered Sucralfate, Predict for Late Radiation Proctitis: Longer Term Follow-up of a Phase III Trial - Trans-Tasman Radiation Oncology Group', International Journal of Radiation: Oncology - Biology - Physics, 54(2) 442-449 (2002) [C1]
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2002 |
Dorr W, Hamilton C, Boyd T, Reed BE, Denham J, 'Radiation-Induced Changes in Cellularity and Proliferation in Human Oral Mucosa', International Journal of Radiation: Oncology - Biology - Physics, 52(4) 911-917 (2002) [C1]
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2002 |
Denham JW, 'Prostate cancer: low alpha/beta the only consideration? (2002) [C1] |
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2002 |
Denham JW, Hauer-Jensen M, Peters LJ, 'In response to Seymour and colleagues (2002) [C1] |
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2002 |
Sakoff J, De Waal E, Garg M, Denham J, Scorgie F, Enno A, et al., 'Telomere Length in Haemopoietic Stem Cells can be Determined from that of Mononuclear Blood Cells or Whole Blood', Leukemia and Lymphoma, 43(10) 2017-2020 (2002) [C1]
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2001 |
Denham J, 'Wigg and Morgan;'New'hope?', Australasian Radiology, 45 541 (2001) [C3] |
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2001 |
Poulson M, Denham J, Pesters L, Lamb D, Spry N, Hindley A, et al., 'A randomised trial of accelerated and conventional radiotherapy for stage III and IV sqamous carcinoma of the head and neck: a Trans-Tasman Radiation Oncology Group Study', Radiotherapy and Oncology, 60 113-122 (2001) [C1]
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2001 |
Denham J, Kron T, 'Extinction of the Weakest', International Journal of Radiation Oncology Biology Physics, 51 807-819 (2001) [C1]
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2001 |
Denham J, Hauer-Jensen M, Peters L, 'Is it time for a new formalism to categorize normal tissue radiation injury', International Journal of Radiation Oncology, Biology & Physics, 50 1105-1106 (2001) [C3]
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2000 |
Wratten C, Kilmurray J, Wright S, O'Brien P, Back M, Hamilton C, Denham J, 'Pilot Study of High-Frequency Ultrasound to Assess Cutaneous Oedema in the Conservatively Managed Breast', International Journal of Cancer, 90 295-301 (2000) [C1]
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2000 |
Duggan L, Butson M, Howlett S, Denham J, Kron T, 'Verificationo f the dose distribution for 192Ir moult treatments using radiochromic film and LiF:Mg,Cu,P TLDs', Australasian Physical and Engineering Sciences in Medicine, 23 15-20 (2000) [C1]
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2000 |
Denham J, Kron T, Hamilton C, 'A TIMELY REMINDER', RADIOTHERAPY AND ONCOLOGY, 56 129-130 (2000) [C3]
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2000 |
Denham J, Hauer-Jensen M, Kron T, Langberg C, 'TREATMENT-TIME-DEPENDENCE MODELS OF EARLY AND DELAYED RADIATION INJURY IN RAT SMALL INTESTINE', INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS, 48 871-887 (2000) [C1]
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2000 |
Denham JW, 'Influence of dose-rate on the inflammatory damage and adhesion molecule expression after abdominal radiation in the rat', INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS, 47 1460-1460 (2000)
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2000 |
Steigler A, Mameghan H, Lamb D, Joseph D, Matthews J, Franklin I, et al., 'A quality assurance audit: Phase 111 trial of maximal androgen deprivation in prostate cancer (TROG 96.01)', AUSTRALASIAN RADIOLOGY, 44 65-71 (2000) [C1]
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2000 |
See A, Kron T, Johansen J, Hamilton C, Bydder S, Hawkins J, et al., 'Decision-making models in the analysis of portal films: A clinical pilot study', Australasian Radiology, 44 77-83 (2000) [C1]
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1999 |
Poulsen M, Denham J, Spry N, Lamb D, Peters L, Krawitz H, et al., 'Acute toxicity and cost analysis of a phase III randomized trial of accelerated and conventional radiotherapy for squamous carcinoma of the head and neck: A Trans-Tasman Radiation Oncology Group study', Australasian Radiology, 43 487-494 (1999)
The primary purpose of the present analysis was to assess the feasibility and acute toxicity of a pure accelerated fractionation regimen in a cooperative group setting. This analy... [more]
The primary purpose of the present analysis was to assess the feasibility and acute toxicity of a pure accelerated fractionation regimen in a cooperative group setting. This analysis included the first 320 patients entered on to the Trans-Tasman Radiation Oncology Group (TROG) randomized controlled trial which compared accelerated radiotherapy (ART) with conventional radiotherapy (CRT) in stage III and IV squamous cell carcinoma (SCC) of the head and neck. Patients were randomized to either 59.4 Gy in 33 fractions over 24 days (ART) or to 70 Gy 35 fractions over 49 days (CRT) after being stratified for site and stage. Accrual began in 1991 and the trial was closed on 3 April 1998 with the targeted 350 patients. The 3-year survival for the whole group was 54%, and the 3-year disease-free survival was 41%. Toxicity data were available on 303 patients (148 ART; 155 CRT). Mucosal toxicity was worse in the accelerated arm, and it peaked ~ 3 weeks earlier than the conventional arm. Skin toxicity was equivalent but occurred ~ 7 days earlier in the accelerated arm. Acute effects in both arms healed completely. Hospitalization was more common in the ART arm (71 vs 52 patients; P = 0.01) but the total bed days in hospital was not greatly different (1707 bed days for ART and 1607 bed days for CRT). Patients were more likely to require nasogastric (NG) feeding in the ART arm (49 vs 33 patients; P = 0.02). There were 1157 NG feeding days for ART and 1154 NG feeding days for CRT. The average cost of radiation treatment per patient including hospitalization, NG feeding and accommodation was $11 750 in the ART arm and $11 587 in the CRT arm. The accelerated arm has been shown to be a tolerable, practical and cost-equivalent regimen. The assessment of the therapeutic ratio of this accelerated protocol (ART) will be determined when the analysis of late effects and loco-regional control is made when the data are more mature.
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1999 |
Denham JW, Atkinson CH, 'Where is your evidence?', Australasian Radiology, 43 124-125 (1999)
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1999 |
Lamb D, Atkinson C, Joseph D, O'Brien P, Ackland S, Bonaventura A, et al., 'Simultaneous adjuvant radiotherapy and chemotherapy for stage I and II breast cancer', Australasian Radiology, 43 220-226 (1999)
The purpose of the present paper was to evaluate treatment outcome after conservative breast surgery or mastectomy followed by simultaneous adjuvant radiotherapy and cyclophospham... [more]
The purpose of the present paper was to evaluate treatment outcome after conservative breast surgery or mastectomy followed by simultaneous adjuvant radiotherapy and cyclophosphamide, methotrexate and fluorouracil (CMF) therapy. Two hundred and sixty eight (268) patients were treated at two Australian and two New Zealand centres between 1981 and July 1995. One hundred and sixty-nine patients underwent conservation surgery and 99 had mastectomies. Median follow-up was 53 months. Conventionally fractionated radiation was delivered simultaneously during the first two cycles of CMF, avoiding radiation on the Fridays that the intravenous components of CMF were delivered. In conservatively treated patients, 5-year actuarial rates of any recurrence, distant recurrence and overall survival were 34.5 ± 5.2%, 25.4 ± 4.5% and 75.5 ± 4.8%, respectively. Crude incidence of local relapse at 4 years was 6.3% and at regional/distant sites was 26.3%. Highest grades of granulocyte toxicity (< 0.5 x 109/L), moist desquamation, radiation pneumonitis and persistent breast oedema were recorded in 10.7, 8.5, 8.9 and 17.2%, respectively. In patients treated by mastectomy, 5-year actuarial rates of any recurrence, distant recurrence and overall survival were 59.7 ± 7.3%, 56.7 ± 7.4% and 50.1 ± 7%. The crude incidence of local relapse at 4 years was 5.6% and at regional/distant sites it was 45.7%. The issue of appropriate timing of adjuvant therapies has become particularly important with the increasing acknowledgement of the value of anthracycline-based regimens. For women in lower risk categories (e.g. 1-3 nodes positive or node negative), CMF may offer a potentially better therapy, particularly where breast-conserving surgical techniques have been used. In such cases CMF allows the simultaneous delivery of radiotherapy with the result of optimum local control, without compromise or regional or systemic relapse rates. Further randomized trials that directly address the optimal integration of the two modalities, such as the one carried out in Boston, are clearly necessary.
