Clinical oncologyPub Date : 2025-02-01DOI: 10.1016/j.clon.2024.103668
C.O. Abana , P.P. Carriere , P.J. Damen , P.S.N. van Rossum , A.K. Yoder , P.L. Bravo , X. Wei , J.M. Pollard-Larkin , P.L. Nitsch , M.B. Murphy , W.L. Hofstetter , Z. Liao , S.H. Lin
{"title":"Comparative Outcomes and Toxicity in Patients With Esophageal Cancer After Trimodality Therapy With Step-and-Shoot Intensity-Modulated Radiation Therapy Versus Volumetric Modulated Arc Therapy: The MD Anderson Experience","authors":"C.O. Abana , P.P. Carriere , P.J. Damen , P.S.N. van Rossum , A.K. Yoder , P.L. Bravo , X. Wei , J.M. Pollard-Larkin , P.L. Nitsch , M.B. Murphy , W.L. Hofstetter , Z. Liao , S.H. Lin","doi":"10.1016/j.clon.2024.103668","DOIUrl":"10.1016/j.clon.2024.103668","url":null,"abstract":"<div><h3>Aims</h3><div>To evaluate outcomes and toxicity after intensity-modulated radiation therapy given as step-and-shoot (SS) or volumetric modulated arc therapy (VMAT) for patients with locally advanced esophageal cancer treated with trimodality therapy (i.e. neoadjuvant concurrent chemoradiation therapy followed by surgery).</div></div><div><h3>Materials and Methods</h3><div>Patients consecutively treated with trimodality therapy including IMRT in 2001–2022 (n = 449) were retrospectively reviewed, and 106 pairs of propensity-matched SS and VMAT patients were identified. Survival, recurrence, surgery-related prognostic factors, and chemoradiation-related toxicities were evaluated between groups.</div></div><div><h3>Results</h3><div>Baseline characteristics were balanced between both groups except for body mass index, history of other cancer, clinical disease stage, and use of induction chemotherapy. Median follow-up time was 40 months. Relative to SS, VMAT led to higher 3-year overall survival (OS; <em>P</em> = 0.028, hazard ratio [HR] 0.645, 95% confidence interval [CI] 0.436–0.954) but not progression-free, locoregional recurrence-free, or distant metastasis-free survival. No predictor of excellent OS by SS versus VMAT was identified in multivariable analyses. However, VMAT was associated with reduced odds of postoperative cardiac complications (<em>P</em> < 0.001, odds ratio [OR] 0.296, 95% CI 0.148–0.591), pulmonary complications (<em>P</em> = 0.048, OR 0.539, 95% CI 0.292–0.994), pathologic partial response or worse (≥10% viable cells; <em>P</em> = 0.003, OR 0.418, 95% CI 0.235–0.743), and positive/close margins (<em>P</em> = 0.023, OR 0.346, 95% CI 0.138–0.867) relative to SS. VMAT was also associated with reduced rates of chemoradiation therapy-related weight loss (33.0% versus 79.2%, <em>P</em> < 0.001), fatigue (40.6% versus 68.9%, <em>P</em> < 0.001), nausea (31.1% versus 58.5%, <em>P</em> < 0.001) and cardiac toxicity (0% versus 6.6%, <em>P</em> = 0.007) than SS.</div></div><div><h3>Conclusion</h3><div>Based on this single institution, retrospective study with a 40-month median follow-up, VMAT utilization in trimodality treatment for locally advanced esophageal cancer appears to be associated with improved OS and rates of concurrent chemoradiation therapy-related toxicity and reduced initial 12-month postoperative complications relative to SS IMRT. Multi-institutional prospective trials addressing the limitations of this study and with longer follow-ups are warranted to validate these findings.</div></div>","PeriodicalId":10403,"journal":{"name":"Clinical oncology","volume":"38 ","pages":"Article 103668"},"PeriodicalIF":3.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142871594","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Clinical oncologyPub Date : 2025-02-01DOI: 10.1016/j.clon.2024.10.016
S. Dipro, S. Appleyard
{"title":"Virtual follow-up after prostate radiotherapy: A successful model utilising non-clinical personnel to streamline care and optimise patient outcomes","authors":"S. Dipro, S. Appleyard","doi":"10.1016/j.clon.2024.10.016","DOIUrl":"10.1016/j.clon.2024.10.016","url":null,"abstract":"","PeriodicalId":10403,"journal":{"name":"Clinical oncology","volume":"38 ","pages":"Page 5"},"PeriodicalIF":3.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143428753","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Clinical oncologyPub Date : 2025-02-01DOI: 10.1016/j.clon.2024.10.012
M. Ling , P. Das , A. Clark , L. Vaz , A. Booth , R. Das
{"title":"A sub-study to assess the agreement between the anti-cancer treatment records in Systemic Anticancer Therapy (SACT) and Hospital Episode Statistics (HES) database from a large-scale retrospective cohort study with patients with renal cell carcinoma in England","authors":"M. Ling , P. Das , A. Clark , L. Vaz , A. Booth , R. Das","doi":"10.1016/j.clon.2024.10.012","DOIUrl":"10.1016/j.clon.2024.10.012","url":null,"abstract":"","PeriodicalId":10403,"journal":{"name":"Clinical oncology","volume":"38 ","pages":"Pages 3-4"},"PeriodicalIF":3.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143428968","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Clinical oncologyPub Date : 2025-02-01DOI: 10.1016/j.clon.2024.103723
S. Mumtaz , R. Muhammad , N. Goyal , A. Konstantis
