186 results on '"Evelyn M Monninkhof"'
Search Results
2. Control group design, contamination and drop-out in exercise oncology trials: a systematic review.
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Charlotte N Steins Bisschop, Kerry S Courneya, Miranda J Velthuis, Evelyn M Monninkhof, Lee W Jones, Christine Friedenreich, Elsken van der Wall, Petra H M Peeters, and Anne M May
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Medicine ,Science - Abstract
Important considerations for exercise trials in cancer patients are contamination and differential drop-out among the control group members that might jeopardize the internal validity. This systematic review provides an overview of different control groups design characteristics of exercise-oncology trials and explores the association with contamination and drop-out rates.Randomized controlled exercise-oncology trials from two Cochrane reviews were included. Additionally, a computer-aided search using Medline (Pubmed), Embase and CINAHL was conducted after completion date of the Cochrane reviews. Eligible studies were classified according to three control group design characteristics: the exercise instruction given to controls before start of the study (exercise allowed or not); and the intervention the control group was offered during (any (e.g., education sessions or telephone contacts) or none) or after (any (e.g., cross-over or exercise instruction) or none) the intervention period. Contamination (yes or no) and excess drop-out rates (i.e., drop-out rate of the control group minus the drop-out rate exercise group) were described according to the three design characteristics of the control group and according to the combinations of these three characteristics; so we additionally made subgroups based on combinations of type and timing of instructions received.40 exercise-oncology trials were included based on pre-specified eligibility criteria. The lowest contamination (7.1% of studies) and low drop-out rates (excess drop-out rate -4.7±9.2) were found in control groups offered an intervention after the intervention period. When control groups were offered an intervention both during and after the intervention period, contamination (0%) and excess drop-out rates (-10.0±12.8%) were even lower.Control groups receiving an intervention during and after the study intervention period have lower contamination and drop-out rates. The present findings can be considered when designing future exercise-oncology trials.
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- 2015
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3. Patient and disease characteristics associated with activation for self-management in patients with diabetes, chronic obstructive pulmonary disease, chronic heart failure and chronic renal disease: a cross-sectional survey study.
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Irene Bos-Touwen, Marieke Schuurmans, Evelyn M Monninkhof, Yvonne Korpershoek, Lotte Spruit-Bentvelzen, Inge Ertugrul-van der Graaf, Niek de Wit, and Jaap Trappenburg
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Medicine ,Science - Abstract
A substantial proportion of chronic disease patients do not respond to self-management interventions, which suggests that one size interventions do not fit all, demanding more tailored interventions. To compose more individualized strategies, we aim to increase our understanding of characteristics associated with patient activation for self-management and to evaluate whether these are disease-transcending. A cross-sectional survey study was conducted in primary and secondary care in patients with type-2 Diabetes Mellitus (DM-II), Chronic Obstructive Pulmonary Disease (COPD), Chronic Heart Failure (CHF) and Chronic Renal Disease (CRD). Using multiple linear regression analysis, we analyzed associations between self-management activation (13-item Patient Activation Measure; PAM-13) and a wide range of socio-demographic, clinical, and psychosocial determinants. Furthermore, we assessed whether the associations between the determinants and the PAM were disease-transcending by testing whether disease was an effect modifier. In addition, we identified determinants associated with low activation for self-management using logistic regression analysis. We included 1154 patients (53% response rate); 422 DM-II patients, 290 COPD patients, 223 HF patients and 219 CRD patients. Mean age was 69.6±10.9. Multiple linear regression analysis revealed 9 explanatory determinants of activation for self-management: age, BMI, educational level, financial distress, physical health status, depression, illness perception, social support and underlying disease, explaining a variance of 16.3%. All associations, except for social support, were disease transcending. This study explored factors associated with varying levels of activation for self-management. These results are a first step in supporting clinicians and researchers to identify subpopulations of chronic disease patients less likely to be engaged in self-management. Increased scientific efforts are needed to explain the greater part of the factors that contribute to the complex nature of patient activation for self-management.
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- 2015
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4. Quality of Life after Diet or Exercise-Induced Weight Loss in Overweight to Obese Postmenopausal Women: The SHAPE-2 Randomised Controlled Trial.
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Willemijn A M van Gemert, Job van der Palen, Evelyn M Monninkhof, Anouk Rozeboom, Roelof Peters, Harriet Wittink, Albertine J Schuit, and Petra H Peeters
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Medicine ,Science - Abstract
This study investigates the effect of a modest weight loss either by a calorie restricted diet or mainly by increased physical exercise on health related quality of life (HRQoL) in overweight-to-obese and inactive postmenopausal women. We hypothesize that HRQoL improves with weight loss, and that exercise-induced weight loss is more effective for this than diet-induced weight loss.The SHAPE-2 trial was primarily designed to evaluate any additional effect of weight loss by exercise compared with a comparable amount of weight loss by diet on biomarkers relevant for breast cancer risk. In the present analysis we focus on HRQoL. We randomly assigned 243 eligible women to a diet (n = 97), exercise (n = 98), or control group (n = 48). Both interventions aimed for 5-6 kg weight loss. HRQoL was measured at baseline and after 16 weeks by the SF-36 questionnaire.Data of 214 women were available for analysis. Weight loss was 4.9 kg (6.1%) and 5.5 kg (6.9%) with diet and exercise, respectively. Scores of the SF-36 domain 'health change' increased significantly by 8.8 points (95% CI 1.6;16.1) with diet, and by 20.5 points (95% CI 13.2;27.7) with exercise when compared with control. Direct comparison of diet and exercise showed a statistically significantly stronger improvement with exercise. Both intervention groups showed a tendency towards improvements in most other domains, which were more pronounced in the exercise group, but not statistically different from control or each other.In a randomized trial in overweight-to-obese and inactive postmenopausal women a comparable 6%-7% weight loss was achieved by diet-only or mainly by exercise and showed improvements in physical and mental HRQoL domains, but results were not statistically significant in either the diet or exercise group. However, a modest weight loss does lead to a positive change in self-perceived health status. This effect was significantly larger with exercise-induced weight loss than with comparable diet-induced weight loss.ClinicalTrials.gov NCT01511276.
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- 2015
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5. Body mass index and cancer risk among adults with and without cardiometabolic diseases: evidence from the EPIC and UK Biobank prospective cohort studies
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Emma Fontvieille, Vivian Viallon, Martina Recalde, Reynalda Cordova, Anna Jansana, Laia Peruchet-Noray, Hannah Lennon, Alicia K. Heath, Dagfinn Aune, Sofia Christakoudi, Verena Katzke, Rudolf Kaaks, Elif Inan-Eroglu, Matthias B. Schulze, Lene Mellemkjær, Anne Tjønneland, Kim Overvad, Marta Farràs, Dafina Petrova, Pilar Amiano, María-Dolores Chirlaque, Conchi Moreno-Iribas, Sandar Tin Tin, Giovanna Masala, Sabina Sieri, Fulvio Ricceri, Salvatore Panico, Anne M. May, Evelyn M. Monninkhof, Elisabete Weiderpass, Marc J. Gunter, Pietro Ferrari, and Heinz Freisling
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Obesity ,Type 2 diabetes ,Cardiovascular diseases ,Comorbidities ,Obesity-related cancers ,Multimorbidity ,Medicine - Abstract
Abstract Background Whether cancer risk associated with a higher body mass index (BMI), a surrogate measure of adiposity, differs among adults with and without cardiovascular diseases (CVD) and/or type 2 diabetes (T2D) is unclear. The primary aim of this study was to evaluate separate and joint associations of BMI and CVD/T2D with the risk of cancer. Methods This is an individual participant data meta-analysis of two prospective cohort studies, the UK Biobank (UKB) and the European Prospective Investigation into Cancer and nutrition (EPIC), with a total of 577,343 adults, free of cancer, T2D, and CVD at recruitment. We used Cox proportional hazard regressions to estimate multivariable-adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) for associations between BMI and incidence of obesity-related cancer and in turn overall cancer with a multiplicative interaction between BMI and the two cardiometabolic diseases (CMD). HRs and 95% CIs for separate and joint associations for categories of overweight/obesity and CMD status were estimated, and additive interaction was quantified through relative excess risk due to interaction (RERI). Results In the meta-analysis of both cohorts, BMI (per ~ 5 kg/m2) was positively associated with the risk of obesity-related cancer among participants without a CMD (HR: 1.11, 95%CI: 1.07,1.16), among participants with T2D (HR: 1.11, 95% CI: 1.05,1.18), among participants with CVD (HR: 1.17, 95% CI: 1.11,1.24), and suggestively positive among those with both T2D and CVD (HR: 1.09, 95% CI: 0.94,1.25). An additive interaction between obesity (BMI ≥ 30 kg/m2) and CVD with the risk of overall cancer translated into a meta-analytical RERI of 0.28 (95% CI: 0.09–0.47). Conclusions Irrespective of CMD status, higher BMI increased the risk of obesity-related cancer among European adults. The additive interaction between obesity and CVD suggests that obesity prevention would translate into a greater cancer risk reduction among population groups with CVD than among the general population.
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- 2023
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6. A body shape index (ABSI) is associated inversely with post-menopausal progesterone-receptor-negative breast cancer risk in a large European cohort
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Sofia Christakoudi, Konstantinos K. Tsilidis, Laure Dossus, Sabina Rinaldi, Elisabete Weiderpass, Christian S. Antoniussen, Christina C. Dahm, Anne Tjønneland, Lene Mellemkjær, Verena Katzke, Rudolf Kaaks, Matthias B. Schulze, Giovanna Masala, Sara Grioni, Salvatore Panico, Rosario Tumino, Carlotta Sacerdote, Anne M. May, Evelyn M. Monninkhof, J. Ramón Quirós, Catalina Bonet, Maria-Jose Sánchez, Pilar Amiano, María-Dolores Chirlaque, Marcela Guevara, Ann H. Rosendahl, Tanja Stocks, Aurora Perez-Cornago, Sandar Tin Tin, Alicia K. Heath, Elom K. Aglago, Laia Peruchet-Noray, Heinz Freisling, and Elio Riboli
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Obesity ,Body shape ,Waist size ,ABSI ,Hip size ,Breast cancer ,Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,RC254-282 - Abstract
Abstract Background Associations of body shape with breast cancer risk, independent of body size, are unclear because waist and hip circumferences are correlated strongly positively with body mass index (BMI). Methods We evaluated body shape with the allometric “a body shape index” (ABSI) and hip index (HI), which compare waist and hip circumferences, correspondingly, among individuals with the same weight and height. We examined associations of ABSI, HI, and BMI (per one standard deviation increment) with breast cancer overall, and according to menopausal status at baseline, age at diagnosis, and oestrogen and progesterone receptor status (ER+/-PR+/-) in multivariable Cox proportional hazards models using data from the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort. Results During a mean follow-up of 14.0 years, 9011 incident breast cancers were diagnosed among 218,276 women. Although there was little evidence for association of ABSI with breast cancer overall (hazard ratio HR = 0.984; 95% confidence interval: 0.961–1.007), we found borderline inverse associations for post-menopausal women (HR = 0.971; 0.942-1.000; n = 5268 cases) and breast cancers diagnosed at age ≥ 55 years (HR = 0.976; 0.951–1.002; n = 7043) and clear inverse associations for ER + PR- subtypes (HR = 0.894; 0.822–0.971; n = 726) and ER-PR- subtypes (HR = 0.906; 0.835–0.983 n = 759). There were no material associations with HI. BMI was associated strongly positively with breast cancer overall (HR = 1.074; 1.049–1.098), for post-menopausal women (HR = 1.117; 1.085–1.150), for cancers diagnosed at age ≥ 55 years (HR = 1.104; 1.076–1.132), and for ER + PR + subtypes (HR = 1.122; 1.080–1.165; n = 3101), but not for PR- subtypes. Conclusions In the EPIC cohort, abdominal obesity evaluated with ABSI was not associated with breast cancer risk overall but was associated inversely with the risk of post-menopausal PR- breast cancer. Our findings require validation in other cohorts and with a larger number of PR- breast cancer cases.