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1999 |
Hamilton C, Poulsen M, Walker Q, Krawitz H, Hindley A, Spry N, et al., 'Quality assurance audit in an Australasian phase III trial of accelerated radiotherapy for head and neck cancer (TROG 91.01)', Australasian Radiology, 43 227-232 (1999)
The Trans-Tasman Radiation Oncology Group (TROG) initiated a randomized trial, testing accelerated (twice daily) radiotherapy against conventional radiotherapy for stage III and s... [more]
The Trans-Tasman Radiation Oncology Group (TROG) initiated a randomized trial, testing accelerated (twice daily) radiotherapy against conventional radiotherapy for stage III and stage IV squamous cell carcinoma of the head and neck in 1991. In 1996, the Trial Management Committee arranged for a technical audit of 76 cases from 11 institutions, conducted by investigators from interstate institutions. A 10% unacceptable protocol violation rate was detected, which compares favourably with initial Radiation Therapy Oncology Group (RTOG) experience in the late 1970s. Infrastructural deficits with poor quality of documentation, incomplete retrieval of films and document return have been demonstrated in some cases. The Trans-Tasman Radiation Oncology Group is actively pursuing procedural and resourcing issues in order to redress this and is actively expanding its Quality Assurance (QA) Programme with an intercentre dosimetry study. Ultimately, comprehensive clinical and technical QA site visits are planned.
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1999 |
Denham JW, Peters LJ, Johansen J, Poulsen M, Lamb DS, Hindley A, et al., 'Do acute mucosal reactions lead to consequential late reactions in patients with head and neck cancer?', RADIOTHERAPY AND ONCOLOGY, 52 157-164 (1999)
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1999 |
Denham JW, O'Brien PC, Dunstan RH, Johansen J, See A, Hamilton CS, et al., 'Is there more than one late radiation proctitis syndrome?', Radiotherapy and Oncology, 51 43-53 (1999) [C1]
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1999 |
Denham JW, Ackland SP, Burmeister B, Walpole E, Lamb DS, Dady P, Spry NA, 'Causes for increased myelosuppression with increasing age in patients with oesophageal cancer treated by chemoradiotherapy', EUROPEAN JOURNAL OF CANCER, 35 921-927 (1999)
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1998 |
Back M, Delaney G, Denham J, Graham P, Hamilton C, Morgan G, et al., 'How should we introduce high-dose chemotherapeutic strategies into the adjuvant management of high-risk breast cancer in Australia?', AUSTRALIAN AND NEW ZEALAND JOURNAL OF SURGERY, 68 10-15 (1998)
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Nova |
1998 |
Simonen P, Hamilton C, Ferguson S, Ostwald P, O'Brien M, O'Brien P, et al., 'Do inflammatory processes contribute to radiation induced erythema observed in the skin of humans?', RADIOTHERAPY AND ONCOLOGY, 46 73-82 (1998)
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1998 |
Lamb DS, Denham JW, Morum PE, Gray AJ, 'Long-term results of accelerated radiation treatment for advanced head and neck cancer', RADIOTHERAPY AND ONCOLOGY, 49 29-32 (1998)
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1998 |
See A, Wright S, Denham JW, 'A pilot study of Dermofilm in acute radiation-induced desquamative skin reactions', Clinical Oncology, 10 182-185 (1998)
Dermofilm (Innovatec, Australia Pty Ltd) is a topical preparation containing hydrophilic and lipophilic agents that enhance the barrier functions of damaged skin. It has been asse... [more]
Dermofilm (Innovatec, Australia Pty Ltd) is a topical preparation containing hydrophilic and lipophilic agents that enhance the barrier functions of damaged skin. It has been assessed in a pilot study of 50 patients with desquamative skin reactions to establish whether it is a suitable candidate to test against an existing, widely used alternative in a randomized controlled trial. Symptomatic improvement, compliance and healing time were the study endpoints. Symptomatic improvement occurred in 49 patients and compliance with the prescribing instructions was uniform. The range of healing times observed at all sites was large but a relationship with the size of the initial desquamated area was noted. It is concluded that a randomized trial comparing Dermofilm with a widely used and cheaper alternative would require a multicentre effort involving approximately 400 patients (200 per arm). Other trial design considerations are discussed.
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1998 |
Peng Y, Dear KBG, Denham JW, 'A generalized
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1998 |
Peng Y, Dear KB, Denham JW, 'Generalized F Mixture Model For Cure Rate Estimation', Statistics in Medicine, 17 813-830 (1998) [C1]
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1997 |
Burmeister BH, Smithers BM, Denham JW, 'Combined modality therapy for carcinoma of the oesophagus: current status and future directions', MEDICAL JOURNAL OF AUSTRALIA, 167 349-350 (1997)
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1997 |
Denham JW, Hamilton CS, OBrien M, Ostwald P, Kron T, Wright S, Dorr W, 'Erythema: Goodbye LQ!', RADIOTHERAPY AND ONCOLOGY, 44 191-193 (1997)
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1997 |
Simonen P, OBrien M, Hamilton C, Ashcroft J, Denham J, 'Normal variation in cutaneous blood content and red blood cell velocity in humans', PHYSIOLOGICAL MEASUREMENT, 18 155-170 (1997)
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1997 |
Denham J, 'Factors influencing outcome following radio-chemotherapy for oesophageal cancer - Response', RADIOTHERAPY AND ONCOLOGY, 42 91-92 (1997)
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1997 |
Hamilton CS, Potten CS, Denham JW, OBrien PC, Kron T, Ostwald P, et al., 'Response of human hair cortical cells to fractionated radiotherapy', RADIOTHERAPY AND ONCOLOGY, 43 289-292 (1997)
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1997 |
OBrien PC, Franklin CI, Dear KBG, Hamilton CC, Poulsen M, Joseph DJ, et al., 'A phase III double-blind randomised study of rectal sucralfate suspension in the prevention of acute radiation proctitis', RADIOTHERAPY AND ONCOLOGY, 45 117-123 (1997)
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Nova |
1997 |
Smithers BM, Devitt P, Jamieson GG, Bessell J, Gotley D, Gill PG, et al., 'A combined modality approach to the management of oesophageal cancer', EUROPEAN JOURNAL OF SURGICAL ONCOLOGY, 23 219-223 (1997)
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1996 |
Denham JW, Hamilton CS, Simpson SA, O'Brien M, 'Low dose rate teletherapy: Updated tumour response', Australasian Radiology, 40 155-157 (1996)
This report presents an update of tumour response experience in patients with locally advanced head and neck cancer treated on the low dose rate teletherapy project at the Mater M... [more]
This report presents an update of tumour response experience in patients with locally advanced head and neck cancer treated on the low dose rate teletherapy project at the Mater Misericordiae Hospital, Newcastle. Long-term progression-free survival figures are disappointing in all dose rate/total dose groupings and offer little encouragement that an improvement in therapeutic ratio can be achieved for head and neck cancer patients using teletherapy apparatus adjusted to treat at low and intermediate dose rates.
