Publications by authors named "Kristopher Dennis"

Background: Palliative radiotherapy (RT) is commonly used for malignancy-associated hemoptysis. This study aims to determine RT control probability, durability, and influencing factors.

Methods: This single-institution prospective observational study included patients ≥18 years old with any lung malignancy and active hemoptysis.

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  • This study looked at whether radiotherapy could help reduce pain from liver cancer in patients who weren't getting better with regular treatments.
  • It included 66 patients who were given either radiotherapy and extra care or just extra care alone.
  • The researchers wanted to see if the patients felt less pain after a month and found out if the treatment was safe for them.
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Purpose: This guideline provides evidence-based recommendations for palliative external beam radiation therapy (RT) in symptomatic bone metastases.

Methods: The ASTRO convened a task force to address 5 key questions regarding palliative RT in symptomatic bone metastases. Based on a systematic review by the Agency for Health Research and Quality, recommendations using predefined consensus-building methodology were established; evidence quality and recommendation strength were also assessed.

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(1) Background: Prognostication in patients with cancer receiving palliative radiotherapy remains a challenge. To improve the process, we aim to identify prognostic factors in this population from the literature and offer evidence-based recommendations on prognostication in patients undergoing palliative radiotherapy for non-curable or advanced cancers. (2) Methods: A systematic review was performed on the medical literature from 2005 to 2023 to extract papers on the prognosis of palliative radiotherapy patients with advanced cancer.

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A 63-year-old woman presented with hypokalemia, hypertension, weight gain, limb edema, and tremors. She was diagnosed with Cushing syndrome, with a 24-hour urine cortisol level of 41,013 nmol/day. Investigations revealed a grade 2 pancreatic neuroendocrine tumor with extensive hepatic metastases.

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Patients with metastatic epidural spinal cord compression (MESCC) and favorable survival prognoses may benefit from radiation doses exceeding 10 × 3.0 Gy. In a multi-center phase 2 trial, patients receiving 15 × 2.

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We studied the use of palliative radiotherapy (RT) among patients with primary, non-curable, locally advanced pancreatic cancer. In this subset of patients, with very poor survival, various palliative RT dose fractionation schemes are used; but, in the absence of a guideline, practice patterns vary, and dose choice is mainly based on the physician's intuition. We divided the patients into three groups, according to the dose fractionation schedules received: low (A), intermediate (B), and high (C) dose groups, to study the potential differences in outcome between the different dose prescriptions.

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  • The study investigates the use of palliative radiotherapy (RT) for patients with critical symptoms from primary genitourinary, gynecologic, and gastrointestinal cancers needing urgent care.
  • The literature review focused on identifying the role and effectiveness of emergent RT for managing bleeding caused by these pelvic tumors, revealing that this was the only acute indication found.
  • Findings indicated limited data on the timing of hemorrhagic response post-RT, highlighting a significant gap in understanding how quickly RT can alleviate bleeding in these patients.
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  • The manuscript aims to update guidelines for managing nausea and vomiting caused by radiotherapy and chemoradiotherapy (RINV and C-RINV) by reviewing recent literature to improve antiemetic treatment options.
  • A systematic review identified 20 relevant articles, with only one study influencing new clinical recommendations, specifically in changing advice for "low emetic risk."
  • The updated guidelines maintain serotonin receptor antagonists as essential for managing high to moderate risks while suggesting that antiemetic prophylaxis is not needed for the "low emetic risk" category to prevent overtreatment.
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A 76-year-old Caucasian male presented with syncope, intermittent melena, anemia, and unexplained weight loss. Esophagogastroduodenoscopy revealed a friable non-obstructing esophageal tumor that appeared thickened on computed tomography (CT). Biopsies confirmed a poorly differentiated carcinoma.

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We studied the dose-local control (LC) relationship in ablative vs. non-ablative radiotherapy in a non-radical treatment setting of "locally advanced pancreatic cancer (LAPC)" by comparing our patients (n = 89) treated with SBRT on the CyberKnife unit vs. conventional radiation between January 2005 and January 2021, and by reviewing the literature.

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Background: Not all patients with locally advanced head and neck cancer (HNC) who are eligible for adjuvant radiotherapy (RT) following upfront surgery appear to receive it.

Methods: Data were obtained from the Surveillance, Epidemiology, and End Results (SEER) database. Selected patients from 2009 to 2018 had locally advanced HNC, underwent upfront surgery, and were eligible for adjuvant RT.

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Purpose Of Review: The authors aimed to highlight trends in, and evidence underlying the use of highly conformal radiotherapy (RT) techniques in conventional nonstereotactic palliative RT. The authors reviewed palliative-intent and curative-intent studies relevant to the use of intensity-modulated radiation therapy (IMRT) for the delivery of nonstereotactic conventional regimens to the brain, head and neck, thorax, abdomen and pelvis, and bone metastases.

