Clinical Oncology

Our medical research library holds 6 studies published in Clinical Oncology (2010–2022). Each entry links to the study's record on PubMed and, where there is one, to the publisher's page and a free full text. 5 have an abstract, the authors' own summary as PubMed records it: open "Abstract" to read it.

About the journal

• Publisher: W.B. Saunders
• Published: 1989 to the present, England
• Language: English
• ISSN: 0936-6555 (print), 1433-2981 (electronic)
• Its record in the NLM Catalog

2020s

• Dosimetric Comparison Between Helical Tomotherapy and Volumetric Modulated Arc Therapy in Patients With Malignant Pleural Mesothelioma. T. Müdder, G.R. Sarria, C. Henkenberens, et al. 2022;34(3):164-171. PubMed · Publisher

  Abstract

  Aims: To carry out a dosimetric comparison and constraints feasibility proof of adjuvant radiotherapy through helical tomotherapy or volumetric modulated arc therapy (VMAT) for malignant pleural mesothelioma patients after pleurectomy/decortication.

  Materials And Methods: Retrospective calculations were carried out on previously acquired simulations. A whole-pleura volume with 50.4 Gy in 28 fractions was prescribed, simulating a no residual tumour situation. Calculations were carried out using an anisotropic analytical algorithm with a 2.0 mm grid. Beam-on time, planning target volume (PTV) coverage, homogeneity index and organ at risk exposure were compared.

  Results: Sixteen patient plans were calculated per device. Constraints were met overall by both modalities. For helical tomotherapy and VMAT plans, median beam-on times were 13.8 (11.6-16.1) min and 6.4 (6.1-7.0) min; P = 0.006. The median left-sided radiotherapy PTV D98 were 48.1 (48.0-48.8) Gy and 47.6 (46.5-48.3) Gy; P = 0.023. No significant difference for right-sided radiotherapy was found. PTV D2 for left-sided radiotherapy was higher with VMAT (P = 0.014). For right-sided radiotherapy, helical tomotherapy showed higher doses (P = 0.039). No homogeneity index differences for left-sided radiotherapy (P = 1.00) and right-sided radiotherapy (P = 0.598) were seen. Significant organ at risk exposure differences were found on left-sided radiotherapy whole-lung V20, as well as D50 (both P = 0.008). Higher contralateral lung and ipsilateral kidney exposures were found with VMAT plans for both treatment sides.

  Conclusion: Adjuvant radiotherapy after pleurectomy/decortication in malignant pleural mesothelioma patients, with a VMAT- or helical tomotherapy-based platform, is dosimetrically feasible. Lung sparing was mostly improved with helical tomotherapy. Technique selection must be carried out according to availability and clinical criteria.

  Copyright © 2021 The Author(s). Published by Elsevier Ltd.. All rights reserved.

2010s

• Malignant mesothelioma, hypoalbuminaemia and the effect of carboplatin/pemetrexed on survival. S. Murphy, G. Probert, J. Anderson, et al. 2013;25(12):713-8. PubMed · Publisher

  Abstract

  Aims: The incidence of malignant mesothelioma in the UK is increasing. The aim of this study was to determine the prognostic factors and assess the effect of carboplatin/pemetrexed chemotherapy on survival.

  Materials And Methods: Cases of malignant mesothelioma diagnosed between 1998 and 2011 were stratified by year of diagnosis. Factors affecting survival were assessed by Cox's proportional hazards regression.

  Results: In total, there were 202 new cases of malignant mesothelioma between 1998 and 2011. The age-standardised rate (95% confidence interval) increased from 2.84 (2.06-3.60) to 4.44 (3.50-5.4); P = 0.025. Chemotherapy use has increased since 2006: 52% versus 34% (P = 0.007). The median survival (interquartile range) by year diagnosed was 9 (4.0-21.9) versus 10 (3.8-20.1) months for 1998-2005 versus 2006-2011. Independent predictors of survival [hazard ratio (95% confidence interval)] were: histology, sarcomatoid 2.22 (1.49-3.31) and unspecified non-epithelioid 1.50 (1.06-2.14); Eastern Cooperative Oncology Group performance status ≥3 2.86 (1.64-5.00); hypoalbuminaemia 2.07 (1.47-2.92), carboplatin/pemetrexed chemotherapy 0.56 (0.38-0.80).

  Conclusion: The incidence of mesothelioma is increasing. Adverse prognostic factors include non-epithelioid histology, performance status and hypoalbuminaemia. Overall survival has not improved significantly, but treatment with carboplatin/pemetrexed chemotherapy is associated with a significant survival benefit.

  Copyright © 2013 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.