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- 2023
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7. Design of a multinational randomized controlled trial to assess the effects of structured and individualized exercise in patients with metastatic breast cancer on fatigue and quality of life: the EFFECT study
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Anouk E. Hiensch, Evelyn M. Monninkhof, Martina E. Schmidt, Eva M. Zopf, Kate A. Bolam, Neil K. Aaronson, Jon Belloso, Wilhelm Bloch, Dorothea Clauss, Johanna Depenbusch, Milena Lachowicz, Mireia Pelaez, Helene Rundqvist, Elzbieta Senkus, Martijn M. Stuiver, Mark Trevaskis, Ander Urruticoechea, Friederike Rosenberger, Elsken van der Wall, G. Ardine de Wit, Philipp Zimmer, Yvonne Wengström, Karen Steindorf, and Anne M. May
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Exercise ,Fatigue ,Metastatic breast cancer ,Quality of life ,Randomized controlled trial ,Medicine (General) ,R5-920 - Abstract
Abstract Background Many patients with metastatic breast cancer experience cancer- and treatment-related side effects that impair activities of daily living and negatively affect the quality of life. There is a need for interventions that improve quality of life by alleviating fatigue and other side effects during palliative cancer treatment. Beneficial effects of exercise have been observed in the curative setting, but, to date, comparable evidence in patients with metastatic breast cancer is lacking. The aim of this study is to assess the effects of a structured and individualized 9-month exercise intervention in patients with metastatic breast cancer on quality of life, fatigue, and other cancer- and treatment-related side effects. Methods The EFFECT study is a multinational, randomized controlled trial including 350 patients with metastatic breast cancer. Participants are randomly allocated (1:1) to an exercise or control group. The exercise group participates in a 9-month multimodal exercise program, starting with a 6-month period where participants exercise twice a week under the supervision of an exercise professional. After completing this 6-month period, one supervised session is replaced by one unsupervised session for 3 months. In addition, participants are instructed to be physically active for ≥30 min/day on all remaining days of the week, while being supported by an activity tracker and exercise app. Participants allocated to the control group receive standard medical care, general written physical activity advice, and an activity tracker, but no structured exercise program. The primary outcomes are quality of life (EORTC QLQ-C30, summary score) and fatigue (EORTC QLQ-FA12), assessed at baseline, 3, 6 (primary endpoint), and 9 months post-baseline. Secondary outcomes include physical fitness, physical performance, physical activity, anxiety, depression, pain, sleep problems, anthropometric data, body composition, and blood markers. Exploratory outcomes include quality of working life, muscle thickness, urinary incontinence, disease progression, and survival. Additionally, the cost-effectiveness of the exercise program is assessed. Adherence and safety are monitored throughout the intervention period. Discussion This large randomized controlled trial will provide evidence regarding the (cost-) effectiveness of exercise during treatment of metastatic breast cancer. If proven (cost-)effective, exercise should be offered to patients with metastatic breast cancer as part of standard care. Trial registration ClinicalTrials.gov NCT04120298 . Registered on October 9, 2019.
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- 2022
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8. Evaluating the Potential Benefit of a Combined Weight Loss Program in Dogs and Their Owners
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J. Rebecca Niese, Tierney Mepham, Mirjam Nielen, Evelyn M. Monninkhof, Floor M. Kroese, Denise T. D. de Ridder, and Ronald J. Corbee
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canine ,obesity ,weight loss ,human-animal bond ,overweight ,Veterinary medicine ,SF600-1100 - Abstract
Introduction: Little has been published on the psychological bond between the owner and the pet, and how this might influence shared habits that could lead to overweight and obesity. Another factor that could improve the effectiveness of a weight loss plan, is that the owner would see the dog as a weight loss partner and therefore this could increase the motivation to follow the assigned diet and exercise guidelines.Objective: The aim of this research was to evaluate the potential mutual effects of weight loss programs for both dogs and dog owners.Methods: Two studies were conducted: In the human-centered trial, 60 dog owners were enrolled, who signed up to receive dietary and exercise recommendations to lose weight themselves during an 8 week period, from which 29 were randomly assigned to also get recommendations for their dog. For the dog-centered trial, we selected 13 dog owners that wanted their dog to lose weight during a 6 week period, from which 7 were randomly assigned to also get recommendations for themselves. The average weight loss over the time period was recorded. A questionnaire was used to evaluate diet and exercise habits, as well as information about the relationship between the dog and owner.Results: The average human weight loss was 2.6% in the owner+dog group (n = 29) and 2.3% in the owner only group (n = 31; p > 0.05). Forty percent (24/60) of the dogs in the human-centered trial were overweight. The overweight dogs in the owner+dog group (n = 12/29) lost 3.7% of their body weight, compared to 1.2% in the overweight dogs from the owner only group (n = 12/31; p > 0.05). In the dog-centered trial, the 7 dogs in the dog+owner group lost 8.0% of their body weight, vs. 8.3% in the six dogs in the dog only group (p > 0.05). The owners in the dog+owner group lost 2.5% of their body weight, compared to 0.5% in the dog only group (p > 0.05). In both trials owners' perceived responsibility for both their own and their dogs' weight significantly increased. In addition, habit strength regarding unhealthy feeding and exercise behaviors in relation to the dogs decreased, and self-efficacy in relation to providing the dog with healthy food and exercise increased.Conclusion: Active weight loss in either dog owner or dog, seemed to lead to passive weight loss in the other, especially when some tools or guidelines were provided. These findings support mutual benefits of weight loss programs for dogs and dog owners, and support future weight loss programs to be a One Health approach.
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- 2021
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9. Effect of exercise and/or reduced calorie dietary interventions on breast cancer-related endogenous sex hormones in healthy postmenopausal women
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Martijn de Roon, Anne M. May, Anne McTiernan, Rob J. P. M. Scholten, Petra H. M. Peeters, Christine M. Friedenreich, and Evelyn M. Monninkhof
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Breast cancer ,Postmenopausal women ,Exercise ,Caloric restriction ,Prevention ,Sex hormones ,Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,RC254-282 - Abstract
Abstract Background Physical inactivity and being overweight are modifiable lifestyle risk factors that consistently have been associated with a higher risk of postmenopausal breast cancer in observational studies. One biologic hypothesis underlying this relationship may be via endogenous sex hormone levels. It is unclear if changes in dietary intake, physical activity, or both, are most effective in changing these hormone levels. Objective This systematic review and meta-analysis examines the effect of reduced caloric dietary intake and/or increased exercise levels on breast cancer-related endogenous sex hormones. Methods We conducted a systematic literature search in MEDLINE, Embase, and Cochrane’s Central Register of Controlled Trials (CENTRAL) up to March 2017. Main outcome measures were breast cancer-related endogenous sex hormones. Randomized controlled trials (RCTs) reporting effects of reduced caloric intake and/or exercise interventions on endogenous sex hormones in healthy, physically inactive postmenopausal women were included. Studies including women using hormone therapy were excluded. The methodological quality of each study was assessed by the Cochrane’s risk of bias tool. Results From the 2599 articles retrieved, seven articles from six RCTs were included in this meta-analysis. These trials investigated 1588 healthy postmenopausal women with a mean age ranging from 58 to 61 years. A combined intervention of reduced caloric intake and exercise, with durations ranging from 16 to 52 weeks, compared with a control group (without an intervention to achieve weight loss) resulted in the largest beneficial effects on estrone treatment effect ratio (TER) = 0.90 (95% confidence interval (CI) = 0.83–0.97), total estradiol TER = 0.82 (0.75–0.90), free estradiol TER = 0.73 (0.66–0.81), free testosterone TER = 0.86 (0.79–0.93), and sex hormone biding globulin (SHBG) TER = 1.23 (1.15–1.31). A reduced caloric intake without an exercise intervention resulted in significant effects compared with control on total estradiol TER = 0.86 (0.77–0.95), free estradiol TER = 0.77 (0.69–0.84), free testosterone TER = 0.91 (0.84–0.98), and SHBG TER = 1.20 (1.06–1.36). Exercise without dietary change, versus control, resulted in borderline significant effects on androstenedione TER = 0.97 (0.94–1.00), total estradiol TER = 0. 97 (0.94–1.00), and free testosterone TER = 0. 0.97 (0.95–1.00). Conclusions and relevance This meta-analysis of six RCTs demonstrated that there are beneficial effects of exercise, reduced caloric dietary intake or, preferably, a combination of exercise and diet on breast cancer-related endogenous sex hormones in physically inactive postmenopausal women.
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- 2018
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10. Data from Prolactin Determinants in Healthy Women: A Large Cross-Sectional Study within the EPIC Cohort
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Rudolf Kaaks, Elio Riboli, Marc J. Gunter, Ruth C. Travis, Timothy J. Key, Kay-Tee Khaw, Marit Waaseth, Eiliv Lund, Elisabete Weiderpass, Eva Lundin, Annika Idahl, N. Charlotte Onland-Moret, Evelyn M. Monninkhof, H. Bas Bueno-de-Mesquita, Aurelio Barricarte, José María Huerta Castaño, Pilar Amiano, Esther Molina-Montes, Soledad Sánchez, Genevieve Buckland, Amalia Mattiello, Carlotta Sacerdote, Rosario Tumino, Claudia Agnoli, Giovanna Masala, Dimitrios Trichopoulos, Pagona Lagiou, Antonia Trichopoulou, Heiner Boeing, Isabelle Romieu, Sabina Rinaldi, Laura Baglietto, Kim Overvad, Anja Olsen, Anne Tjønneland, Françoise Clavel-Chapelon, Laure Dossus, Theron Johnson, Disorn Sookthai, and Kaja Tikk
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Background: Experimental and epidemiologic data suggest that higher circulating prolactin is associated with breast cancer risk; however, how various risk factors for breast cancer influence prolactin levels in healthy women is not clear.Methods: We analyzed cross-sectional associations between several suggested reproductive and lifestyle risk factors for breast cancer and circulating prolactin among pre- and postmenopausal women, taking into account the use of current postmenopausal hormone therapy, among 2,560 controls from a breast cancer nested case–control study within the EPIC cohort.Results: Adjusted geometric mean prolactin levels were significantly higher among premenopausal women, and among postmenopausal women using hormone therapy compared with nonusers (8.2, 7.0, and 6.3 ng/mL, respectively; Pcat = Pcat = 0.001). Prolactin levels were lower among parous women compared with nulliparous women (8.61 vs. 10.95 ng/mL; Pcat = 0.0002, premenopausal women); the magnitude of this difference depended on the number of full-term pregnancies (22.1% lower, ≥3 vs. 1 pregnancy, Ptrend = 0.01). Results for parity were similar but lower in magnitude among postmenopausal women. Prolactin did not vary by other studied factors, with the exception of lower levels among postmenopausal smokers compared with never smokers.Conclusions: Our study shows that current hormone therapy use, especially the use of combined hormone therapy, is associated with higher circulating prolactin levels in postmenopausal women, and confirms prior findings of lower circulating prolactin in parous women.Impact: Our study extends the knowledge linking various breast cancer risk factors with circulating prolactin. Cancer Epidemiol Biomarkers Prev; 23(11); 2532–42. ©2014 AACR.
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- 2023
11. Supplementary Tables S1-S3 from Prolactin Determinants in Healthy Women: A Large Cross-Sectional Study within the EPIC Cohort
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Rudolf Kaaks, Elio Riboli, Marc J. Gunter, Ruth C. Travis, Timothy J. Key, Kay-Tee Khaw, Marit Waaseth, Eiliv Lund, Elisabete Weiderpass, Eva Lundin, Annika Idahl, N. Charlotte Onland-Moret, Evelyn M. Monninkhof, H. Bas Bueno-de-Mesquita, Aurelio Barricarte, José María Huerta Castaño, Pilar Amiano, Esther Molina-Montes, Soledad Sánchez, Genevieve Buckland, Amalia Mattiello, Carlotta Sacerdote, Rosario Tumino, Claudia Agnoli, Giovanna Masala, Dimitrios Trichopoulos, Pagona Lagiou, Antonia Trichopoulou, Heiner Boeing, Isabelle Romieu, Sabina Rinaldi, Laura Baglietto, Kim Overvad, Anja Olsen, Anne Tjønneland, Françoise Clavel-Chapelon, Laure Dossus, Theron Johnson, Disorn Sookthai, and Kaja Tikk
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Supplementary Table S1. Adjusteda geometric mean prolactin levels, ng/ml (95% CI) by established correlates at the time of blood donation. Supplementary Table S2. Adjusteda geometric mean prolactin levels, ng/ml (95% CI) depending on the anthropometric factors. Supplementary Table S3. Adjusteda geometric mean prolactin levels, ng/ml (95% CI) depending on the lifestyle factors.
