Search

Your search keyword '"Hawkins, M.A."' showing total 8 results
Start Over Author "Hawkins, M.A." Database OAIster
8 results on '"Hawkins, M.A."'

1. Definition, diagnosis and treatment of oligometastatic oesophagogastric cancer: A Delphi consensus study in Europe

Author

Kroese, T.E., Laarhoven, H.W.M. van, Schoppman, S.F., Deseyne, P., Cutsem, E. Van, Haustermans, K., Nafteux, P., Thomas, M., Obermannova, R., Mortensen, H.R., Nordsmark, M., Pfeiffer, P., Elme, A., Adenis, A., Piessen, G., Bruns, C.J., Lordick, F., Gockel, I., Moehler, M., Gani, C., Liakakos, T., Reynolds, J., Morganti, A.G., Rosati, R., Castoro, C., Cellini, F., D'Ugo, D., Roviello, F., Bencivenga, M., Manzoni, G. de, Henegouwen, M.I. van Berge, Hulshof, M., Dieren, J. van, Vollebergh, M., Sandick, J.W. van, Jeene, P., Muijs, C.T., Slingerland, M., Voncken, F.E.M., Hartgrink, H., Creemers, G.J., Sangen, M.J. van der, Nieuwenhuijzen, G., Berbee, M., Verheij, M., Wijnhoven, B., Beerepoot, L.V., Mohammad, N.H., Mook, S., Ruurda, J.P., Kolodziejczyk, P., Polkowski, W.P., Wyrwicz, L., Alsina, M., Pera, M., Kanonnikoff, T.F., Cervantes, A., Nilsson, M., Monig, S., Wagner, A.D., Guckenberger, M., Griffiths, E.A., Smyth, E., Hanna, G.B., Markar, S., Chaudry, M.A., Hawkins, M.A., Cheong, E., Rütten, H., Gootjes, E.C., Hillegersberg, R. van, Rossum, P.S.N. van, Kroese, T.E., Laarhoven, H.W.M. van, Schoppman, S.F., Deseyne, P., Cutsem, E. Van, Haustermans, K., Nafteux, P., Thomas, M., Obermannova, R., Mortensen, H.R., Nordsmark, M., Pfeiffer, P., Elme, A., Adenis, A., Piessen, G., Bruns, C.J., Lordick, F., Gockel, I., Moehler, M., Gani, C., Liakakos, T., Reynolds, J., Morganti, A.G., Rosati, R., Castoro, C., Cellini, F., D'Ugo, D., Roviello, F., Bencivenga, M., Manzoni, G. de, Henegouwen, M.I. van Berge, Hulshof, M., Dieren, J. van, Vollebergh, M., Sandick, J.W. van, Jeene, P., Muijs, C.T., Slingerland, M., Voncken, F.E.M., Hartgrink, H., Creemers, G.J., Sangen, M.J. van der, Nieuwenhuijzen, G., Berbee, M., Verheij, M., Wijnhoven, B., Beerepoot, L.V., Mohammad, N.H., Mook, S., Ruurda, J.P., Kolodziejczyk, P., Polkowski, W.P., Wyrwicz, L., Alsina, M., Pera, M., Kanonnikoff, T.F., Cervantes, A., Nilsson, M., Monig, S., Wagner, A.D., Guckenberger, M., Griffiths, E.A., Smyth, E., Hanna, G.B., Markar, S., Chaudry, M.A., Hawkins, M.A., Cheong, E., Rütten, H., Gootjes, E.C., Hillegersberg, R. van, and Rossum, P.S.N. van

