84 results on '"Kerkmeijer L"'
Search Results
52. Towards fast online intrafraction replanning for free-breathing stereotactic body radiation therapy with the MR-linac
- Author
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Kontaxis, C, Bol, G H, Stemkens, B, Glitzner, M, Prins, F M, Kerkmeijer, L G W, Lagendijk, J J W, Raaymakers, B W, Kontaxis, C, Bol, G H, Stemkens, B, Glitzner, M, Prins, F M, Kerkmeijer, L G W, Lagendijk, J J W, and Raaymakers, B W
- Published
- 2017
53. First patients treated with a 1.5 T MRI-Linac: Clinical proof of concept of a high-precision, high-field MRI guided radiotherapy treatment
- Author
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Experimentele klinische fysica, Cancer, MS Radiotherapie, Klinische Fysica RT, Fysica Radiotherapie Research, Raaymakers, B W, Jürgenliemk-Schulz, I M, Bol, G H, Glitzner, M, Kotte, A N T J, van Asselen, B, de Boer, J C J, Bluemink, J J, Hackett, S L, Moerland, M A, Woodings, S J, Wolthaus, J W H, van Zijp, H M, Philippens, M E P, Tijssen, R, Kok, J G M, de Groot-van Breugel, E N, Kiekebosch, I, Meijers, L T C, Nomden, C.N., Sikkes, Gonda G, Doornaert, P A H, Eppinga, W S C, Kasperts, N, Kerkmeijer, L G W, Tersteeg, J H A, Brown, Kristy J., Pais, B, Woodhead, P, Lagendijk, J J W, Experimentele klinische fysica, Cancer, MS Radiotherapie, Klinische Fysica RT, Fysica Radiotherapie Research, Raaymakers, B W, Jürgenliemk-Schulz, I M, Bol, G H, Glitzner, M, Kotte, A N T J, van Asselen, B, de Boer, J C J, Bluemink, J J, Hackett, S L, Moerland, M A, Woodings, S J, Wolthaus, J W H, van Zijp, H M, Philippens, M E P, Tijssen, R, Kok, J G M, de Groot-van Breugel, E N, Kiekebosch, I, Meijers, L T C, Nomden, C.N., Sikkes, Gonda G, Doornaert, P A H, Eppinga, W S C, Kasperts, N, Kerkmeijer, L G W, Tersteeg, J H A, Brown, Kristy J., Pais, B, Woodhead, P, and Lagendijk, J J W
- Published
- 2017
54. Towards fast online intrafraction replanning for free-breathing stereotactic body radiation therapy with the MR-linac
- Author
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Klinische Fysica RT, Cancer, Fysica Radiotherapie Research, Onderzoek Radiotherapie, MS Radiotherapie, Experimentele klinische fysica, Kontaxis, C, Bol, G H, Stemkens, B, Glitzner, M, Prins, F M, Kerkmeijer, L G W, Lagendijk, J J W, Raaymakers, B W, Klinische Fysica RT, Cancer, Fysica Radiotherapie Research, Onderzoek Radiotherapie, MS Radiotherapie, Experimentele klinische fysica, Kontaxis, C, Bol, G H, Stemkens, B, Glitzner, M, Prins, F M, Kerkmeijer, L G W, Lagendijk, J J W, and Raaymakers, B W
- Published
- 2017
55. Towards fast online intrafraction replanning for free-breathing stereotactic body radiation therapy with the MR-linac
- Author
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Kontaxis, C, primary, Bol, G H, additional, Stemkens, B, additional, Glitzner, M, additional, Prins, F M, additional, Kerkmeijer, L G W, additional, Lagendijk, J J W, additional, and Raaymakers, B W, additional
- Published
- 2017
- Full Text
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56. Evaluation of innovation in radiation oncology: R-IDEAL
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Verkooijen, H., primary, Kerkmeijer, L., additional, Fuller, D., additional, Huddart, Robbert, additional, Faivre-Finn, C., additional, Verheij, M., additional, Sahgal, A., additional, Hall, E., additional, and van Vulpen, M., additional
- Published
- 2016
- Full Text
- View/download PDF
57. Development and clinical introduction of automated radiotherapy treatment planning for prostate cancer
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Winkel, D, primary, Bol, G H, additional, van Asselen, B, additional, Hes, J, additional, Scholten, V, additional, Kerkmeijer, L G W, additional, and Raaymakers, B W, additional
- Published
- 2016
- Full Text
- View/download PDF
58. Development and clinical introduction of automated radiotherapy treatment planning for prostate cancer
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Winkel, D, Bol, G H, van Asselen, B, Hes, J, Scholten, V, Kerkmeijer, L G W, Raaymakers, B W, Winkel, D, Bol, G H, van Asselen, B, Hes, J, Scholten, V, Kerkmeijer, L G W, and Raaymakers, B W
- Published
- 2016
59. MRI-guided prostate adaptive radiotherapy – A systematic reviewMRI-linac and prostate motion review
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McPartlin, A. J., Li, X. A., Kershaw, L. E., Heide, U., Kerkmeijer, L., Lawton, C., Mahmood, U., Pos, F., van As, N., van Herk, M., Vesprini, D., van der Voort van Zyp, J., Tree, A., Choudhury, A., McPartlin, A. J., Li, X. A., Kershaw, L. E., Heide, U., Kerkmeijer, L., Lawton, C., Mahmood, U., Pos, F., van As, N., van Herk, M., Vesprini, D., van der Voort van Zyp, J., Tree, A., and Choudhury, A.
