Publications by authors named "Sanghera P"

Typically, root system architecture (RSA) is not visible, and realistically, high-throughput methods for RSA trait phenotyping should capture key features of developing root systems in solid substrates in 3D. In a published 2-D study using thin rhizoboxes, vermiculite as a growing medium, and photography for imaging, triplicates of 137 soybean cultivars were phenotyped for their RSA. In the transition to 3-D work using X-ray computed tomography (CT) scanning and mineral soil, two research questions are addressed: (1) how different is the soybean RSA characterization between the two phenotyping systems; and (2) is a direct comparison of the results reliable? Prior to a full-scale study in 3D, we grew, in pots filled with sand, triplicates of the Casino and OAC Woodstock cultivars that had shown the most contrasting RSAs in the 2-D study, and CT scanned them at the V1 vegetative stage of development of the shoots.

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Aims: Treatment with stereotactic radiosurgery/radiotherapy (SRS/SRT) is standard practice in selected patients with small numbers of brain metastases (BMs). It is less accepted in those with ≥5 BMs, due to the lack of a prospective evidence base. While randomised trials are ongoing, we present the experience of a single UK cancer centre in using SRS/SRT for patients with 5 or more BMs without whole brain radiotherapy (WBRT).

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Aims: Tissue V12Gy (total brain volume receiving 12Gy including target) can predict for late toxicity in single target benign disease treated with stereotactic radiosurgery (SRS). The value of this metric remains uncertain for multiple brain metastases. This retrospective cohort study reports the outcomes and evaluates the predictors of toxicity in patients with four or more brain metastases treated with single-fraction SRS.

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Article Synopsis
  • - This study aims to determine the safe planning margins (PRV) for protecting optic nerves during CyberKnife stereotactic radiosurgery (SRS) due to potential motion of the nerves during treatment.
  • - MRI scans of healthy volunteers were used to assess optic nerve motion in various directions, leading to the calculation of two different PRV margins: a non-isotropic margin of 3mm in the left/right direction and an isotropic margin of 1mm when patients maintain a neutral gaze.
  • - The findings suggest that incorporating these PRV margins in CyberKnife treatment plans is crucial to minimize risks to the optic nerves, particularly in patients with perioptic lesions like sphenoid wing meningiomas.
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Background: Recent studies have challenged the notion that patients with brain metastasis (BM) or leptomeningeal metastasis (LM) should be excluded from systemic therapy clinical trials. This scoping study summarizes the BM/LM clinical studies published between 2010 and 2023.

Methods: MEDLINE, CINAHL, CAB Abstracts, PsycINFO, Cochrane Library, HINARI, International Pharmaceutical Abstracts, PubMed, Scopus, Web of Science, and EMBASE electronic databases were searched on June 21, 2021.

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  • The study focuses on the T2-FLAIR mismatch sign, which indicates a specific type of astrocytoma with IDH mutations, and how this sign changes as the tumor progresses.
  • A total of 128 IDH-mutant gliomas were analyzed using advanced MRI techniques to observe the evolution of the T2-FLAIR mismatch and the tumors' internal variations over time.
  • The research shows that smaller tumors start as uniform T2 lesions but develop a T2-FLAIR mismatch as they grow, while larger tumors demonstrate increased heterogeneity, suggesting a progression to higher grade tumors.
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Aims: To assess in patients with 1-10 brain metastases, each of which has been treated by neurosurgery or stereotactic radiosurgery, whether hippocampal sparing whole brain radiotherapy (HS-WBRT) better spares neurocognitive function (NCF) than standard WBRT. Further, to assess whether a phase III randomised trial of HS-WBRT would be feasible in the UK.

Materials And Methods: A multicentre, randomised, open label phase II trial was undertaken, randomising patients to 30Gy in 10 fractions of WBRT or HS-WBRT.

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  • A diagnostic delay in identifying primary central nervous system lymphoma (PCNSL) often arises from recognizing lesions incorrectly and premature steroid treatment, complicating biopsy results.
  • Multiparametric MRI, which includes advanced imaging techniques, is emphasized as crucial for reducing diagnostic uncertainties in PCNSL cases.
  • In a study of 10 patients, most exhibited consistent MRI parameters indicative of PCNSL, suggesting this imaging approach could streamline diagnosis and hasten treatment initiation.
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Background: Patients with intermediate and high-risk oropharyngeal cancer (OPC) have poorer response to standard treatment and poorer overall survival compared to low-risk OPC. CompARE is designed to test alternative approaches to intensified treatment for these patients to improve survival.

Methods: CompARE is a pragmatic phase III, open-label, multicenter randomised controlled trial with an adaptive multi-arm, multi-stage design and an integrated QuinteT Recruitment Intervention.

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Background: Glioblastoma (GB) is the most common intrinsic brain cancer and is notorious for its aggressive nature. Despite widespread research and optimization of clinical management, the improvement in overall survival has been limited. The aim of this study was to characterize the impact of service reconfiguration on GB outcomes in a single centre.

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The use of stereotactic ablative radiotherapy (SABR) in the UK has expanded over the past decade, in part as the result of several UK clinical trials and a recent NHS England Commissioning through Evaluation programme. A UK SABR Consortium consensus for normal tissue constraints for SABR was published in 2017, based on the existing literature at the time. The published literature regarding SABR has increased in volume over the past 5 years and multiple UK centres are currently working to develop new SABR services.

