Local Treatment of the Axilla in Early Breast Cancer: So Many Questions, Still Few Answers
Madam — Axillary management for early breast cancer with micrometastatic sentinel nodes is well established [1,2], whereas there is still no consensus in the case of macrometastatic involvement. It is crucial to make a clear distinction between different questions: (Source: Clinical Oncology)
Source: Clinical Oncology - August 14, 2019 Category: Radiology Authors: I. Meattini, M.C. De Santis, F. De Rose, I. Desideri, P. Franco, O. Kaidar-Person, B. Meduri, N. Pasinetti, V. Lancellotta, Clinical Oncology Breast Cancer Group (COBCG) Investigators Tags: Letter Source Type: research

Cutaneous Lymphomas
Primary cutaneous lymphomas are the second most common form of extra-nodal lymphomas. They have special characteristics compared with other lymphomas. They are most frequently of T-cell origin and they generally have a much more indolent course than lymphomas of similar histology in other locations. Mycosis fungoides is the most common type of cutaneous lymphoma. Primary cutaneous lymphomas remain confined to the skin for a long time. Skin-directed therapies are the main treatments; systemic treatments are not very effective for the skin lesions. (Source: Clinical Oncology)
Source: Clinical Oncology - August 9, 2019 Category: Radiology Authors: L. Specht, L. Skov Tags: Overview Source Type: research

Salvage Re-irradiation With Single-modality Interstitial Brachytherapy for the Treatment of Recurrent Gynaecological Tumours in the Pelvis: A Multi-institutional Study
This study investigates the strategy of salvage single-modality interstitial brachytherapy (SM-ISBT) for recurrent gynaecological pelvic cancer at two specialised ISBT centres. (Source: Clinical Oncology)
Source: Clinical Oncology - August 8, 2019 Category: Radiology Authors: H. Raziee, D. D'Souza, V. Velker, E. Barnes, A. Taggar, L. Mendez, E. Leung Tags: Original Article Source Type: research

The Intensity-Modulated Pelvic Node and Bladder Radiotherapy (IMPART) Trial: A Phase II Single-Centre Prospective Study
Node-positive bladder cancer (NPBC) carries a poor prognosis and has traditionally been treated palliatively. However, surgical series suggest that a subset of NPBC patients can achieve long-term control after cystectomy and lymph node dissection. There is little published data regarding the use of radiotherapy to treat NPBC patients. This is in part due to concerns regarding the toxicity of whole-pelvis radiotherapy using conventional techniques. We hypothesised that, using intensity-modulated radiotherapy (IMRT), the pelvic nodes and bladder could be treated within a radical treatment volume with acceptable toxicity prof...
Source: Clinical Oncology - August 8, 2019 Category: Radiology Authors: M.P. Tan, V. Harris, K. Warren-Oseni, F. McDonald, H. McNair, H. Taylor, V. Hansen, M. Sharabiani, K. Thomas, K. Jones, D. Dearnaley, S. Hafeez, R.A. Huddart Tags: Original Article Source Type: research

PRECISION-Panc: the Next Generation Therapeutic Development Platform for Pancreatic Cancer
With the development of next generation sequencing (NGS) technology there has been an enormous increase in our knowledge and understanding of the molecular pathology of various cancer types, including pancreatic cancer. Pancreatic cancer remains the most lethal solid tumour type in our population. There has been little improvement in overall outcomes, with few effective therapies available for patients with advanced disease. Pancreatic cancer is a disease of low incidence, being the 11th most common cancer, yet the persisting high mortality will see it become the second leading cause of cancer death in the West by 2025 [1]...
Source: Clinical Oncology - August 2, 2019 Category: Radiology Authors: S.B. Dreyer, N.B. Jamieson, S.L. Cooke, J.W. Valle, C.J. McKay, A.V. Biankin, D.K. Chang Tags: Editorial Source Type: research

When Should we Irradiate the Primary in Metastatic Lung Cancer?
Metastatic lung cancer encompasses a heterogenous group of patients in terms of burdens of disease, ranging from patients with extensive metastases to those with a limited number of metastatic lesions (oligometastatic disease). Histopathological heterogeneity also exists within two broad categories, non-small cell lung cancer (NSCLC) and small cell lung cancer (SCLC), portraying different patterns and evolution of disease. Local consolidative therapy to the primary tumour and metastatic sites, including surgery and/or radical dose radiotherapy, is increasingly being used to improve survival outcomes, particularly in the co...
Source: Clinical Oncology - August 2, 2019 Category: Radiology Authors: A.-M. Shiarli, F. McDonald, D.R. Gomez Tags: Overview Source Type: research