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1996 |
MacKean J, Burmeister BH, Lamb DS, Denham JW, 'Concurrent chemoradiation for oesophageal cancer: Factors influencing myelotoxicity', Australasian Radiology, 40 424-429 (1996)
Concurrent chemotherapy and radiation (CT/RT) for localized oesophageal cancer can cause life-threatening myelosuppression. This non-randomized study examines 95 patients from thr... [more]
Concurrent chemotherapy and radiation (CT/RT) for localized oesophageal cancer can cause life-threatening myelosuppression. This non-randomized study examines 95 patients from three Australasian centres treated on the Trans-Tasman Radiation Oncology 'definitive' chemoradiation study. Duration of fluorouracil infusion and patient age were independently predictive of myelotoxicity after the first cycle of CT/RT. Overall rates of grade III and IV neutropaenia were 23% and of thrombocytopaenia 8% following the first cycle of chemotherapy. Five neutropaenic septic episodes followed the first cycle and six the second. All five patients recovered after the first cycle but there were four treatment-related deaths occurring after the second cycle of CT/RT. Recommendations are made concerning initial dosing, dose reductions and delays to minimize adverse patient outcomes from myelosuppression.
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1996 |
Lamb DS, Burmeister BH, Denham JW, 'Combined modality treatment for carcinoma oesophagus - Experience of the Trans-Tasman Radiation Oncology Group', BRITISH JOURNAL OF CANCER, 74 37-37 (1996) |
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1996 |
Ostwald PM, Kron T, Hamilton CS, Denham JW, 'Carbon-loaded LiF chips for in vivo skin dose assessment on patients undergoing radiotherapy', RADIATION PROTECTION DOSIMETRY, 66 319-322 (1996)
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1996 |
Kron T, Ostwald PM, Hamilton CS, Denham JW, 'TLD extrapolation measurements for entrance and exit dose in radiotherapy', RADIATION PROTECTION DOSIMETRY, 66 323-326 (1996)
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1996 |
Hamilton CS, Denham JW, OBrien M, Ostwald P, Kron T, Wright S, Dorr W, 'Underprediction of human skin erythema at low doses per fraction by the linear quadratic model', RADIOTHERAPY AND ONCOLOGY, 40 23-30 (1996)
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1996 |
Denham JW, Burmeister BH, Lamb DS, Spry NA, Joseph DJ, Hamilton CS, et al., 'Factors influencing outcome following radio-chemotherapy for oesophageal cancer', RADIOTHERAPY AND ONCOLOGY, 40 31-43 (1996)
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Nova |
1996 |
Denham JW, Walker QJ, Lamb DS, Hamilton CS, OBrien PC, Spry NA, et al., 'Mucosal regeneration during radiotherapy', RADIOTHERAPY AND ONCOLOGY, 41 109-118 (1996)
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Nova |
1996 |
Kron T, Butson M, Hunt F, Denham J, 'TLD extrapolation for skin dose determination in vivo', RADIOTHERAPY AND ONCOLOGY, 41 119-123 (1996)
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1996 |
Denham JW, Burmeister BH, Lamb DS, Spry NA, Joseph DJ, Hamilton CS, et al., 'Factors influencing outcome following radio-chemotherapy for oesophageal cancer. The Trans Tasman Radiation Oncology Group (TROG)', Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology, 40 31-43 (1996)
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1996 |
Denham JW, Walker QJ, Lamb DS, Hamilton CS, O'Brien PC, Spry NA, et al., 'Mucosal regeneration during radiotherapy. Trans Tasman Radiation Oncology Group (TROG).', Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology, 41 109-118 (1996)
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1996 |
Howlett SJ, Denham JW, Kron T, 'Evaluation of rectal shielding in a Henschke system applicator', Strahlentherapie und Onkologie, 172 265-269 (1996)
Purpose: To assess the effectiveness of avoid shielding in the Henschke intracavitary gynaecologic 3-channel applicator. Material and methods: An acrylic phantom was used with our... [more]
Purpose: To assess the effectiveness of avoid shielding in the Henschke intracavitary gynaecologic 3-channel applicator. Material and methods: An acrylic phantom was used with our locally modified 3-channel Henschke applicator so that standard treatments with caesium-137 sources could be simulated. Thermoluminescent dosimeters were used to measure point A and rectal doses with and without ovoid shielding to assess the benefits of this shielding. Unshielded measurements were also compared to our planning computer calculations to assess its accuracy. The thermoluminescent dosimeters were calibrated against a caesium teletherapy unit. An estimate of shielding effect produced by the ovoid shielding when using iridium-192 wire was also determined. Results: Doses received at points in the plane containing the rectal point as defined by the ICRU in its report 38 show a reduction ranging from 5% to 15% over the area measured due to the ovoid shielding. As expected this benefit is more pronounced when using iridium-192 sources. Given the steep dose gradients, good agreement is found between computed and measured values of point A doses. Conclusion: While ovoid shielding will never provide a large reduction in rectal dose using caesium-137 sources, our results indicate that it can be a worthwhile option when using the Henschke applicator.
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1996 |
Denham JW, Hamilton CS, OBrien P, 'Regarding actuarial late effect analyses', INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS, 35 197-197 (1996)
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1996 |
Denham JW, Hamilton CS, O'Brien P, Caplan RJ, Pajak TF, Cox JD, 'Regarding actuarial late effect analyses: Bentzen et al., IJROBP 32:1531- 1534; 1995 and Caplan et al., IJROBP 32:1547; 1995 [1]', International Journal of Radiation Oncology Biology Physics, 35 197 (1996)
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Nova |
1996 |
Denham JW, Denham E, Dear KB, Hudson GV, 'The follicular non-Hodgkin's lymphomas .1. The possibility of cure', EUROPEAN JOURNAL OF CANCER, 32A 470-479 (1996)
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1996 |
Denham JW, Denham E, Dear KB, Hudson GV, 'The follicular non-Hodgkin's lymphomas .2. Prognostic factors: What do they mean?', EUROPEAN JOURNAL OF CANCER, 32A 480-490 (1996)
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1996 |
Christie DRH, OBrien MY, Christie JA, Kron T, Ferguson SA, Hamilton CS, Denham JW, 'A comparison of methods of cosmetic assessment in breast conservation treatment', BREAST, 5 358-367 (1996)
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1995 |
DENHAM JW, HAMILTON CS, CHRISTIE D, OBRIEN M, BONAVENTURA A, STEWART JF, et al., 'SIMULTANEOUS ADJUVANT RADIATION-THERAPY AND CHEMOTHERAPY IN HIGH-RISK BREAST-CANCER - TOXICITY AND DOSE MODIFICATION - A TRANS-TASMAN RADIATION ONCOLOGY GROUP MULTI-INSTITUTION STUDY', INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS, 31 305-313 (1995)
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1995 |
BURMEISTER BH, DENHAM JW, OBRIEN M, JAMIESON GG, GILL PG, DEVITT P, et al., 'COMBINED-MODALITY THERAPY FOR ESOPHAGEAL-CARCINOMA - PRELIMINARY-RESULTS FROM A LARGE AUSTRALASIAN MULTICENTER STUDY', INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS, 32 997-1006 (1995)
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1995 |
OSTWALD PM, KRON T, HAMILTON CS, DENHAM JW, 'CLINICAL USE OF CARBON-LOADED THERMOLUMINESCENT DOSIMETERS FOR SKIN DOSE DETERMINATION', INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS, 33 943-950 (1995)
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1995 |
Ferguson S, Ostwald P, Kron T, Denham J, 'Verification of surface dose on patients undergoing low to medium energy X-ray therapy', Medical Dosimetry, 20 161-165 (1995)
About 5% of patients still undergo cancer treatment with superficial (peak energy = 120 kVp) X-ray radiation. Dosimetry of these beams is difficult since the maximum dose is deliv... [more]
About 5% of patients still undergo cancer treatment with superficial (peak energy = 120 kVp) X-ray radiation. Dosimetry of these beams is difficult since the maximum dose is delivered at the surface and backscatter contributes significantly to the dose. This is particularly a problem in the difficult geometries encountered in superficial treatments in the head and neck area. It has recently been shown that surface dose measurements in mega-voltage X-ray beams can be performed using TLD (Thermoluminescence Dosimetry) extrapolation. In this technique, LiF TLD chips with a surface area of 3.15 × 3.15 cm2 and three different thicknesses (0.230, 0.099, and 0.038 g/cm2) are used together in the same radiation beam which allows the extrapolation of the measured dose back to the true surface. The energy response curve of the three thicknesses of LiF chips was measured for the energy range of 60kVp, HVL 1.6 mm Al to 300kVp, 4 mm Cu. LiF was found to over respond by a factor of 1.7 at 60kVp HVL 1.6 mm Al with respect to a 6MV photon beam. A feasibility study was carried out on three patients undergoing treatment at 120kVp. Because of the small field sizes involved it was necessary to limit irradiation to one or two chips at a time. The dose fall off in the first millimetre of tissue could be clearly detected. TLD extrapolation, in low to medium energy beams, was found to be useful to assess the dose of patients undergoing treatment for superficial lesions. © 1995.