Abstract

Item does not contain fulltext, BACKGROUND: Local treatment improves the outcomes for oligometastatic disease (OMD, i.e. an intermediate state between locoregional and widespread disseminated disease). However, consensus about the definition, diagnosis and treatment of oligometastatic oesophagogastric cancer is lacking. The aim of this study was to develop a multidisciplinary European consensus statement on the definition, diagnosis and treatment of oligometastatic oesophagogastric cancer. METHODS: In total, 65 specialists in the multidisciplinary treatment for oesophagogastric cancer from 49 expert centres across 16 European countries were requested to participate in this Delphi study. The consensus finding process consisted of a starting meeting, 2 online Delphi questionnaire rounds and an online consensus meeting. Input for Delphi questionnaires consisted of (1) a systematic review on definitions of oligometastatic oesophagogastric cancer and (2) a discussion of real-life clinical cases by multidisciplinary teams. Experts were asked to score each statement on a 5-point Likert scale. The agreement was scored to be either absent/poor (<50%), fair (50%-75%) or consensus (≥75%). RESULTS: A total of 48 experts participated in the starting meeting, both Delphi rounds, and the consensus meeting (overall response rate: 71%). OMD was considered in patients with metastatic oesophagogastric cancer limited to 1 organ with ≤3 metastases or 1 extra-regional lymph node station (consensus). In addition, OMD was considered in patients without progression at restaging after systemic therapy (consensus). For patients with synchronous or metachronous OMD with a disease-free interval ≤2 years, systemic therapy followed by restaging to consider local treatment was considered as treatment (consensus). For metachronous OMD with a disease-free interval >2 years, either upfront local treatment or systemic treatment followed by restaging was considered as treatment (fair agreement). CONCLUSION: The OMEC project has resul

Published
2023

2. Definitions and treatment of oligometastatic oesophagogastric cancer according to multidisciplinary tumour boards in Europe

Author

Kroese, T.E., Hillegersberg, R. van, Schoppmann, S., Deseyne, P., Nafteux, P., Obermannova, R., Nordsmark, M., Pfeiffer, P., Hawkins, M.A., Smyth, E., Markar, S., Hanna, G.B., Cheong, E., Chaudry, A., Elme, A., Adenis, A., Piessen, G., Gani, C., Bruns, C.J., Moehler, M., Liakakos, T., Reynolds, J., Morganti, A., Rosati, R., Castoro, C., D'Ugo, D., Roviello, F., Bencivenga, M., Manzoni, G. de, Jeene, P., Sandick, J.W. van, Muijs, C., Slingerland, M., Nieuwenhuijzen, G., Wijnhoven, B., Beerepoot, L.V., Kolodziejczyk, P., Polkowski, W.P., Alsina, M., Pera, M., Kanonnikoff, T.F., Nilsson, M., Guckenberger, M., Monig, S., Wagner, D., Wyrwicz, L., Berbee, M., Gockel, I., Lordick, F., Griffiths, E.A., Rütten, H., Rosman, C., Verheij, M., Rossum, P.S.N. van, Laarhoven, H.W. van, Kroese, T.E., Hillegersberg, R. van, Schoppmann, S., Deseyne, P., Nafteux, P., Obermannova, R., Nordsmark, M., Pfeiffer, P., Hawkins, M.A., Smyth, E., Markar, S., Hanna, G.B., Cheong, E., Chaudry, A., Elme, A., Adenis, A., Piessen, G., Gani, C., Bruns, C.J., Moehler, M., Liakakos, T., Reynolds, J., Morganti, A., Rosati, R., Castoro, C., D'Ugo, D., Roviello, F., Bencivenga, M., Manzoni, G. de, Jeene, P., Sandick, J.W. van, Muijs, C., Slingerland, M., Nieuwenhuijzen, G., Wijnhoven, B., Beerepoot, L.V., Kolodziejczyk, P., Polkowski, W.P., Alsina, M., Pera, M., Kanonnikoff, T.F., Nilsson, M., Guckenberger, M., Monig, S., Wagner, D., Wyrwicz, L., Berbee, M., Gockel, I., Lordick, F., Griffiths, E.A., Rütten, H., Rosman, C., Verheij, M., Rossum, P.S.N. van, and Laarhoven, H.W. van