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- 2023
12. Supplementary Material from Effect of Exercise on Insulin Sensitivity in Healthy Postmenopausal Women: The SHAPE Study
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Albertine J. Schuit, Petra H. Peeters, Anne M. May, Evelyn M. Monninkhof, and Willemijn A. van Gemert
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Supplementary Material: Exercise programme of the SHAPE study
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- 2023
13. Data from Effect of Exercise on Insulin Sensitivity in Healthy Postmenopausal Women: The SHAPE Study
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Albertine J. Schuit, Petra H. Peeters, Anne M. May, Evelyn M. Monninkhof, and Willemijn A. van Gemert
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Background: An inactive lifestyle is a risk factor for several types of cancer. A proposed pathway through which exercise influences cancer risk is via insulin. We aim to investigate the effect of a one-year exercise intervention on insulin sensitivity, and the role of body fat in this association, in healthy, normal to overweight/obese, postmenopausal women.Methods: In the Sex Hormones And Physical Exercise (SHAPE) study, 189 healthy, inactive and postmenopausal women [ages, 50–69 years; body mass index (BMI), 22–40 kg/m2] were randomly assigned to a one-year aerobic and strength exercise intervention (150 min/wk), or a control group. Between-group differences in fasting insulin, glucose, and homeostatic model assessment of insulin resistance (HOMA2) over time were estimated using linear mixed models.Results: Follow-up measurements of insulin sensitivity were available for 181 (95.8%) and 182 (96.3%) women at 4 and 12 months, respectively. The intention-to-treat analysis showed no significant differences between the two study groups [treatment effect ratio of the exercise group vs. control (β; 95% confidence interval): insulin, β, 1.07 (0.96–1.19); glucose, β, 1.01 (0.99–1.02); and HOMA2, β, 1.07 (0.96–1.20)]. Similar results were found in a per protocol analysis in compliant women, and in a subgroup of women who lost >2% body fat [measured by dual-energy X-ray absorptiometry (DEXA)].Conclusions: Participation in a one-year aerobic and strength exercise intervention program did not result in changes in insulin sensitivity in healthy postmenopausal and inactive women.Impact: Our findings suggest that 150 min/wk of exercise, as recommended by current guidelines, is not enough to achieve improvements in insulin sensitivity and subsequent cancer risk, in healthy postmenopausal women. Cancer Epidemiol Biomarkers Prev; 24(1); 81–87. ©2014 AACR.
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- 2023
14. Lifestyle correlates of eight breast cancer-related metabolites: a cross-sectional study within the EPIC cohort
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Mathilde His, Vivian Viallon, Laure Dossus, Julie A. Schmidt, Ruth C. Travis, Marc J. Gunter, Kim Overvad, Cecilie Kyrø, Anne Tjønneland, Lucie Lécuyer, Joseph A. Rothwell, Gianluca Severi, Theron Johnson, Verena Katzke, Matthias B. Schulze, Giovanna Masala, Sabina Sieri, Salvatore Panico, Rosario Tumino, Alessandra Macciotta, Jolanda M. A. Boer, Evelyn M. Monninkhof, Karina Standahl Olsen, Therese H. Nøst, Torkjel M. Sandanger, Antonio Agudo, Maria-Jose Sánchez, Pilar Amiano, Sandra M. Colorado-Yohar, Eva Ardanaz, Linda Vidman, Anna Winkvist, Alicia K. Heath, Elisabete Weiderpass, Inge Huybrechts, Sabina Rinaldi, International Agency for Cancer Research (IACR), University of Oxford, Aarhus University [Aarhus], Danish Cancer Society Research Center [Copenhagen, Denmark] (DCSRC), University of Copenhagen = Københavns Universitet (UCPH), Centre de recherche en épidémiologie et santé des populations (CESP), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris-Saclay, Università degli Studi di Firenze = University of Florence (UniFI), Molecular Genetics of Breast Cancer, German Cancer Research Center (DKFZ), German Cancer Research Center - Deutsches Krebsforschungszentrum [Heidelberg] (DKFZ), German Institute of Human Nutrition Potsdam-Rehbruecke [Nuthetal, Germany] (GIHNP-R), University of Potsdam = Universität Potsdam, Istituto per lo Studio, la Prevenzione e la rete Oncologica [Florence, Italy] (ISPRO), IRCCS Istituto Nazionale dei Tumori [Milano], University of Naples Federico II = Università degli studi di Napoli Federico II, Provincial Health Authority (ASP 7) [Ragusa, Italy], Università degli studi di Torino = University of Turin (UNITO), National Institute for Public Health and the Environment [Bilthoven] (RIVM), University Medical Center [Utrecht], The Arctic University of Norway [Tromsø, Norway] (UiT), Catalan Institute of Oncology [Barcelone, Espagne], L’Hospitalet de Llobregat [Barcelona, Spain], Escuela Andaluza de Salud Pública [Granada, Spain] (EASP), Universidad de Granada = University of Granada (UGR), CIBER de Epidemiología y Salud Pública (CIBERESP), Public Health Division of Gipuzkoa, Basque Government, CIBER en Salud Pública, CIBERSP, Biodonostia Health Research Institute [Donostia-San Sebastian, Spain] (IIS Biodonostia), Murcia Regional Health Council [Murcia], Universidad de Antioquia = University of Antioquia [Medellín, Colombia], Navarra Public Health Institute, Umeå University, Imperial College London, Kræftens Bekæmpelse, DCS, Deutsches Krebsforschungszentrum, DKFZ, Centre International de Recherche sur le Cancer, CIRC, National Research Council, NRC, University of Maryland School of Public Health, SPH, Cancer Research UK, CRUK, World Cancer Research Fund, WCRF, University of Cambridge, Institut National de la Santé et de la Recherche Médicale, Inserm, Bundesministerium für Bildung und Forschung, BMBF, Cancerfonden, Ministerie van Volksgezondheid, Welzijn en Sport, VWS, Fondation ARC pour la Recherche sur le Cancer, ARC, Ligue Contre le Cancer, Vetenskapsrådet, VR, Instituto de Salud Carlos III, ISCIII, Associazione Italiana per la Ricerca sul Cancro, AIRC, Deutsche Krebshilfe, Institut National Du Cancer, INCa: 2015-166, Institut Gustave-Roussy, Mutuelle Générale de l'Education Nationale, MGEN, NIHR Imperial Biomedical Research Centre, BRC, The national cohorts are supported by Danish Cancer Society (Denmark), Ligue Contre le Cancer, Institut Gustave Roussy, Mutuelle Générale de l’Education Nationale, Institut National de la Santé et de la Recherche Médicale (INSERM) (France), German Cancer Aid, German Cancer Research Center (DKFZ), German Institute of Human Nutrition Potsdam-Rehbruecke (DIfE), Federal Ministry of Education and Research (BMBF) (Germany), Associazione Italiana per la Ricerca sul Cancro-AIRC-Italy, Compagnia di SanPaolo and National Research Council (Italy), Dutch Ministry of Public Health, Welfare and Sports (VWS), LK Research Funds, Dutch Prevention Funds, Dutch ZON (Zorg Onderzoek Nederland), World Cancer Research Fund (WCRF) (The Netherlands), Health Research Fund (FIS) - Instituto de Salud Carlos III (ISCIII), Regional Governments of Andalucía, Asturias, Basque Country, Murcia and Navarra, and the Catalan Institute of Oncology - ICO (Spain), Swedish Cancer Society, Swedish Research Council and County Councils of Skåne and Västerbotten (Sweden), and Cancer Research UK (14136 to EPIC-Norfolk (DOI 10.22025/2019.10.105.00004), C8221/A29017 to EPIC-Oxford), Medical Research Council (1000143, MR/N003284/1, MC-UU_12015/1 and MC_UU_00006/1 to EPIC-Norfolk, MR/M012190/1 to EPIC-Oxford) (UK). The funders were not involved in designing the study, collecting, analyzing, or interpreting the data, or writing or submitting the manuscript for publication., The coordination of EPIC is financially supported by International Agency for Research on Cancer (IARC) and also by the Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, which has additional infrastructure support provided by the NIHR Imperial Biomedical Research Centre (BRC)., This work was funded by the French National Cancer Institute (grant number 2015-166). Mathilde His’ work reported here was undertaken during the tenure of a postdoctoral fellowship awarded by the International Agency for Research on Cancer, financed by the Fondation ARC., The authors would like to thank Mr Bertrand Hemon for his support in preparing the databases, Ms Audrey Gicquiau and Dr David Achaintre for the analyses of samples in several of the original studies, and all EPIC participants. The EPIC-Norfolk team thank all the participants who have been part of the project and the many members of the study teams at the University of Cambridge who have enabled this research. Where authors are identified as personnel of the International Agency for Research on Cancer/World Health Organization, the authors alone are responsible for the views expressed in this article and they do not necessarily represent the decisions, policy, or views of the International Agency for Research on Cancer/World Health Organization., and HAL UVSQ, Équipe
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cross-sectional ,lifestyle ,Estils de vida ,BIOMARKERS ,Lifestyles ,Breast Neoplasms ,[SDV.CAN]Life Sciences [q-bio]/Cancer ,DIET ,SERUM ,Càncer de mama ,Cohort Studies ,Medicine, General & Internal ,Breast cancer ,[SDV.CAN] Life Sciences [q-bio]/Cancer ,Risk Factors ,Cross-sectional ,General & Internal Medicine ,Metabolites ,Humans ,Metabolomics ,Prospective Studies ,VALIDITY ,Life Style ,11 Medical and Health Sciences ,metabolites ,RISK ,Cancer och onkologi ,Science & Technology ,anthropometry ,Anthropometry ,Public Health, Global Health, Social Medicine and Epidemiology ,General Medicine ,PROFILES ,Lifestyle ,AMINO-ACID ,BODY-MASS INDEX ,Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi ,PHYSICAL-ACTIVITY ,Cross-Sectional Studies ,Metabolòmica ,[SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie ,Cancer and Oncology ,TARGETED METABOLOMICS ,Medicine ,Female ,[SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie ,Life Sciences & Biomedicine ,Research Article - Abstract