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1995 |
Canaganayagam S, Hsu W, Ferguson S, Howlett S, Denham J, Kron T, 'A perspex flattening filter for a 300k Vp orthovoltage X-ray beam.', Australasian physical & engineering sciences in medicine / supported by the Australasian College of Physical Scientists in Medicine and the Australasian Association of Physical Sciences in Medicine, 18 53-56 (1995)
For economic reasons modern equipment which produces low to medium energy X-rays covers the whole range of beam qualities from traditional superficial to orthovoltage radiation qu... [more]
For economic reasons modern equipment which produces low to medium energy X-rays covers the whole range of beam qualities from traditional superficial to orthovoltage radiation qualities. A recent trend shows an increasing number of installations of orthovoltage units in the cancer therapy community in the last five years. The use of a single anode for accelerating voltages between 60 and 300 kVp leads to compromises with regards to beam flatness and symmetry in the anode/cathode direction of the Siemens Stabilipan II radiation beam. A perspex flattening filter was designed to improve these beam parameters of the 300 kVp radiation beam (HVT 4mm Cu) at 50 cm and 60 cm FSD using a diaphragm-mounted field defining device. The filter design correlates with focal spot characteristics of the beam. The use of the filter improves flatness and symmetry for all measured field sizes from 6 x 6 cm2 to 18 x 18 cm2 by up to 8% (flatness) and 7% (symmetry) respectively. No significant difference in the depth dose characteristic of the 300 kVp beam was found with and without the filter. The only modification in the planning procedures required is the use of an attenuation factor of 0.89 for the filter. The use of the filter improves the dose distribution in treatment of patients undergoing orthovoltage radiotherapy--in particular treatments with large field sizes such as for metastases in the spinal column.
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1995 |
Denham J, 'How do we bring an acceptable level of radiotherapy services to a dispersed population?', Australasian Radiology, 39 171-173 (1995)
Radiotherapy referral data from four Australian States confirm that access difficulties contribute to low radiotherapy utilization rates. Access could be improved by the provision... [more]
Radiotherapy referral data from four Australian States confirm that access difficulties contribute to low radiotherapy utilization rates. Access could be improved by the provision of further small treatment centres in moderately large rural or semi-rural population centres. Such a policy, however, could endanger existing standards of radiotherapeutic care unless the potential pitfalls of such an approach are addressed prospectively. Copyright © 1995, Wiley Blackwell. All rights reserved
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1995 |
DENHAM JW, HAMILTON CS, SIMPSON SA, OBRIEN MY, OSTWALD PM, KRON T, DEAR KBG, 'ACUTE REACTION PARAMETERS FOR HUMAN OROPHARYNGEAL MUCOSA', RADIOTHERAPY AND ONCOLOGY, 35 129-137 (1995)
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1995 |
DENHAM JW, HAMILTON CS, SIMPSON SA, OSTWALD PM, OBRIEN M, KRON T, et al., 'FACTORS INFLUENCING THE DEGREE OF ERYTHEMATOUS SKIN REACTIONS IN HUMANS', RADIOTHERAPY AND ONCOLOGY, 36 107-120 (1995)
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1994 |
DALLY MJ, DENHAM JW, BODDY GA, 'Exploring the role of educational videos in radiation oncology practice', Australasian Radiology, 38 34-35 (1994)
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1994 |
Hamilton CS, Denham JW, 'Low dose rate teletherapy and tumour response [1]', Australasian Radiology, 38 85 (1994) |
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1994 |
DENHAM JW, DOBBS HJ, HAMILTON CS, 'ICRU 50: A commentary', Australasian Radiology, 38 204-207 (1994)
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1994 |
DENHAM JW, HAMILTON CS, 'RESOURCE RESTRAINTS - WHAT DO WE TELL OUR PATIENTS', MEDICAL JOURNAL OF AUSTRALIA, 160 95-96 (1994)
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1994 |
DENHAM JW, 'ESOPHAGEAL CANCER - GUARDED OPTIMISM', MEDICAL JOURNAL OF AUSTRALIA, 160 669-670 (1994)
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1994 |
DENHAM JW, HAMILTON CS, OBRIEN PC, 'WOMEN WHO DEVELOP BREAST-CANCER', MEDICAL JOURNAL OF AUSTRALIA, 161 507-507 (1994)
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1994 |
OSTWALD PM, COOPER SG, DENHAM JW, HAMILTON CS, 'DOSIMETRY OF HIGH-ENERGY ELECTRON THERAPY TO THE PAROTID REGION', RADIOTHERAPY AND ONCOLOGY, 33 148-156 (1994)
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1994 |
OSTWALD PM, METCALFE PE, DENHAM JW, HAMILTON CS, 'A COMPARISON OF 3 ELECTRON PLANNING-ALGORITHMS FOR A 16 MEV ELECTRON-BEAM', INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS, 28 731-740 (1994)
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1993 |
HAMILTON CS, SIMPSON SA, FERGUSON S, OSTWALD P, HSU W, O'BRIEN M, DENHAM JW, 'Low dose rate teletherapy and tumour response', Australasian Radiology, 37 210-212 (1993)
Tumour responses in 25 patients with locally advanced head and neck cancer, treated on an experimental fractionated low dose rate (FLDR) teletherapy program are reported. Treatmen... [more]
Tumour responses in 25 patients with locally advanced head and neck cancer, treated on an experimental fractionated low dose rate (FLDR) teletherapy program are reported. Treatment was given at dose rates ranging from 1.8 to 3 Gy/h to a range of total doses from 32¿38 Gy, with palliative intent. The total doses delivered have been predicted by the linear quadratic formula to be equivalent to 33¿41 Gy using conventionally fractionated high dose rate treatment, in terms of acute normal tissue effects. A complete response rate (no visible or palpable disease 2 months after treatment) was observed in 28% of cases. Analysis of these response rates suggests that the linear quadratic formula may underestimate the anti-tumour effect of FLDR teletherapy at the various dose rates and total dose permutations in this study. Copyright © 1993, Wiley Blackwell. All rights reserved
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1993 |
Denham JW, Hamilton CS, Joseph DJ, Lamb DS, Spry NA, Gray AJ, et al., 'The use of simulator and CT information in the planning of radiotherapy for non-small cell lung cancer: An Australasian patterns of practice study', Lung Cancer, 8 275-284 (1993)
In a patterns of practice study 14 Australasian radiation oncologists were invited to define tumour and target volumes in 12 sample cases of non-small cell carcinoma of the lung (... [more]
In a patterns of practice study 14 Australasian radiation oncologists were invited to define tumour and target volumes in 12 sample cases of non-small cell carcinoma of the lung (NSCCL) firstly using orthogonal simulator AP and lateral radiographic views, then using computed tomography (CT) slices obtained in the treatment position. In addition, they were asked to complete questionnaires addressing their criteria for determining treatment policy and their reasons for choosing specific tumour and target volume boundaries in individual cases. Significant variations in choice of size and position of both tumour and target volume were apparent between clinicians. These variations, however were no greater for simulator planned volumes than for CT planned volumes, except in cases selected for palliative treatment, were CT planned volumes were significantly larger. Failure to include tumour extensions, the mistaken inclusion of normal structures as tumour, and major differences in allowance for microscopic tumour spread were identified as the most significant cause for variation in the size and positioning of target volumes between clinicians. Differences over margins to allow for factors such as variation in day-to-day set-up, patient movement, equipment-related factors, etc, were also apparent. CT and simulator planned target volumes were equally successful in adequate tumour coverage; 79 162 (49%), and 80 162 (49%) respectively. Gross miss of tumour was more common in simulator planned target volumes than CT planned target volumes; 70 162 (43%) and 55 162 (34%), respectively. This study supports the integration of diagnostic expertise into the planning process for simulator and CT planning, but suggests that substantial practice variation would still exist in planning for radiotherapy in NSCCL. © 1993.