RCR Meetings
(Source: Clinical Oncology)
Source: Clinical Oncology - August 1, 2019 Category: Radiology Source Type: research

Application of Hereditary Renal Cell Carcinoma Risk Criteria to a Large Prospective Database
To evaluate the clinical impact of the Canadian criteria for identifying patients and families at risk for hereditary renal cell carcinoma (RCC). (Source: Clinical Oncology)
Source: Clinical Oncology - August 1, 2019 Category: Radiology Authors: I. Kushnir, L. Kirk, R. Mallick, R.H. Kim, G.E. Graham, R.H. Breau, J.-B. Lattouf, P.D. Violette, S.E. Pautler, M. Care, A. Kapoor, M.A.S. Jewett, L. Wood, S. Tanguay, D.Y.C. Heng, N.S. Basappa, A. So, F. Pouliot, N.M. Reaume Tags: Original Article Source Type: research

Stereotactic Ablative Body Radiotherapy Versus Radical Radiotherapy: Comparing Real-World Outcomes in Stage I Lung Cancer
Stereotactic ablative body radiotherapy (SABR) is now considered the standard of care for medically inoperable stage I non-small cell lung cancer (NSCLC). The English National Cancer Registration and Analysis Service (NCRAS) collects data on all patients diagnosed with lung cancer, including information on treatment. We wanted to compare outcomes for patients with stage I NSCLC treated with radical radiotherapy with either SABR or fractionated radiotherapy. (Source: Clinical Oncology)
Source: Clinical Oncology - July 31, 2019 Category: Radiology Authors: I. Phillips, S. Sandhu, M. L üchtenborg, S. Harden Tags: Original Article Source Type: research

The Potential Role of Intensity-modulated Proton Therapy in the Regional Nodal Irradiation of Breast Cancer: A Treatment Planning Study
To investigate the role of intensity-modulated proton therapy (IMPT) for regional nodal irradiation in patients with breast carcinoma in comparison with volumetric-modulated arc therapy (VMAT). (Source: Clinical Oncology)
Source: Clinical Oncology - July 31, 2019 Category: Radiology Authors: F. De Rose, L. Cozzi, I. Meattini, A. Fogliata, D. Franceschini, C. Franzese, S. Tomatis, C. Becherini, L. Livi, M. Scorsetti Tags: Original Article Source Type: research

Differences Between the East and the West in Managing Advanced-Stage Non-small Cell Lung Cancer
Lung cancer is a common cancer associated with high mortality rates worldwide. Unfortunately, it usually presents at a late stage, precluding the chance of curative therapy. The discovery of oncogenic driver mutations in patients with non-small cell lung cancer over the past 20 years has led to new molecular targeted therapies that have dramatically improved treatment efficacy and quality of life. New generations of therapy that target the drug-resistant mutations have also quickly evolved, benefiting patients who are refractory or intolerant to first-line targeted therapy. (Source: Clinical Oncology)
Source: Clinical Oncology - July 30, 2019 Category: Radiology Authors: V.H.F. Lee, T.S.K. Mok, Y. Goto, V.C.C. Hsue, L. Yang, Y. Jiang, D.K.C. Leung, K.S. Lau, P.Y. Tse Tags: Overview Source Type: research

Intensity-Modulated Radiotherapy With a Simultaneous Integrated Boost in Rectal Cancer
Dose –response curves suggest that higher doses of radiotherapy improve the complete response rate in rectal cancer. The UK adopted the EXPERT trial dose and fractionation, 45 Gy in 25 fractions to the pelvis with a sequential 9 Gy in five fractions to the gross tumour, in patients where the aim was to maximise the complete response. In the Oxford University Hospital NHS Foundation Trust (Oxford, UK) we deliver a biological equivalent dose (BED5) in selected patients using intensity-modulated radiotherapy (IMRT) with a simultaneous integrated boost (SIB) in 25 fractions. (Source: Clinical Oncology)
Source: Clinical Oncology - July 27, 2019 Category: Radiology Authors: R. Owens, S. Mukherjee, S. Padmanaban, E. Hawes, C. Jacobs, A. Weaver, M. Betts, R. Muirhead Tags: Original Article Source Type: research

The Breast Cancer Trainees Research Collaborative Group: A New Multidisciplinary Network to Facilitate Breast Cancer Research
UK research data indicate that although there are currently more clinical trials in breast cancer than ever before, the total number of breast cancer patients participating in clinical studies has declined over recent years and there is significant geographical variation in patient involvement in research [1]. Several possible barriers to research participation have been identified. Advances in the subtyping of breast cancers and the increasing complexity of treatments have resulted in a relative lack of low intervention studies with broad eligibility criteria suitable to run at cancer units as well as tertiary centres. (S...
Source: Clinical Oncology - July 26, 2019 Category: Radiology Authors: V.W.T. Cheng, A. Heetun, T. Robinson, C.E. Coles, C. Palmieri, D. Rea, E.R. Copson Tags: Editorial Source Type: research