This work was funded by the French National Cancer Institute (grant number 2015-166). Mathilde His' work reported here was undertaken during the tenure of a postdoctoral fellowship awarded by the International Agency for Research on Cancer, financed by the Fondation ARC. The coordination of EPIC is financially supported by International Agency for Research on Cancer (IARC) and also by the Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, which has additional infrastructure support provided by the NIHR Imperial Biomedical Research Centre (BRC). The national cohorts are supported by Danish Cancer Society (Denmark); Ligue Contre le Cancer, Institut Gustave Roussy, Mutuelle Generale de l'Education Nationale, Institut National de la Sante et de la Recherche Medicale (INSERM) (France); German Cancer Aid, German Cancer Research Center (DKFZ), German Institute of Human Nutrition Potsdam-Rehbruecke (DIfE), Federal Ministry of Education and Research (BMBF) (Germany); Associazione Italiana per la Ricerca sul Cancro-AIRC-Italy, Compagnia di SanPaolo and National Research Council (Italy); Dutch Ministry of Public Health, Welfare and Sports (VWS), LK Research Funds, Dutch Prevention Funds, Dutch ZON (Zorg Onderzoek Nederland), World Cancer Research Fund (WCRF) (The Netherlands); Health Research Fund (FIS) - Instituto de Salud Carlos III (ISCIII), Regional Governments of Andalucia, Asturias, Basque Country, Murcia and Navarra, and the Catalan Institute of Oncology-ICO (Spain); Swedish Cancer Society, Swedish Research Council and County Councils of Skane and Vasterbotten (Sweden); and Cancer Research UK (14136 to EPIC-Norfolk (DOI 10.22025/2019.10.105.00004); C8221/A29017 to EPIC-Oxford), Medical Research Council (1000143, MR/N003284/1, MC-UU_12015/1 and MC_UU_00006/1 to EPIC-Norfolk; MR/M012190/1 to EPIC-Oxford) (UK). The funders were not involved in designing the study; collecting, analyzing, or interpreting the data; or writing or submitting the manuscript for publication., Background: Metabolomics is a promising molecular tool for identifying novel etiological pathways leading to cancer. In an earlier prospective study among pre- and postmenopausal women not using exogenous hormones, we observed a higher risk of breast cancer associated with higher blood concentrations of one metabolite (acetylcarnitine) and a lower risk associated with higher blood concentrations of seven others (arginine, asparagine, phosphatidylcholines (PCs) aa C36:3, ae C34:2, ae C36:2, ae C36:3, and ae C38:2). Methods: To identify determinants of these breast cancer-related metabolites, we conducted a cross-sectional analysis to identify their lifestyle and anthropometric correlates in 2358 women, who were previously included as controls in case-control studies nested within the European Prospective Investigation into Cancer and Nutrition cohort and not using exogenous hormones at blood collection. Associations of each metabolite concentration with 42 variables were assessed using linear regression models in a discovery set of 1572 participants. Significant associations were evaluated in a validation set (n = 786). Results: For the metabolites previously associated with a lower risk of breast cancer, concentrations of PCs ae C34: 2, C36:2, C36:3, and C38:2 were negatively associated with adiposity and positively associated with total and saturated fat intakes. PC ae C36:2 was also negatively associated with alcohol consumption and positively associated with two scores reflecting adherence to a healthy lifestyle. Asparagine concentration was negatively associated with adiposity. Arginine and PC aa C36:3 concentrations were not associated to any of the factors examined. For the metabolite previously associated with a higher risk of breast cancer, acetylcarnitine, a positive association with age was observed. Conclusions: These associations may indicate possible mechanisms underlying associations between lifestyle and anthropometric factors, and risk of breast cancer. Further research is needed to identify potential non-lifestyle correlates of the metabolites investigated., Institut National du Cancer (INCA) France 2015-166, International Agency for Research on Cancer - Fondation ARC, World Health Organization, Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, Danish Cancer Society, Ligue Contre le Cancer (France), Institut Gustave Roussy (France), Mutuelle Generale de l'Education Nationale (France), Institut National de la Sante et de la Recherche Medicale (Inserm), Deutsche Krebshilfe, German Cancer Research Center (DKFZ) (Germany), German Institute of Human Nutrition Potsdam-Rehbruecke (DIfE) (Germany), Federal Ministry of Education & Research (BMBF), Fondazione AIRC per la ricerca sul cancro, Compagnia di San Paolo, Consiglio Nazionale delle Ricerche (CNR), Netherlands Government, World Cancer Research Fund International (WCRF), Health Research Fund (FIS) - Instituto de Salud Carlos III (ISCIII) (Spain), Junta de Andalucia, Regional Government of Asturias (Spain), Regional Government of Basque Country (Spain), Regional Government of Murcia (Spain), Regional Government of Navarra (Spain), Catalan Institute of Oncology-ICO (Spain), Swedish Cancer Society, Swedish Research Council, County Council of Skane (Sweden), County Council of Vasterbotten (Sweden), Cancer Research UK 14136 C8221/A29017, UK Research & Innovation (UKRI), Medical Research Council UK (MRC) 1000143 MR/N003284/1 MC-UU_12015/1 MC_UU_00006/1 MR/M012190/1
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- 2021
15. The course of swallowing problems in the first 2 years after diagnosis of head and neck cancer
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Jorine A. Vermaire, Cornelis P. J. Raaijmakers, Evelyn M. Monninkhof, C. René Leemans, Robert J. Baatenburg de Jong, Robert P. Takes, Irma M. Verdonck-de Leeuw, Femke Jansen, Johannes A. Langendijk, Chris H. J. Terhaard, Caroline M. Speksnijder, Clinical Psychology, APH - Mental Health, Otolaryngology / Head & Neck Surgery, CCA - Cancer Treatment and quality of life, APH - Personalized Medicine, Guided Treatment in Optimal Selected Cancer Patients (GUTS), Damage and Repair in Cancer Development and Cancer Treatment (DARE), and Otorhinolaryngology and Head and Neck Surgery
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Linear mixed-effects model ,Oncology ,SDG 3 - Good Health and Well-being ,Oral function ,SWAL-QOL ,Swallowing ,Head and neck cancer ,Rare cancers Radboud Institute for Health Sciences [Radboudumc 9] - Abstract
Introduction Head and neck cancer (HNC) and its treatment often negatively impact swallowing function. The aim was to investigate the course of patient-reported swallowing problems from diagnosis to 3, 6, 12, and 24 months after treatment, in relation to demographic, clinical, and lifestyle factors. Methods Data were used of the Netherlands Quality of Life and Biomedical Cohort Study in head and neck cancer research (NET-QUBIC). The primary outcome measures were the subscales of the Swallowing Quality of Life Questionnaire (SWAL-QOL). Linear mixed-effects models (LMM) were conducted to investigate changes over time and associations with patient, clinical, and lifestyle parameters as assessed at baseline. Results Data were available of 603 patients. There was a significant change over time on all subscales. Before treatment, 53% of patients reported swallowing problems. This number increased to 70% at M3 and decreased to 59% at M6, 50% at M12, and 48% at M24. Swallowing problems (i.e., longer eating duration) were more pronounced in the case of female, current smoking, weight loss prior to treatment, and stage III or IV tumor, and were more prevalent at 3 to 6 months after treatment. Especially patients with an oropharynx and oral cavity tumor, and patients receiving (C)RT following surgery or CRT only showed a longer eating duration after treatment, which did not return to baseline levels. Conclusion Half of the patients with HNC report swallowing problems before treatment. Eating duration was associated with sex, smoking, weight loss, tumor site and stage, and treatment modality, and was more pronounced 3 to 6 months after treatment.
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- 2022
16. Changes in lifestyle and risk of colorectal cancer in the European Prospective Investigation into Cancer and Nutrition
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Edoardo Botteri, Giulia Peveri, Paula Berstad, Vincenzo Bagnardi, Sairah L.F. Chen, Torkjel M. Sandanger, Geir Hoff, Christina C. Dahm, Christian S. Antoniussen, Anne Tjønneland, Anne Kirstine Eriksen, Guri Skeie, Aurora Perez-Cornago, José María Huerta, Paula Jakszyn, Sophia Harlid, Björn Sundström, Aurelio Barricarte, Evelyn M. Monninkhof, Jeroen W.G. Derksen, Matthias B. Schulze, Bas Bueno-de-Mesquita, Maria-Jose Sánchez, Amanda J. Cross, Konstantinos K. Tsilidis, Maria Santucci De Magistris, Rudolf Kaaks, Verena Katzke, Joseph A. Rothwell, Nasser Laouali, Gianluca Severi, Pilar Amiano, Paolo Contiero, Carlotta Sacerdote, Marcel Goldberg, Mathilde Touvier, Heinz Freisling, Vivian Viallon, Elisabete Weiderpass, Elio Riboli, Marc J. Gunter, Mazda Jenab, Pietro Ferrari, Botteri, E, Peveri, G, Berstad, P, Bagnardi, V, Chen, S, Sandanger, T, Hoff, G, Dahm, C, Antoniussen, C, Tjonneland, A, Eriksen, A, Skeie, G, Perez-Cornago, A, Huerta, J, Jakszyn, P, Harlid, S, Sundstrom, B, Barricarte, A, Monninkhof, E, Derksen, J, Schulze, M, Bueno-De-Mesquita, B, Sanchez, M, Cross, A, Tsilidis, K, De Magistris, M, Kaaks, R, Katzke, V, Rothwell, J, Laouali, N, Severi, G, Amiano, P, Contiero, P, Sacerdote, C, Goldberg, M, Touvier, M, Freisling, H, Viallon, V, Weiderpass, E, Riboli, E, Gunter, M, Jenab, M, and Ferrari, P
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lifestyle ,Hepatology ,alcohol ,Gastroenterology ,Nutritional Status ,colorectal cancer ,smoking ,Settore MED/01 - Statistica Medica ,nutrition ,Risk Factors ,Humans ,Prospective Studies ,Life Style ,Colorectal Neoplasms/epidemiology - Abstract
Introduction: We investigated the impact of changes in lifestyle habits on colorectal cancer (CRC) risk in a multi-country European cohort. Methods: We used baseline and follow-up questionnaire data from the EPIC cohort to assess changes in lifestyle habits and their associations with CRC development. We calculated a healthy lifestyle index (HLI) score based on smoking status, alcohol consumption, body mass index and physical activity collected at the two timepoints. HLI ranged from 0 (most unfavourable) to 16 (most favourable). We estimated the association between HLI changes and CRC risk using Cox regression models and reported hazard ratios (HR) with 95% confidence intervals (CI). Results: Among 295,865 participants, 2,799 CRC cases were observed over a median of 7.8 years. Median time between questionnaires was 5.7 years. Each unit increase in HLI from the baseline to the follow-up assessment was associated with a statistically significant 3% lower CRC risk. Among participants in the top tertile at baseline (HLI>11), those in the bottom tertile at follow-up (HLI≤9) had a higher CRC risk (HR 1.34; 95%CI 1.02-1.75) than those remaining in the top tertile. Among individuals in the bottom tertile at baseline, those in the top tertile at follow-up had a lower risk (HR 0.77; 95%CI 0.59-1.00) than those remaining in the bottom tertile. Discussion: Improving adherence to a healthy lifestyle was inversely associated with CRC risk, while worsening adherence was positively associated with CRC risk. These results justify and support recommendations for healthy lifestyle changes and healthy lifestyle maintenance for CRC prevention.