Abstract

Item does not contain fulltext, BACKGROUND: Consensus about the definition and treatment of oligometastatic oesophagogastric cancer is lacking. OBJECTIVE: To assess the definition and treatment of oligometastatic oesophagogastric cancer across multidisciplinary tumour boards (MDTs) in Europe. MATERIAL AND METHODS: European expert centers (n = 49) were requested to discuss 15 real-life cases in their MDT with at least a medical, surgical, and radiation oncologist present. The cases varied in terms of location and number of metastases, histology, timing of detection (i.e. synchronous versus metachronous), primary tumour treatment status, and response to systemic therapy. The primary outcome was the agreement in the definition of oligometastatic disease at diagnosis and after systemic therapy. The secondary outcome was the agreement in treatment strategies. Treatment strategies for oligometastatic disease were categorised into upfront local treatment (i.e. metastasectomy or stereotactic radiotherapy), systemic therapy followed by restaging to consider local treatment or systemic therapy alone. The agreement across MDTs was scored to be either absent/poor (<50%), fair (50%-75%), or consensus (≥75%). RESULTS: A total of 47 MDTs across 16 countries fully discussed the cases (96%). Oligometastatic disease was considered in patients with 1-2 metastases in either the liver, lung, retroperitoneal lymph nodes, adrenal gland, soft tissue or bone (consensus). At follow-up, oligometastatic disease was considered after a median of 18 weeks of systemic therapy when no progression or progression in size only of the oligometastatic lesion(s) was seen (consensus). If at restaging after a median of 18 weeks of systemic therapy the number of lesions progressed, this was not considered as oligometastatic disease (fair agreement). There was no consensus on treatment strategies for oligometastatic disease. CONCLUSION: A broad consensus on definitions of oligometastatic oesophagogastric cancer was found among MDTs of oeso

Published
2022

3. Definitions and treatment of oligometastatic oesophagogastric cancer according to multidisciplinary tumour boards in Europe

Author

Kroese, T.E., Hillegersberg, R. van, Schoppmann, S., Deseyne, P., Nafteux, P., Obermannova, R., Nordsmark, M., Pfeiffer, P., Hawkins, M.A., Smyth, E., Markar, S., Hanna, G.B., Cheong, E., Chaudry, A., Elme, A., Adenis, A., Piessen, G., Gani, C., Bruns, C.J., Moehler, M., Liakakos, T., Reynolds, J., Morganti, A., Rosati, R., Castoro, C., D'Ugo, D., Roviello, F., Bencivenga, M., Manzoni, G. de, Jeene, P., Sandick, J.W. van, Muijs, C., Slingerland, M., Nieuwenhuijzen, G., Wijnhoven, B., Beerepoot, L.V., Kolodziejczyk, P., Polkowski, W.P., Alsina, M., Pera, M., Kanonnikoff, T.F., Nilsson, M., Guckenberger, M., Monig, S., Wagner, D., Wyrwicz, L., Berbee, M., Gockel, I., Lordick, F., Griffiths, E.A., Rütten, H., Rosman, C., Verheij, M., Gootjes, E.C., Rossum, P.S.N. van, Laarhoven, H.W. van, Kroese, T.E., Hillegersberg, R. van, Schoppmann, S., Deseyne, P., Nafteux, P., Obermannova, R., Nordsmark, M., Pfeiffer, P., Hawkins, M.A., Smyth, E., Markar, S., Hanna, G.B., Cheong, E., Chaudry, A., Elme, A., Adenis, A., Piessen, G., Gani, C., Bruns, C.J., Moehler, M., Liakakos, T., Reynolds, J., Morganti, A., Rosati, R., Castoro, C., D'Ugo, D., Roviello, F., Bencivenga, M., Manzoni, G. de, Jeene, P., Sandick, J.W. van, Muijs, C., Slingerland, M., Nieuwenhuijzen, G., Wijnhoven, B., Beerepoot, L.V., Kolodziejczyk, P., Polkowski, W.P., Alsina, M., Pera, M., Kanonnikoff, T.F., Nilsson, M., Guckenberger, M., Monig, S., Wagner, D., Wyrwicz, L., Berbee, M., Gockel, I., Lordick, F., Griffiths, E.A., Rütten, H., Rosman, C., Verheij, M., Gootjes, E.C., Rossum, P.S.N. van, and Laarhoven, H.W. van