- Published
- 2016
60. Development and clinical introduction of automated radiotherapy treatment planning for prostate cancer
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Fysica Radiotherapie Research, Cancer, Klinische Fysica RT, MS Radiotherapie, Other research (not in main researchprogram), Experimentele klinische fysica, Winkel, D, Bol, G H, van Asselen, B, Hes, J, Scholten, V, Kerkmeijer, L G W, Raaymakers, B W, Fysica Radiotherapie Research, Cancer, Klinische Fysica RT, MS Radiotherapie, Other research (not in main researchprogram), Experimentele klinische fysica, Winkel, D, Bol, G H, van Asselen, B, Hes, J, Scholten, V, Kerkmeijer, L G W, and Raaymakers, B W
- Published
- 2016
61. MRI-guided prostate adaptive radiotherapy – A systematic reviewMRI-linac and prostate motion review
- Author
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UMC Utrecht, Cancer, McPartlin, A. J., Li, X. A., Kershaw, L. E., Heide, U., Kerkmeijer, L., Lawton, C., Mahmood, U., Pos, F., van As, N., van Herk, M., Vesprini, D., van der Voort van Zyp, J., Tree, A., Choudhury, A., UMC Utrecht, Cancer, McPartlin, A. J., Li, X. A., Kershaw, L. E., Heide, U., Kerkmeijer, L., Lawton, C., Mahmood, U., Pos, F., van As, N., van Herk, M., Vesprini, D., van der Voort van Zyp, J., Tree, A., and Choudhury, A.
- Published
- 2016
62. SU-F-J-150: Development of An End-To-End Chain Test for the First-In-Man MR-Guided Treatments with the MRI Linear Accelerator by Using the Alderson Phantom
- Author
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Hoogcarspel, S, primary, Kerkmeijer, L, additional, Lagendijk, J, additional, Van Vulpen, M, additional, and Raaymakers, B, additional
- Published
- 2016
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63. SU-D-207A-07: The Effects of Inter-Cycle Respiratory Motion Variation On Dose Accumulation in Single Fraction MR-Guided SBRT Treatment of Renal Cell Carcinoma
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Stemkens, B, primary, Glitzner, M, additional, Kontaxis, C, additional, Denis de Senneville, B, additional, Prins, F, additional, Crijns, SPM, additional, Kerkmeijer, L, additional, Lagendijk, J, additional, van den Berg, CAT, additional, and Tijssen, RHN, additional
- Published
- 2016
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64. PO-172 CURRENT RISK CLASSIFICATION FOR PROSTATE CANCER DOES NOT ACCURATELY PREDICT SURVIVAL AFTER I-125 BRACHYTHERAPY
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Kerkmeijer, L., primary, Monninkhof, E., additional, and Van Vulpen, M., additional
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- 2012
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65. PD-0157 DOSE COVERAGE IN IMAGE GUIDED SBRT FOR NSCLC USING TOMOTHERAPY
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Kerkmeijer, L., primary, Althof, V., additional, Minken, A., additional, Steenberg, R., additional, and Vonk, E., additional
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- 2012
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66. External validation of serum hCG cutoff levels for prediction of resistance to single-agent chemotherapy in patients with persistent trophoblastic disease
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Kerkmeijer, L G, primary, Thomas, C M, additional, Harvey, R, additional, Sweep, F C, additional, Mitchell, H, additional, Massuger, L F, additional, and Seckl, M J, additional
- Published
- 2009
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67. Long-Term Effects of QCA-Guided Implantation Techniques in Lesion-Oriented Cardiac Events in Patients Undergoing Percutaneous Coronary Intervention Using a 2nd-Generation Drug-Eluting Stent.
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Tijssen, R.Y., Renkens, M., Kerkmeijer, L., Kraak, R., Grundeken, M., Serruys, P., Onuma, Y., de Winter, R., and Wykrzykowska, J.J.
- Subjects
- *
DRUG-eluting stents , *PERCUTANEOUS coronary intervention , *CARDIAC patients - Published
- 2024
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68. Guidelines following hydatidiform mole: a reappraisal.
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Wiesma S, Kerkmeijer L, Bekkers R, Pyman J, Tan J, and Quinn M
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- 2006
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69. Persistent trophoblast disease following partial molar pregnancy.
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Wiesma S, Kerkmeijer L, Bekkers R, Pyman J, Tan J, and Quinn M
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- 2006
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70. Intra-prostatic recurrences after radiotherapy with focal boost: Location and dose mapping in the FLAME trial.
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Menne Guricová K, Pos FJ, Schoots IG, Vogel WV, Kerkmeijer LGW, Monninkhof EM, de Boer JCJ, van der Voort van Zyp JRN, Kunze-Busch M, Smeenk RJ, Draulans C, Haustermans K, van Houdt PJ, and van der Heide UA
- Abstract
Introduction: The FLAME trial demonstrated that the dose to the gross tumor volume (GTV) is associated with tumour control in prostate cancer patients. This raises the question if dose de-escalation to the remaining prostate gland can be considered. Therefore, we investigated if intraprostatic recurrences occur at the location of the GTV and which dose was delivered at that location., Materials and Methods: For FLAME trial patients with an intra-prostatic recurrence, we collected pre-treatment images, GTV delineations, dose distributions and post-recurrence images. Pre-treatment images were registered to the post-recurrence images (PSMA-PET CT). An overlap between GTV and PSMA-PET activity was considered an intra-prostatic recurrence at the location of the primary tumor., Results: Twenty eight out of 535 patients in the FLAME trial had an intra-prostatic recurrence. Its location could be determined for 24 patients. One patient recurred in the prostate gland outside the GTV. The median near-minimum dose to the GTV (D98%) was 76.5 Gy (range: 73.3-86.5 Gy). Only one patient with a recurrence in the GTV received a substantial focal boost of 86.5 Gy. The D98% of all remaining patients was < 81 Gy., Conclusion: Intra-prostatic recurrences of intermediate- and high-risk prostate cancer patients treated with radiotherapy appeared predominantly at the location of the primary tumor. All but one patient did not receive a high dose to the GTV. Intra-prostatic failure is likely a consequence of the undertreatment of the primary tumor rather than the undertreatment of the remaining prostate gland., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier B.V. All rights reserved.)