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- 2022
17. Clinical Trial Protocol for PSMA-SELECT: A Dutch National Randomised Study of Prostate-specific Membrane Antigen Positron Emission Tomography/Computed Tomography as a Triage Tool for Pelvic Lymph Node Dissection in Patients Undergoing Radical Prostatectomy
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Timo F.W. Soeterik, Lieke Wever, Lea M. Dijksman, Geert W.J. Frederix, Harm H.E. Van Melick, Evelyn M. Monninkhof, Helena M. Verkooijen, Harrie P. Beerlage, Jean-Paul A. van Basten, Roderick C.N. van den Bergh, and Urology
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Male ,Prostatectomy ,Urology ,Positron Emission Tomography Computed Tomography ,Prostate ,Humans ,Lymph Node Excision ,Triage ,Randomized Controlled Trials as Topic - Published
- 2022
18. What is the prevalence of fear of cancer recurrence in cancer survivors and patients?:A systematic review and individual participant data meta-analysis
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Yvonne L. Luigjes‐Huizer, Nina M. Tauber, Gerry Humphris, Nadine A. Kasparian, Wendy W. T. Lam, Sophie Lebel, Sébastien Simard, Allan Ben Smith, Robert Zachariae, Yati Afiyanti, Katy J. L. Bell, José A. E. Custers, Niek J. de Wit, Peter L. Fisher, Jacqueline Galica, Sheila N. Garland, Charles W. Helsper, Mette M. Jeppesen, Jianlin Liu, Roxana Mititelu, Evelyn M. Monninkhof, Lahiru Russell, Josée Savard, Anne E. M. Speckens, Sanne J. van Helmondt, Sina Vatandoust, Nicholas Zdenkowski, Marije L. van der Lee, and Medical and Clinical Psychology
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Male ,Adult ,FEASIBILITY ,prevalence ,Stress-related disorders Donders Center for Medical Neuroscience [Radboudumc 13] ,INVENTORY ,Experimental and Cognitive Psychology ,chemical and pharmacologic phenomena ,MELANOMA ,PROGRESSION ,VALIDATION ,1117 Public Health and Health Services ,Cancer Survivors ,QUALITY-OF-LIFE ,BREAST-CANCER ,cancer ,Humans ,VERSION ,Neoplasm Recurrence, Local/epidemiology ,correlates ,Fear ,COGNITIVE-BEHAVIOR THERAPY ,Women's cancers Radboud Institute for Health Sciences [Radboudumc 17] ,Psychiatry and Mental health ,fear of recurrence ,Phobic Disorders ,oncology ,CLINICAL-LEVELS ,Female ,Neoplasm Recurrence, Local - Abstract
Contains fulltext : 288352.pdf (Publisher’s version ) (Open Access) OBJECTIVE: Care for fear of cancer recurrence (FCR) is considered the most common unmet need among cancer survivors. Yet the prevalence of FCR and predisposing factors remain inconclusive. To support targeted care, we provide a comprehensive overview of the prevalence and severity of FCR among cancer survivors and patients, as measured using the short form of the validated Fear of Cancer Recurrence Inventory (FCRI-SF). We also report on associations between FCR and clinical and demographic characteristics. METHODS: This is a systematic review and individual participant data (IPD) meta-analysis on the prevalence of FCR. In the review, we included all studies that used the FCRI-SF with adult (≥18 years) cancer survivors and patients. Date of search: 7 February 2020. Risk of bias was assessed using the Joanna Briggs Institute critical appraisal tool. RESULTS: IPD were requested from 87 unique studies and provided for 46 studies comprising 11,226 participants from 13 countries. 9311 respondents were included for the main analyses. On the FCRI-SF (range 0-36), 58.8% of respondents scored ≥13, 45.1% scored ≥16 and 19.2% scored ≥22. FCR decreased with age and women reported more FCR than men. FCR was found across cancer types and continents and for all time periods since cancer diagnosis. CONCLUSIONS: FCR affects a considerable number of cancer survivors and patients. It is therefore important that healthcare providers discuss this issue with their patients and provide treatment when needed. Further research is needed to investigate how best to prevent and treat FCR and to identify other factors associated with FCR. The protocol was prospectively registered (PROSPERO CRD42020142185).
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- 2022
19. The course of swallowing problems in the first 2 years after diagnosis of head and neck cancer
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Jorine A, Vermaire, Cornelis P J, Raaijmakers, Evelyn M, Monninkhof, C René, Leemans, Robert J Baatenburg, de Jong, Robert P, Takes, Irma M Verdonck-de, Leeuw, Femke, Jansen, Johannes A, Langendijk, Chris H J, Terhaard, and Caroline M, Speksnijder
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Cohort Studies ,Head and Neck Neoplasms ,Weight Loss ,Quality of Life ,Humans ,Female ,Deglutition Disorders ,Deglutition - Abstract
Head and neck cancer (HNC) and its treatment often negatively impact swallowing function. The aim was to investigate the course of patient-reported swallowing problems from diagnosis to 3, 6, 12, and 24 months after treatment, in relation to demographic, clinical, and lifestyle factors.Data were used of the Netherlands Quality of Life and Biomedical Cohort Study in head and neck cancer research (NET-QUBIC). The primary outcome measures were the subscales of the Swallowing Quality of Life Questionnaire (SWAL-QOL). Linear mixed-effects models (LMM) were conducted to investigate changes over time and associations with patient, clinical, and lifestyle parameters as assessed at baseline.Data were available of 603 patients. There was a significant change over time on all subscales. Before treatment, 53% of patients reported swallowing problems. This number increased to 70% at M3 and decreased to 59% at M6, 50% at M12, and 48% at M24. Swallowing problems (i.e., longer eating duration) were more pronounced in the case of female, current smoking, weight loss prior to treatment, and stage III or IV tumor, and were more prevalent at 3 to 6 months after treatment. Especially patients with an oropharynx and oral cavity tumor, and patients receiving (C)RT following surgery or CRT only showed a longer eating duration after treatment, which did not return to baseline levels.Half of the patients with HNC report swallowing problems before treatment. Eating duration was associated with sex, smoking, weight loss, tumor site and stage, and treatment modality, and was more pronounced 3 to 6 months after treatment.
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- 2022
20. Factors associated with masticatory function as measured with the Mixing Ability Test in patients with head and neck cancer before and after treatment: a prospective cohort study
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Jorine A. Vermaire, Cornelis P. J. Raaijmakers, Evelyn M. Monninkhof, Irma M. Verdonck-de Leeuw, Chris H. J. Terhaard, Caroline M. Speksnijder, CCA - Cancer Treatment and quality of life, APH - Personalized Medicine, APH - Mental Health, and Otolaryngology / Head & Neck Surgery
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Oncology ,Head and Neck Neoplasms ,Humans ,Mastication ,Prospective Studies - Abstract
Purpose After treatment for head and neck cancer (HNC), patients often experience major problems in masticatory function. The aim of this prospective cohort study among patients with HNC was to investigate which personal and clinical factors are associated with masticatory function from diagnosis up to 2 years after treatment with curative intent. Methods Masticatory function was measured using the Mixing Ability Test (MAT) before treatment (baseline), and 3, 6, 12, and 24 months after treatment. A linear mixed-effects model with a random intercept and slope was conducted to investigate changes over time and the association with personal (sex, age) and clinical (tumor site, tumor stage, treatment modality) factors as measured at baseline. Result One-hundred-twenty-five patients were included. The prevalence of masticatory dysfunction was estimated at 29% at M0, 38% at M3, 28% at M6, 26% at M12, and 36% at M24. A higher (worse) MAT score was associated with age, tumor stage, tumor site, timing of assessment, and the interaction between assessment moment and tumor site. Conclusion In patients with HNC, masticatory function changed over time and dysfunction was associated with a higher age, a tumor in the oral cavity, a higher tumor stage, and a shorter time since treatment. The prevalence of masticatory dysfunction ranged from 26 to 38%.
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- 2022
21. OC-0511 Urethra and bladder dose-effect relations for genitourinary toxicity after EBRT for prostate cancer
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Sofie Isebaert, Robert Jan Smeenk, M. Kunze-Busch, Evelyn M. Monninkhof, V. Groen, K. Haustermans, Nicolaas P.A. Zuithoff, Helena M. Verkooijen, Floris J. Pos, M. Van Schie, J. Van der Voort van Zijp, J. de Boer, U.A. Van der Heide, Cédric Draulans, and Linda G W Kerkmeijer
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medicine.medical_specialty ,business.industry ,Genitourinary system ,Urology ,Hematology ,medicine.disease ,Prostate cancer ,Urethra ,medicine.anatomical_structure ,Oncology ,Toxicity ,medicine ,Dose effect ,Radiology, Nuclear Medicine and imaging ,business - Published
- 2021
22. Focal Boost to the Intraprostatic Tumor in External Beam Radiotherapy for Patients With Localized Prostate Cancer: Results From the FLAME Randomized Phase III Trial
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Linda G W Kerkmeijer, Marco van Vulpen, Laura Van den Bergh, Sofie Isebaert, Robert Jan Smeenk, Floris J. Pos, M. Kunze-Busch, Karin Haustermans, Jochem R. N. van der Voort van Zijp, Evelyn M. Monninkhof, Johannes C J de Boer, Uulke A. van der Heide, V. Groen, and Cédric Draulans
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Cancer Research ,medicine.medical_specialty ,business.industry ,medicine.medical_treatment ,Phase (waves) ,medicine.disease ,030218 nuclear medicine & medical imaging ,03 medical and health sciences ,Prostate cancer ,0302 clinical medicine ,Oncology ,030220 oncology & carcinogenesis ,Urological cancers Radboud Institute for Health Sciences [Radboudumc 15] ,medicine ,In patient ,External beam radiotherapy ,Radiology ,business ,Rare cancers Radboud Institute for Health Sciences [Radboudumc 9] - Abstract
PURPOSE This study investigates whether focal boosting of the macroscopic visible tumor with external beam radiotherapy increases biochemical disease-free survival (bDFS) in patients with localized prostate cancer. PATIENTS AND METHODS In the phase III, multicenter, randomized controlled Focal Lesion Ablative Microboost in Prostate Cancer trial, 571 patients with intermediate- and high-risk prostate cancer were enrolled between 2009 and 2015. Patients assigned to standard treatment received 77 Gy (fractions of 2.2 Gy) to the entire prostate. The focal boost arm received an additional simultaneous integrated focal boost up to 95 Gy (fractions up to 2.7 Gy) to the intraprostatic lesion visible on multiparametric magnetic resonance imaging. Organ at risk constraints were prioritized over the focal boost dose. The primary end point was 5-year bDFS. Secondary end points were disease-free survival (DFS), distant metastases-free survival, prostate cancer-specific survival, overall survival, toxicity, and health-related quality of life. RESULTS Median follow-up was 72 months. Biochemical DFS was significantly higher in the focal boost compared with the standard arm (hazard ratio 0.45, 95% CI, 0.28 to 0.71, P < .001). At 5-year follow-up bDFS was 92% and 85%, respectively. We did not observe differences in prostate cancer-specific survival ( P = .49) and overall survival ( P = .50). The cumulative incidence of late genitourinary and GI toxicity grade ≥ 2 was 23% and 12% in the standard arm versus 28% and 13% in the focal boost arm, respectively. Both for late toxicity as health-related quality of life, differences were small and not statistically significant. CONCLUSION The addition of a focal boost to the intraprostatic lesion improved bDFS for patients with localized intermediate- and high-risk prostate cancer without impacting toxicity and quality of life. The Focal Lesion Ablative Microboost in Prostate Cancer study shows that a high focal boost strategy to improve tumor control while respecting organ at risk dose constraints is effective and safe.
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- 2021
23. Effectiveness of the nurse-led Activate intervention in patients at risk of cardiovascular disease in primary care: a cluster-randomised controlled trial
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Evelyn M. Monninkhof, Daphne A de Vette, Jaap C.A. Trappenburg, Marjolein A de Bruin-van Leersum, Carin D. Schröder, Irene D. Bos-Touwen, Heleen Westland, and Marieke J. Schuurmans
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Male ,self-management ,medicine.medical_specialty ,Randomization ,nurse-led intervention ,Psychological intervention ,cluster-randomised controlled trial ,physical activity ,Disease ,030204 cardiovascular system & hematology ,Nurse's Role ,primary care ,03 medical and health sciences ,Social support ,0302 clinical medicine ,Intervention (counseling) ,Humans ,Medicine ,030212 general & internal medicine ,Cluster randomised controlled trial ,Intensive care medicine ,Exercise ,Aged ,Advanced and Specialized Nursing ,Self-efficacy ,Self-management ,Primary Health Care ,business.industry ,Original Articles ,Middle Aged ,Exercise Therapy ,Medical–Surgical Nursing ,Cardiovascular Diseases ,Female ,Patient Participation ,Sedentary Behavior ,Cardiology and Cardiovascular Medicine ,business ,Behaviour change wheel - Abstract
Background To understand better the success of self-management interventions and to enable tailoring of such interventions at specific subgroups of patients, the nurse-led Activate intervention is developed targeting one component of self-management (physical activity) in a heterogeneous subgroup (patients at risk of cardiovascular disease) in Dutch primary care. Aim The aim of this study was to evaluate the effectiveness of the Activate intervention and identifying which patient-related characteristics modify the effect. Methods A two-armed cluster-randomised controlled trial was conducted comparing the intervention with care as usual. The intervention consisted of four nurse-led behaviour change consultations within a 3-month period. Data were collected at baseline, 3 months and 6 months. Primary outcome was the daily amount of moderate to vigorous physical activity at 6 months. Secondary outcomes included sedentary behaviour, self-efficacy for physical activity, patient activation for self-management and health status. Prespecified effect modifiers were age, body mass index, level of education, social support, depression, patient provider relationship and baseline physical activity. Results Thirty-one general practices (n = 195 patients) were included (intervention group n = 93; control group n = 102). No significant between-group difference was found for physical activity (mean difference 2.49 minutes; 95% confidence interval -2.1; 7.1; P = 0.28) and secondary outcomes. Patients with low perceived social support (P = 0.01) and patients with a low baseline activity level (P = 0.02) benefitted more from the intervention. Conclusion The Activate intervention did not improve patients’ physical activity and secondary outcomes in primary care patients at risk of cardiovascular disease. To understand the results, the intervention fidelity and active components for effective self-management require further investigation. Trial registration: ClinicalTrials.gov NCT02725203.