Nimotuzumab Dosing and Outcomes in Locally Advanced Head and Neck Cancer
Madam — A flat dose of 200 mg is approved for nimotuzumab in head and neck cancer [1]. However, doses up to 400 mg are used in pancreatic cancer [2]. This analysis was carried out to determine whether an increment in nimotuzumab dose according to body weight or body surface area is associated with impro ved outcomes. This was a post-hoc analysis of a phase III randomised study carried out in locally advanced head and neck cancer [1]. Of 536 patients enrolled in the study, 268 patients randomised on cisplatin–radical radiation with a nimotuzumab 200 mg flat dose were selected for this analysis. (Source: Clinical Oncology)
Source: Clinical Oncology - July 25, 2019 Category: Radiology Authors: A. Joshi, V.M. Patil, V. Noronha, A. Abhyankar, N. Menon, K. Prabhash Tags: Letter Source Type: research

Differential Relapse Patterns for Non-small Cell Lung Cancer Subtypes Adenocarcinoma and Squamous Cell Carcinoma: Implications for Radiation Oncology
Curative-intent (radical) radiotherapy aims to control local disease and cure non-small cell lung cancer (NSCLC). The predominant subtypes of NSCLC are adenocarcinoma and squamous cell carcinoma (SCC). The radiotherapy paradigm offered to patients does not differ according to these two subtypes. Relapse patterns and disease control rates for adenocarcinoma and SCC treated with radical radiotherapy were determined. (Source: Clinical Oncology)
Source: Clinical Oncology - July 24, 2019 Category: Radiology Authors: J. McAleese, A. Taylor, G.M. Walls, G.G. Hanna Tags: Original Article Source Type: research

Embryonal and Alveolar Rhabdomyosarcoma in Adults: Real-Life Data From a Tertiary Sarcoma Centre
Embryonal and alveolar rhabdomyosarcoma (ERMS, ARMS) are subtypes of RMS that mainly occur in children, with relatively good outcomes. The incidence in adults is extremely low and survival is significantly worse compared with children. Data are scarce and literature generally combines all RMS subtypes, including pleomorphic RMS, which primarily occurs in adults and behaves more like undifferentiated pleomorphic sarcoma. The aim of this study was to evaluate patient and tumour characteristics, outcome and prognostic factors in adult patients with ERMS and ARMS. (Source: Clinical Oncology)
Source: Clinical Oncology - July 23, 2019 Category: Radiology Authors: C. Drabbe, C. Benson, E. Younger, S. Zaidi, R.L. Jones, I. Judson, J. Chisholm, H. Mandeville, C. Fisher, K. Thway, O. Al Muderis, C. Messiou, D. Strauss, O. Husson, A. Miah, W.T.A. Van der Graaf Tags: Original Article Source Type: research

Referral Patterns and Outcome of Patients With Synchronous Brain Metastases From Non-small Cell Lung Cancer Treated With Gamma Knife Radiosurgery in a Third-Line Treatment Centre in The Netherlands – A Retrospective Analysis
Little understanding exists of referral patterns for patients with brain metastasis from non-small cell lung cancer (NSCLC) towards treatment with Gamma Knife radiosurgery (GKRS). Therefore, we explored current clinical daily practice and prognosis. (Source: Clinical Oncology)
Source: Clinical Oncology - July 22, 2019 Category: Radiology Authors: D.M.H.J. ten Berge, M.J. Aarts, P.E.J. Hanssens, G.N. Beute, J.G.J.V. Aerts, J.S. Kloover Tags: Original Article Source Type: research

The Challenge Facing Academic Radiotherapy Physics in the UK
Medical physics has been central to the scientific and technical development of radiotherapy since its inception as a treatment modality for cancer patients. As well as delivering a safe and effective cancer treatment, radiotherapy centres are routinely implementing innovations into the clinic [1] and physicists are central to innovation generation and innovation adoption. Bortfeld and Jeraj [2] highlighted the historic achievements of physics research in radiation therapy (radiotherapy) and argued for the continuing role and the need to develop academic medical physics and radiotherapy physics research. (Source: Clinical Oncology)
Source: Clinical Oncology - July 22, 2019 Category: Radiology Authors: A.R. Hounsell, M.A. Hawkins, P. Evans, National Cancer Research Institute Clinical and Translational Radiotherapy Research Working Group (CTRad) Executive and Workstream 4 Tags: Editorial Source Type: research