- Published
- 2024
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71. Angiography-Based Superficial Wall Strain of De Novo Stenotic Coronary Arteries: Serial Assessment of Vessels Treated with Bioresorbable Scaffold or Drug-Eluting Stent.
- Author
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Wu X, Renkens MPL, Kerkmeijer L, Lunardi M, Huang J, Ding D, O'Leary N, de Winter RJ, Onuma Y, Serruys PW, Wykrzykowska J, Tu S, and Wijns W
- Subjects
- Humans, Everolimus, Absorbable Implants, Coronary Vessels diagnostic imaging, Coronary Angiography, Treatment Outcome, Prosthesis Design, Drug-Eluting Stents, Percutaneous Coronary Intervention adverse effects
- Abstract
Objectives: This study sought to present an angiography-based computational model for serial assessment of superficial wall strain (SWS, dimensionless) of de-novo coronary stenoses treated with either bioresorbable scaffold (BRS) or drug-eluting stent (DES)., Background: A novel method for SWS allows the assessment of the mechanical status of arteries in-vivo, which may help for predicting cardiovascular outcomes., Methods: Patients with arterial stenosis treated with BRS (n = 21) or DES (n = 21) were included from ABSORB Cohort B1 and AIDA trials. The SWS analyses were performed along with quantitative coronary angiography (QCA) at pre-PCI, post-PCI, and 5-year follow-up. Measurements of QCA and SWS parameters were quantified at the treated segment and adjacent 5-mm proximal and distal edges., Results: Before PCI, the peak SWS on the 'to be treated' segment (0.79 ± 0.36) was significantly higher than at both virtual edges (0.44 ± 0.14 and 0.45 ± 0.21; both p < 0.001). The peak SWS in the treated segment significantly decreased by 0.44 ± 0.13 (p < 0.001). The surface area of high SWS decreased from 69.97mm
2 to 40.08mm2 (p = 0.002). The peak SWS in BRS group decreased to a similar extent (p = 0.775) from 0.81 ± 0.36 to 0.41 ± 0.14 (p < 0.001), compared with DES group from 0.77 ± 0.39 to 0.47 ± 0.13 (p = 0.001). Relocation of high SWS to device edges was often observed in both groups after PCI (35 of 82 cases, 41.7 %). At follow-up of BRS, the peak SWS remained unchanged compared to post-PCI (0.40 ± 0.12 versus 0.36 ± 0.09, p = 0.319)., Conclusion: Angiography-based SWS provided valuable information about the mechanical status of coronary arteries. Device implantation led to a significant decrease of SWS to a similar extent with either polymer-based scaffolds or permanent metallic stents., Competing Interests: Declaration of competing interest Y. Onuma reports institutional research grants related to his work as the chairman of cardiovascular imaging core labs of several clinical trials and registry sponsored by industry, for which they receive no direct compensation. P. W. Serruys reports personal fees from Sino Medical Sciences Technology, Philips/Volcano, Xeltis, outside the submitted work. S. Tu reports grants and consultancy from Pulse Medical. Authors have no other disclosures or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed., (Copyright © 2023 The Authors. Published by Elsevier Inc. All rights reserved.)- Published
- 2023
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72. Implementation of MR-linac and proton therapy in two radiotherapy departments in The Netherlands: Recommendations based on lessons learned.
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Jacobs M, Kerkmeijer L, de Ruysscher D, Brunenberg E, Boersma L, and Verheij M
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- Humans, Magnetic Resonance Imaging methods, Netherlands, Particle Accelerators, Radiotherapy Planning, Computer-Assisted methods, Proton Therapy
- Abstract
Recently, two new treatment techniques, i.e. proton therapy and MR-linac based radiotherapy (RT), have been introduced in Dutch RT centres with major impact on daily practice. The content and context of these techniques are frequently described in scientific literature while little is reported about the implementation phase. This process is complex due to a variety of aspects, such as the involvement of multiple stakeholders, significant unpredictability in the start-up phase, the impact of the learning curve, standard operating procedures under development, new catchment areas, and extensive training programs. Insight about implementation in daily care is utterly important for clinics that are about to introduce these new technologies in order to prevent that every centre needs to reinvent the wheel. This position paper gives an overview of the implementation of proton therapy and MR-linac based RT in two large academic RT centres in the Netherlands, i.e. Maastro and Radboudumc respectively. With this paper we aim to report our lessons learned, in order to facilitate other RT centres that consider introducing these and other new techniques in their departments., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2021 The Authors. Published by Elsevier B.V. All rights reserved.)
- Published
- 2022
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73. Salvage stereotactic body radiotherapy (SBRT) for intraprostatic relapse after prostate cancer radiotherapy: An ESTRO ACROP Delphi consensus.