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- 2020
24. Correction to: The course of swallowing problems in the first 2 years after diagnosis of head and neck cancer
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Jorine A. Vermaire, Cornelis P. J. Raaijmakers, Evelyn M. Monninkhof, C. René Leemans, Robert J. Baatenburg de Jong, Robert P. Takes, Irma M. Verdonck-de Leeuw, Femke Jansen, Johannes A. Langendijk, Chris H. J. Terhaard, and Caroline M. Speksnijder
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Oncology - Published
- 2022
25. Quality of Life After Stereotactic Body Radiation Therapy Versus Conventional Radiation Therapy in Patients With Bone Metastases
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Bart J. Pielkenrood, Roxanne Gal, Nicolien Kasperts, Joost J.C. Verhoeff, Marcia M.T.J. Bartels, Enrica Seravalli, Yvette M. van der Linden, Evelyn M. Monninkhof, Jorrit-Jan Verlaan, Joanne M. van der Velden, and Helena M. Verkooijen
- Subjects
Cancer Research ,Radiation ,Oncology ,Palliative Care ,Quality of Life ,Humans ,Pain ,Radiology, Nuclear Medicine and imaging ,Bone Neoplasms ,Patient Reported Outcome Measures ,Radiosurgery - Abstract
Purpose: Painful bone metastases hamper quality of life (QoL). The aim of this prespecified secondary analysis of the PRESENT trial was to compare change in global QoL, physical functioning, emotional functioning, functional interference, and psychosocial aspects after conventional radiation therapy (cRT) versus stereotactic body RT (SBRT).Methods and Materials: A total of 110 patients were enrolled in the phase 2 randomized controlled VERTICAL trial (NCT02364115) following the " trials within cohorts" design and randomized 1:1 to cRT or SBRT. Patient-reported global QoL, physical functioning, emotional functioning, functional interference, and psychosocial aspects were assessed by the European Organization for Research and Treatment of Cancer QoL Questionnaire (QLQ) Core 15 Palliative Care and QLQ Bone Metastases 22 modules. Changes in QoL domains over time were compared between patients treated with cRT and SBRT using intention-to-treat (ITT) and per-protocol (PP) linear mixed model analysis adjusting for baseline scores. Proportions of patients in the cRT versus SBRT arm reporting a clinically relevant change in QoL within 3 months were compared using a x2 test.Results: QoL scores had improved over time and were comparable between groups for all domains in both the ITT and PP analyses, except for functional interference and psychological aspects in the ITT. Functional interference scores had improved more after 12 weeks in the cRT arm than in the SBRT arm (25.5 vs 14.1 points, respectively; effect size [ES] = 0.49, P =.04). Psychosocial aspects scores had improved more after 8 weeks in the cRT arm than in the SBRT arm (12.2 vs 7.3; ES = 0.56, P =.04). No clinically relevant differences between groups at 12 weeks in terms of global QoL, physical functioning, emotional functioning, functional interference, and psychosocial aspects were observed.Conclusions: Palliative RT improves QoL. Both SBRT and cRT have a comparable effect on patient-reported QoL outcomes in patients with painful bone metastases. Functional interference and psychological aspects scores improved more in patients treated with cRT versus patients offered SBRT. (C) 2022 Elsevier Inc. All rights reserved.
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- 2022
26. Association Between Adherence to Clinical Practice Guidelines for Adjuvant Therapy for Breast Cancer and Survival in a Resource-Limited Setting
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Chin Vern Song, Cheng-Har Yip, Nur Aishah Mohd Taib, Mee Hoong See, Li Ying Teoh, Evelyn M. Monninkhof, Marniza Saad, Cuno S.P.M. Uiterwaal, and Nirmala Bhoo-Pathy
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Cancer Research ,Oncology ,Humans ,Breast Neoplasms ,Female ,Guideline Adherence ,Combined Modality Therapy ,Proportional Hazards Models - Abstract
PURPOSE Addressing unwarranted clinical variation in oncology practices is expected to lead to improved cancer outcomes. Particularly, the application and impact of treatment guidelines on breast cancer outcomes are poorly studied in resource-limited settings. We measured adherence to a set of locally developed adjuvant treatment guidelines in a middle-income setting. Importantly, the impact of guidelines adherence on survival following breast cancer was determined. METHODS Data of 3,100 Malaysian women with nonmetastatic breast cancer diagnosed between 2010 and 2017 were analyzed. Adherence to the Malaysian Clinical Practice Guidelines for Management of Breast Cancer second Edition was measured. Outcomes comprised overall survival and event-free survival. RESULTS Guideline adherence for chemotherapy, radiotherapy, hormonal therapy, and targeted therapy were 61.7%, 79.2%, 85.1%, and 26.2%, respectively. Older age was generally associated with lower adherence to guidelines. Compared with patients who were treated according to treatment guidelines, overall survival and event-free survival were substantially lower in patients who were not treated accordingly; hazard ratios for all-cause mortality were 1.69 (95% CI, 1.29 to 2.22), 2.59 (95% CI, 1.76 to 3.81), 3.08 (95% CI, 1.94 to 4.88), and 4.48 (95% CI, 1.98 to 10.13) for chemotherapy, radiotherapy, hormone therapy, and targeted therapy, respectively. Study inferences remain unchanged following sensitivity analyses. CONCLUSION Our study findings appear to suggest that adherence to treatment guidelines that have been adapted for resource-limited settings may still provide effective guidance in improving breast cancer outcomes.
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- 2022
27. Author response for 'Factors associated with swallowing dysfunction in patients with head and neck cancer'
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null Jorine A. Vermaire, null Cornelis P.J. Raaijmakers, null Evelyn M. Monninkhof, null Irma M. Verdonck‐de Leeuw, null Chris H.J. Terhaard, and null Caroline M. Speksnijder
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- 2022
28. Knowledge-Based Assessment of Focal Dose Escalation Treatment Plans in Prostate Cancer
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Tomas Janssen, Robert Jan Smeenk, Peter de Ruiter, Karin Haustermans, Linda G W Kerkmeijer, Iris Walraven, Evelyn M. Monninkhof, Floris J. Pos, Alexis N.T.J. Kotte, Robin De Roover, Cédric Draulans, Uulke A. van der Heide, Marcel A van Schie, M. Kunze-Busch, and D. Eekhout
- Subjects
Male ,Organs at Risk ,Entire prostate ,Cancer Research ,medicine.medical_specialty ,Knowledge Bases ,medicine.medical_treatment ,Dose constraints ,Disease-Free Survival ,030218 nuclear medicine & medical imaging ,03 medical and health sciences ,Prostate cancer ,0302 clinical medicine ,All institutes and research themes of the Radboud University Medical Center ,Planned Dose ,medicine ,Dose escalation ,Humans ,Radiology, Nuclear Medicine and imaging ,Radiation Injuries ,Radiation ,business.industry ,Quality assessment ,Radiotherapy Planning, Computer-Assisted ,Prostate ,Rectum ,Prostatic Neoplasms ,Reproducibility of Results ,Seminal Vesicles ,Radiotherapy Dosage ,Models, Theoretical ,Prostate-Specific Antigen ,medicine.disease ,Magnetic Resonance Imaging ,Tumor Burden ,Radiation therapy ,Oncology ,030220 oncology & carcinogenesis ,Urological cancers Radboud Institute for Health Sciences [Radboudumc 15] ,Linear Models ,Feasibility Studies ,Radiology ,Neoplasm Recurrence, Local ,Tomography, X-Ray Computed ,business ,Rare cancers Radboud Institute for Health Sciences [Radboudumc 9] - Abstract
PurposeIn a randomized focal dose escalation radiation therapy trial for prostate cancer (FLAME), up to 95 Gy was prescribed to the tumor in the dose-escalated arm, with 77 Gy to the entire prostate in both arms. As dose constraints to organs at risk had priority over dose escalation and suboptimal planning could occur, we investigated how well the dose to the tumor was boosted. We developed an anatomy-based prediction model to identify plans with suboptimal tumor dose and performed replanning to validate our model.Methods and MaterialsWe derived dose-volume parameters from planned dose distributions of 539 FLAME trial patients in 4 institutions and compared them between both arms. In the dose-escalated arm, we determined overlap volume histograms and derived features representing patient anatomy. We predicted tumor D98% with a linear regression on anatomic features and performed replanning on 21 plans.ResultsIn the dose-escalated arm, the median tumor D50% and D98% were 93.0 and 84.7 Gy, and 99% of the tumors had a dose escalation greater than 82.4 Gy (107% of 77 Gy). In both arms organs at risk constraints were met. Five out of 73 anatomic features were found to be predictive for tumor D98%. Median predicted tumor D98% was 4.4 Gy higher than planned D98%. Upon replanning, median tumor D98% increased by 3.0 Gy. A strong correlation between predicted increase in D98% and realized increase upon replanning was found (ρ = 0.86).ConclusionsFocal dose escalation in prostate cancer was feasible with a dose escalation to 99% of the tumors. Replanning resulted in an increased tumor dose that correlated well with the prediction model. The model was able to identify tumors on which a higher boost dose could be planned. The model has potential as a quality assessment tool in focal dose escalated treatment plans.
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- 2020
29. Mediating role of lifestyle behaviors in the association between education and cancer: results from the European Prospective Investigation into Cancer and Nutrition
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Alessandra Macciotta, Alberto Catalano, Maria Teresa Giraudo, Elisabete Weiderpass, Pietro Ferrari, Heinz Freisling, Sandra M. Colorado-Yohar, Carmen Santiuste, Pilar Amiano, Alicia K. Heath, Heather A. Ward, Sofia Christakoudi, Paolo Vineis, Deependra Singh, Salvatore Vaccarella, Matthias B. Schulze, Anouk E. Hiensch, Evelyn M. Monninkhof, Verena Katzke, Rudolf Kaaks, Rosario Tumino, Fulvio Lazzarato, Lorenzo Milani, Antonio Agudo, Christina C. Dahm, Laura Baglietto, Vittorio Perduca, Gianluca Severi, Sara Grioni, Salvatore Panico, Eva Ardanaz, Kristin B. Borch, Faith O. Benebo, Tonje Braaten, Maria-Jose Sánchez, Claudia Giachino, Carlotta Sacerdote, and Fulvio Ricceri
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Male ,Cohort Studies ,Oncology ,Epidemiology ,Risk Factors ,Incidence ,Humans ,Educational Status ,Female ,Breast Neoplasms ,Prospective Studies ,Life Style ,Europe/epidemiology - Abstract
Background: Many studies have shown that socioeconomic position (SEP) is associated with the incidence of malignant tumors at different sites. This study aims to estimate the association between educational level (as proxy for SEP) and cancer incidence and to understand whether the observed associations might be partially explained by lifestyle behaviors. Methods: The analyses were performed on data from the European Prospective Investigation into Cancer and Nutrition (EPIC) study, globally and by sex. We used Cox proportional hazards models together with mediation analysis to disentangle the total effect (TE) of educational level [measured through the Relative Index of Inequality (RII)] on cancer incidence into pure direct (PDE) and total indirect (TIE) effect, unexplained and explained by mediators, respectively. PDE and TIE were then combined to compute the proportions mediated (PM). Results: After an average of 14 years of follow-up, 52,422 malignant tumors were ascertained. Low educated participants showed higher risk of developing stomach, lung, kidney (in women), and bladder (in men) cancers, and, conversely, lower risk of melanoma and breast cancer (in post-menopausal women), when compared with more educated participants. Mediation analyses showed that portions of the TE of RII on cancer could be explained by site-specific related lifestyle behaviors for stomach, lung, and breast (in women). Conclusions: Cancer incidence in Europe is determined at least in part by a socioeconomically stratified distribution of risk factors. Impact: These observational findings support policies to reduce cancer occurrence by altering mediators, such as lifestyle behaviors, particularly focusing on underprivileged strata of the population.
