Publications by authors named "Francis Ho"
Introduction: Both Geriatric-8 (G8) and geriatric assessment (GA) assess frailty and facilitate providing appropriate interventions as recommended by the International Society for Geriatric Oncology. The main objective of this study is to evaluate the impact of G8 and GA-based interventions on the quality of life (QOL) of older adults with cancer.
Materials And Methods: This is a prospective study of patients with cancer aged ≥70 y.
Article Synopsis
- The study examined whether comprehensive geriatric assessment (CGA)-guided care enhances health-related quality of life (HRQL) in older cancer patients compared to standard care.
- Meta-analyses showed a potential moderate improvement in HRQL scores at 3 months, though results were not definitive and depended on the size and type of trials.
- Overall, findings suggested that larger RCTs and those requiring CGA before cancer treatment were more likely to show better HRQL outcomes.
The Head and Neck Cancer International Group (HNCIG) has undertaken an international modified Delphi process to reach consensus on the essential data variables to be included in a minimum database for HNC research. Endorsed by 19 research organisations representing 34 countries, these recommendations provide the framework to facilitate and harmonise data collection and sharing for HNC research. These variables have also been incorporated into a ready to use downloadable HNCIG minimum database, available from the HNCIG website.
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- - Survivors of head and neck cancers (HNC) in Singapore have a higher risk of stroke, and a study aimed to understand this risk among different subpopulations of HNC survivors from January 2005 to December 2020.
- - The study used data from national cancer and stroke registries, focusing on demographic and treatment factors to analyze stroke outcomes over a median follow-up period of about 42.5 months.
- - Out of nearly 10,000 HNC survivors studied, 3.4% suffered a stroke, showing a significant stroke risk increase with an SIRR of 2.46, indicating they were over twice as likely to have a stroke compared to the general population.
Purpose: This systematic review and meta-analysis evaluates the efficacy of Mepitel Film in preventing acute radiation dermatitis (RD) in patients with head and neck cancer (HNC) across randomized controlled trials (RCTs).
Methods: Embase, MEDLINE, and Cochrane Central Register of Controlled Trials were searched on 5 March 2023 to identify relevant RCTs. RD assessment tools and outcomes were compared across studies.
Introduction: In the National University Cancer Institute, Singapore (NCIS), 2 pilot programs providing (i) surgical prehabilitation before cancer surgery and (ii) geriatric oncology support for older adults planned for chemotherapy and/or radiotherapy were merged to form the Geriatric Oncology Longitudinal End to eNd (GOLDEN) program in 2019 to support patients from the time of their cancer diagnosis, through their treatment process, to cancer survivorship.
Methods And Materials: Older adults aged ≥65 years were enrolled in either surgical prehabilitation, the geriatric medical oncology (GO) arm, or both. All patients undergo a geriatric assessment.
Article Synopsis
- - The study aimed to compare the dosimetric outcomes of advanced radiation techniques (IMRT vs. VMAT) through a systematic review and meta-analysis, consolidating previous non-randomized research findings where results were inconsistent.
- - A total of 17 studies involving 383 patients were analyzed, revealing that dual arc VMAT significantly reduced doses to specific organs, treatment times, and the number of monitor units required, while IMRT showed better target coverage in certain scenarios.
- - Subgroup analyses determined that the Eclipse treatment planning system performed better in terms of integral dose and delivery time, while IMRT outperformed VMAT in target coverage when using the Pinnacle and Monaco systems.
Importance: The Cancer and Aging Research Group (CARG) prediction model for chemotherapy-related toxic effects has been developed but not yet validated in older Asian adults. In view of differences in drug metabolism and toxic effect reporting in the Asian population, the ability of this tool to guide the cancer treatment decision-making process in older Asian adults needs to be assessed.
Objective: To examine the validity of the CARG predictive model in a multiethnic Asian cohort of older adults.
Background: Forty percent of hepatitis B carriers have no knowledge of their diagnosis. A prior study in British Columbia suggested high rates of hepatitis B among immigrants. The authors undertook a large-scale screening study to validate these rates.
View Article and Find Full Text PDFCancer affects older adults with varying levels of frailty, but cancer treatment is extrapolated from clinical trials involving predominantly young and robust subjects. Recent geriatric oncology randomised controlled trials (RCT) report that geriatric assessment leading to frailty-guided intervention reduces treatment-related toxicity whilst maintaining survival and improving quality of life (QoL). However, these positive results have not have been consistently reported in the literature.
View Article and Find Full Text PDFIntroduction: The COVID-19 pandemic has impacted healthcare on an unprecedented scale, with healthcare resources being channeled into managing the devastating effects of the outbreak. Healthcare provision for vulnerable older adults has also been affected by lockdowns and suspension of selected medical services worldwide. In our tertiary cancer center, the National University Cancer Institute, Singapore (NCIS), our Geriatric Oncology (GO) service for older adults with cancer was halted for five months.
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- * After reviewing 23 studies with over 1,100 patients, the survival rates were significantly higher for CRT-S (65% at 1 year) compared to CRT (30% at 1 year), while treatment-related complications were relatively low for both groups.
- * The researchers concluded that while chemoradiotherapy is a viable option for T4 esophageal cancer, the combination with surgery may be beneficial for some patients, but more high-quality randomized controlled trials are needed to confirm these results.
