Publications by authors named "Nicholas Slevin"
Purpose: To evaluate the safety and efficacy of yttrium-90 transarterial radioembolization (TARE) for the treatment of unresectable, chemotherapy-refractory intrahepatic cholangiocarcinoma (ICC).
Methods: A prospective, observational study was carried out in 10 centers between 2013 and 2017. TARE plus standard care was delivered to patients with unresectable, chemotherapy-refractory or chemotherapy-intolerant ICC.
Pre-treatment tumour perfusion parameters and initial RECIST response do not predict long-term survival outcomes for patients with head and neck squamous cell carcinoma treated with induction chemotherapy.
PLoS One
July 2018
Objectives: Previously, we showed that pre-treatment tumour plasma perfusion (Fp) predicts RECIST response to induction chemotherapy (ICT) in locoregionally advanced head and neck squamous cell carcinoma (HNSCC). The aim here was to determine whether the pre-treatment tumour Fp estimate, changes in tumour Fp or RECIST response post 2 cycles of ICT were prognostic for long-term survival outcomes.
Methods: A prospective study enrolled patients with high stage HNSCC treated with docetaxel (T), cisplatin (P) and 5-fluorouracil (F) (ICT) followed by synchronous cisplatin and intensity modulated radiotherapy.
Purpose: The benefit of adding docetaxel, cisplatin and 5-fluorouracil (TPF) induction chemotherapy to chemoradiotherapy (CRT) in head and neck squamous cell carcinoma (HNSCC) remains uncertain. We aimed to investigate whether ICT is well tolerated when given with prophylactic treatment against predicted adverse effects and which patients benefit most.
Methods: A single-centre audit identified 132 HNSCC patients with stage IVa/b neck node-positive disease, prescribed TPF followed by CRT.
Article Synopsis
- The study investigated the effects of hypofractionated accelerated radiotherapy on T2 glottic cancers, focusing on outcomes and late toxicity.
- It treated 112 patients with a specific dose regimen and reported a 67% overall survival rate and 82% local control after five years.
- The findings suggest that hypofractionated treatments improve local control while maintaining low levels of late toxicity, indicating they should be considered as standard care for early glottic laryngeal cancers.
Contour propagation is an essential component of adaptive radiotherapy, but current contour propagation algorithms are not yet sufficiently accurate to be used without manual supervision. Manual review of propagated contours is time-consuming, making routine implementation of real-time adaptive radiotherapy unrealistic. Automated methods of monitoring the performance of contour propagation algorithms are therefore required.
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- Infractional anatomical changes can affect how well step-and-shoot IMRT and VMAT deliver radiation doses, but their impact on head and neck cancer has not been thoroughly studied.
- A study involving 10 patients undergoing repeat CT scans analyzed and compared the effectiveness of step-and-shoot IMRT versus VMAT in dose delivery and target coverage.
- Results showed that although both techniques had notable dosimetric changes following the second CT scan, there were no significant differences in plan robustness between IMRT and VMAT for the patients in this study.
Objectives: Non-response to induction chemotherapy (IC) occurs in 30% of head and neck squamous cell carcinoma (HNSCC) and has been predicted by tumor plasma flow (Fp) derived by perfusion computed tomography. The present study was designed to test whether baseline tumor Fp determined by dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) would predict IC response.
Materials And Methods: A prospective open study powered to test the relationship between tumor Fp and response to IC (docetaxel, cisplatin, 5-fluorouracil) enrolled 50 patients with stage IV HNSCC.
Article Synopsis
- The study focused on improving loco-regional control in stage II and III head and neck squamous cell carcinoma using an intensified radiation therapy combined with cetuximab, aiming to minimize late normal tissue toxicity.
- In a phase I/II trial with 27 patients, the treatment was generally well-tolerated, with most experiencing acute toxicities like pain and oral mucositis, but only a few had significant late toxicities after 12 months.
- The results indicated promising survival rates and quality of life outcomes, suggesting that this therapy regimen is both effective and safe for the treatment of HNSCC.
Introduction: Anaplastic thyroid carcinoma (ATC) is rare yet accounts for up to 50% of all thyroid cancer deaths. This study reviews outcomes of patients with confirmed ATC referred to a tertiary oncology centre plus reviews the literature to explore how poor outcomes may be improved.
Materials And Methods: The management and outcomes of 20 patients with ATC were reviewed.
Article Synopsis
- The study analyzes the effectiveness of the Smart Probabilistic Image Contouring Engine (SPICE) for automatically defining organs at risk (OARs) in intensity-modulated radiotherapy (IMRT) for head and neck cancer, noting that manual delineation is time-consuming and varies between observers.! -
- While SPICE was found to be less accurate than manual contouring for delineating important structures like parotid and submandibular glands, it did achieve acceptable accuracy levels but failed to save time or improve efficiency in the process.! -
- The authors conclude that enhancements in the accuracy of automatic segmentation tools like SPICE are necessary before they can be reliably used in clinical settings for treating head and neck cancer patients
Article Synopsis
- - The study investigates the use of sorafenib, a multikinase inhibitor, to treat advanced adenoid cystic carcinoma (ACC), which has poor chemotherapy response rates and limited success with targeted agents.