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- 2022
30. Urethral and bladder dose-effect relations for late genitourinary toxicity following external beam radiotherapy for prostate cancer in the FLAME trial
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Veerle H. Groen, Marcel van Schie, Nicolaas P.A. Zuithoff, Evelyn M. Monninkhof, Martina Kunze-Busch, Johannes C.J. de Boer, Jochem van der Voort van Zijp, Floris J. Pos, Robert Jan Smeenk, Karin Haustermans, Sofie Isebaert, Cédric Draulans, Tom Depuydt, Helena M. Verkooijen, Uulke A. van der Heide, and Linda G.W. Kerkmeijer
- Subjects
Male ,Prostate cancer ,Focal boosting ,Brachytherapy ,Urinary Bladder ,External beam radiotherapy ,Prostatic Neoplasms ,Radiotherapy Dosage ,Hematology ,Bladder dose ,Dose-effect relations ,Oncology ,Urethra ,Genitourinary toxicity ,Urological cancers Radboud Institute for Health Sciences [Radboudumc 15] ,Humans ,Radiology, Nuclear Medicine and imaging ,Urethral dose ,Radiation Injuries ,Rare cancers Radboud Institute for Health Sciences [Radboudumc 9] - Abstract
Contains fulltext : 249595.pdf (Publisher’s version ) (Open Access) PURPOSE OR OBJECTIVES: The FLAME trial (NCT01168479) showed that by adding a focal boost to conventional fractionated EBRT in the treatment of localized prostate cancer, the five-year biochemical disease-free survival increased, without significantly increasing toxicity. The aim of the present study was to investigate the association between radiation dose to the bladder and urethra and genitourinary (GU) toxicity grade ≥2 in the entire cohort. MATERIAL AND METHODS: The dose-effect relations of the urethra and bladder dose, separately, and GU toxicity grade ≥2 (CTCAE 3.0) up to five years after treatment were assessed. A mixed model analysis for repeated measurements was used, adjusting for age, diabetes mellitus, T-stage, baseline GU toxicity grade ≥1 and institute. Additionally, the association between the dose and separate GU toxicity subdomains were investigated. RESULTS: Dose-effect relations were observed for the dose (Gy) to the bladder D2 cm(3) and urethra D0.1 cm(3), with adjusted odds ratios of 1.14 (95% CI 1.12-1.16, p
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- 2022
31. Factors associated with swallowing dysfunction in patients with head and neck cancer
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Jorine A. Vermaire, Cornelis P. J. Raaijmakers, Evelyn M. Monninkhof, Irma M. Verdonck‐de Leeuw, Chris H. J. Terhaard, Caroline M. Speksnijder, CCA - Cancer Treatment and quality of life, APH - Personalized Medicine, APH - Mental Health, and Otolaryngology / Head & Neck Surgery
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Otorhinolaryngology ,digestive, oral, and skin physiology ,otorhinolaryngologic diseases ,General Dentistry - Abstract
Background: The aim of this prospective cohort study was to investigate swallowing function in relation to personal and clinical factors among patients with head and neck cancer (HNC) from diagnosis up to 2 years after treatment. Methods: The 100 ml water swallow test was measured before treatment, and 3, 6, 12, and 24 months after treatment. Linear mixed-effects model analysis was conducted to investigate changes over time and the association with personal (sex and age) and clinical (tumor site, tumor stage, and treatment modality) factors. Results: Among 128 included patients, number of swallows increased from baseline to 3 months after treatment and decreased to baseline again at 6 months after treatment. The number of swallows was associated with age and treatment modality. Conclusions: In patients with HNC, swallowing (dys)function changes over time with the worst score 3 months after treatment. A higher age and being treated with surgery are factors associated with swallowing dysfunction over time.
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- 2022
32. Prediagnosis Leisure-Time Physical Activity and Lung Cancer Survival: A Pooled Analysis of 11 Cohorts
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Jae Jeong Yang, Danxia Yu, Emily White, Dong Hoon Lee, William Blot, Kim Robien, Rashmi Sinha, Yikyung Park, Yumie Takata, Yu-Tang Gao, Karl Smith-Byrne, Evelyn M Monninkhof, Rudolf Kaaks, Arnulf Langhammer, Kristin Benjaminsen Borch, Laila Al-Shaar, Qing Lan, Elin Pettersen Sørgjerd, Xuehong Zhang, Clair Zhu, María Dolores Chirlaque, Gianluca Severi, Kim Overvad, Carlotta Sacerdote, Dagfinn Aune, Mattias Johansson, Stephanie A Smith-Warner, Wei Zheng, and Xiao-Ou Shu
- Subjects
Cancer Research ,Lung Neoplasms ,Science & Technology ,Lung Neoplasms/diagnosis ,MORTALITY ,SEDENTARY BEHAVIOR ,QUESTIONNAIRE ,WOMENS HEALTH ,EXERCISE ,Motor Activity ,United States/epidemiology ,OBSTRUCTIVE PULMONARY-DISEASE ,PREVENTION ,United States ,Leisure Activities ,Oncology ,REPRODUCIBILITY ,Humans ,Prospective Studies ,VALIDITY ,CARDIORESPIRATORY FITNESS ,Life Sciences & Biomedicine - Abstract
BackgroundLittle is known about the association between physical activity before cancer diagnosis and survival among lung cancer patients. In this pooled analysis of 11 prospective cohorts, we investigated associations of prediagnosis leisure-time physical activity (LTPA) with all-cause and lung cancer–specific mortality among incident lung cancer patients.MethodsUsing self-reported data on regular engagement in exercise and sports activities collected at study enrollment, we assessed metabolic equivalent hours (MET-h) of prediagnosis LTPA per week. According to the Physical Activity Guidelines for Americans, prediagnosis LTPA was classified into inactivity, less than 8.3 and at least 8.3 MET-h per week (the minimum recommended range). Cox regression was used to estimate hazard ratios (HRs) and 95% confidence interval (CIs) for all-cause and lung cancer–specific mortality after adjustment for major prognostic factors and lifetime smoking history.ResultsOf 20 494 incident lung cancer patients, 16 864 died, including 13 596 deaths from lung cancer (overall 5-year relative survival rate = 20.9%, 95% CI = 20.3% to 21.5%). Compared with inactivity, prediagnosis LTPA of more than 8.3 MET-h per week was associated with a lower hazard of all-cause mortality (multivariable-adjusted HR = 0.93, 95% CI = 0.88 to 0.99), but not with lung cancer–specific mortality (multivariable-adjusted HR = 0.99, 95% CI = 0.95 to 1.04), among the overall population. Additive interaction was found by tumor stage (Pinteraction = .008 for all-cause mortality and .003 for lung cancer–specific mortality). When restricted to localized cancer, prediagnosis LTPA of at least 8.3 MET-h per week linked to 20% lower mortality: multivariable-adjusted HRs were 0.80 (95% CI = 0.67 to 0.97) for all-cause mortality and 0.80 (95% CI = 0.65 to 0.99) for lung cancer–specific mortality.ConclusionsRegular participation in LTPA that met or exceeded the minimum Physical Activity Guidelines was associated with reduced hazards of mortality among lung cancer patients, especially those with early stage cancer.
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- 2021
33. Cost-Effectiveness of Magnetic Resonance Imaging Screening for Women With Extremely Dense Breast Tissue
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H. Amarens Geuzinge, Ritse M. Mann, Harry J. de Koning, Evelyn M. Monninkhof, Wouter B. Veldhuis, Carla H. van Gils, Marleen J. Emaus, Petra K de Koekkoek-Doll, Nicolien T. van Ravesteyn, Stéphanie V de Lange, Marije F. Bakker, Eveline A.M. Heijnsdijk, Ruud M. Pijnappel, and Public Health
- Subjects
Cancer Research ,medicine.medical_specialty ,Cost effectiveness ,Cost-Benefit Analysis ,Breast Neoplasms ,All institutes and research themes of the Radboud University Medical Center ,Breast cancer ,SDG 3 - Good Health and Well-being ,medicine ,Mammography ,Humans ,Mass Screening ,Radiology, Nuclear Medicine and imaging ,Breast density ,Overdiagnosis ,Early Detection of Cancer ,Aged ,Breast Density ,Clinical Trials as Topic ,medicine.diagnostic_test ,business.industry ,Magnetic resonance imaging ,General Medicine ,Articles ,Middle Aged ,medicine.disease ,Magnetic Resonance Imaging ,Women's cancers Radboud Institute for Health Sciences [Radboudumc 17] ,Quality-adjusted life year ,Editor's Choice ,Oncology ,Extremely Dense Breast ,Female ,Radiology ,business ,AcademicSubjects/MED00010 - Abstract
Background Extremely dense breast tissue is associated with increased breast cancer risk and limited sensitivity of mammography. The DENSE trial showed that additional magnetic resonance imaging (MRI) screening in women with extremely dense breasts resulted in a substantial reduction in interval cancers. The cost-effectiveness of MRI screening for these women is unknown. Methods We used the MISCAN-breast microsimulation model to simulate several screening protocols containing mammography and/or MRI to estimate long-term effects and costs. The model was calibrated using results of the DENSE trial and adjusted to incorporate decreases in breast density with increasing age. Screening strategies varied in the number of MRIs and mammograms offered to women ages 50-75 years. Outcomes were numbers of breast cancers, life-years, quality-adjusted life-years (QALYs), breast cancer deaths, and overdiagnosis. Incremental cost-effectiveness ratios (ICERs) were calculated (3% discounting), with a willingness-to-pay threshold of €22 000. Results Calibration resulted in a conservative fit of the model regarding MRI detection. Both strategies of the DENSE trial were dominated (biennial mammography; biennial mammography plus MRI). MRI alone every 4 years was cost-effective with €15 620 per QALY. Screening every 3 years with MRI alone resulted in an incremental cost-effectiveness ratio of €37 181 per QALY. All strategies with mammography and/or a 2-year interval were dominated because other strategies resulted in more additional QALYs per additional euro. Alternating mammography and MRI every 2 years was close to the efficiency frontier. Conclusions MRI screening is cost-effective for women with extremely dense breasts, when applied at a 4-year interval. For a willingness to pay more than €22 000 per QALY gained, MRI at a 3-year interval is cost-effective as well.
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- 2021
34. Effects of exercise in breast cancer patients: implications of the trials within cohorts (TwiCs) design in the UMBRELLA Fit trial
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Petra H.M. Peeters, Carla H. van Gils, Roxanne Gal, Evelyn M. Monninkhof, Desirée H.J.G. van den Bongard, Anne M. May, Helena M. Verkooijen, Sjoerd G. Elias, Rolf H.H. Groenwold, Radiotherapy, and CCA - Cancer Treatment and Quality of Life
- Subjects
Quality of life ,Cancer Research ,medicine.medical_specialty ,Randomization ,Increased physical activity ,Physical activity ,TwiCs ,Breast Neoplasms ,Breast cancer ,medicine ,Humans ,Prospective Studies ,Fatigue ,business.industry ,medicine.disease ,Clinical Trial ,Exercise Therapy ,Oncology ,Research Design ,Usual care ,Propensity score matching ,Cohort ,Physical therapy ,Female ,Trials within cohorts ,business - Abstract
Purpose The Trials within Cohorts (TwiCs) design aims to overcome problems faced in conventional RCTs. We evaluated the TwiCs design when estimating the effect of exercise on quality of life (QoL) and fatigue in inactive breast cancer survivors. Methods UMBRELLA Fit was conducted within the prospective UMBRELLA breast cancer cohort. Patients provided consent for future randomization at cohort entry. We randomized inactive patients 12–18 months after cohort enrollment. The intervention group (n = 130) was offered a 12-week supervised exercise intervention. The control group (n = 130) was not informed and received usual care. Six-month exercise effects on QoL and fatigue as measured in the cohort were analyzed with intention-to-treat (ITT), instrumental variable (IV), and propensity scores (PS) analyses. Results Fifty-two percent (n = 68) of inactive patients accepted the intervention. Physical activity increased in patients in the intervention group, but not in the control group. We found no benefit of exercise for dimensions of QoL (ITT difference global QoL: 0.8, 95% CI = − 2.2; 3.8) and fatigue, except for a small beneficial effect on physical fatigue (ITT difference: − 1.1, 95% CI = − 1.8; − 0.3; IV: − 1.9, 95% CI = − 3.3; − 0.5, PS: − 1.2, 95% CI = − 2.3; − 0.2). Conclusion TwiCs gave insight into exercise intervention acceptance: about half of inactive breast cancer survivors accepted the offer and increased physical activity levels. The offer resulted in no improvement on QoL, and a small beneficial effect on physical fatigue. Trial registration Netherlands Trial Register (NTR5482/NL.52062.041.15), date of registration: December 07, 2015.