NUT Midline Carcinoma
Madam – NUT midline carcinoma (NMC) is a rare, recently discovered, genetically defined, highly aggressive cancer [1]. Because of its rarity, few data are available regarding incidence, risk factors, indication, outcomes and sequencing of treatment modalities. Hence, we decided to audit data of individu al patients diagnosed as NMC (defined on the basis of NUT-1 antibody positivity status on immunohistochemistry) in our institute between 2015 and 2018. (Source: Clinical Oncology)
Source: Clinical Oncology - July 19, 2019 Category: Radiology Authors: V.M. Patil, A. Toshniwal, V. Noronha, A. Joshi, N. Menon, S. Banavali, K. Prabhash Tags: Letter Source Type: research

DPYD Mutation in Indian Patients
Madam — A pharmacogenomics-based drug modification of 5-fluorouracil (a 25–50% dose reduction) was recommended by the Clinical Pharmacogenetics Implementation Consortium (CPIC) guidelines. However, this was never studied in a prospective systematic manner [1]. A recent study by Henricks et al. [2] su ggested that the incidence of dihydropyrimidine dehydrogenase gene mutation was 8%, which is higher than the incidence reported among Caucasians in most of the studies. We want to highlight that the incidence of DPYD mutation might have ethnic differences. (Source: Clinical Oncology)
Source: Clinical Oncology - July 19, 2019 Category: Radiology Authors: V.M. Patil, A. Chougule, V. Noronha, A. Joshi, A. Abhyankar, V. Ostwal, A. Ramaswamy, P. Bagayatkar, S. Banavali, K. Prabhash Tags: Letter Source Type: research

Time to Diagnosis and Treatment with Palliative Radiotherapy among Inuit Patients with Cancer from the Arctic Territory of Nunavut, Canada
The cancer burden among Circumpolar Inuit is high. Palliative radiotherapy is a mainstay treatment for controlling symptoms of advanced cancers, but Inuit are required to travel far distances to access this service. Access to palliative radiotherapy and time away from home communities have not been explored among this population. We sought to describe the time intervals from symptom onset to the start of palliative radiotherapy among Canadian Inuit patients treated at The Ottawa Hospital (TOH). (Source: Clinical Oncology)
Source: Clinical Oncology - July 19, 2019 Category: Radiology Authors: J. Chan, K. Linden, C. McGrath, J. Renaud, P. Doering, S. MacDonald, M. Gaudet, J.R. Pantarotto, T. Asmis, B. Slotman, K. Dennis Tags: Original Article Source Type: research

The Role of Biomarkers for the Prediction of Response to Checkpoint Immunotherapy and the Rationale for the Use of Checkpoint Immunotherapy in Cervical Cancer
Checkpoint immunotherapy has revolutionised the way that melanoma is treated and has also shown significant effectiveness in lung, bladder, renal, and head and neck cancers. At the present time, trials of checkpoint immunotherapy in cervical cancer are at early phases, but there is very good rationale for pursuing this as a treatment option, especially as cervical cancer is a virally driven cancer and therefore should be recognised by the immune system as being foreign. This review explores the biomarkers for the selection of patients for immunotherapy in other cancers, such as programmed death ligand 1 (PD-L1) expression,...
Source: Clinical Oncology - July 19, 2019 Category: Radiology Authors: S.J. Otter, J. Chatterjee, A.J. Stewart, A. Michael Tags: Overview Source Type: research

When Can We Discharge Differentiated Thyroid Cancer Patients Who Present With High-Risk Disease and Subsequently Have an Excellent Response to Treatment?
Madam — Further to the publication on low-risk differentiated thyroid cancer (DTC) follow-up [1], the authors wanted to quantify the recurrence rate in DTC patients who present with American Thyroid Association (ATA) high-risk disease and subsequently have an excellent response to treatment (ERST) after dynamic risk stratification (DRS). The only published series include 10 [2] and five patients [3], with no recurrences reported. (Source: Clinical Oncology)
Source: Clinical Oncology - July 17, 2019 Category: Radiology Authors: O. Mulla, K. Seejore, G.E. Gerrard, V.M. Gill, R.D. Murray Tags: Letter Source Type: research

Stereotactic Body Radiotherapy in Metastatic Disease: The Known Unknowns and the Unknown Unknowns
Medical reversals are many and frequent, but this should be considered a sign of progress and testament to the evidence-based medicine era that we live in. For most of us, when we were training, we were taught that there was no point irradiating the tumour(s) unless you could give a radical dose to all disease. This was accepted dogma, handed down from generation to generation. The fact that this assertion has been turned on its head in the last few years is testament to how little we still know about cancer and how much we have to learn. (Source: Clinical Oncology)
Source: Clinical Oncology - July 17, 2019 Category: Radiology Authors: A.C. Tree Tags: Editorial Source Type: research