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Jereczek-Fossa BA, Marvaso G, Zaffaroni M, Gugliandolo SG, Zerini D, Corso F, Gandini S, Alongi F, Bossi A, Cornford P, De Bari B, Fonteyne V, Hoskin P, Pieters BR, Tree AC, Arcangeli S, Fuller DB, Franzese C, Hannoun-Levi JM, Janoray G, Kerkmeijer L, Kwok Y, Livi L, Loi M, Miralbell R, Pasquier D, Pinkawa M, Scher N, Scorsetti M, Shelan M, Toledano A, van As N, Vavassori A, Zilli T, Pepa M, and Ost P
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- Consensus, Humans, Male, Neoplasm Recurrence, Local pathology, Prostatic Neoplasms pathology, Neoplasm Recurrence, Local surgery, Practice Guidelines as Topic standards, Prostatic Neoplasms surgery, Radiosurgery methods, Salvage Therapy methods
- Abstract
Background and Purpose: Between 30% and 47% of patients treated with definitive radiotherapy (RT) for prostate cancer are at risk of intraprostatic recurrence during follow-up. Re-irradiation with stereotactic body RT (SBRT) is emerging as a feasible and safe therapeutic option. However, no consensus or guidelines exist on this topic. The purpose of this ESTRO ACROP project is to investigate expert opinion on salvage SBRT for intraprostatic relapse after RT., Materials and Methods: A 40-item questionnaire on salvage SBRT was prepared by an internal committee and reviewed by a panel of leading radiation oncologists plus a urologist expert in prostate cancer. Following the procedure of a Delphi consensus, 3 rounds of questionnaires were sent to selected experts on prostate re-irradiation., Results: Among the 33 contacted experts, 18 (54.5%) agreed to participate. At the end of the final round, participants were able to find consensus on 14 out of 40 questions (35% overall) and major agreement on 13 questions (32.5% overall). Specifically, the consensus was reached regarding some selection criteria (no age limit, ECOG 0-1, satisfactory urinary flow), diagnostic procedures (exclusion of metastatic disease, SBRT target defined on the MRI) and therapeutic approach (no need for concomitant ADT, consideration of the first RT dose, validity of Phoenix criteria for salvage SBRT failure)., Conclusion: While awaiting the results of ongoing studies, our ESTRO ACROP Delphi consensus may serve as a practical guidance for salvage SBRT. Future research should address the existing disagreements on this promising approach., (Copyright © 2021 Elsevier Ltd. All rights reserved.)
- Published
- 2021
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74. Adaptive Magnetic Resonance-Guided Stereotactic Body Radiotherapy: The Next Step in the Treatment of Renal Cell Carcinoma.
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Keller B, Bruynzeel AME, Tang C, Swaminath A, Kerkmeijer L, and Chu W
- Abstract
Adaptive MR-guided radiotherapy (MRgRT) is a new treatment paradigm and its role as a non-invasive treatment option for renal cell carcinoma is evolving. The early clinical experience to date shows that real-time plan adaptation based on the daily MRI anatomy can lead to improved target coverage and normal tissue sparing. Continued technological innovations will further mitigate the challenges of organ motion and enable more advanced treatment adaptation, and potentially lead to enhanced oncologic outcomes and preservation of renal function. Future applications look promising to make a positive clinical impact and further the personalization of radiotherapy in the management of renal cell carcinoma., Competing Interests: AB reports personal fees from ViewRay Inc., outside the submitted work. AS has received honoraria from Bristol Myers Squibb, AstraZeneca, and Eisai, and trial funding in kind from Bristol Myers Squibb. BK, CT, LK and WC are members of the Elekta MR-Linac Consortium, and Elekta financially supports projects in the member institutes. BK and WC have received travel support from Elekta., (Copyright © 2021 Keller, Bruynzeel, Tang, Swaminath, Kerkmeijer and Chu.)
- Published
- 2021
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75. 68 Ga-PSMA-11 PET, 18 F-PSMA-1007 PET, and MRI for Gross Tumor Volume Delineation in Primary Prostate Cancer: Intermodality and Intertracer Variability.
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Draulans C, Pos F, Smeenk RJ, Kerkmeijer L, Vogel WV, Nagarajah J, Janssen M, Mai C, Heijmink S, van der Leest M, Zámecnik P, Oyen R, Isebaert S, Maes F, Joniau S, Kunze-Busch M, De Roover R, Defraene G, van der Heide UA, Goffin K, and Haustermans K
- Subjects
- Gallium Isotopes, Gallium Radioisotopes, Humans, Magnetic Resonance Imaging, Male, Niacinamide analogs & derivatives, Oligopeptides, Positron-Emission Tomography, Tumor Burden, Positron Emission Tomography Computed Tomography, Prostatic Neoplasms diagnostic imaging
- Abstract
Purpose: To assess the intermodality and intertracer variability of gallium-68 (
68 Ga)- or fluorine-18 (18 F)-labeled prostate-specific membrane antigen (PSMA) positron emission tomography (PET) and biparametric magnetic resonance imaging (bpMRI)-based gross tumor volume (GTV) delineation for focal boosting in primary prostate cancer., Methods: Nineteen prospectively enrolled patients with prostate cancer underwent a PSMA PET/MRI scan, divided into a 1:1 ratio between68 Ga-PSMA-11 and18 F-PSMA-1007, before radical prostatectomy (IWT140193). Four delineation teams performed manual contouring of the GTV based on bpMRI and PSMA PET imaging, separately. Index lesion coverage (overlap%) and interobserver variability were assessed. Furthermore, the distribution of the voxelwise normalized standardized uptake values (SUV%) was determined for the majority-voted (>50%) GTV (GTVmajority ) and whole prostate gland to investigate intertracer variability. The median patientwise SUV% contrast ratio (SUV%-CR, calculated as median GTVmajority SUV% / median prostate gland without GTVmajority SUV%) was calculated according to the tracer used., Results: A significant difference in overlap% favoring PSMA PET compared with bpMRI was found in the18 F subgroup (median, 63.0% vs 53.1%; P = .004) but was not present in the68 Ga subgroup (32.5% vs 50.6%; P = .100). Regarding interobserver variability, measured Sørensen-Dice coefficients (0.58 vs 0.72) and calculated mean distances to agreement (2.44 mm vs 1.22 mm) were statistically significantly lower and higher, respectively, for the18 F cohort compared with the68 Ga cohort. For the bpMRI-based delineations, the median Sørensen-Dice coefficient and mean distance to agreement were 0.63 and 1.76 mm, respectively. Median patientwise SUV%-CRs of 1.8 (interquartile range [IQR], 1.6-2.7) for18 F-PSMA and 3.3 (IQR, 2.7-5.9) for68 Ga-PSMA PET images were found., Conclusions: Both MRI and PSMA PET provided consistent intraprostatic GTV lesion detection. However, the PSMA tracer seems to have a major influence on the contour characteristics, owing to an apparent difference in SUV% distribution in the prostate gland., (Copyright © 2020 American Society for Radiation Oncology. Published by Elsevier Inc. All rights reserved.)- Published
- 2021
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76. Optimal 68 Ga-PSMA and 18 F-PSMA PET window levelling for gross tumour volume delineation in primary prostate cancer.
