External Validation of PATHFx Version 3.0 in Patients Treated Surgically and Nonsurgically for Symptomatic Skeletal Metastases.

External Validation of PATHFx Version 3.0 in Patients Treated Surgically and Nonsurgically for Symptomatic Skeletal Metastases. Clin Orthop Relat Res. 2020 Apr;478(4):808-818 Authors: Anderson AB, Wedin R, Fabbri N, Boland P, Healey J, Forsberg JA Abstract BACKGROUND: PATHFx is a clinical decision-support tool based on machine learning capable of estimating the likelihood of survival after surgery for patients with skeletal metastases. The applicability of any machine-learning tool depends not only on successful external validation in unique patient populations but also on remaining relevant as more effective systemic treatments are introduced. With advancements in the treatment of metastatic disease, it is our responsibility to patients to ensure clinical support tools remain contemporary and accurate. QUESTION/PURPOSES: Therefore, we sought to (1) generate updated PATHFx models using recent data from patients treated at one large, urban tertiary referral center and (2) externally validate the models using two contemporary patient populations treated either surgically or nonsurgically with external-beam radiotherapy alone for symptomatic skeletal metastases for symptomatic lesions. METHODS: After obtaining institutional review board approval, we collected data on 208 patients undergoing surgical treatment for pathologic fractures at Memorial Sloan Kettering Cancer Center between 2015 and 2018. These data were combined with the original PATHFx ...
Source: Clinical Orthopaedics and Related Research - Category: Orthopaedics Authors: Tags: Clin Orthop Relat Res Source Type: research

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Authors: Konat-Bąska K, Chicheł A, Staszek-Szewczyk U, Maciejczyk A, Matkowski R Abstract Purpose: Prostate and colorectal cancers are the first and the third most popular malignancies in male population, in which some patients may develop these tumors metachronously or synchronously. At present, there are no standard recommendations, and oncologists need to provide an optimal management for two different cancers with an acceptable risk of possible treatment of adverse effects. Material and methods: This case report presents the treatment of a 61-year-old patient suffering from synchronous prostate and rectal...
Source: Journal of Contemporary Brachytherapy - Category: Cancer & Oncology Tags: J Contemp Brachytherapy Source Type: research
Radiation-cystitis is an unavoidable side effect of external beam radiation therapy to the pelvis, even when delivered using normal tissue sparing delivery methods such as image guided radiation therapy (IGRT) and volumetric modulated arc therapy (VMAT). Cystitis symptoms include dysuria, urinary frequency, urgency, nocturia, the sensation of incomplete bladder voiding, haematuria and an increased risk of urinary tract infections. Acute radiation-cystitis develops during radiation therapy and generally resolves within weeks of completing radiation treatment.
Source: Radiotherapy and Oncology - Category: Radiology Authors: Tags: Original Article Source Type: research
Keratinocyte carcinoma (KC, previously nonmelanoma skin cancer) represents the most common cancer worldwide. While surgical treatment is commonly utilized, various radiation therapy techniques are available including external beam and brachytherapy. As such, the American Brachytherapy Society has created an updated consensus statement regarding the use of brachytherapy in the treatment of KCs.
Source: Brachytherapy - Category: Cancer & Oncology Authors: Source Type: research
Abstract BACKGROUND: Most cancer centers prefer preoperative radiation therapy (preRT) over postoperative therapy to treat soft-tissue sarcoma (STS) to limit long-term fibrosis, joint stiffness, and edema. Surgery is often delayed after preRT to allow for tissue recovery and to reduce wound complications. However, the association between the time interval between preRT and surgery and survival is unknown. QUESTIONS/PURPOSES: (1) What factors are associated with the preRT-surgery interval in patients with STS? (2) Is the preRT-surgery interval associated with overall survival? METHODS: The National Cancer...
