Publications by authors named "Slevin N"

Purpose: Tumor hypoxia is an adverse prognostic factor in head and neck squamous cell carcinoma (HNSCC). We assessed whether patients with hypoxic HNSCC benefited from the addition of nimorazole to definitive intensity modulated radiation therapy (IMRT).

Methods And Materials: NIMRAD was a phase 3, multicenter, placebo-controlled, double-anonymized trial of patients with HNSCC unsuitable for concurrent platinum chemotherapy or cetuximab with definitive IMRT (NCT01950689).

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Introduction: Auto contouring models help consistently define volumes and reduce clinical workload. This study aimed to evaluate the cross acquisition of a Magnetic Resonance (MR) deep learning auto contouring model for organ at risk (OAR) delineation in head and neck radiotherapy.

Methods: Two auto contouring models were evaluated using deep learning contouring expert (DLCExpert) for OAR delineation: a CT model (model) and an MR model (model).

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Background: Stereotactic ablative body radiotherapy (SABR) is increasingly being used to treat oligometastatic cancers, but high-level evidence to provide a basis for policy making is scarce. Additional evidence from a real-world setting is required. We present the results of a national study of patients with extracranial oligometastases undergoing SABR, representing the largest dataset, to our knowledge, on outcomes in this population so far.

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Objective: To evaluate dosimetric consequences of inter-fraction setup variation and anatomical changes in patients receiving multifield optimised (MFO) intensity modulated proton therapy for post-operative oropharyngeal (OPC) and oral cavity (OCC) cancers.

Methods: Six patients receiving MFO for post-operative OPC and OCC were evaluated. Plans were robustly optimised to clinical target volumes (CTVs) using 3 mm setup and 3.

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Aims: To report the outcomes of nasopharyngeal carcinoma in adults across three large centres in a non-endemic region in the era of intensity-modulated radiotherapy (IMRT).

Materials And Methods: Adult patients with nasopharyngeal carcinoma treated in three large cancer centres with IMRT ± chemotherapy with curative intent between 2009 and 2016 were identified from institutional databases. Radiotherapy was delivered with 70 Gy in 33-35 daily fractions.

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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.

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Article Synopsis
  • * Seven clinicians tested their ability to outline these muscles on CT scans with and without the atlas, revealing that the atlas significantly improved agreement among clinicians.
  • * Results showed that the atlas reduced variability in muscle contouring and could serve as a valuable educational resource for clinicians planning radiotherapy for head and neck cancer patients.
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Aims: Patients with chemotherapy-refractory colorectal cancer liver metastases have limited therapeutic options. Selective internal radiation therapy (SIRT) delivers yttrium 90 microspheres as a minimally invasive procedure. This prospective, single-arm, observational, service-evaluation study was part of National Health Service England Commissioning through Evaluation.

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Purpose: To identify imaged regions in which dose is associated with radiation-induced trismus after head and neck cancer radiation therapy (HNRT) using a novel image-based data mining (IBDM) framework.

Methods And Materials: A cohort of 86 HNRT patients were analyzed for region identification. Trismus was characterized as a continuous variable by the maximum incisor-to-incisor opening distance (MID) at 6 months after radiation therapy.

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  • The study investigates long-term swallowing outcomes in patients with oropharyngeal carcinoma who underwent chemoradiotherapy at two UK centers, aiming to gather patient-reported results and identify influencing factors.
  • After excluding patients needing enteral feeding or those with disease relapse, 201 out of 242 eligible patients completed a swallowing inventory two years post-treatment, revealing a median score indicating varying degrees of swallowing function.
  • Findings indicate that many patients experience long-term swallowing dysfunction, particularly those with poor pre-treatment diets or who required feeding tubes, highlighting the need for better management strategies in these groups.
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Article Synopsis
  • This feasibility study explored the connection between radiation doses to the masticatory muscles and the development of trismus (limited jaw movement) in patients undergoing radiotherapy for oral cavity or oropharyngeal cancers.
  • A total of 20 patients were measured for maximal inter-incisor distance (MID) before and 6 months after starting treatment, while also considering various factors like age and exercise compliance.
  • Results indicated that higher radiation doses to specific muscles were linked to worsening trismus, suggesting that keeping doses below 40 Gy might help reduce this side effect in certain cancer patients.
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Introduction: Patients can develop trismus from their head and neck cancer or as a result of treatment. Trismus affects the jaw muscles and makes mouth opening difficult. To potentially combat trismus, patients could undertake proactive jaw stretching exercises prior to, during and after radiotherapy, although currently these are not the standard of care.

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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.

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Our aim was to compare the efficacy of the Therabite jaw motion rehabilitation system (Atos Medical) with that of wooden spatulas to relieve and prevent trismus in patients who have had radiotherapy for stage three and four oral and oropharyngeal cancer. Secondary aims were to assess the feasibility and the impact of exercise on health-related quality of life (QoL), and the use of health services after treatment. We designed a randomised, open-label, controlled, three-centre feasibility study to compare the effectiveness and cost of the Therabite and wooden spatulas.

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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.

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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.
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Aims: Treatment for head and neck cancers using definitive radiotherapy, with or without chemotherapy, is associated with significant acute toxicity. Our aim was to assess 90 day mortality after radical radiotherapy. A further aim was to identify patient, tumour or treatment factors associated with early death after treatment and whether these could be used to predict outcomes.

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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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This is the official guideline endorsed by the specialty associations involved in the care of head and neck cancer patients in the UK. It provides recommendations on the work up and management of lateral skull base cancer based on the existing evidence base for this rare condition. Recommendations • All patients with more than one of: chronic otalgia, bloody otorrhoea, bleeding, mass, facial swelling or palsy should be biopsied.

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There is an established role for post-operative radiotherapy in the treatment of benign and malignant salivary gland tumours. For benign disease, the addition of radiotherapy improves local tumour control in cases with incomplete excision, involved surgical margins or multi-focal disease recurrence. After capsule rupture or spillage alone, surveillance should usually be advised.

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Article Synopsis
  • 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.
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Background: Patients with human papillomavirus (HPV)-positive oropharyngeal squamous cell carcinoma (OPSCC) have a better prognosis than those with HPV-negative tumours. There is interest in de-escalating their treatment but strategies are needed for risk stratification to identify subsets with a poor prognosis. This study investigated tumour-infiltrating lymphocytes (TILs) in relation to HPV tumour status and patient survival.

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