Abstract

Contains fulltext : 249567.pdf (Publisher’s version ) (Open Access), BACKGROUND: Consensus about the definition and treatment of oligometastatic oesophagogastric cancer is lacking. OBJECTIVE: To assess the definition and treatment of oligometastatic oesophagogastric cancer across multidisciplinary tumour boards (MDTs) in Europe. MATERIAL AND METHODS: European expert centers (n = 49) were requested to discuss 15 real-life cases in their MDT with at least a medical, surgical, and radiation oncologist present. The cases varied in terms of location and number of metastases, histology, timing of detection (i.e. synchronous versus metachronous), primary tumour treatment status, and response to systemic therapy. The primary outcome was the agreement in the definition of oligometastatic disease at diagnosis and after systemic therapy. The secondary outcome was the agreement in treatment strategies. Treatment strategies for oligometastatic disease were categorised into upfront local treatment (i.e. metastasectomy or stereotactic radiotherapy), systemic therapy followed by restaging to consider local treatment or systemic therapy alone. The agreement across MDTs was scored to be either absent/poor (<50%), fair (50%-75%), or consensus (≥75%). RESULTS: A total of 47 MDTs across 16 countries fully discussed the cases (96%). Oligometastatic disease was considered in patients with 1-2 metastases in either the liver, lung, retroperitoneal lymph nodes, adrenal gland, soft tissue or bone (consensus). At follow-up, oligometastatic disease was considered after a median of 18 weeks of systemic therapy when no progression or progression in size only of the oligometastatic lesion(s) was seen (consensus). If at restaging after a median of 18 weeks of systemic therapy the number of lesions progressed, this was not considered as oligometastatic disease (fair agreement). There was no consensus on treatment strategies for oligometastatic disease. CONCLUSION: A broad consensus on definitions of oligometastatic oesophagogastric cancer was found among MDTs of oeso

Published
2022

4. Consensus statement on the multidisciplinary management of patients with recurrent and primary rectal cancer beyond total mesorectal excision planes

Author

Bhangu, A., Beynon, J., Brown, G., Chang, G., Das, P., Desai, A., Frizelle, F., Glynne-Jones, R., Goldin, R., Hawkins, M.A., Heriot, A., Laurberg, S., Mirnezami, A., Nicholls, R.J., Sagar, P., Tekkis, P., Vuong, T., Wilson, M., Ali, S.M., Antoniou, A., Bose, P., Boyle, K., Branagan, G., Burling, D., Clark, S.K., Colquhuon, P., Crane, C.H., Darzi, A., Davies, M., Delaney, C.P., Dietz, D., Dozois, E.J., Duff, M., Dziki, A., Faria, J., Fitzgerald, J.E., Georgiou, P., George, B., George, M.L., Gupta, A., Guy, R., Harji, D.P., Harris, D.A., Herzig, D., Holm, T., Hompes, R., Jeys, L., Jenkins, J.T., Kiran, R.P., Koh, C.E., Law, W.L., Liberman, A.S., Marshall, M., McArthur, D.R., Mortensen, N., Myers, E., O'Connell, P.R., O'Dwyer, S.T., Oliver, A., Pallan, A., Patel, P., Patel, U.B., Radley, S., Ramsey, K.W.D., Rasmussen, P.C., Richard, C., Rutten, H.J., Sebag-Montefiore, D., Solomon, M.J., Stocchi, L., Swallow, C.J., Tait, D.M., Tan, E.C.T.H., As, N. van, Wiggers, T., Wilt, J.H.W. de, Winter, D.C., Woodhouse, C., Bhangu, A., Beynon, J., Brown, G., Chang, G., Das, P., Desai, A., Frizelle, F., Glynne-Jones, R., Goldin, R., Hawkins, M.A., Heriot, A., Laurberg, S., Mirnezami, A., Nicholls, R.J., Sagar, P., Tekkis, P., Vuong, T., Wilson, M., Ali, S.M., Antoniou, A., Bose, P., Boyle, K., Branagan, G., Burling, D., Clark, S.K., Colquhuon, P., Crane, C.H., Darzi, A., Davies, M., Delaney, C.P., Dietz, D., Dozois, E.J., Duff, M., Dziki, A., Faria, J., Fitzgerald, J.E., Georgiou, P., George, B., George, M.L., Gupta, A., Guy, R., Harji, D.P., Harris, D.A., Herzig, D., Holm, T., Hompes, R., Jeys, L., Jenkins, J.T., Kiran, R.P., Koh, C.E., Law, W.L., Liberman, A.S., Marshall, M., McArthur, D.R., Mortensen, N., Myers, E., O'Connell, P.R., O'Dwyer, S.T., Oliver, A., Pallan, A., Patel, P., Patel, U.B., Radley, S., Ramsey, K.W.D., Rasmussen, P.C., Richard, C., Rutten, H.J., Sebag-Montefiore, D., Solomon, M.J., Stocchi, L., Swallow, C.J., Tait, D.M., Tan, E.C.T.H., As, N. van, Wiggers, T., Wilt, J.H.W. de, Winter, D.C., and Woodhouse, C.

