Publications by authors named "Khoo V"

Introduction: Prostate cancer (PCa) is the most common cancer in men. Recurrence may occur in up to half of patients initially treated with curative intent for high-risk localised/locally advanced PCa. Pelvic nodal recurrence is common in this setting, but no clear standard of care exists for these patients, with potential therapeutic approaches including stereotactic body radiotherapy (SBRT) to the involved node(s) alone, extended nodal irradiation (ENI) to treat sites of potential micrometastatic spread in addition to involved node(s) and androgen deprivation therapy with or without additional systemic anticancer therapies.

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Objectives: This study aimed to determine the clinical utility of the androgen deprivation therapy (ADT)+docetaxel (DOCE)+androgen receptor-targeted agent (ARTA) triplet therapy in patients with metastatic hormone-sensitive prostate cancer (mHSPC) in the UK.

Design: A modified Delphi method. A steering group of eight UK healthcare professionals experienced in prostate cancer care discussed treatment challenges, developing 39 consensus statements across four topics.

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Background: This study examined the social well-being of single older adults through the companionship of a social robot, LOVOT (Love+Robot; Groove X). It is designed as a companion for older adults, providing love and affection through verbal and physical interaction. We investigated older adults' perceptions of the technology and how they benefitted from interacting with LOVOT, to guide the future development of social robots.

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Background And Objective: Cytoreductive treatments for patients diagnosed with de novo synchronous metastatic hormone-sensitive prostate cancer (mHSPC) confer incremental survival benefits over systemic therapy, but these may lead to added toxicity and morbidity. Our objective was to determine patients' preferences for, and trade-offs between, additional cytoreductive prostate and metastasis-directed interventions.

Methods: A prospective multicentre discrete choice experiment trial was conducted at 30 hospitals in the UK between December 3, 2020 and January 25, 2023 (NCT04590976).

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Introduction: The global burden of peripheral artery disease (PAD) has been increasing. Guidelines for PAD recommend evidence-based medical therapy (EBMT) to reduce the risks of cardiovascular events and death but the implementation of this is highly variable. This study aimed to understand the current practices regarding EBMT prescription in PAD patients and the key barriers and facilitators for implementing PAD guidelines.

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Background: Moderately hypofractionated radiotherapy regimens or stereotactic body radiotherapy (SBRT) are standard of care for localised prostate cancer. However, some patients are unable or unwilling to travel daily to the radiotherapy department and do not have access to, or are not candidates for, SBRT. For many years, The Royal Marsden Hospital NHS Foundation Trust has offered a weekly ultra-hypofractionated radiotherapy regimen to the prostate (36 Gy in 6 weekly fractions) to patients unable/unwilling to travel daily.

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Photocatalytic hydrogen evolution is an environmentally friendly means of energy generation. Although g-CN possesses fascinating features, its inherent shortcomings limit its photocatalytic applications. Therefore, modifying the intrinsic properties of g-CN and introducing cocatalysts are essential to ameliorate the photocatalytic efficiency.

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Article Synopsis
  • A clinical trial called RADICALS-HD studied the effects of adding short-course androgen deprivation therapy (ADT) to postoperative radiotherapy in patients with localized prostate cancer after surgery.
  • It involved 1480 patients, examining how ADT impacts metastasis-free survival compared to radiotherapy alone, and measured outcomes like distant metastasis and overall survival.
  • The trial aimed to see if combining ADT with radiotherapy could improve the 10-year metastasis-free survival rate, potentially increasing it from 80% to 86%.
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Introduction: Medium-term clinical outcome data are lacking for cyanoacrylate glue (CAG) ablation for symptomatic varicose veins, especially from the Asian population.

Objectives: Aim was to determine the 3-year symptomatic relief gained from using the VenaSeal™ device to close refluxing truncal veins from the Singaporean ASVS prospective registry.

Methods: The revised Venous Clinical Severity Score (rVCSS) and three quality of life (QoL) questionnaires were completed to assess clinical improvement in venous disease symptoms along with a dedicated patient satisfaction survey.

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Semiconductor-based materials utilized in photocatalysts and electrocatalysts present a sophisticated solution for efficient solar energy utilization and bias control, a field extensively explored for its potential in sustainable energy and environmental management. Recently, 3D printing has emerged as a transformative technology, offering rapid, cost-efficient, and highly customizable approaches to designing photocatalysts and electrocatalysts with precise structural control and tailored substrates. The adaptability and precision of printing facilitate seamless integration, loading, and blending of diverse photo(electro)catalytic materials during the printing process, significantly reducing material loss compared to traditional methods.

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Background: The European Society for Radiotherapy & Oncology (ESTRO) Advisory Committee for Radiation Oncology Practice (ACROP) panel on prostate bed delineation reflected on macroscopic local recurrences in patients referred for postoperative radiotherapy (PORT), a challenging situation without standardized approach, and decided to propose a consensus recommendation on target volume selection and definition.

Methods: An ESTRO ACROP contouring consensus panel consisting of 12 radiation oncologists and one radiologist, all with subspecialty expertise in prostate cancer, was established. Participants were asked to delineate the prostate bed clinical target volumes (CTVs) in two separate clinically relevant scenarios: a local recurrence at the seminal vesicle bed and one apically at the level of the anastomosis.