Medical Oncology Workload in Europe: One Continent, Several Worlds
The workload pressure on medical oncologists will increase in the near future. There are no comprehensive data available about the current workload of medical oncologists in Europe. Here we report the European results of a global survey of the workload of medical oncologists. (Source: Clinical Oncology)
Source: Clinical Oncology - July 16, 2019 Category: Radiology Authors: B. Seruga, R. Sullivan, A. Fundytus, W.M. Hopman, A. Ocana, J. Joffe, G. Bodoky, C. Le Tourneau, V. Vanderpuye, G. Lopes, N. Hammad, M. Sengar, M.D. Brundage, C.M. Booth Tags: Original Article Source Type: research

Clinical Outcome of Exclusively Radiographer-led Delivery of Postoperative Vaginal Vault Brachytherapy for Endometrial Cancer – The Addenbrooke's Experience
Postoperative vaginal vault brachytherapy (VBT) reduces local recurrence in operable endometrial cancer. Radiographer-led delivery of VBT, carried out without image guidance, was implemented at Addenbrooke's in 2010 to maximise skills mix and to improve service delivery. The purpose of this study was to evaluate the safety and effectiveness of this service. (Source: Clinical Oncology)
Source: Clinical Oncology - July 13, 2019 Category: Radiology Authors: H. Buckley, K. Bradshaw, D. Gregory, S. Prewett, L.T. Tan Tags: Original Article Source Type: research

Comprehensive Review of Cranial Chordomas Using National Databases in the USA
The management of cranial chordomas is controversial. We provide a comprehensive review of the evolving patterns of care of cranial chordomas in the USA. (Source: Clinical Oncology)
Source: Clinical Oncology - July 11, 2019 Category: Radiology Authors: M.M. Hulou, C.R. Garcia, S.A. Slone, A. Dugan, F. Lei, B. Huang, T. Pittman, J.L. Villano Tags: Original Article Source Type: research

Adaptive Radiotherapy for Carcinoma of the Urinary Bladder: Long-term Outcomes With Dose Escalation
To report long-term outcomes with dose-escalated, image-guided adaptive radiotherapy (ART) for bladder preservation in muscle-invasive bladder cancer (MIBC). (Source: Clinical Oncology)
Source: Clinical Oncology - July 10, 2019 Category: Radiology Authors: V. Murthy, P. Gupta, K. Baruah, R. Krishnatry, A. Joshi, K. Prabhash, V. Noronha, S. Menon, M. Pal, G. Prakash, G. Bakshi Tags: Original Article Source Type: research

Tumour Hypoxia
Tumours are commonly hypoxic relative to surrounding tissues and oxygen plays an important role in radiosensitivity [1]. An understanding of hypoxia in tumours is therefore a key element of radiobiology, with hypoxia a target for improving patient outcomes. Here we discuss some of the fundamental principles related to understanding hypoxia as a therapeutic target, including the influence of oxygen on radiosensitivity, the oxygen enhancement ratio (OER), the relationship between the OER and linear energy transfer (LET) and the role of reoxygenation. (Source: Clinical Oncology)
Source: Clinical Oncology - July 10, 2019 Category: Radiology Authors: C.M. West, F. Slevin Tags: Editorial Source Type: research

Relative Biological Effect/Linear Energy Transfer in Proton Beam Therapy: A Primer
Proton beam therapy is a rapidly developing tool in cancer treatment. This educational piece will outline the key physical, biological and clinical parameters that give a basic understanding of the radiobiology of proton therapy (Figure  1). In particular, it will focus on the important parameters of linear energy transfer (LET) and relative biological effectiveness (RBE). (Source: Clinical Oncology)
Source: Clinical Oncology - July 10, 2019 Category: Radiology Authors: S.L. Gulliford, K.M. Prise Tags: Editorial Source Type: research

A Systematic Review and Meta-Analysis of Prognostic Biomarkers in Anal Squamous Cell Carcinoma Treated With Primary Chemoradiotherapy
Recent studies suggest that the treatment response and survival from head and neck tumours can be stratified according to biomarker status, particularly human papillomavirus (HPV) status and p16 expression, but the evidence for predictive biomarkers in anal squamous cell carcinoma (ASCC) remains limited. The aim of this study was to determine which biomarkers were associated with locoregional recurrence (LRR), overall survival and disease-free survival (DFS) in ASCC. A systematic search was undertaken of the MEDLINE, Embase, Cochrane Library, CINAHL and Web of Science databases using validated terms for ASCC, biomarkers an...
Source: Clinical Oncology - July 10, 2019 Category: Radiology Authors: I. Parwaiz, T.A. MacCabe, M.G. Thomas, D.E. Messenger Tags: Overview Source Type: research