Abstract

Item does not contain fulltext

Published
2013

5. Consensus statement on the multidisciplinary management of patients with recurrent and primary rectal cancer beyond total mesorectal excision planes

Author

Bhangu, A., Beynon, J., Brown, G., Chang, G., Das, P., Desai, A., Frizelle, F., Glynne-Jones, R., Goldin, R., Hawkins, M.A., Heriot, A., Laurberg, S., Mirnezami, A., Nicholls, R.J., Sagar, P., Tekkis, P., Vuong, T., Wilson, M., Ali, S.M., Antoniou, A., Bose, P., Boyle, K., Branagan, G., Burling, D., Clark, S.K., Colquhuon, P., Crane, C.H., Darzi, A., Davies, M., Delaney, C.P., Dietz, D., Dozois, E.J., Duff, M., Dziki, A., Faria, J., Fitzgerald, J.E., Georgiou, P., George, B., George, M.L., Gupta, A., Guy, R., Harji, D.P., Harris, D.A., Herzig, D., Holm, T., Hompes, R., Jeys, L., Jenkins, J.T., Kiran, R.P., Koh, C.E., Law, W.L., Liberman, A.S., Marshall, M., McArthur, D.R., Mortensen, N., Myers, E., O'Connell, P.R., O'Dwyer, S.T., Oliver, A., Pallan, A., Patel, P., Patel, U.B., Radley, S., Ramsey, K.W.D., Rasmussen, P.C., Richard, C., Rutten, H.J., Sebag-Montefiore, D., Solomon, M.J., Stocchi, L., Swallow, C.J., Tait, D.M., Tan, E.C.T.H., As, N. van, Wiggers, T., Wilt, J.H.W. de, Winter, D.C., Woodhouse, C., Bhangu, A., Beynon, J., Brown, G., Chang, G., Das, P., Desai, A., Frizelle, F., Glynne-Jones, R., Goldin, R., Hawkins, M.A., Heriot, A., Laurberg, S., Mirnezami, A., Nicholls, R.J., Sagar, P., Tekkis, P., Vuong, T., Wilson, M., Ali, S.M., Antoniou, A., Bose, P., Boyle, K., Branagan, G., Burling, D., Clark, S.K., Colquhuon, P., Crane, C.H., Darzi, A., Davies, M., Delaney, C.P., Dietz, D., Dozois, E.J., Duff, M., Dziki, A., Faria, J., Fitzgerald, J.E., Georgiou, P., George, B., George, M.L., Gupta, A., Guy, R., Harji, D.P., Harris, D.A., Herzig, D., Holm, T., Hompes, R., Jeys, L., Jenkins, J.T., Kiran, R.P., Koh, C.E., Law, W.L., Liberman, A.S., Marshall, M., McArthur, D.R., Mortensen, N., Myers, E., O'Connell, P.R., O'Dwyer, S.T., Oliver, A., Pallan, A., Patel, P., Patel, U.B., Radley, S., Ramsey, K.W.D., Rasmussen, P.C., Richard, C., Rutten, H.J., Sebag-Montefiore, D., Solomon, M.J., Stocchi, L., Swallow, C.J., Tait, D.M., Tan, E.C.T.H., As, N. van, Wiggers, T., Wilt, J.H.W. de, Winter, D.C., and Woodhouse, C.