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  • The study aimed to compare hearing outcomes between patients with vestibular schwannoma treated with stereotactic radiosurgery (SRS) and those managed conservatively.
  • A total of 247 patients were included, with 140 receiving conservative treatment and 107 undergoing SRS, both showing significant hearing deterioration over time; however, SRS patients fared worse.
  • The findings suggest that patients with small to medium-sized tumors tend to preserve their hearing better with conservative management, indicating that SRS should be reserved for cases of disease progression.
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Adenoid cystic carcinoma (ACC) is a rare cancer of secretory glands. Recurrent or metastatic (R/M) ACC is generally considered resistant to cytotoxic chemotherapy. Recent phase II studies have reported improved objective response rates (ORR) with the use of the multi-kinase inhibitor lenvatinib.

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Aims: The De-ESCALaTE study showed an overall survival advantage for the administration of synchronous cisplatin chemotherapy with radiotherapy in low-risk oropharyngeal cancer when compared with synchronous cetuximab. During the trial, a radiotherapy quality assurance protocol amendment permitted centres to swap from the original radiotherapy contouring protocol (incorporating the whole oropharynx into the high-dose clinical target volume (CTV); anatomical protocol) to a protocol that incorporated the gross tumour volume with a 10 mm margin into the CTV (volumetric protocol). The purpose of this study was to examine both toxicity and tumour control related to this protocol amendment.

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Background: Radical (chemo)radiotherapy offers potentially curative treatment for patients with locally advanced laryngeal or hypopharyngeal cancer. We aimed to show that dose-escalated intensity-modulated radiotherapy (DE-IMRT) improved locoregional control.

Methods: We performed a phase III open-label randomised controlled trial in patients with laryngeal or hypopharyngeal cancer (AJCC III-IVa/b, TNM 7).

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  • The COVID-19 pandemic led to significant changes in head and neck oncology practices in the UK, with varying responses from different medical centers due to delayed guidelines.
  • A multi-centre survey by the NCRI aimed to examine standard practices before and during the pandemic, focusing on treatment modifications related to feeding tubes, radiotherapy, and chemotherapy.
  • The survey found that most participating centers made at least one modification, including changes in radiation treatment schedules and the cessation or adjustment of chemotherapy protocols, reflecting a shift to adapt to the pandemic's challenges.
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West Nile Virus (WNV) is the most common mosquito-borne virus in the United States and North America. Although WNV disease occurs on a spectrum ranging from a relatively benign febrile illness to life-threatening neuroinvasive disease, the clinical presentations can vary widely and thus necessitates a high degree of suspicion. Here we describe three such cases where each individual presented with a unique constellation of symptoms that made the diagnosis challenging.

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Aim: To investigate machine learning based models combining clinical, radiomic, and molecular information to distinguish between early true progression (tPD) and pseudoprogression (psPD) in patients with glioblastoma.

Materials And Methods: A retrospective analysis was undertaken of 76 patients (46 tPD, 30 psPD) with early enhancing disease following chemoradiotherapy for glioblastoma. Outcome was determined on follow-up until 6 months post-chemoradiotherapy.

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Nivolumab is an anti-PD-1 monoclonal antibody currently used as immunotherapy for patients with recurrent/metastatic head and neck squamous cell carcinoma (HNSCC) with evidence of disease progression after platinum-based chemotherapy. This study evaluates real-world safety and treatment outcomes of non-trial nivolumab use. A retrospective multicenter cohort study of patients with recurrent/metastatic HNSCC treated with nivolumab between January 2017 and March 2020 was performed.

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Background: We present our 9-year consecutive case series of skull base chordomas and chondrosarcomas from a UK tertiary referral centre, discussing treatments offered and outcomes. This was carried out to improve understanding around current treatment and to better inform the management of future patients.

Methods: Consecutive case series over a 9-year period (2007-2016).

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Background: In the EORTC 1410/INTELLANCE 2 randomised, phase II study (NCT02343406), with the antibody-drug conjugate depatuxizumab mafodotin (Depatux-M, ABT-414) in patients with recurrent EGFR-amplified glioblastoma, the primary end-point (overall survival) was not met, and the drug had ocular dose-limiting toxicity. This study reports results from the prespecified health-related quality of life (HRQoL) and neurological deterioration-free survival (NDFS) exploratory analysis.

Patients And Methods: Patients (n = 260) were randomised 1:1:1 to receive either Depatux-M 1.

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Small scale observational evidence suggested that Vitamin E (VE) might play beneficial role in human and animal respiratory conditions of various origin by stabilizing surfactant functions. The intra-aleveolar VE level is directly proportionate to the lung's response to inflammation. Electronic cigarette or vaping associated lung injury was a dominantly respiratory syndrome in the United States with seemingly strong association between potential Vitamin E acetate inhalation exposure and the onset of symptoms.

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There has been increased interest in hypofractionated accelerated chemoradiation for head and neck cancer during the recent first peak of the COVID-19 pandemic. Prospective data regarding this approach from randomised trials is lacking. In the PET NECK study, 564 patients with squamous cell carcinoma of the head and neck receiving definitive chemoradiation were randomised to either planned neck dissection or PET CT scan guided surveillance.

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