Inter-Observer Variability in Target Volume Delineations of Benign and Metastatic Brain Tumours for Stereotactic Radiosurgery: Results of a National Quality Assurance Programme
To quantify inter-observer variation between all the intracranial stereotactic radiosurgery (SRS) providers in England in delineating the target volumes of four brain tumour cases. (Source: Clinical Oncology)
Source: Clinical Oncology - July 10, 2019 Category: Radiology Authors: S. Growcott, T. Dembrey, R. Patel, D. Eaton, A. Cameron Tags: Original Article Source Type: research

Quality Assurance Peer Review for Radiotherapy for Haematological Malignancies
To assess the impact of weekly scheduled peer review of radiotherapy planning contours for definitive treatment of haematological malignancies based on rates of recommended changes. (Source: Clinical Oncology)
Source: Clinical Oncology - July 8, 2019 Category: Radiology Authors: R. Samuel, E. Thomas, D. Gilson, R.J.D. Prestwich Tags: Original Article Source Type: research

Taxane-based Induction Chemotherapy Plus Concurrent Chemoradiotherapy in Nasopharyngeal Carcinoma: Prospective Results from a Non-endemic Cohort
To report the outcomes of induction chemotherapy (ICT) followed by chemoradiotherapy (CTRT) for a large cohort of locoregionally advanced nasopharyngeal cancer (LA-NPC) from a non-endemic region. (Source: Clinical Oncology)
Source: Clinical Oncology - July 8, 2019 Category: Radiology Authors: S. Ghosh-Laskar, A. Pilar, K. Prabhash, A. Joshi, J.P. Agarwal, T. Gupta, A. Budrukkar, V. Murthy, M. Swain, V. Noronha, V.M. Patil, P. Pai, D. Nair, D.A. Chaukar, S. Thiagarajan, G. Pantvaidya, A. Deshmukh, P. Chaturvedi, S. Nair, A. D ‘Cruz Tags: Original Article Source Type: research

The Linear –Quadratic Model and Implications for Fractionation
For any new clinician practising radiotherapy, the diverse array of dose-fractionation regimens in routine clinical usage can seem bewildering. Understanding the clinical and laboratory rationale behind these schedules is an essential part of training, allowing personal practice to be grounded upon the many successes, and of course setbacks, of the last century. (Source: Clinical Oncology)
Source: Clinical Oncology - July 5, 2019 Category: Radiology Authors: D.H. Brand, J.R. Yarnold Tags: Editorial Source Type: research

Advancing Care for Head and Neck Cancers in a Multidisciplinary Tumour Board in the East
Managing head and neck cancers is an excellent example of the importance of teamwork, with head and neck surgeons, clinical oncologists, radiologists, pathologists and other allied health professionals specialised in this disease site working together. The reliable imaging and dedicated pretreatment work-up entailing the comprehensive anatomical description of tumour involvement by the radiologists, the expertise of surgeons in performing en-bloc gross tumour resection, the uneventful speedy postoperative rehabilitation and recovery by the speech therapists and nutritionists, as well as the dedicated treatment planning of ...
Source: Clinical Oncology - July 4, 2019 Category: Radiology Authors: V.H.F. Lee, J.Y.W. Chan, V. Vardhanabhuti, D.L.W. Kwong, T.W. Leung, S.Y. Chan, C.C. Tong, Z.Y. Xu, L. Shen, A.W.M. Lee Tags: Overview Source Type: research

Contrasting Some Differences in Managing Advanced Unresectable Hepatocellular Carcinoma Between the East and the West
Hepatocellular carcinoma (HCC) is a common malignancy worldwide, although its aetiologies vary significantly between the East and the West. About a half of HCC cases present with advanced unresectable HCC at the time of diagnosis, leading to a worse prognosis. Over the past 20 years, the treatment paradigm for advanced unresectable HCC has shifted from an entirely palliative approach to a multidisciplinary treatment, with continuous reassessment and possible repeat treatment attributed to the advent of novel and improved local, regional and systemic therapeutic options, contributed by both the East and the West. (Source: Clinical Oncology)
Source: Clinical Oncology - July 4, 2019 Category: Radiology Authors: V.H.F. Lee, J. Seong, S.M. Yoon, T.C.L. Wong, B. Wang, J.L. Zhang, C.L. Chiang, P.P.Y. Ho, L.A. Dawson Tags: Overview Source Type: research