Introduction: We report outcomes of patients with oesophageal cancer treated with neoadjuvant chemoradiotherapy (NACRT) plus surgery or definitive chemoradiotherapy (chemoRT) at our institution.
Methods: We retrospectively reviewed patients who underwent chemoRT from 2005 to 2017. The primary outcome was overall survival (OS).
Radiation oncology training in Singapore - A non-Australasian RANZCR training site.
J Med Imaging Radiat Oncol
July 2021
The Radiation Oncology Department at The National Cancer Institute, Singapore (NCIS) and the Royal Australian and New Zealand College of Radiology (RANZCR) has had a well-established relationship that began as a partnership to grow a pool of local radiation oncologists to meet a nation's demand for radiotherapy services. This journey has surpassed its initial aims and now has produced a generation of radiation oncologists leading a national cancer institute. We recount the history and progress of this partnership here, as well as the unique success of its product; the only RANZCR-accredited radiation oncology training site outside of Australia and New Zealand since 2002.
View Article and Find Full Text PDFThe implementation of an advanced practice radiation therapy (APRT) program in Singapore.
Tech Innov Patient Support Radiat Oncol
March 2021
Background: The exploration of Advanced Practiced Radiation Therapists (APRTs) development in Singapore started in 2011. This study aims to provide an overview of the development of the APRT roles, and to discuss the approaches used to develop and implement these roles in Singapore.
Materials And Methods: A mixed methods approach was used in the development of the APRT program.
Liver is the most common site for metastasis from colorectal cancer (CRC). Non-surgical treatment options for oligometastatic CRC confined to the liver which represents an intermediate state in the metastatic cascade are fast expanding. Currently, several liver-directed local therapeutic options are available, such as hepatic arterial infusion (HAI) therapy, radio-frequency ablation (RFA), transarterial chemoembolization (TACE), stereotactic body radiotherapy and high dose rate brachytherapy (HDRBT).
View Article and Find Full Text PDFBackground/purpose: The optimal dose fractionation for palliative radiotherapy (RT) in patients with symptomatic advanced bladder cancer is unclear. This study aimed to determine if a higher dose of RT was associated with improved symptoms response rates.
Methods: We searched PubMed, Central and Embase for eligible studies published from 1990 to 2019.
Article Synopsis
- - The study aimed to compare the incremental clinical benefits (ICB) and costs of three treatment approaches for locally advanced nasopharyngeal cancer: induction chemotherapy (IC) added to concurrent chemoradiotherapy (CCRT), concurrent chemotherapy (CC) added to radiotherapy (RT), and CC plus adjuvant chemotherapy (AC) added to RT.
- - Three clinical trials for IC, three for CC, and four for CC + AC were analyzed, revealing that all approaches had similar ICB scores and incremental drug costs, with no significant differences found statistically.
- - The conclusions indicate that the ICB and drug costs associated with these treatment methods do not significantly differ, suggesting that choosing between them may depend more on patient
Purpose: Induction cisplatin and gemcitabine chemotherapy is a standard treatment for locally advanced nasopharyngeal carcinoma (NPC). Inhibition of VEGF axis has been shown to promote maturation of microvasculature and improve perfusion. We conducted a four-arm study to assess the effect of two doses of either sunitinib or bevacizumab with chemotherapy in NPC.
View Article and Find Full Text PDFEmerging radiotherapy technologies and trends in nasopharyngeal cancer.
Cancer Commun (Lond)
September 2020
Article Synopsis
- Technology has significantly advanced radiotherapy treatments for nasopharyngeal cancer (NPC), leading to improved outcomes over recent decades.
- Key emerging trends include personalized medicine, advanced imaging, better treatment planning, adaptive re-planning, the use of particle therapy, and the integration of artificial intelligence in clinical settings.
- The expectation is that these innovations will greatly enhance the effectiveness and safety of NPC radiotherapy in the coming decade.
Introduction: Synchronous colorectal and prostate malignancies are uncommon, with standard treatment guidelines not yet established. Chemoradiation therapy is involved in both colorectal and prostate cancers. However, differing dosage regimens and effects of irradiation field on anatomical planes for surgery makes management of the synchronous cancers challenging.
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- - In December 2019, a pneumonia outbreak in China was identified as being caused by a new coronavirus (SARS-CoV-2), leading to the disease known as COVID-19, with Singapore confirming its first case on January 23, 2020.
- - Singapore was better equipped to handle the outbreak due to previous experiences with SARS and H1N1, implementing quick measures to control the virus's spread and protect healthcare workers.
- - The article discusses recommendations and workflows from Singapore's National Cancer Centres, focusing on the unique challenges faced by radiation oncology departments amidst the pandemic and proposing strategies for managing COVID-19 positive patients undergoing radiotherapy.
Article Synopsis
- The study investigates the best timing for the first MRI scan following radiotherapy in patients with nasopharyngeal carcinoma to effectively monitor for any local recurrences.
- It includes an analysis of 262 patients who underwent post-treatment MRIs, revealing that about one-third had complete responses while many others had indeterminate results, often requiring additional scans for a clearer diagnosis.
- The findings suggest that waiting approximately four months after treatment for the first MRI could lower the number of patients with indeterminate results and emphasizes MRI's role in detecting recurrences.