Tuesday, January 26, 2010

HeLa Cell Line in Wired

Wired has a nice little "gee whiz" article on the history of the HeLa cell line this month.

Tuesday, January 19, 2010

Post Op prostate bed contouring atlas

This weeks red journal - A consensus atlas is designed for the RTOG in postop prostate. For the atlas follow this link:http://goo.gl/et6F

For the Article:

Development of RTOG Consensus Guidelines for the Definition of the Clinical Target Volume for Postoperative Conformal Radiation Therapy for Prostate Cancer: "Purpose: To define a prostate fossa clinical target volume (PF-CTV) for Radiation Therapy Oncology Group (RTOG) trials using postoperative radiotherapy for prostate cancer.Methods and Materials: An RTOG-sponsored meeting was held to define an appropriate PF-CTV after radical prostatectomy. Data were presented describing radiographic failure patterns after surgery. Target volumes used in previous trials were reviewed. Using contours independently submitted by 13 radiation oncologists, a statistical imputation method derived a preliminary “consensus” PF-CTV.Results: Starting from the model-derived CTV, consensus was reached for a CT image–based PF-CTV. The PF-CTV should extend superiorly from the level of the caudal vas deferens remnant to >8–12 mm inferior to vesicourethral anastomosis (VUA). Below the superior border of the pubic symphysis, the anterior border extends to the posterior aspect of the pubis and posteriorly to the rectum, where it may be concave at the level of the VUA. At this level, the lateral border extends to the levator ani. Above the pubic symphysis, the anterior border should encompass the posterior 1–2 cm of the bladder wall; posteriorly, it is bounded by the mesorectal fascia. At this level, the lateral border is the sacrorectogenitopubic fascia. Seminal vesicle remnants, if present, should be included in the CTV if there is pathologic evidence of their involvement.Conclusions: Consensus on postoperative PF-CTV for RT after prostatectomy was reached and is available as a CT image atlas on the RTOG website. This will allow uniformity in defining PF-CTV for clinical trials that include postprostatectomy RT."

Wednesday, January 13, 2010

Association of the Recurrence Score (Oncotype DX) with Local Recurrence

Online in the JCO:

The recurrence score (oncotype DX) has been an extremely valuable tool in decision making for the delivery of systemic therapy in node negative, ER+ breast cancer. The primary analyses published to date describe it's association with distant failure, survival and the relative benefit of cytotoxic chemotherapy. This article describes the association of this score with loco-regional recurrence, of upmost interest to radiation oncologists as we move to an era of personalized medicine. Perhaps not surprisingly, an association is indeed found. Of course whether radiation should be intensified somehow in the higher risk patients, or de-intensified in the lower risk patients is something that this report cannot address, but does open up the door to some potentially quite interesting clinical questions to test prospectively....

Tuesday, January 12, 2010

Radiotherapy plus cetuximab for locoregionally advanced head and neck cancer: 5-year survival data from a phase 3 randomised trial, and relation between cetuximab-induced rash and survival

The "Bonner" trial reports five year data in this months Lancet Oncology. The initial survival benefit is continued out to longer follow up than the prior NEJM article. A subgroup analysis also demonstrates that in those recieving cetuximab, the development of a more severe acneiform rash was associated with an improved survival. This finding is similar to prior reports in colon cancer. What is causing this is unknown, but it may be a surrogate for reaching systemic drug levels...

Link -

[Articles] Radiotherapy plus cetuximab for locoregionally advanced head and neck cancer: 5-year survival data from a phase 3 randomised trial, and relation between cetuximab-induced rash and survival: "Previous results from our phase 3 randomised trial showed that adding cetuximab to primary radiotherapy increased overall survival in patients with locoregionally advanced squamous-cell carcinoma of the head and neck (LASCCHN) at 3 years. Here we report the 5-year survival data, and investigate the relation between cetuximab-induced rash and survival."

Friday, January 8, 2010

Phase I Study of Accelerated Conformal Radiotherapy for Stage I NSCLC

This weeks JCO:

The results of the CALGB 39904 trial are published after multiple abstract presentations. This was looking at an alternative to SBRT in the treatment of early stage NSCLC, increasing the intensity of treatment, while keeping the nominal dose stable at 70Gy. The results are encouraging, however, SBRT has probably already lapped this style of RT for this patient population.

Link and Abstract

Phase I Study of Accelerated Conformal Radiotherapy for Stage I Non-Small-Cell Lung Cancer in Patients With Pulmonary Dysfunction: CALGB 39904 [Thoracic Oncology]: "Purpose

The optimal treatment for medically inoperable stage I non–small-cell lung cancer (NSCLC) has not been defined.

Patients and Methods

Cancer and Leukemia Group B trial 39904 prospectively assessed accelerated, once-daily, three-dimensional radiotherapy for early-stage NSCLC. The primary objectives were to define the maximally accelerated course of conformal radiotherapy and to describe the short-term and long-term toxicity of therapy. Entry was limited to patients with clinical stage T1N0 or T2N0 NSCLC (< 4 cm) and pulmonary dysfunction. The nominal total radiotherapy dose remained at 70 Gy, while the number of daily fractions in each successive cohort was reduced.

Results

Thirty-nine eligible patients were accrued (eight patients each on cohorts 1 to 4 and seven patients on cohort 5) between January 2001 and July 2005. One grade 3 nonhematologic toxicity was observed in both cohort 3 (dyspnea) and cohort 4 (pain). The major response rate was 77%. After a median follow-up time of 53 months, the actuarial median survival time of all eligible patients was 38.5 months. Local relapse was observed in three patients.

Conclusion

Accelerated conformal radiotherapy was well tolerated in a high-risk population with clinical stage I NSCLC. Outcomes are comparable to prospective reports of alternative therapies, including stereotactic body radiation therapy and limited resection, with less apparent severe toxicity. Further investigation of this approach is warranted.

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