Breast Cancer Demographics, Types and Management Pathways: Can Western Algorithms be Optimally used in Eastern Countries?
Over the past decade, breast cancer has overtaken cervical cancer to become the most common cancer among women in India, as in most Western nations. In addition to the high incidence, the morbidity and mortality associated with this malignancy are disproportionately higher in India. Although some efforts are being made to increase awareness about this disease, a large majority of Indian patients present with advanced disease. Here, important institutional data and treatment outcomes are reviewed and compared with data from the West. (Source: Clinical Oncology)
Source: Clinical Oncology - July 4, 2019 Category: Radiology Authors: S. Chakraborty, T. Wadasadawala, R. Ahmed, C. Coles, S. Chatterjee Tags: Overview Source Type: research

RCR Meetings
(Source: Clinical Oncology)
Source: Clinical Oncology - July 4, 2019 Category: Radiology Source Type: research

Mode of Histological Diagnosis in Patients With Non-small Cell Lung Cancer Treated With Chemoradiotherapy: Its Prognostic Implication, Especially in Light of the European Durvalumab Licence?
Madam – Chemoradiotherapy is the standard of care in locally advanced non-small cell lung cancer. The PACIFIC trial showed that durvalumab after chemoradiotherapy was associated with a significant survival benefit [1]. However, the European Medicines Agency restricted durvalumab approval to patients wit h PDL1-positive tumours [2]. Experts criticised this restriction as it was based on an unplanned post-hoc analysis [3]. (Source: Clinical Oncology)
Source: Clinical Oncology - July 2, 2019 Category: Radiology Authors: M.S. Iqbal, E. Smith, M. Cunnell, A. Greystoke Tags: Letter Source Type: research

A Prospective Cohort Study of Human Papillomavirus-Driven Oropharyngeal Cancers: Implications for Prognosis and Immunisation
Oropharyngeal cancer (OPC) is increasing on a global scale, including the component driven by high-risk human papillomavirus (HR-HPV); contemporary data that provides insight into the prognosis of this disease in addition to the fraction attributable to HR-HPV are essential to inform primary and secondary disease management strategies. (Source: Clinical Oncology)
Source: Clinical Oncology - June 24, 2019 Category: Radiology Authors: K. Wakeham, J. Pan, K.G. Pollock, D. Millan, S. Bell, D. McLellan, A. McPhaden, D.I. Conway, S.V. Graham, K. Kavanagh, K. Cuschieri Tags: Original Article Source Type: research

Integrative Palliative Cancer Care in Hong Kong: An Overview and an Example from the East
Cancer is the most common cause of mortality worldwide. Although recent advances of multiple modality cancer management have significantly improved the cure and control rates, a significant proportion of patients are still refractory to the standard and available treatments. Early initiation of palliative care can reduce cancer suffering, improve health-related quality of life and possibly prolong survival. It also allows patients and their caretakers to perceive the trajectory of their cancer, so that better and advanced care planning can be contemplated and implemented. (Source: Clinical Oncology)
Source: Clinical Oncology - June 20, 2019 Category: Radiology Authors: V.H.F. Lee, T.C. Lam, H.M. Jing, F. Liu, Y.S. Zhang, J.J. Huang, A.W.M. Lee Tags: Overview Source Type: research

Prostate Radiotherapy in India: Evolution, Practice and Challenges in the 21st Century
The practice of prostate radiotherapy is evolving rapidly while there is an increase in the incidence of prostate cancer in India. Here, the diverse socioeconomic milieu and varied healthcare delivery models interact to exert a significant influence on the adoption of new technologies and evidence emerging from the Western world. Using a targeted cross-country survey of radiation oncologists, this article captures the changing trends in prostate imaging, conformal techniques, dose escalation, hypofractionation, stereotactic ablation and prostate brachytherapy in the context of practice patterns in the West. (Source: Clinical Oncology)
Source: Clinical Oncology - June 19, 2019 Category: Radiology Authors: V. Murthy, I. Mallick, M. Arunsingh, P. Gupta Tags: Overview Source Type: research

Axillary Surgery Following Neoadjuvant Chemotherapy – Multidisciplinary Guidance From the Association of Breast Surgery, Faculty of Clinical Oncology of the Royal College of Radiologists, UK Breast Cancer Group, National Coordinating Committee for Breast Pathology and British Society of Breast Radiology
These multidisciplinary guidelines aim to provide clinically helpful, evidence-based recommendations on the surgical management of the axilla in patients who have received neo-adjuvant chemotherapy for early breast cancer. (Source: Clinical Oncology)
Source: Clinical Oncology - June 19, 2019 Category: Radiology Authors: A. Gandhi, C. Coles, A. Makris, E. Provenzano, A. Goyal, A.J. Maxwell, J. Doughty Tags: Guidelines Source Type: research