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Draulans C, De Roover R, van der Heide UA, Kerkmeijer L, Smeenk RJ, Pos F, Vogel WV, Nagarajah J, Janssen M, Isebaert S, Maes F, Mai C, Oyen R, Joniau S, Kunze-Busch M, Goffin K, and Haustermans K
- Subjects
- Edetic Acid analogs & derivatives, Gallium Isotopes, Gallium Radioisotopes, Humans, Male, Oligopeptides, Tumor Burden, Positron Emission Tomography Computed Tomography, Prostatic Neoplasms diagnostic imaging
- Abstract
Purpose: This study proposes optimal tracer-specific threshold-based window levels for PSMA PET-based intraprostatic gross tumour volume (GTV) contouring to reduce interobserver delineation variability., Methods: Nine
68 Ga-PSMA-11 and nine18 F-PSMA-1007 PET scans including GTV delineations of four expert teams (GTVmanual ) and a majority-voted GTV (GTVmajority ) were assessed with respect to a registered histopathological GTV (GTVhisto ) as the gold standard reference. The standard uptake values (SUVs) per voxel were converted to a percentage (SUV%) relative to the SUVmax . The statistically optimised SUV% threshold (SOST) was defined as those that maximises accuracy for threshold-based contouring. A leave-one-out cross-validation receiver operating characteristic (ROC) curve analysis was performed to determine the SOST for each tracer. The SOST analysis was performed twice, first using the GTVhisto contour as training structure (GTVSOST-H ) and second using the GTVmajority contour as training structure (GTVSOST-MA ) to correct for any limited misregistration. The accuracy of both GTVSOST-H and GTVSOST-MA was calculated relative to GTVhisto in the 'leave-one-out' patient of each fold and compared with the accuracy of GTVmanual ., Results: ROC curve analysis for68 Ga-PSMA-11 PET revealed a median threshold of 25 SUV% (range, 22-27 SUV%) and 41 SUV% (40-43 SUV%) for GTVSOST-H and GTVSOST-MA , respectively. For18 F-PSMA-1007 PET, a median threshold of 42 SUV% (39-45 SUV%) for GTVSOST-H and 44 SUV% (42-45 SUV%) for GTVSOST-MA was found. A significant pairwise difference was observed when comparing the accuracy of the GTVSOST-H contours with the median accuracy of the GTVmanual contours (median, - 2.5%; IQR, - 26.5-0.2%; p = 0.020), whereas no significant pairwise difference was found for the GTVSOST-MA contours (median, - 0.3%; IQR, - 4.4-0.6%; p = 0.199)., Conclusions: Threshold-based contouring using GTVmajority -trained SOSTs achieves an accuracy comparable with manual contours in delineating GTVhisto . The median SOSTs of 41 SUV% for68 Ga-PSMA-11 PET and 44 SUV% for18 F-PSMA-1007 PET form a base for tracer-specific window levelling., Trial Registration: Clinicaltrials.gov ; NCT03327675; 31-10-2017.- Published
- 2021
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77. Prostate intrafraction motion during the preparation and delivery of MR-guided radiotherapy sessions on a 1.5T MR-Linac.
- Author
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de Muinck Keizer DM, Kerkmeijer LGW, Willigenburg T, van Lier ALHMW, Hartogh MDD, van der Voort van Zyp JRN, de Groot-van Breugel EN, Raaymakers BW, Lagendijk JJW, and de Boer JCJ
- Subjects
- Humans, Magnetic Resonance Imaging, Male, Movement, Particle Accelerators, Prostatic Neoplasms diagnostic imaging, Prostatic Neoplasms radiotherapy, Radiotherapy Planning, Computer-Assisted
- Abstract
Purpose: To evaluate prostate intrafraction motion using MRI during the full course of online adaptive MR-Linac radiotherapy (RT) fractions, in preparation of MR-guided extremely hypofractionated RT., Material and Methods: Five low and intermediate risk prostate cancer patients were treated with 20 × 3.1 Gy fractions on a 1.5T MR-Linac. Each fraction, initial MRI (Pre) scans were obtained at the start of every treatment session. Pre-treatment planning MRI contours were propagated and adapted to this Pre scan after which plan re-optimization was started in the treatment planning system followed by dose delivery. 3D Cine-MR imaging was started simultaneously with beam-on and acquired over the full beam-on period. Prostate intrafraction motion in this cine-MR was determined with a previously validated soft-tissue contrast based tracking algorithm. In addition, absolute accuracy of the method was determined using a 4D phantom., Results: Prostate motion was completely automatically determined over the full on-couch period (approx. 45 min) with no identified mis-registrations. The translation 95% confidence intervals are within clinically applied margins of 5 mm, and plan adaption for intrafraction motion was required in only 4 out of 100 fractions., Conclusion: This is the first study to investigate prostate intrafraction motions during entire MR-guided RT sessions on an MR-Linac. We have shown that high quality 3D cine-MR imaging and prostate tracking during RT is feasible with beam-on. The clinically applied margins of 5 mm have proven to be sufficient for these treatments and may potentially be further reduced using intrafraction plan adaptation guided by cine-MR imaging., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2020 The Author(s). Published by Elsevier B.V. All rights reserved.)