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1993 |
DENHAM JW, DALLY MJ, HUNTER K, WHEAT J, FAHEY PP, HAMILTON CS, 'OBJECTIVE DECISION-MAKING FOLLOWING A PORTAL FILM - THE RESULTS OF A PILOT-STUDY', INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS, 26 869-876 (1993)
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1993 |
Ackland SP, Hamilton CS, Joseph DJ, Denham JW, 'Phase I/II study of concurrent weekly carboplatin and radiation therapy in advanced head and neck cancer', Clinical Oncology, 5 133-138 (1993)
Thirty-two patients with locally advanced head and neck cancer have been treated with concurrent weekly carboplatin and conventional radiation therapy (RT) (2 Gy fractions 4-5 day... [more]
Thirty-two patients with locally advanced head and neck cancer have been treated with concurrent weekly carboplatin and conventional radiation therapy (RT) (2 Gy fractions 4-5 days/week to a total dose of 64-70 Gy over 7-8 weeks) in a Phase I/II study. Carboplatin was administered weekly during RT at doses of 75-150 mg/m2//wk as a 1-hour infusion. The maximum tolerated dose of carboplatin was 130 mg/m2//wk, with myelosuppression, predominantly neutropenia, being dose limiting. Other systemic toxicities were insignificant and no overlapping toxicity was evident. Ultimate locoregional control and survival probabilities were disappointing. It is suggested that either further studies using radiation and carboplatin at the dose 130 mg/m2//wk, or variations on dose and scheduling be performed prior to the instigation of Phase III studies. © 1993 The Royal College of Radiologists.
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1993 |
Cooper SG, Bonaventura A, Ackland SP, Joseph DJ, Stewart JF, Hamilton CS, Denham JW, 'Pelvic radiotherapy with concurrent 5-fluorouracil modulated by leucovorin for rectal cancer: A phase II study', Clinical Oncology, 5 169-173 (1993)
Combined modality treatment for cancer of the rectum has been shown to reduce recurrences and improve overall survival. We wished to find out if we could safely give concurrent ra... [more]
Combined modality treatment for cancer of the rectum has been shown to reduce recurrences and improve overall survival. We wished to find out if we could safely give concurrent radiotherapy and 5-fluorouracil (5-FU) modulated by leucovorin (LV) in 3 settings: pre-operatively, adjuvantly and in recurrent disease. A total of 39 patients were treated, 11 preoper-atively, 17 adjuvantly and 11 with recurrent disease. There were 26 males and 13 females with a median age of 64 years. The median radiotherapy (RT) dose was 45 Gy/25 fractions/1.8 Gy per fraction (range 25-63 Gy). Chemotherapy consisted of LV 80 mg/m2 i.v. infusion over 1.5 hours followed by 5-FU 400 mg/m2 i.v. bolus, both given once a week. The median number of cycles was 8 (range 3-12). Diarrhoea was the main toxicity, and was encountered in 30 patients (77%): grade 1 in 3 (8%), grade 2 in 12 (30%), grade 3 in 11 (28%), and grade 4 in 4 (10%). This required 18 (46%) patients to have modifications to their RT (20% had breaks and 26% ceased at doses <45 Gy). Nine patients (23%) had modifications in the chemotherapy (10% had breaks and 13% received <6 cycles). Encouraging responses were seen in the preoperative setting. Concurrent RT and 5-FU/LV, as given in this schedule, results in an unacceptable incidence of diarrhoea, limiting both the total dose of RT and chemotherapy that can be delivered, particulary in patients who have had previous surgery. © 1993 The Royal College of Radiologists.
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1992 |
GILL PG, DENHAM JW, JAMIESON GG, DEVITT PG, YEOH E, OLWENY C, 'PATTERNS OF TREATMENT FAILURE AND PROGNOSTIC FACTORS ASSOCIATED WITH THE TREATMENT OF ESOPHAGEAL-CARCINOMA WITH CHEMOTHERAPY AND RADIOTHERAPY EITHER AS SOLE TREATMENT OR FOLLOWED BY SURGERY', JOURNAL OF CLINICAL ONCOLOGY, 10 1037-1043 (1992)
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1992 |
HAMILTON CS, DENHAM JW, 'Dose Normalisation and Specification: From Woe to Go', Australasian Radiology, 36 137-141 (1992)
A questionnaire has been completed by 16 practising Radiation Oncologists from 10 centres in Australia and New Zealand which confirms that considerable variation in dose normalisa... [more]
A questionnaire has been completed by 16 practising Radiation Oncologists from 10 centres in Australia and New Zealand which confirms that considerable variation in dose normalisation and specification practices exists between Australasian centres. The establishment of a working party to determine whether a uniform code of practice (such as ICRU 29 or a modification thereof) is desirable, and can be adopted in Australasia, is recommended. Copyright © 1992, Wiley Blackwell. All rights reserved
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1992 |
DENHAM JW, 'IMPLANTATION OF THE TONGUE AND FLOOR OF MOUTH - WHAT FACTORS REALLY DO CONTRIBUTE TO NECROSIS', RADIOTHERAPY AND ONCOLOGY, 24 64-65 (1992)
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1992 |
HAMILTON CS, CHAN LY, MCELWAIN DLS, DENHAM JW, 'A PRACTICAL EVALUATION OF 5-DOSE-VOLUME HISTOGRAM REDUCTION ALGORITHMS', RADIOTHERAPY AND ONCOLOGY, 24 251-260 (1992)
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1992 |
CROSS P, JOSEPH DJ, CANT J, COOPER SG, DENHAM JW, 'TANGENTIAL BREAST IRRADIATION - SIMPLE IMPROVEMENTS', INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS, 23 433-442 (1992)
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1992 |
Hamilton CS, Denham JW, Joseph DJ, Lamb DS, Spry NA, Gray AJ, et al., 'Treatment and planning decisions in non-small cell carcinoma of the lung: An Australasian patterns of practice study', Clinical Oncology, 4 141-147 (1992)
Fourteen practising radiation oncologists were surveyed to assess their treatment and planning habits utilizing six sample cases of non-small cell carcinoma of the lung. Responden... [more]
Fourteen practising radiation oncologists were surveyed to assess their treatment and planning habits utilizing six sample cases of non-small cell carcinoma of the lung. Respondents were first given a general questionnaire, designed to evaluate their theoretical treatment and planning recommendations based on various tumour and patient related variables. Respondents then undertook a practical planning exercise utilizing planning CT and simulator radiographs for each of the six sample cases. Each case was accompanied by a brief history and report outlining specific tumour stage and non-stage related variables. The practical planning exercise was repeated on the second day of the survey utilizing different non-stage related variables but identical radiology and stage-related information. This design enabled firstly, a comparison of clinicians' intended policy and planning methods with actual policy and planning decisions, and secondly, an assessment of intra-clinician variability in decision making and planning practice. Good agreement was evident among clinicians with respect to general, non-case specific treatment policies; however, very significant variation occurred at an inter- and intra-clinician level and involved the entire treatment and planning process for individual cases. Despite identical treatment intent across identical radiological case pairings, clinicians chose widely differing margins and target volumnes in their planning exercise. Treatment intent appeared to be influenced more by non-stage related variables rather than stage related information and radiological appearances per se. We have shown that experienced radiation oncologists do not adhere to stated case selection criteria and show inconsistencies in their treatment planning for non-small cell carcinoma of the lung. © 1992 The Royal College of Radiologists.