Abstract

Item does not contain fulltext

Published
2013

6. Consensus statement on the multidisciplinary management of patients with recurrent and primary rectal cancer beyond total mesorectal excision planes

Author

Bhangu, A., Beynon, J., Brown, G., Chang, G., Das, P., Desai, A., Frizelle, F., Glynne-Jones, R., Goldin, R., Hawkins, M.A., Heriot, A., Laurberg, S., Mirnezami, A., Nicholls, R.J., Sagar, P., Tekkis, P., Vuong, T., Wilson, M., Ali, S.M., Antoniou, A., Bose, P., Boyle, K., Branagan, G., Burling, D., Clark, S.K., Colquhuon, P., Crane, C.H., Darzi, A., Davies, M., Delaney, C.P., Dietz, D., Dozois, E.J., Duff, M., Dziki, A., Faria, J., Fitzgerald, J.E., Georgiou, P., George, B., George, M.L., Gupta, A., Guy, R., Harji, D.P., Harris, D.A., Herzig, D., Holm, T., Hompes, R., Jeys, L., Jenkins, J.T., Kiran, R.P., Koh, C.E., Law, W.L., Liberman, A.S., Marshall, M., McArthur, D.R., Mortensen, N., Myers, E., O'Connell, P.R., O'Dwyer, S.T., Oliver, A., Pallan, A., Patel, P., Patel, U.B., Radley, S., Ramsey, K.W.D., Rasmussen, P.C., Richard, C., Rutten, H.J., Sebag-Montefiore, D., Solomon, M.J., Stocchi, L., Swallow, C.J., Tait, D.M., Tan, E.C.T.H., As, N. van, Wiggers, T., Wilt, J.H.W. de, Winter, D.C., Woodhouse, C., Bhangu, A., Beynon, J., Brown, G., Chang, G., Das, P., Desai, A., Frizelle, F., Glynne-Jones, R., Goldin, R., Hawkins, M.A., Heriot, A., Laurberg, S., Mirnezami, A., Nicholls, R.J., Sagar, P., Tekkis, P., Vuong, T., Wilson, M., Ali, S.M., Antoniou, A., Bose, P., Boyle, K., Branagan, G., Burling, D., Clark, S.K., Colquhuon, P., Crane, C.H., Darzi, A., Davies, M., Delaney, C.P., Dietz, D., Dozois, E.J., Duff, M., Dziki, A., Faria, J., Fitzgerald, J.E., Georgiou, P., George, B., George, M.L., Gupta, A., Guy, R., Harji, D.P., Harris, D.A., Herzig, D., Holm, T., Hompes, R., Jeys, L., Jenkins, J.T., Kiran, R.P., Koh, C.E., Law, W.L., Liberman, A.S., Marshall, M., McArthur, D.R., Mortensen, N., Myers, E., O'Connell, P.R., O'Dwyer, S.T., Oliver, A., Pallan, A., Patel, P., Patel, U.B., Radley, S., Ramsey, K.W.D., Rasmussen, P.C., Richard, C., Rutten, H.J., Sebag-Montefiore, D., Solomon, M.J., Stocchi, L., Swallow, C.J., Tait, D.M., Tan, E.C.T.H., As, N. van, Wiggers, T., Wilt, J.H.W. de, Winter, D.C., and Woodhouse, C.

Abstract

Item does not contain fulltext

Published
2013

7. Stepwise multicenter introduction of intensity modulated radiation therapy for anal cancer in the United Kingdom: from consensus guidance to large-scale prospective audit, prior to future clinical trials

Author

Gilbert, D.C., Drinkwater, K., O'Cathail, S.M., Adams, R., Glynne-Jones, R., Harrison, M., Hawkins, M.A., Sebag-Montefiore, D., Muirhead, R., Gilbert, D.C., Drinkwater, K., O'Cathail, S.M., Adams, R., Glynne-Jones, R., Harrison, M., Hawkins, M.A., Sebag-Montefiore, D., and Muirhead, R.