Recent Findings: The use of IMRT has become standard with certain indications for brain metastases such as hippocampus-avoiding/limiting whole brain RT.

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Purpose: The European Organisation for Research and Treatment of Cancer (EORTC) health-related quality of life questionnaire for anal cancer (QLQ-ANL27) supplements the EORTC cancer generic measure (QLQ-C30) to measure concerns specific to people with anal cancer treated with chemoradiotherapy. This study tested the psychometric properties and acceptability of the QLQ-ANL27.

Methods And Materials: People with anal cancer were recruited from 15 countries to complete the QLQ-C30 and QLQ-ANL27 and provide feedback on the QLQ-ANL27.

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Background: An analytical tool is empirically validated and used to assess the delivered dose to liver lesions accounting for different types of errors in robotic radiosurgery treatment.

Material And Methods: A tool is proposed to estimate the target doses taking into account the translation, rotation, and deformation of a target. Translational errors are modeled as a spatial convolution of the planned dose with a probability distribution function derived from treatment data.

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Purpose: To establish a practical contouring strategy with reference atlases for the abdominopelvic bowel bag on treatment planning computed tomography (TPCT) and cone beam computed tomography (CBCT) images.

Methods And Materials: A scoping literature review was done to evaluate the existing definitions and contouring guidelines for bowel bag and small bowel planning-at-risk volume-like structures. A comprehensive definition was proposed for the abdominopelvic bowel bag that expanded the Radiation Therapy Oncology Group Pelvic Normal Tissue Consensus definition.

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Purpose: Brachytherapy is most often applied in the curative or salvage setting, but many forms of brachytherapy can be helpful for symptom palliation. Declining utilization is seen, for multiple reasons, such as lack of awareness, insufficient expertise, or poor access to equipment. High level evidence for many types of palliative brachytherapy has been lacking.

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Background: Anal cancer is a rare cancer with rising incidence. Despite the relatively good outcomes conferred by state-of-the-art chemoradiotherapy, further improving disease control and reducing toxicity has proven challenging. Developing and validating prognostic models using routinely collected data may provide new insights for treatment development and selection.

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  • The review examines how treatments for gastric cancer (GC) impact health-related quality of life (HRQoL) and underscores the need for effective monitoring of these impacts across different cultures.
  • It assesses 267 publications from 2001 to 2021, finding that most studies focused on East Asian patients, with the QLQ-C30 questionnaire being the most commonly used tool to measure HRQoL.
  • The study identifies specific HRQoL concerns like abdominal pain and weight loss, along with the psychosocial factors associated, while pointing out potential cultural mismatches in HRQoL measures designed for Western patients.
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Background And Purpose: Access to radiotherapy (RT) is a key component of a cancer control strategy. However, radiotherapy utilization (RTU) rates fall short of desired benchmarks in certain Canadian provinces. We aimed to describe provincial variations in RTU across Canada.

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Background: Patients with chronic kidney disease are commonly excluded from clinical trials. The impact of chronic kidney disease on outcomes in patients with locally advanced rectal cancer has not been previously studied.

Objective: This study aimed to investigate the impact of chronic kidney disease on outcomes in patients with locally advanced rectal cancer.

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Background: A mainstay therapy for pain relief from uncomplicated bone metastases is external beam radiation therapy. Single fraction radiation therapy (SFRT) is more convenient and cost-effective, causes fewer acute side effects, and is equivalent to multiple fraction radiation therapy for pain relief. Despite these advantages, radiation oncologists seldom prescribe SFRT.

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Introduction: Nausea is a difficult symptom to report and measure in clinical trials. We conducted a pilot interview study to improve our understanding of the nausea experience.

Materials And Methods: Female patients with breast cancer that had experienced nausea during radiation therapy and/or chemotherapy underwent semi-structured interviews that focused on patient-defined and standard definitions, preferences for nausea grading scales, and nausea sub-features: intensity, location, timing/duration, character, associated symptoms, precipitating/alleviating factors, impact on quality of life.

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  • The guideline update aims to include new anticancer agents, antiemetics, and antiemetic regimens, specifically recommending dexamethasone for patients on checkpoint inhibitors (CPIs).
  • A systematic review analyzed recent studies on the efficacy of adding CPIs to chemotherapy, highlighting that dexamethasone should be part of the antiemetic regimen based on positive outcomes in two major trials with lung cancer patients.
  • Adult recommendations largely remain the same but now include options for olanzapine and updated dosing information, while pediatric recommendations incorporate fosaprepitant; no evidence supports removing dexamethasone when using CPIs with chemotherapy.
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