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1992 |
DENHAM JW, HAMILTON CS, JOSEPH D, 'HOW SHOULD A WAITING LIST FOR TREATMENT BE MANAGED?', Australasian Radiology, 36 274-275 (1992)
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1991 |
DENHAM JW, ABBOTT RL, 'CONCURRENT CISPLATIN, INFUSIONAL FLUOROURACIL, AND CONVENTIONALLY FRACTIONATED RADIATION-THERAPY IN HEAD AND NECK-CANCER - DOSE-LIMITING MUCOSAL TOXICITY', JOURNAL OF CLINICAL ONCOLOGY, 9 458-463 (1991)
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1991 |
Hamilton CS, Piyaratna N, Ferguson SA, Callaghan TM, Denham JW, 'Clinical utility of high-resolution portal films', Clinical Oncology, 3 90-95 (1991)
We have evaluated the film quality and overall clinical utility of a unique high-resolution portal film system which utilizes high contrast graphics art film. A total of 127 unsel... [more]
We have evaluated the film quality and overall clinical utility of a unique high-resolution portal film system which utilizes high contrast graphics art film. A total of 127 unselected patients had their conventional portal films and high-resolution films of the same site, compared and graded subjectively for a variety of parameters by an independent panel of radiotherapists and radiographers. Although consistent improvements in most aspects of image quality were noted, improved overall clinical usefulness of the high-resolution portal film system in comparison to the conventional films, when subjected to multiple regression analysis, was confined to lateral neck views only. High-resolution portal film utility was also found to depend significantly on field size with areas less than 110 cm2 having a markedly worse clinical utility score. © 1991 The Royal College of Radiologists.
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1991 |
Denham JW, Hamilton CS, Cross P, 'Breast conservation, the problem of treating the excision site effectively: Physical criteria for the choice of technique used', Clinical Oncology, 3 250-256 (1991)
This paper examines how physical factors such as the depth of the excision cavity below the skin surface and its distance from the underlying lung may impact upon the choice betwe... [more]
This paper examines how physical factors such as the depth of the excision cavity below the skin surface and its distance from the underlying lung may impact upon the choice between the use of an electron field (from a Varian Clinac 1800) or an implant (using a double plane of iridium-192 wires). Data have been derived from a phantom dosimetry experiment simulating different permutations of breast size and depth of excision cavity. An anthropomorphic female phantom with two different-sized wax breast phantoms has been used to simulate the clinical circumstances envisaged and iso-dose distributions have been estimated from an array of TLD readings. The biological significance of doses measured in skin and lung have been examined using the linear-quadratic (LQ) model. Both on physical and biological grounds, the results favour the implant under the experimental conditions adopted. The use of the electron beam to definitively treat the excision cavity (omitting breast tangents) to 60 Gy would result in unacceptable late effects in the skin and an observable incidence of pneumonitis if the excision cavity were near the chest wall. Small carcinogenic risks, particularly to the lung, are apparent with each modality, but may be moderated for the iridium-192 implant by a reduced carcinogenic potential associated with low-dose rate radiation. The use of the newer radionuclides iodine-125 and samarium-145, with less penetrating gamma ray emissions, might be preferred to iridium-192 from the point of view of bronchial carcinogenesis if definitive treatment of the exision cavity became widespread practice. © 1991 The Royal College of Radiologists.
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1991 |
Denham JW, Sillar RW, Clarke D, 'Boost dosage to the excision site following conservative surgery for breast cancer: It's easy to miss!', Clinical Oncology, 3 257-261 (1991)
Surgical haemoclips have been left in situ in 27 consecutive patients conservatively operated on for early breast cancer by two surgeons in Newcastle, New South Wales, to demarcat... [more]
Surgical haemoclips have been left in situ in 27 consecutive patients conservatively operated on for early breast cancer by two surgeons in Newcastle, New South Wales, to demarcate the limits of the excision cavity for accurate postoperative irradiation. As anticipated, the position of these clips varied widely in relation to the patient's recollection of the position of the original lump, the surgical notes, and the surgical scar. In addition the dimensions of the clipped area also varied considerably. So great was the variation in position of the clips that incomplete coverage of the excision cavity in the 'coronal' (en face) plane using an electron field could have occurred in an estimated 10/24 (42%) evaluable cases had surgical clips not been left in situ. Depth of the surgical clips below the skin surface also varied markedly between patients. In 9/26 (73%) evaluable cases the clips were observed to be sited 3 cm or more below the skin surface, while in only 5/26 (19.2%) were the clips found to be 2 cm or less deep to the surface. Had a 9 MeV beam from our Clinac 1800 been used to treat all the cases, a major underdose of the excision cavity would have been likely in 21/26 (81%) evaluable cases. This figure would be improved to 11/26 (42%) had a 12 MeV beam been used - still a very high figure. Neither of these points have received much attention in the literature. This small study sounds a distinct warning and needs to be repeated on a larger scale. © 1991 The Royal College of Radiologists.