- Published
- 2020
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78. Association of Sex With Outcomes in Patients Undergoing Percutaneous Coronary Intervention: A Subgroup Analysis of the GLOBAL LEADERS Randomized Clinical Trial.
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Chichareon P, Modolo R, Kerkmeijer L, Tomaniak M, Kogame N, Takahashi K, Chang CC, Komiyama H, Moccetti T, Talwar S, Colombo A, Maillard L, Barlis P, Wykrzykowska J, Piek JJ, Garg S, Hamm C, Steg PG, Jüni P, Valgimigli M, Windecker S, Onuma Y, Mehran R, and Serruys PW
- Subjects
- Aged, Aspirin therapeutic use, Drug-Eluting Stents, Dual Anti-Platelet Therapy adverse effects, Dual Anti-Platelet Therapy methods, Female, Hemorrhage chemically induced, Hemorrhagic Stroke chemically induced, Humans, Ischemic Stroke epidemiology, Male, Middle Aged, Mortality, Myocardial Infarction epidemiology, Myocardial Revascularization statistics & numerical data, Proportional Hazards Models, Secondary Prevention, Sex Factors, Thrombosis epidemiology, Ticagrelor therapeutic use, Coronary Artery Disease therapy, Hemorrhage epidemiology, Hemorrhagic Stroke epidemiology, Percutaneous Coronary Intervention methods, Platelet Aggregation Inhibitors therapeutic use
- Abstract
Importance: Women experience worse ischemic and bleeding outcomes after percutaneous coronary intervention (PCI)., Objectives: To assess the association of sex with patient outcomes at 2 years after contemporary PCI and with the efficacy and safety of 2 antiplatelet strategies., Design, Setting, and Participants: This study is a prespecified subgroup analysis of the investigator-initiated, prospective, randomized GLOBAL LEADERS study evaluating 2 strategies of antiplatelet therapy after PCI in an unselected population including 130 secondary/tertiary care hospitals in different countries. The main study enrolled 15 991 unselected patients undergoing PCI between July 2013 and November 2015. Patients had an outpatient clinic visit at 30 days and 3, 6, 12, 18, and 24 months after the index procedure. Data were analyzed between January 1, 2019, and March 31, 2019., Interventions: Eligible patients were randomized to either the experimental or reference antiplatelet strategy. Experimental strategy consisted of 1 month of dual antiplatelet therapy (DAPT) followed by 23 months of ticagrelor monotherapy, while the reference strategy comprised of 12 months of DAPT followed by 12 months of aspirin monotherapy., Main Outcomes and Measures: The primary efficacy end point was the composite of all-cause mortality and new Q-wave myocardial infarction at 2 years. The secondary safety end point was Bleeding Academic Research Consortium type 3 or 5 bleeding., Results: Of the 15 968 patients included in this study, 3714 (23.3%) were women. The risk of the primary end point at 2 years was similar between women and men (adjusted hazard ratio [HR], 1.00; 95% CI, 0.83-1.20). Compared with men, women had higher risk of Bleeding Academic Research Consortium type 3 or 5 bleeding (adjusted HR, 1.32; 95% CI, 1.04-1.67) and hemorrhagic stroke at 2 years (adjusted HR, 4.76; 95% CI, 1.92-11.81). At 2 years, there was no between-sex difference in the efficacy and safety of the 2 antiplatelet strategies. At 1 year, compared with DAPT, ticagrelor monotherapy was associated with a lower risk of bleeding in men (HR, 0.72; 95% CI, 0.53-0.98) but not in women (HR, 1.23; 95% CI, 0.80-1.89; P for interaction = .045)., Conclusions and Relevance: Compared with men, women experienced a higher risk of bleeding and hemorrhagic stroke after PCI. The effect of 2 antiplatelet strategies on death and Q-wave myocardial infarction following PCI did not differ between the sexes at 2 years., Trial Registration: ClinicalTrials.gov identifier: NCT01813435.
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- 2020
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79. Stereotactic body radiation therapy with optional focal lesion ablative microboost in prostate cancer: Topical review and multicenter consensus.
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Draulans C, De Roover R, van der Heide UA, Haustermans K, Pos F, Smeenk RJ, De Boer H, Depuydt T, Kunze-Busch M, Isebaert S, and Kerkmeijer L
- Subjects
- Humans, Male, Consensus, Prospective Studies, Radiotherapy Dosage, Retrospective Studies, Prostatic Neoplasms radiotherapy, Radiosurgery methods, Radiosurgery standards
- Abstract
Stereotactic body radiotherapy (SBRT) for prostate cancer (PCa) is gaining interest by the recent publication of the first phase III trials on prostate SBRT and the promising results of many other phase II trials. Before long term results became available, the major concern for implementing SBRT in PCa in daily clinical practice was the potential risk of late genitourinary (GU) and gastrointestinal (GI) toxicity. A number of recently published trials, including late outcome and toxicity data, contributed to the growing evidence for implementation of SBRT for PCa in daily clinical practice. However, there exists substantial variability in delivering SBRT for PCa. The aim of this topical review is to present a number of prospective trials and retrospective analyses of SBRT in the treatment of PCa. We focus on the treatment strategies and techniques used in these trials. In addition, recent literature on a simultaneous integrated boost to the tumor lesion, which could create an additional value in the SBRT treatment of PCa, was described. Furthermore, we discuss the multicenter consensus of the FLAME consortium on SBRT for PCa with a focal boost to the macroscopic intraprostatic tumor nodule(s)., (Copyright © 2019 Elsevier B.V. All rights reserved.)