• Nervous system metastases from malignant mesothelioma. N.M. Martinez, I.T. Gavrilovic, C. Grommes. 2013;25(1):74. Letter PubMed · Publisher · Free full text

• The management of lung cancer: a UK survey of oncologists. S.L. Prewett, S. Aslam, M.V. Williams, et al. 2012;24(6):402-9. PubMed · Publisher

  Abstract

  Aims: This report reviews current radiotherapy practice across the UK in the management of lung cancer, and the way new treatments and technologies are being introduced, where improvements have occurred, and where work is still required. We wanted to determine adherence to both National Radiotherapy Advisory Group and National Institute for Health and Clinical Excellence (NICE) guidance. This survey was conducted on behalf of the Department of Health Lung Cancer & Mesothelioma Advisory Group.

  Materials And Methods: We sent a questionnaire to all UK radiotherapy departments. It covered radical radiotherapy dose fractionation, the use of concurrent or sequential chemotherapy for both non-small cell and small cell lung cancers, the use of continuous hyperfractionated accelerated radiotherapy, new radiotherapy techniques, the use of positron emission tomography/computed tomography for planning purposes and patient accrual into current National Cancer Research Network UK trials.

  Results: This UK-wide survey of radiotherapy practice for lung cancer showed broad compliance with NICE clinical guidance, but highlighted significant variation in fractionation schedules and the use of concomitant chemoradiotherapy. Clinical trial entry into lung cancer radiotherapy trials was variable and many centres are not fully participating in recruitment into these trials.

  Conclusions: This report has shown the variability of radiotherapy provision nationally. Current practice is largely consistent with current and updated NICE recommendations and best practice and should be recognised as such. It has also highlighted areas where improvements are still needed, particularly fractionation and new technologies. One particular aspect of concern is the poor recruitment to current UK-based clinical trials in lung cancer.

  Copyright © 2012 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.

• Life after first-line chemotherapy in malignant pleural mesothelioma: a North-East England experience. J. Steer, G. Bough, A.R. Razak, et al. 2010;22(3):231-5. PubMed · Publisher

  Abstract

  Aims: The benefit of first-line chemotherapy in malignant pleural mesothelioma (MPM) has been established. However, this disease invariably progresses and little is known about how this disease subsequently relapses after initial treatment. Data on second-line treatment are also scarce, especially outside the context of a clinical trial. We conducted a review to observe the presentation of MPM patients when their disease progresses after initial therapy and the use of second-line therapy and its associated outcomes.

  Materials And Methods: Patients were retrospectively identified from the Sunderland Royal Hospital and the Northern Centre for Cancer Care, Newcastle upon Tyne, UK. Data, including demographics, clinical presentation and treatment details at first line and beyond, together with its associated benefits, were collected. Related times to treatment failure (TTF), rates of symptom improvement and survival data were also collated.

  Results: There were 62 evaluable patients in our series. At the time of data collection, 58 patients (94%) had relapsed. At disease progression, symptoms were usually similar to those at initial presentation, but in patients with prolonged TTF (>9 months) they were more likely to relapse with clinical lymphadenopathy in the neck and axilla compared with patients with TTF < or =9 months (52% vs 13%, respectively, P<0.05). Second-line treatment was given in 45% of patients. Twenty-one patients (36%) received second-line chemotherapy outside the context of a clinical trial and most had retreatment with pemetrexed-based chemotherapy due to a prolonged TTF. In patients treated with second-line therapy outside the remit of a clinical trial, a disease control rate was achieved in nine patients (43%, 95% confidence interval 22-64), whereas improvement in symptoms were noted in 13 patients (62%, 95% confidence interval 41-83). The median TTF in this setting was 6.5 months.

  Conclusion: Patients with a prolonged TTF after first-line treatment are more likely to relapse with neck and axillary lymphadenopathy. The use of second-line chemotherapy, including rechallenge treatment, in this disease is a viable option for a selected group of MPM patients.

  Copyright 2010 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.

• Palliation of male genital cancers. C.J. Shukla, M. Shabbir, M.R. Feneley, et al. 2010;22(9):747-54. Review PubMed · Publisher

  Abstract

  Advanced genital tumours are rare. Traditionally, surgical intervention in these patients has had a limited role due to the associated co-morbidities, poor performance status and overall poor prognosis. Because the potential benefit of surgical intervention in advanced cases is not evidence based, a large proportion of these patients are treated palliatively with chemoradiation therapy, which may have a limited role in advanced disease together with no significant improvement in quality of life for the patient. We present a review of palliative surgical techniques and non-surgical interventions in a range of male genital malignancies. Although the focus relates to advanced tumours with a palliative intent, a brief discussion on treatment with a view to cure is also covered. The traditional dogma is challenged with demonstration of value in surgery as part of multimodal therapy. Various surgical techniques that are used not only to excise the primary tumour, but also those of reconstruction of the urinary tract as well as techniques of flap and graft-based coverage are described. We show the essential role of surgery as part of multimodal therapy in well-motivated patients. No longer is surgery considered as having a limited role in these patients with advanced male genital malignancy.

  Copyright © 2010 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.

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