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1991 |
Hamilton CS, Piyaratna N, Ferguson SA, Callaghan TM, Denham JW, 'Clinical utility of high-resolution portal films.', Clinical oncology (Royal College of Radiologists (Great Britain)), 3 90-95 (1991)
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1991 |
Denham JW, Hamilton CS, Joseph DJ, 'Patterns of care studies in Australasia.', Australasian Radiology, 35 205 (1991) |
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1990 |
GILL PG, JAMIESON GG, DENHAM J, DEVITT PG, AHMAD A, YEOH E, JONES AM, 'TREATMENT OF ADENOCARCINOMA OF THE CARDIA WITH SYNCHRONOUS CHEMOTHERAPY AND RADIOTHERAPY', BRITISH JOURNAL OF SURGERY, 77 1020-1023 (1990)
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1990 |
HAMILTON CS, DENHAM JW, 'The Cure of Primary Prostate Cancer by Radiotherapy High-tech Quest for a Non-existent Grail?', Australasian Radiology, 34 5-11 (1990)
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1990 |
COOPER SG, CARDEW AP, FERGUSON S, JOSEPH DJ, HAMILTON CS, DENHAM JW, WILLIAMS AR, 'Low Dose Rate Teletherapy Using a Telecaesium 137 Unit Radiobiological, Physical and Clinical Considerations', Australasian Radiology, 34 241-246 (1990)
Low dose rate teletherapy aims to combine the supposedly superior results obtained with low dose rate implants with the convenience and staff protection characteristics of externa... [more]
Low dose rate teletherapy aims to combine the supposedly superior results obtained with low dose rate implants with the convenience and staff protection characteristics of external beam therapy. Previous investigators have used telecobalt units to produce dose rates of 1.1 to 1.8 Gy/hr to treat in daily sessions lasting 6¿10 hours to total doses of 60¿70 Gy. These studies have not discounted the possibility that much of the advantage of interstitial implants results from the low dose rates used per se, and from the fact that the total dose is delivered in a short overall time. The relationship between total dose, dose rate and volume giving normal tissue and anti-tumour effects, however, remains ill-defined. At the Newcastle Mater Misericordiae Hospital a Caesium teletherapy unit has been modified to treat at low dose rates and a study has been designed with a view to establish which permutations of total dose and dose rate are isoeffective for acute mucosal and acute skin reactions in the dose rate range between 0.8 and 9.6 Gy/hr (1.3 and 16 cGy/min). Copyright © 1990, Wiley Blackwell. All rights reserved
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1990 |
HAMILTON CS, JOSEPH DJ, SKOV A, DENHAM JW, 'CT Scanning for Definitive Radiotherapy Planning of Prostate Cancer: Necessity or Nicety? Results from survey of radiation oncologists working at different institutions in Australasia', Australasian Radiology, 34 288-292 (1990)
Interactive computerised tomographic (CT) planning techniques offer the prospect of better anatomical localisation, more consistent tumour coverage, and limiting normal tissue dos... [more]
Interactive computerised tomographic (CT) planning techniques offer the prospect of better anatomical localisation, more consistent tumour coverage, and limiting normal tissue dose. However, its value in the management of prostate cancer remains undefined. The present study addresses the impact of planning CT on the designated target volumes for localised carcinoma of the prostate at a multi-institution national level. Nine radiation oncologists from different centres in Australia and New Zealand were asked to designate a target volume on five sample patients with different disease stages (A2-C2) using both conventional cystogram films and planning CT scans. Target volumes estimated by CT means in this study differed by more than 10% from those estimated by conventional means in 75.6% of instances, being smaller in 55.6%. Volumes varied widely between individual radiation oncologists, both using conventional planning and CT information. These variations were found to exceed any differences in the volume caused by the planning technique itself. Results from this survey suggest that volumes appear to change more according to the individual radiation oncologist rather than to any other factor. In most or all of the sample cases six of nine radiation oncologists defined the borders of their CT volumes to be either consistently smaller (5 out of 9) or greater (1 out of 9) than their conventionally defined borders. The results of this survey are potentially important and warrant repetition with larger sample numbers in other countries where interactive CT planning facilities exist, both with and without diagnostic radiological input, to exclude similar variation and to define causes for any variations that do become apparent. Copyright © 1990, Wiley Blackwell. All rights reserved
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1990 |
COOPER SG, DENHAM JW, 'PROGRESSIVE SYSTEMIC-SCLEROSIS (DIFFUSE SCLERODERMA) AND RADIOTHERAPY', BRITISH JOURNAL OF RADIOLOGY, 63 804-805 (1990)
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1990 |
JOSEPH DJ, HAMILTON CS, DENHAM JW, ACKLAND SP, STEWART JF, 'WHITHER SCREENING MAMMOGRAPHY IN AUSTRALIA - ESTABLISHING A SATISFACTORY BASIS FOR FUNDING', MEDICAL JOURNAL OF AUSTRALIA, 152 545-546 (1990)
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1990 |
FENECH M, DENHAM J, FRANCIS W, MORLEY A, 'MICRONUCLEI IN CYTOKINESIS-BLOCKED LYMPHOCYTES OF CANCER-PATIENTS FOLLOWING FRACTIONATED PARTIAL-BODY RADIOTHERAPY', INTERNATIONAL JOURNAL OF RADIATION BIOLOGY, 57 373-383 (1990)
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1989 |
REECE PA, STAFFORD I, ABBOTT RL, ANDERSON C, DENHAM J, FREEMAN S, et al., '2-HOUR VERSUS 24-HOUR INFUSION OF CISPLATIN - PHARMACOKINETIC CONSIDERATIONS', JOURNAL OF CLINICAL ONCOLOGY, 7 270-275 (1989)
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1989 |
COOPER SG, DENHAM JW, HAMILTON CS, JOSEPH DJ, STEWART JF, ACKLAND SP, 'THE PRICE OF A FALSE-NEGATIVE RESULT OF MAMMOGRAPHY AND AN OVERENTHUSIASTIC LAY PRESS', MEDICAL JOURNAL OF AUSTRALIA, 150 664-664 (1989)
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1988 |
DENHAM JW, GILL PG, JAMIESON GG, HETZEL D, DEVITT P, FITCH R, et al., 'PRELIMINARY EXPERIENCE WITH A COMBINED-MODALITY APPROACH TO THE MANAGEMENT OF ESOPHAGEAL CANCER', MEDICAL JOURNAL OF AUSTRALIA, 148 9-13 (1988)
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1988 |
DENHAM JW, BALDACCHINO AC, GUTTE J, NICHOLLS RL, 'REMOTE AFTERLOADING TECHNIQUES FOR THE TREATMENT OF NASOPHARYNGEAL AND ENDOMETRIAL CANCER', INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS, 14 191-195 (1988)
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1988 |
DENHAM JW, CARTER ML, GILL PG, 'CONSERVATIVE TREATMENT OF BREAST-CANCER - WHERE SHOULD THE BOOSTER DOSE GO', INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS, 14 399-400 (1988)
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1988 |
DENHAM JW, 'SYNCHRONOUS RADIATION AND CHEMOTHERAPY - REPLY', MEDICAL JOURNAL OF AUSTRALIA, 148 370-370 (1988) |
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1987 |
OBRIEN PC, DENHAM JW, LEONG ASY, 'MERKEL CELL-CARCINOMA - A REVIEW OF BEHAVIOR PATTERNS AND MANAGEMENT STRATEGIES', AUSTRALIAN AND NEW ZEALAND JOURNAL OF SURGERY, 57 847-850 (1987)
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1987 |
DENHAM JW, ABBOTT RL, GILL PG, 'SYNCHRONOUS RADIATION AND CHEMOTHERAPY IN CARCINOMA OF THE UPPER AERODIGESTIVE TRACTS', MEDICAL AND PEDIATRIC ONCOLOGY, 15 135-135 (1987) |
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1987 |
DENHAM JW, YEOH EK, WITTWER G, WARD GG, AHMAD AS, HARVEY NDM, 'RADIATION-THERAPY IN HYPERBARIC-OXYGEN FOR HEAD AND NECK-CANCER AT ROYAL ADELAIDE HOSPITAL - 1964 TO 1980', INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS, 13 201-208 (1987)