Abstract

Purpose/Objective(s) The ACT 2 trial determined the standard UK radiotherapy technique in chemoradiotherapy for anal cancer. Intensity-modulated radiotherapy (IMRT) is increasingly used due to reduced acute toxicity, however the implementation in a multicenter setting is challenging. We planned a stepwise implementation of IMRT prior to the PLATO study; an anal cancer trial due to open in 2016, investigating optimization of radiotherapy dose. We developed a consensus guidance document, adapting the ACT 2 doses and volumes for IMRT, and this was presented and published in 2014 [1]. We then performed an audit of clinical practice prior to the opening of the PLATO trial. Materials/Methods The Royal College of Radiologists carried out a prospective national audit, over a 6-month period between February and July 2015. All UK cancer centers were asked to submit details of consecutive anal cancer patients receiving radiotherapy over that period. Results Two hundred and forty-two cases were received from 41 centers. Median age was 62 (range = 29 to 90), with a female to male ratio of 2.8. 99% had invasive squamous cell, basaloid, or cacogenic carcinoma. T1/2 and T3/4 constituted 53.5% and 46.7% of tumors respectively. 49.6% had positive lymph nodes. 64.5% and 28.1% underwent Mitomycin / 5FU and Mitomycin / Capecitabine respectively. Initial analysis reveals 187 (77.3%) received treatment using inverse planning of which 148 patients received full dose radiotherapy using the doses and delivery proposed in the guidance. For toxicity comparisons the grade 3 + 4 toxicity in 3 groups were compared; those treated as per consensus guidance, those treated using the ACT 2 protocol within the audit and the published toxicity from the ACT 2 trial. Toxicity was as follows: Non-hematological - 40%, 49%, and 62%; hematological - 17%, 13%, and 26%; skin - 26%, 43%, 48%; and pain - 12%, 17%, 26%. Diarrhea was reported in 12%, 2%, and 9%. Further analysis demonstrated this was different in c

8. The development of an umbrella trial (PLATO) to address radiation therapy dose questions in the locoregional management of squamous cell carcinoma of the anus

Author

Sebag-Montefiore, D., Adams, R., Bell, S., Berkman, L., Gilbert, D.C., Glynne-Jones, R., Goh, V., Gregory, W., Harrison, M., Kachnic, L.A., Lee, M.T., McParland, L., Muirhead, R., O'Neill, B.D., Hutchins, G.G., Rao, S., Renehan, A., Smith, A., Velikova, G., Hawkins, M.A., Sebag-Montefiore, D., Adams, R., Bell, S., Berkman, L., Gilbert, D.C., Glynne-Jones, R., Goh, V., Gregory, W., Harrison, M., Kachnic, L.A., Lee, M.T., McParland, L., Muirhead, R., O'Neill, B.D., Hutchins, G.G., Rao, S., Renehan, A., Smith, A., Velikova, G., and Hawkins, M.A.

Abstract

Purpose/Objective(s) Randomized controlled trials for patients with squamous cell carcinoma of the anus have been successfully performed, despite the rarity of the disease. The RTOG 9811 and ACT2 trials demonstrated no improvement in cancer outcomes when neoadjuvant or adjuvant cisplatin 5FU chemotherapy was used. To capture as many anal cancer patients as possible in future clinical trials, we developed an umbrella of trials testing efficacy and acceptable morbidity across different loco-regional risk strata. Materials/Methods We formed a network of UK and international multi-disciplinary trialists and identified the following priorities:- i] the need for national consensus guidance for the introduction of intensity modulated radiation therapy (IMRT) based on the successful principles and fractionation used in the ACT2 protocol prior to future trials; ii] to evaluate a strategy using selective chemoradiation therapy (CRT) after local excision of anal margin tumors; iii] to evaluate reduced dose CRT to the primary tumor in order to limit late effects whilst maintaining elective nodal irradiation in early stage disease; iv] to evaluate dose escalated CRT in locally advanced T3/4 and N+ stage disease. Results The PLATO (personalizing radiotherapy dose in anal cancer) umbrella trial comprising of the ACT3, 4 and 5 trials is funded by Cancer Research UK and is due to commence recruitment in Q3 2016.The ACT 3 trial (n = 90) is a non-randomized phase II study that will evaluate a strategy of local excision for T1N0 anal margin tumors with selective postoperative involved field CRT using 41.4 Gy in 23 fractions (F) and concurrent capecitabine reserved for patients with margins <=1mm. An exact single-stage A’Hern design is used. The ACT4 trial (n = 162) is a randomized phase II trial (2:1) comparing reduced dose CRT with 41.4 Gy in 23F to GTV with 50.4 Gy in 28F using concurrent capecitabine for T1-2(<4cm)N0 disease. An exact single-stage A’Hern design is used. The ACT5 tri

Catalog

Books, media, physical & digital resources
See catalog results