{"title":"Chemotherapy tolerance and outcomes in geriatric breast cancer patients aged >70 assessed using the Edmonton Frail Scale","authors":"S. Mumtaz , R. Muhammad , N. Goyal , A. Konstantis","doi":"10.1016/j.clon.2024.103723","DOIUrl":"10.1016/j.clon.2024.103723","url":null,"abstract":"","PeriodicalId":10403,"journal":{"name":"Clinical oncology","volume":"38 ","pages":"Article 103723"},"PeriodicalIF":3.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143429248","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Clinical oncologyPub Date : 2025-02-01DOI: 10.1016/j.clon.2024.07.009
L. Sarkies , P. Thomas , E.A. Edeko , S. Leiter , J. Trotman , R. Armstrong , A. Vedi
{"title":"Developing a Paired Whole Genome Sequencing Service for Children With Cancer","authors":"L. Sarkies , P. Thomas , E.A. Edeko , S. Leiter , J. Trotman , R. Armstrong , A. Vedi","doi":"10.1016/j.clon.2024.07.009","DOIUrl":"10.1016/j.clon.2024.07.009","url":null,"abstract":"<div><h3>Background</h3><div>The uniqueness of paired (tumor and germline) whole genome sequencing (PWGS) in cancer diagnosis and management lies in not just its ability to uncover oncogenic drivers and potential treatment targets but also on the identification of underlying cancer predisposition syndromes, which has significant implications for the patient and their family.</div></div><div><h3>Aims</h3><div>This is a descriptive article highlighting the processes taken by our team to incorporate PWGS into routine National Health Service (NHS) clinical care for children with cancer. The main aim of this article is to share our experience with other centers that may wish to set up similar services and set the stage for future quantitative/qualitative research.</div></div><div><h3>Methods</h3><div>This article is further supported by an audit focusing on children in whom an underlying cancer predisposition was confirmed.</div></div><div><h3>Results</h3><div>The audit highlights the success of the program to date, with 100% of families identified as being at risk of a cancer predisposition syndrome being offered referral to clinical genetics and 100% of at-risk first-degree relatives being offered predictive counseling and testing. Areas requiring improvement included discussion of reproductive options as only six out of nine families (67%) had a documented discussion.</div></div><div><h3>Conclusions</h3><div>Incorporation of the audit recommendations will improve our service, and sharing of our experience will hopefully encourage more pediatric oncology services to introduce PWGS into routine clinical care and reduce inequity of access. Further work is required to assess the long-term cancer risk reduction and establish the psychosocial impact of PWGS for the child and family.</div></div>","PeriodicalId":10403,"journal":{"name":"Clinical oncology","volume":"38 ","pages":"Article 103623"},"PeriodicalIF":3.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142104947","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Clinical oncologyPub Date : 2025-02-01DOI: 10.1016/j.clon.2024.08.006
W. Cheah, R.I. Cutress, D. Eccles, E. Copson
{"title":"Clinical Impact of Constitutional Genomic Testing on Current Breast Cancer Care","authors":"W. Cheah, R.I. Cutress, D. Eccles, E. Copson","doi":"10.1016/j.clon.2024.08.006","DOIUrl":"10.1016/j.clon.2024.08.006","url":null,"abstract":"<div><div>The most commonly diagnosed cancer in women worldwide is cancer of the breast. Up to 20% of familial cases are attributable to pathogenic mutations in high-penetrance (BReast CAncer gene 1 [BRCA1], BRCA2, tumor protein p53 [TP53], partner and localizer of breast cancer 2 [PALB2]) or moderate-penetrance (checkpoint kinase 2 [CHEK2], Ataxia-telangiectasia mutated [ATM], RAD51C, RAD51D) breast-cancer-predisposing genes. Most of the breast-cancer-predisposing genes are involved in DNA damage repair via homologous recombination pathways. Understanding these pathways can facilitate the development of risk-reducing and therapeutic strategies. The number of breast cancer patients undergoing testing for pathogenic mutations in these genes is rapidly increasing due to various factors. Advances in multigene panel testing have led to increased detection of pathogenic mutation carriers at high risk for developing breast cancer and contralateral breast cancer. However, the lack of long-term clinical outcome data and incomplete understanding of variants, particularly for moderate-risk genes limits clinical application. In this review, we have summarized the key functions, risks, and prognosis of breast-cancer-predisposing genes listed in the National Health Service (NHS) England National Genomic Test Directory for inherited breast cancer and provide an update on current management implications including surgery, radiotherapy, systemic treatments, and post-treatment surveillance.</div></div>","PeriodicalId":10403,"journal":{"name":"Clinical oncology","volume":"38 ","pages":"Article 103631"},"PeriodicalIF":3.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142145311","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Clinical oncologyPub Date : 2025-02-01DOI: 10.1016/j.clon.2024.103704
I.S. Boon
{"title":"Sequencing Targeted Therapy in Era of Precision Medicine for Thyroid Cancers","authors":"I.S. Boon","doi":"10.1016/j.clon.2024.103704","DOIUrl":"10.1016/j.clon.2024.103704","url":null,"abstract":"","PeriodicalId":10403,"journal":{"name":"Clinical oncology","volume":"38 ","pages":"Article 103704"},"PeriodicalIF":3.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142964051","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}