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1987 |
DENHAM JW, 'SYNCHRONOUS RADIATION AND CHEMOTHERAPY FOR LOCALLY-ADVANCED CANCER - IS IT THE ANSWER .1.', MEDICAL JOURNAL OF AUSTRALIA, 147 590-595 (1987)
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1987 |
Denham JW, Cross P, 'The cost of interstitial curietherapy using iridium pins and needles.', Australasian Radiology, 31 93-94 (1987) |
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1987 |
O'BRIEN PC, DENHAM JW, 'Radiation Therapy in AIDS Related Kaposi's Sarcoma', Australasian Radiology, 31 319-321 (1987)
The first case of epidemic Kaposi's Sarcoma requiring radiotherapy in Adelaide is described. A number of points related to the treatment of this condition and particularly th... [more]
The first case of epidemic Kaposi's Sarcoma requiring radiotherapy in Adelaide is described. A number of points related to the treatment of this condition and particularly the oral mucosa type of lesion are discussed. Copyright © 1987, Wiley Blackwell. All rights reserved
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1986 |
DENHAM JW, CARTER ML, 'THE SELECTION OF CASES FOR WEDGE EXCISION FOLLOWED BY RADIOTHERAPY AS THE TREATMENT OF THEIR PRIMARY BREAST-CANCER', AUSTRALIAN AND NEW ZEALAND JOURNAL OF SURGERY, 56 5-12 (1986)
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1986 |
DENHAM JW, CARTER ML, 'LOCATION OF THE EXCISION SITE FOLLOWING SEGMENTAL-MASTECTOMY FOR ACCURATE POSTOPERATIVE IRRADIATION', AUSTRALIAN AND NEW ZEALAND JOURNAL OF SURGERY, 56 685-688 (1986)
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1986 |
DENHAM JW, 'THE RADIATION DOSE-RESPONSE RELATIONSHIP FOR CONTROL OF PRIMARY BREAST-CANCER', RADIOTHERAPY AND ONCOLOGY, 7 107-123 (1986)
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1986 |
YEOH EK, DENHAM JW, DAVIES SA, SPITTLE MF, 'PRIMARY BREAST-CANCER - COMPLICATIONS OF AXILLARY MANAGEMENT', ACTA RADIOLOGICA ONCOLOGY, 25 105-108 (1986)
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1986 |
DENHAM JW, JUTTNER CA, WARD GG, KIMBER RJ, HO JQK, CROSS P, et al., 'Total Body Irradiation and Bone Marrow Transplantation in Adelaide A Short Report on 7 Years Experience', Australasian Radiology, 30 262-267 (1986)
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1986 |
Yeoh EK, Denham JW, Davies SA, Spittle MF, 'Primary breast cancer. Complications of axillary management', Acta Radiologica Oncology, 25 105-108 (1986)
The complications following surgery and postoperative radiation therapy in the management of the axilla in 187 patients with primary breast cancer treated between 1978 and 1982 ha... [more]
The complications following surgery and postoperative radiation therapy in the management of the axilla in 187 patients with primary breast cancer treated between 1978 and 1982 have been studied. Although no difference in complication rate could be detected between the three different postoperative radiation schedules utilised there was a strong and positive correlation between complication rate and increasing extent of surgical intervention. When the groups were sub-divided according to the extent of surgery performed, no differences in regional recurrence rates were observed but complication rates (defined as significant lymphoedema of the arm and/or restriction of shoulder movements) were significantly different (p < 0.001) at 30 months between those who had no surgical intervention (25%), those who had had 'sampling' performed (50%) and those who had had formal dissection performed (84%).
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1985 |
HUDSON FR, DENHAM JW, 'THE COMPUTER-ANALYSIS OF INTERSTITIAL IMPLANTS IN RADIOTHERAPY', RADIOTHERAPY AND ONCOLOGY, 4 175-184 (1985)
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1985 |
DENHAM JW, HARVEY NDM, WARD GG, DIBDEN FA, AHMAD A, DIBDEN CFA, et al., 'A Decade of Radiotherapy in Head and Neck Cancer in South Australia: Results of Radiotherapy 1970 1980 at the Royal Adelaide Hospital', Australasian Radiology, 29 370-382 (1985)
The results of treatment in 368 patients with head and neck cancer treated in the decade 1970¿1980 are presented. Patients with six of the most common malignancies, namely carcino... [more]
The results of treatment in 368 patients with head and neck cancer treated in the decade 1970¿1980 are presented. Patients with six of the most common malignancies, namely carcinoma of the Tongue, Tonsil, Nasopharynx, Pyriform Fossa, Supraglottic and Glottic Larynx, who have been treated primarily by radiation or where radiation has been used as a part of a planned combined approach, have been included in this report. Results have been presented in both crude and actuarial form and are discussed in the light of changing management trends during the decade. Copyright © 1985, Wiley Blackwell. All rights reserved
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1984 |
DENHAM JW, STRICKLAND P, 'RECENT EXPERIENCE IN THE RADICAL IRRADIATION OF PRIMARY BREAST-CANCER AT MOUNT-VERNON-HOSPITAL', EUROPEAN JOURNAL OF CANCER & CLINICAL ONCOLOGY, 20 189-& (1984)
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1984 |
OLES KS, DENHAM JW, 'HYPONATREMIA INDUCED BY THIAZIDE-LIKE DIURETICS IN THE ELDERLY', SOUTHERN MEDICAL JOURNAL, 77 1314-1315 (1984)
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1984 |
DENHAM JW, MACLENNAN KA, 'THE MANAGEMENT OF PRIMARY-CARCINOMA OF THE FALLOPIAN-TUBE - EXPERIENCE OF 40 CASES', CANCER, 53 166-172 (1984)
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1983 |
DENHAM JW, HUDSON FR, 'IRIDIUM AFTERLOADING TECHNIQUES', BRITISH JOURNAL OF RADIOLOGY, 56 780-781 (1983)
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1983 |
HUDSON FR, DENHAM JW, 'NEEDLE AFTERLOADING TECHNIQUES', BRITISH JOURNAL OF RADIOLOGY, 56 781-781 (1983)
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1982 |
Denham JW, Strickland P, Alderson AM, Hudson FR, Bennett MH, 'Interstitial radiation therapeutic techniques at mount Vernon hospital', Acta Oncologica, 21 385-392 (1982)
Retrospective analysis of 56 cases of carcinoma on the lateral border of the anterior two thirds of the tongue treated at Mount Vernon Hospital using radium needle implant alone y... [more]
Retrospective analysis of 56 cases of carcinoma on the lateral border of the anterior two thirds of the tongue treated at Mount Vernon Hospital using radium needle implant alone yielded 5-year actuarial survivals of 75.3 per cent in 25 T1NO cases and 81.8 per cent in 25 T2NO cases. Five-year actuarial local recurrence of 17.5 per cent was recorded in the T1 group and 35 per cent in the T2 group. Local recurrences were attributed to failure of the implant to encompass extensions of the tumour along the lateral border or into the musculature of the tongue. Five-year actuarial local recurrence of 66.2 per cent was recorded in 18 patients with carcinoma of the breast treated by radium needle implant alone; 4 of these 9 local recurrences occurred at some distance from the treated area and could not be classed as marginal recurrences. A preliminary investigation carried out in 1981 indicated that significant improvements in source distribution, particularly at poorly accessible sites, could be achieved using afterloading techniques. In addition the use of 192Ir as a source could result in improvements in staff protection. ©1982 Informa UK Ltd All rights reserved: reproduction in whole or part not permitted.
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1982 |
DENHAM JW, 'A CASE OF THERMALLY INDUCED CANCER', CLINICAL ONCOLOGY, 8 357-360 (1982)
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1982 |
DENHAM JW, STRICKLAND P, ALDERSON AM, HUDSON FR, BENNETT MH, 'INTERSTITIAL RADIATION THERAPEUTIC TECHNIQUES AT MOUNT-VERNON-HOSPITAL', ACTA RADIOLOGICA ONCOLOGY, 21 385-392 (1982)
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