- - In a phase II trial, 23 patients were treated daily with sorafenib, resulting in median progression-free survival of 11.3 months and overall survival of 19.6 months, with 6-month and 12-month PFS rates of 69.3% and 46.2%.
- - Sorafenib was found to have modest effectiveness in ACC but was associated with significant side effects, leading to the conclusion that it is not recommended for further evaluation based on its limited benefits and high toxicity.
Article Synopsis
- The study aimed to assess the effectiveness of active manuka honey in treating radiation-induced mucositis in patients with head and neck cancer undergoing radiotherapy.
- A total of 131 patients were involved, randomizing them to take either manuka honey or a placebo (golden syrup) for 6 weeks while monitoring their mucositis and health.
- Ultimately, there was no significant difference in mucositis improvement between the two groups, but both treatments appeared to reduce bacterial infections; compliance issues were noted as a potential factor in the results.
Purpose: To evaluate the effect of epoetin alfa on local disease-free survival (DFS), overall survival (OS), and cancer treatment-related anemia and fatigue in patients with head and neck cancer receiving radical radiotherapy with curative intent.
Patients And Methods: Patients (N = 301) with hemoglobin (Hb) less than 15 g/dL were randomly assigned in a ratio of 1:1 to receive radiotherapy plus epoetin alfa (10,000 U subcutaneously [SC] three times weekly if baseline Hb was < 12.5 g/dL; 4,000 U SC three times weekly if baseline Hb > or = 12.
The impact of radiotherapy on swallowing and speech in patients who undergo total laryngectomy.
Otolaryngol Head Neck Surg
December 2008
Objectives: Quality of life studies have shown no detrimental effect with radiotherapy (RT) in patients who have a total laryngectomy. We wished to determine the effect of RT (initial or postoperative) specifically on the swallowing and voice function in patients treated by total laryngectomy (TL) for carcinoma of the larynx.
Design: Multicenter chart review.
Article Synopsis
- The study aimed to evaluate the effectiveness of honey in health care, particularly in cancer treatment, through a systematic review of existing research.
- A total of 43 studies were reviewed, focusing on various applications of honey in wound care, burns, skin conditions, and cancer, with mixed results regarding its efficacy compared to standard treatments.
- Though honey showed promise as a complementary treatment for wound healing and skin reactions related to cancer therapies, the overall quality of studies was limited due to issues like small sample sizes and lack of rigorous methodology.
Introduction: Post-operative residual disease in differentiated thyroid cancer is an indication for external beam radiotherapy (EBRT) especially if there is poor radioiodine uptake by the residual disease. There are no standardized guidelines or consensus in target delineation for radiotherapy in thyroid cancer.
Aims: To determine the pattern of recurrence in patients with well differentiated thyroid cancer who received adjuvant or definitive radiotherapy as well as radioiodine ablation following surgery or biopsy with a view to better defining future target volume delineation for radiotherapy.
Background And Purpose: To identify objective pre-treatment clinical parameters that could be used to predict for patients at high risk of requiring enteral tube feeding prior to head and neck radiotherapy.
Patients And Methods: A retrospective study was conducted on 160 consecutive patients attending for radiotherapy assessment. Regression analysis was used to determine various pre-treatment nutritional and tumour specific parameters associated with the use of enteral nutrition either before (prophylactic) or during (reactive) radiotherapy (RT).
The tyrosine kinase inhibitor imatinib (STI 571; glivec) is a potent inhibitor of bcr-abl, c-kit and platelet-derived growth factor receptors. Imatinib was evaluated both alone and in combination with established chemotherapeutic agents in adenoid cystic carcinoma (ACC) primary cultures and established cell lines representing squamous cell carcinoma of the head and neck (HNSCC). Over 90% of ACC tumors are c-kit-positive, and these primary cultures proved to be of short-term usefulness in assessing chemosensitivity.
View Article and Find Full Text PDFVocal fold functionality may alter in response to direct radiotherapy or indirectly by perturbation of the hypothalamic-pituitary axis. Perceptual assessment of voice quality is difficult to summarise in a single, reliable figure of normality and normality itself is undefined. In this study spectral analysis of vocal fold vibration, based on impedance variations measured across the larynx using an electro-glottogram, is used to build a single parameter description of standard vowel phonation in the normal male population.
View Article and Find Full Text PDFBackground And Purpose: Elderly patients with head and neck cancer may not be treated aggressively with radiotherapy, due to concerns regarding tolerance of treatment and toxicity. A retrospective study was undertaken of patients aged 80 years and over, treated by definitive radiotherapy for head and neck cancer.
Material And Methods: 98 patients aged 80-92 received radiotherapy for carcinoma of the head and neck between 1991 and 1995.
Background And Purpose: Radiotherapy for laryngeal carcinoma is conventionally given over a 6-7-week period. However, in a number of UK centres early lesions are treated over 3 weeks. We review recent results of this policy and discuss the reasons why short treatment times may be advantageous.
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