- Published
- 2019
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80. Focal Salvage Treatment of Radiorecurrent Prostate Cancer: A Narrative Review of Current Strategies and Future Perspectives.
- Author
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van Son M, Peters M, Moerland M, Kerkmeijer L, Lagendijk J, and van der Voort van Zyp J
- Abstract
Over the last decades, primary prostate cancer radiotherapy saw improving developments, such as more conformal dose administration and hypofractionated treatment regimens. Still, prostate cancer recurrences after whole-gland radiotherapy remain common, especially in patients with intermediate- to high-risk disease. The vast majority of these patients are treated palliatively with androgen deprivation therapy (ADT), which exposes them to harmful side-effects and is only effective for a limited amount of time. For patients with a localized recurrent tumor and no signs of metastatic disease, local treatment with curative intent seems more rational. However, whole-gland salvage treatments such as salvage radiotherapy or salvage prostatectomy are associated with significant toxicity and are, therefore, uncommonly performed. Treatments that are solely aimed at the recurrent tumor itself, thereby better sparing the surrounding organs at risk, potentially provide a safer salvage treatment option in terms of toxicity. To achieve such tumor-targeted treatment, imaging developments have made it possible to better exclude metastatic disease and accurately discriminate the tumor. Currently, focal salvage treatment is being performed with different modalities, including brachytherapy, cryotherapy, high-intensity focused ultrasound (HIFU), and stereotactic body radiation therapy (SBRT). Oncologic outcomes seem comparable to whole-gland salvage series, but with much lower toxicity rates. In terms of oncologic control, these results will improve further with better understanding of patient selection. Other developments, such as high-field diagnostic MRI and live adaptive MRI-guided radiotherapy, will further improve precision of the treatment.
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- 2018
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81. Magnetic Resonance Imaging only Workflow for Radiotherapy Simulation and Planning in Prostate Cancer.
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Kerkmeijer LGW, Maspero M, Meijer GJ, van der Voort van Zyp JRN, de Boer HCJ, and van den Berg CAT
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- Humans, Male, Software, Magnetic Resonance Imaging methods, Prostatic Neoplasms radiotherapy, Radiotherapy Planning, Computer-Assisted methods, Radiotherapy, Computer-Assisted methods, Radiotherapy, Image-Guided methods, Workflow
- Abstract
Magnetic resonance imaging (MRI) is often combined with computed tomography (CT) in prostate radiotherapy to optimise delineation of the target and organs-at-risk (OAR) while maintaining accurate dose calculation. Such a dual-modality workflow requires two separate imaging sessions, and it has some fundamental and logistical drawbacks. Due to the availability of new MRI hardware and software solutions, CT examinations can be omitted for prostate radiotherapy simulations. All information for treatment planning, including electron density maps and bony anatomy, can nowadays be obtained with MRI. Such an MRI-only simulation workflow reduces delineation ambiguities, eases planning logistics, and improves patient comfort; however, careful validation of the complete MRI-only workflow is warranted. The first institutes are now adopting this MRI-only workflow for prostate radiotherapy. In this article, we will review technology and workflow requirements for an MRI-only prostate simulation workflow., (Copyright © 2018 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.)
- Published
- 2018
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82. Magnetic Resonance-based Response Assessment and Dose Adaptation in Human Papilloma Virus Positive Tumors of the Oropharynx treated with Radiotherapy (MR-ADAPTOR): An R-IDEAL stage 2a-2b/Bayesian phase II trial.
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Bahig H, Yuan Y, Mohamed ASR, Brock KK, Ng SP, Wang J, Ding Y, Hutcheson K, McCulloch M, Balter PA, Lai SY, Al-Mamgani A, Sonke JJ, van der Heide UA, Nutting C, Li XA, Robbins J, Awan M, Karam I, Newbold K, Harrington K, Oelfke U, Bhide S, Philippens MEP, Terhaard CHJ, McPartlin AJ, Blanchard P, Garden AS, Rosenthal DI, Gunn GB, Phan J, Cazoulat G, Aristophanous M, McSpadden KK, Garcia JA, van den Berg CAT, Raaijmakers CPJ, Kerkmeijer L, Doornaert P, Blinde S, Frank SJ, and Fuller CD
- Abstract
Background: Current standard radiotherapy for oropharynx cancer (OPC) is associated with high rates of severe toxicities, shown to adversely impact patients' quality of life. Given excellent outcomes of human papilloma virus (HPV)-associated OPC and long-term survival of these typically young patients, treatment de-intensification aimed at improving survivorship while maintaining excellent disease control is now a central concern. The recent implementation of magnetic resonance image - guided radiotherapy (MRgRT) systems allows for individual tumor response assessment during treatment and offers possibility of personalized dose-reduction. In this 2-stage Bayesian phase II study, we propose to examine weekly radiotherapy dose-adaptation based on magnetic resonance imaging (MRI) evaluated tumor response. Individual patient's plan will be designed to optimize dose reduction to organs at risk and minimize locoregional failure probability based on serial MRI during RT. Our primary aim is to assess the non-inferiority of MRgRT dose adaptation for patients with low risk HPV-associated OPC compared to historical control, as measured by Bayesian posterior probability of locoregional control (LRC)., Methods: Patients with T1-2 N0-2b (as per AJCC 7th Edition) HPV-positive OPC, with lymph node <3 cm and <10 pack-year smoking history planned for curative radiotherapy alone to a dose of 70 Gy in 33 fractions will be eligible. All patients will undergo pre-treatment MRI and at least weekly intra-treatment MRI. Patients undergoing MRgRT will have weekly adaptation of high dose planning target volume based on gross tumor volume response. The stage 1 of this study will enroll 15 patients to MRgRT dose adaptation. If LRC at 6 months with MRgRT dose adaptation is found sufficiently safe as per the Bayesian model, stage 2 of the protocol will expand enrollment to an additional 60 patients, randomized to either MRgRT or standard IMRT., Discussion: Multiple methods for safe treatment de-escalation in patients with HPV-positive OPC are currently being studied. By leveraging the ability of advanced MRI techniques to visualize tumor and soft tissues through the course of treatment, this protocol proposes a workflow for safe personalized radiation dose-reduction in good responders with radiosensitive tumors, while ensuring tumoricidal dose to more radioresistant tumors. MRgRT dose adaptation could translate in reduced long term radiation toxicities and improved survivorship while maintaining excellent LRC outcomes in favorable OPC., Trial Registration: ClinicalTrials.gov ID: NCT03224000; Registration date: 07/21/2017.