Global Collaborations for Cervical Cancer: Can the East –West Alliance Facilitate Treatment for all?
Despite the advances in the primary prevention of cervical cancer, there is an absolute increase in the incidence of cervical cancer as a result of an increase in world population. A vast majority of patients in low and low –middle income countries continue to present at a locally advanced stage, necessitating treatment with chemoradiation and brachytherapy. There is a dearth of equipment and trained professionals for the treatment of cervical cancer, especially in low and low–middle income countries. (Source: Clinical Oncology)
Source: Clinical Oncology - June 19, 2019 Category: Radiology Authors: S. Chopra, P. Mittal, A. Viswanathan, E. Tharavichitkul, E. Zubizarreta, R.A. Nout, M.L. Yap, S. Grover, D. Rodin, B. Rai, S. Gondhowiardjo, S.K. Shrivastava Tags: Overview Source Type: research

East Meets West: Convergence of the Art and Science of Oncology
Non-communicable diseases (NCDs) are now responsible for most deaths globally, with cancer emerging as a leading cause of death across the world in the 21st century [1,2]. The incidence of and mortality from cancer continues to grow rapidly in an ever-increasing and aging global population. Although the incidence of cancer is significantly higher in the West (North America and Western Europe) compared with the developing low- and middle-income countries from the East, the overall burden of disease remains much higher in the East (including India and China), which is home to nearly 60% of the global population, compared wit...
Source: Clinical Oncology - June 19, 2019 Category: Radiology Authors: J.P. Agarwal, V.H.-F. Lee Tags: Editorial Source Type: research

Radiotherapy Quality Assurance for the CHHiP Trial: Conventional Versus Hypofractionated High-Dose Intensity-Modulated Radiotherapy in Prostate Cancer
The CHHiP trial investigated the use of moderate hypofractionation for the treatment of localised prostate cancer using intensity-modulated radiotherapy (IMRT). A radiotherapy quality assurance programme was developed to assess compliance with treatment protocol and to audit treatment planning and dosimetry of IMRT. This paper considers the outcome and effectiveness of the programme. (Source: Clinical Oncology)
Source: Clinical Oncology - June 11, 2019 Category: Radiology Authors: O. Naismith, H. Mayles, M. Bidmead, C.H. Clark, S. Gulliford, S. Hassan, V. Khoo, K. Roberts, C. South, E. Hall, D. Dearnaley, the CHHiP Investigators Tags: Original Article Source Type: research

Oropharyngeal Cancers in the East and the West – Implications of Aetiopathogenesis on Prognosis and Research
There has been a surge in human papillomavirus (HPV)-positive oropharyngeal cancers (OPCs) in the West. Although the prognosis of HPV-positive OPC is good, de-escalation strategies have so far not been able to confirm comparable cancer control. We examine the strategies implemented across the globe to safely reduce toxicities in HPV-positive disease. HPV-negative OPC has a poorer prognosis and is more prevalent in Eastern countries. We outline the intensification strategies currently used in HPV-negative cancers, with an aim to better prognosis. (Source: Clinical Oncology)
Source: Clinical Oncology - June 11, 2019 Category: Radiology Authors: S. Chatterjee, S. Ghosh Laskar, H. Mehanna, C.M. Nutting, I. Mallick Tags: Overview Source Type: research

Oncology Healthcare Provision in Hong Kong: Viewpoint of a Clinical Oncologist
Hong Kong is undoubtedly one of the most successful cities where East meets West. It became a British colony after the signing of the Treaty of Nanking (Nanjing) following the defeat of the Qing Dynasty of China in the Opium War in 1842. Subsequently, the Kowloon peninsula, the New Territories and other outlying islands were ceded and leased to Britain in 1860 and 1898, respectively. It has never been imagined before that these historical events have drastically changed Hong Kong from a fishing port to a metropolitan city over the past 177 years. (Source: Clinical Oncology)
Source: Clinical Oncology - June 8, 2019 Category: Radiology Authors: V.H.-F. Lee Tags: Editorial Source Type: research

An Audit of Consultations to Manage Oestrogen Deprivation in Patients Undergoing Early Breast Cancer Treatment
Purpose: An audit was undertaken to define outpatient workload relating to the management of oestrogen deprivation symptoms (EDS), in terms of numbers, nature, outcomes and duration of consultations. (Source: Clinical Oncology)
Source: Clinical Oncology - June 7, 2019 Category: Radiology Authors: A. Aleksic, S. Cleator Source Type: research