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Introduction: Patients undergoing prostate radiotherapy with an enlarged prostate can have short-term and long-term urinary complications. Currently, transurethral resection of the prostate (TURP) is the mainstay surgical intervention for men with urinary symptoms due to an enlarged prostate prior to radiotherapy. UroLift (NeoTract, Pleasanton, CA, USA) is a recent minimally invasive alternative, widely used in benign disease but is untested in men with prostate cancer.

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The hybrid magnetic resonance image (MRI) scanner and radiation therapy linear accelerator (MR-Linac) has the potential to enhance clinical outcomes for anal cancer (AC) patients with improved soft tissue visualization and daily plan adaption but has planning and delivery limitations due to the incorporation of MRI. We aimed to identify if Elekta Unity MR-Linac-based radiation therapy is feasible for anal cancer. Ten prospectively enrolled AC patients treated with radical chemoradiotherapy were replanned for MR-Linac treatment using departmental planning criteria.

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Article Synopsis
  • Research shows that intensified systemic therapy for metastatic renal cell carcinoma (mRCC) has improved patient outcomes, focusing on local control of metastases through various ablative therapies.* -
  • A systematic review identified 18 studies on metastasis-directed therapies, predominantly stereotactic body radiotherapy (SBRT), which showed a local control rate of 84.4% at 12 months and a median overall survival of 22.7 months for patients.* -
  • While SBRT demonstrated excellent local control with manageable toxicity, only a few studies on thermal ablation therapies were found, indicating a need for more comprehensive research in this area.*
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Objectives: To report the NHS Digital (NHSD) data for patients diagnosed with kidney cancer (KC) in England. We explore the incidence, route to diagnosis (RTD), treatment, and survival patterns from 2013 to 2019.

Materials And Methods: Data was extracted from the Cancer Data NHSD portal for International Classification of Diseases, 10th edition coded KC; this included Cancer Registry data, Hospital Episode Statistics, and cancer waiting times data.

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Article Synopsis
  • Platelet activation is linked to the spread of cancer, and ongoing trials are testing if aspirin can help prevent this process by reducing platelet activation.
  • A study involving 716 cancer patients measured a specific biomarker (U-TXM) related to platelet activation after treatment and its relation to patient factors and aspirin use.
  • Results showed that while lower doses of aspirin significantly reduced U-TXM levels across different cancer types, higher doses didn’t provide any additional benefit; elevated U-TXM levels suggest ongoing malignancy activity, especially in patients with colorectal and gastro-oesophageal cancers.
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Purpose/objective: Radiotherapy to the prostate bed is a potentially curative salvage option after radical prostatectomy. Although prostate bed contouring guidelines are available in the literature, important variabilities exist. The objective of this work is to provide a contemporary consensus guideline for prostate bed delineation for postoperative radiotherapy.

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Introduction: Image guidance with gold fiducials improves outcomes of prostate radiotherapy. However, gold produces artefact on CT imaging, interfering with contouring and verification. The purpose of this study was to compare polymer to standard gold fiducials using radiotherapy imaging modalities to assess the visibility and artefact.

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Aims: Stereotactic body radiotherapy (SBRT) is increasingly used to treat sacral metastases. We analysed our centre's local relapse rates and patterns of failure after sacral SBRT and assessed whether using the consensus contouring recommendation (CCR) may have prevented local relapse.

Materials And Methods: We conducted a single-centre retrospective review of patients treated with sacral SBRT between February 2012 and December 2021.

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Background And Purpose: The use of SBRT for the treatment of oligometastatic prostate cancer is increasing rapidly. While consensus guidelines are available for non-spinal bone metastases practice continues to vary widely. The aim of this study is to look at inter-observer variability in the contouring of prostate cancer non-spinal bone metastases with different imaging modalities.

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Article Synopsis
  • The study investigates how effective neoadjuvant chemotherapy (NAC) is for patients with localized muscle-invasive bladder cancer (MIBC) by using diffusion-weighted MRI (DWI) to analyze treatment response and long-term survival outcomes.
  • It involved 48 patients, using DWI to measure changes in tumor characteristics before and after NAC, and linking these changes to patient outcomes based on ADC values and response classifications.
  • Results showed that patients with a significant increase in ADC values after NAC had better survival rates, indicating that DWI metrics could predict treatment response and long-term outcomes effectively.
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Pyelolymphatic backflow is a rare type of pyelolymphatic fistula that occurs in cases of urinary obstruction. This phenomenon may help to decompress an acutely obstructed kidney, and therefore, alleviate renal function from deteriorating. Pyelolymphatic backflow has specific imaging characteristics best shown on CT urography.

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Objectives: Aim was to report a prospective two-centre Singaporean experience using Endovenous Microwave Ablation (EMA) to treat symptomatic primary great saphenous vein reflux. We evaluated 1-year safety, efficacy and patient satisfaction.

Methods: 50 patients (63 limbs; 29 females; mean age 58.

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Introduction: Anal cancer (AC) is F-FDG-PET avid and has been used to evaluate treatment response several months after chemoradiotherapy. This pilot study aimed to assess the utility of semi-automated contouring methods and quantitative measures of treatment response using F-FDG-PET imaging at the early time point of 1-month post-chemoradiotherapy.

Methods: Eleven patients with AC referred for chemoradiotherapy were prospectively enrolled into this study, with 10 meeting eligibility requirements.

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