Source: Clinical Orthopaedics and Related Research - Category: Orthopaedics Authors: Tags: Clin Orthop Relat Res Source Type: research
18F-labeled prostate-specific membrane antigen (PSMA) PET tracers are increasingly used in preference to 68Ga-PSMA-11 for restaging biochemical recurrence (BCR) of prostate cancer. They are associated with longer half-lives, larger-scale production, and lower positron range than their 68Ga-labeled counterparts. Here, we describe the efficacy of an 18F-labeled radiohybrid PSMA, rhPSMA-7, a novel theranostic PSMA-targeting agent for imaging BCR of prostate cancer. Methods: Datasets from 261 consecutive patients with noncastrate BCR after radical prostatectomy who underwent 18F-rhPSMA-7 PET/CT at our institution between June ...
Source: Journal of Nuclear Medicine - Category: Nuclear Medicine Authors: Tags: Clinical Source Type: research
According to international recommendations by GEC-ESTRO GYN working group [1], combined radiation therapy is the most effective treatment for locally advanced cervical cancer (LACC). Classical combined radiotherapy includes two sequential stages: external beam radiotherapy (EBRT) and brachytherapy (BT) [1]. EBRT is used for irradiation of the tumour itself and the lymph nodes to total dose values up to 50Gy. BT is used as a boost for irradiation of the tumour up to EQD2 doses as high as 90Gy. The golden standard of modern combined radiotherapy includes EBRT followed by image-guided adaptive BT.
Source: Physica Medica: European Journal of Medical Physics - Category: General Medicine Authors: Tags: Original paper Source Type: research
In the early 1990 ’s, the increasingly widespread use of prostate-specific antigen as a screening test resulted in an impressive “spike” in the incidence of prostate cancer, unprecedented in the history of oncology. Men with clinically localized cancers facing treatment generally had to decide among radical pro statectomy, external beam radiation therapy, and some form of expectant management. Our group had documented that rates of radical prostatectomy among Medicare beneficiaries increased fivefold between 1984 and 1990.
Source: Urology - Category: Urology & Nephrology Authors: Source Type: research
An 85-year-old asymptomatic man with suspected biochemical recurrence of prostate cancer underwent an 18F-fluciclovine PET/CT scan, which revealed a solitary suspicious tracer uptake in the dorsal right corporal body of the proximal pendulous penis. The patient underwent ultrasound-guided fine-needle aspiration of the penile lesion, which revealed metastatic prostate cancer. The patient had definitive external beam radiation therapy 3 years before the examination. At the time of scan, the prostatic-specific antigen (PSA) was only 1.0 ng/mL, although the PSA doubling time was 2.6 months. It is unusual to detect a solitary p...
Source: Clinical Nuclear Medicine - Category: Nuclear Medicine Tags: Interesting Images Source Type: research
SpaceOAR© hydrogel rectal dose reduction prediction model: a decision support tool. J Appl Clin Med Phys. 2020 Apr 06;: Authors: Paetkau O, Gagne IM, Alexander A Abstract Prostate cancer external beam radiation therapy can result in toxicity due to organ at risk (OAR) dose, potentially impairing quality of life. A polyethylene glycol-based spacer, SpaceOAR© hydrogel (SOH), implanted between prostate gland and rectum may significantly reduce dose received by the rectum and hence risk of rectal toxicity. SOH implant is not equally effective in all patients. Determining patients in which the im...
Source: Journal of Applied Clinical Medical Physics - Category: Physics Authors: Tags: J Appl Clin Med Phys Source Type: research
gins Len W. Seymour Janet Lei-Rossmann Ionising radiation causes cell death through the induction of DNA damage, particularly double-stranded DNA (dsDNA) breaks. Evidence suggests that adenoviruses inhibit proteins involved in the DNA damage response (DDR) to prevent recognition of double-stranded viral DNA genomes as cellular dsDNA breaks. We hypothesise that combining adenovirus treatment with radiotherapy has the potential for enhancing tumour-specific cytotoxicity through inhibition of the DDR and augmentation of virus production. We show that EnAd, an Ad3/Ad11p chimeric oncolytic adenovirus currently being tri...
Source: Cancers - Category: Cancer & Oncology Authors: Tags: Article Source Type: research
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