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- 2018
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83. Guidelines following hydatidiform mole: a reappraisal.
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Kerkmeijer L, Wielsma S, Bekkers R, Pyman J, Tan J, and Quinn M
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- Adult, Biomarkers, Tumor blood, Chemotherapy, Adjuvant, Female, Follow-Up Studies, Humans, Hydatidiform Mole drug therapy, Hydatidiform Mole surgery, Hysterectomy methods, Maternal Age, Monitoring, Physiologic standards, Neoplasm Recurrence, Local blood, Parity, Pregnancy, Pregnancy Complications, Neoplastic diagnosis, Pregnancy Complications, Neoplastic therapy, Pregnancy Outcome, Registries, Retrospective Studies, Risk Assessment, Sensitivity and Specificity, Uterine Neoplasms drug therapy, Uterine Neoplasms surgery, Chorionic Gonadotropin blood, Hydatidiform Mole diagnosis, Neoplasm Recurrence, Local diagnosis, Practice Guidelines as Topic, Uterine Neoplasms diagnosis
- Abstract
Objective: The aim of this study was to determine how often patients with complete hydatidiform mole (CHM) who spontaneously achieve normal human chorionic gonadotrophin (hCG) levels subsequently develop persistent or recurrent gestational trophoblast disease., Methods: Four hundred and fourteen cases of CHM registered at the Hydatidiform Mole Registry of Victoria were reviewed retrospectively after molar evacuation. Maternal age, gestational age, gravidity and parity were determined for each patient, as well as the need for chemotherapy., Results: Among the 414 patients, 55 (13.3%) required chemotherapy for persistent trophoblastic disease. None of the patients whose hCG levels spontaneously fell to normal subsequently developed persistent molar disease., Conclusion: Weekly hCG measurements are recommended for all patients until normal levels are achieved. For patients who attain normal hCG levels within 2 months after evacuation, it seems safe to discontinue monitoring once normal levels are achieved. Patients who fail to achieve normal hCG levels by 2 months after evacuation should be monitored with monthly hCG measurements for 1 year after normalisation to assure sustained remission.
- Published
- 2006
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84. Persistent trophoblast disease following partial molar pregnancy.
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Wielsma S, Kerkmeijer L, Bekkers R, Pyman J, Tan J, and Quinn M
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- Adult, Australia, Biomarkers, Tumor blood, Female, Follow-Up Studies, Gestational Age, Humans, Hydatidiform Mole drug therapy, Maternal Age, Neoplasm Recurrence, Local drug therapy, Neoplasm Recurrence, Local epidemiology, Parity, Pregnancy, Pregnancy Complications, Neoplastic diagnosis, Pregnancy Complications, Neoplastic drug therapy, Pregnancy Outcome, Registries, Retrospective Studies, Risk Assessment, Trophoblastic Neoplasms diagnosis, Trophoblastic Neoplasms drug therapy, Uterine Neoplasms therapy, Chorionic Gonadotropin blood, Hydatidiform Mole diagnosis, Methotrexate therapeutic use, Neoplasm Recurrence, Local diagnosis, Uterine Neoplasms diagnosis
- Abstract
Objective: Human chorionic gonadotrophin (hCG) follow-up data were analysed retrospectively in all patients registered in the Hydatidiform Mole Registry at the Royal Women's Hospital, Melbourne from January 1992 to January 2001 to determine the risk of persistent trophoblast disease following partial molar pregnancy and to review the present follow-up protocol of patients suffering from partial hydatidiform molar pregnancy (PHM)., Methods: Demographic factors were determined for all 344 cases with a review diagnosis of PHM, included age, history of previous hydatidiform mole, gestation length, hCG levels and compliance with follow-up., Findings: Six of the 344 patients diagnosed with PHM required treatment with single-agent methotrexate and folinic acid rescue. All six patients achieved and maintained a complete biochemical remission after chemotherapy. hCG regression assays were analysed for 235 patients: 225 patients had at least one normal hCG measurement during follow-up, of whom 152 (64.7%) patients obtained normal values within 2 months after evacuation. All patients obtained normal levels within 32 weeks after evacuation of the partial hydatidiform mole. Only 63 (25.6%) patients completed the recommended follow-up program. No patient who achieved normal hCG levels required chemotherapy because of a recurrent gestational trophoblastic tumour., Recommendations: This study indicates that 1.7% of all partial mole pregnancy patients needed treatment for malignant sequelae. In contrast, no patient diagnosed with partial mole had a biochemical or clinical relapse after achieving normal levels of hCG, consistent with previous studies. Patients who have had a partial hydatidiform mole should be followed by hCG assays until normal levels are achieved and then follow-up can be safely discontinued.
- Published
- 2006
- Full Text
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