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- 2021
35. Patterns of Failure Following External Beam Radiotherapy With or Without an Additional Focal Boost in the Randomized Controlled FLAME Trial for Localized Prostate Cancer
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Veerle H. Groen, Karin Haustermans, Floris J. Pos, Cédric Draulans, Sofie Isebaert, Evelyn M. Monninkhof, Robert J. Smeenk, Martina Kunze-Busch, Johannes C.J. de Boer, Jochem van der Voort van Zijp, Linda G.W. Kerkmeijer, and Uulke A. van der Heide
- Subjects
Male ,Urology ,Urological cancers Radboud Institute for Health Sciences [Radboudumc 15] ,Brachytherapy ,Humans ,Prostatic Neoplasms ,Radiotherapy Dosage ,Disease-Free Survival ,Rare cancers Radboud Institute for Health Sciences [Radboudumc 9] ,Proportional Hazards Models - Abstract
Contains fulltext : 283434.pdf (Publisher’s version ) (Closed access) BACKGROUND: Focal dose escalation in external beam radiotherapy (EBRT) showed an increase in 5-yr biochemical disease-free survival in the Focal Lesion Ablative Microboost in Prostate Cancer (FLAME) trial. OBJECTIVE: To analyze the effect of a focal boost to intraprostatic lesions on local failure-free survival (LFS) and regional + distant metastasis-free survival (rdMFS). DESIGN, SETTING, AND PARTICIPANTS: Patients with intermediate- or high-risk localized prostate cancer were included in FLAME, a phase 3, multicenter, randomized controlled trial. INTERVENTION: Standard treatment of 77 Gy to the entire prostate in 35 fractions was compared to an additional boost to the macroscopic tumor of up to 95 Gy during EBRT. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS: LFS and rdMFS, measured via any type of imaging, were compared between the treatment arms using Kaplan-Meier and Cox regression analyses. Dose-response curves were created for local failure (LF) and regional + distant metastatic failure (rdMF) using logistic regression. RESULTS AND LIMITATIONS: A total of 571 patients were included in the FLAME trial. Over median follow-up of 72 mo (interquartile range 58-86), focal boosting decreased LF (hazard ratio [HR] 0.33, 95% confidence interval [CI] 0.14-0.78) and rdMF (HR 0.58, 95% CI 0.35-0.93). Dose-response curves showed that a greater dose to the tumor resulted in lower LF and rdMF rates. CONCLUSIONS: A clear dose-response relation for LF and rdMF was observed, suggesting that adequate focal dose escalation to intraprostatic lesions prevents undertreatment of the primary tumor, resulting in an improvement rdMF. PATIENT SUMMARY: Radiotherapy is a treatment option for high-risk prostate cancer. The FLAME trial has shown that a high dose specifically targeted at the tumor within the prostate will result in better disease outcome, with less likelihood of regional and distant disease spread. The FLAME trial is registered on ClinicalTrials.gov as NCT01168479.
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- 2021
36. OC-0407 Quality of Life after Palliative Radiotherapy for Bone Metastases: Analysis of the PRESENT-cohort
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Y.M. van der Linden, J.M. Van der Velden, Jorrit-Jan Verlaan, Max Peters, M. Bras, Evelyn M. Monninkhof, B. Pielkenrood, Helena M. Verkooijen, M. Bartels, and S. Gerlich
- Subjects
Pediatrics ,medicine.medical_specialty ,Quality of life (healthcare) ,Oncology ,Palliative radiotherapy ,business.industry ,Cohort ,Medicine ,Radiology, Nuclear Medicine and imaging ,Hematology ,business - Published
- 2021
37. Anorectal dose-effect relations for late gastrointestinal toxicity following external beam radiotherapy for prostate cancer in the FLAME trial
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Linda G W Kerkmeijer, V. Groen, Jochem R.N. van der Voort van Zyp, Sofie Isebaert, Robert Jan Smeenk, Evelyn M. Monninkhof, Karin Haustermans, Floris J. Pos, Uulke A. van der Heide, Cédric Draulans, Marcel A van Schie, Tom Depuydt, Helena M. Verkooijen, Nicolaas P.A. Zuithoff, M. Kunze-Busch, and Hans C.J. de Boer
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Male ,medicine.medical_specialty ,Gastrointestinal Diseases ,Focal boosting ,medicine.medical_treatment ,Brachytherapy ,Gastrointestinal toxicity ,External beam radiotherapy ,CONFORMAL RADIOTHERAPY ,Urology ,PARAMETERS ,Disease-Free Survival ,030218 nuclear medicine & medical imaging ,RATE BRACHYTHERAPY BOOST ,MORBIDITY ,03 medical and health sciences ,Prostate cancer ,0302 clinical medicine ,Clinical Protocols ,RADIATION-THERAPY ,Diabetes mellitus ,medicine ,FAILURE ,Humans ,Dose effect ,Radiology, Nuclear Medicine and imaging ,Anorectal dose parameters ,Science & Technology ,business.industry ,Radiology, Nuclear Medicine & Medical Imaging ,Prostatic Neoplasms ,Radiotherapy Dosage ,Hematology ,Odds ratio ,medicine.disease ,Dose-effect relations ,Oncology ,030220 oncology & carcinogenesis ,Urological cancers Radboud Institute for Health Sciences [Radboudumc 15] ,Toxicity ,Hormonal therapy ,business ,Life Sciences & Biomedicine ,ESCALATION TRIAL ,Rare cancers Radboud Institute for Health Sciences [Radboudumc 9] - Abstract
Contains fulltext : 238196.pdf (Publisher’s version ) (Open Access) BACKGROUND AND PURPOSE: The phase III FLAME trial (NCT01168479) showed an increase in five-year biochemical disease-free survival, with no significant increase in toxicity when adding a focal boost to external beam radiotherapy (EBRT) for localized prostate cancer [Kerkmeijer et al. JCO 2021]. The aim of this study was to investigate the association between delivered radiation dose to the anorectum and gastrointestinal (GI) toxicity (grade >/=2). MATERIAL AND METHODS: All patients in the FLAME trial were analyzed, irrespective of treatment arm. The dose-effect relation of the anorectal dose parameters (D2cm(3) and D50%) and GI toxicity grade >/=2 in four years of follow-up was assessed using a mixed model analysis for repeated measurements, adjusted for age, cardiovascular disease, diabetes mellitus, T-stage, baseline toxicity grade >/=1, hormonal therapy and institute. RESULTS: A dose-effect relation for D2cm(3) and D50% was observed with adjusted odds ratios of 1.17 (95% CI 1.13-1.21, p < 0.0001) and 1.20 (95% CI 1.14-1.25, p < 0.0001) for GI toxicity, respectively. CONCLUSION: Although there was no difference in toxicity between study arms, a higher radiation dose to the anorectum was associated with a statistically significant increase in GI toxicity following EBRT for prostate cancer. This dose-effect relation was present for both large and small anorectal volumes. Therefore, further increase in dose to the anorectum should be weighed against the benefit of focal dose escalation for prostate cancer.
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- 2021
38. Health-related quality of life after ultrafocal salvage high-dose-rate brachytherapy for radiorecurrent prostate cancer: reporting the patient's perspective
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Evelyn M. Monninkhof, Marieke van Son, Jan J W Lagendijk, Jochem R.N. van der Voort van Zyp, and Max Peters
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medicine.medical_specialty ,medicine.medical_treatment ,Urinary system ,Brachytherapy ,R895-920 ,Article ,030218 nuclear medicine & medical imaging ,03 medical and health sciences ,Prostate cancer ,Medical physics. Medical radiology. Nuclear medicine ,0302 clinical medicine ,Quality of life ,Prostate ,Health-related quality of Life ,Focal therapy ,Internal medicine ,medicine ,Local recurrence ,Radiology, Nuclear Medicine and imaging ,RC254-282 ,Salvage treatment ,business.industry ,Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,medicine.disease ,Radiation therapy ,Urethra ,medicine.anatomical_structure ,Oncology ,030220 oncology & carcinogenesis ,Sexual function ,business - Abstract
Highlights • We analyzed patient-reported quality of life in 100 patients who underwent ultrafocal salvage HDR-brachytherapy. • Patient-reported bowel symptoms were neglible. • Urinary complaints increased and sexual functioning declined over time. • Lower impact is predicted for patients with favorable function at baseline and lower dose to the urethra., Purpose For patients with a localized prostate cancer recurrence after radiotherapy, focal salvage treatment offers a less toxic alternative to whole-gland treatments, with the potential of preserving health-related quality of life (HR-QoL). With a focus on the patient’s perspective of treatment, this study aims to describe HR-QoL after ultrafocal salvage high-dose-rate brachytherapy (HDR-BT), and to explore predictive factors affecting HR-QoL. Material and methods We included 100 patients treated with ultrafocal salvage HDR-BT. Prostate cancer-related HR-QoL was assessed by the EORTC QLQ-PR25 questionnaire. Domains were urinary symptoms, bowel symptoms and sexual activity/functioning. For each domain, a mixed effects model was made to estimate HR-QoL trends over time. For domains showing clinically relevant change (≥10 points difference), the mixed effects model was used to explore potential predictors (age, baseline HR-QoL score, T-stage, tumor location, CTV size, dose to organs at risk and history of ADT). Results Median follow-up was 20 months (IQR 13–30). Mean questionnaire response rate was 86% (range 72–100%). Median baseline scores were 12 (urinary), 0 (bowel) and 67/50 (sexual activity/functioning). Urinary symptoms and sexual functioning showed clinically relevant deterioration over time (maximum difference of 11 and 12 points, respectively). Worse baseline score and higher administered dose to the urethra (≥16 Gy) were predictive of increased urinary symptoms (p
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- 2020
39. Physical activity and risks of breast and colorectal cancer : a Mendelian randomisation analysis
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Michael O. Woods, Fränzel J.B. van Duijnhoven, Tilman Kühn, Graham G. Giles, Temitope O. Keku, Konstantinos K. Tsilidis, Andrew T. Chan, Mingyang Song, Michael Hoffmeister, Gad Rennert, Tabitha A. Harrison, Anna H. Wu, Kenneth Offit, Mark A. Jenkins, Elizabeth A Platz, Sabina Sieri, Noralane M Lindor, John D. Potter, D Timothy Bishop, Barbara L. Banbury, Anne M. May, Sonja I. Berndt, José María Huerta, Antonia Trichopoulou, Paul D.P. Pharoah, Niki Dimou, Christopher I. Li, Roger L. Milne, Marc J. Gunter, Hermann Brenner, Martha L. Slattery, Catherine M. Tangen, Gianluca Severi, Richard M. Martin, Nabila Kazmi, Ruth C. Travis, Sanford D. Markowitz, Jeroen R. Huyghe, Heather Hampel, Ulrike Peters, John L. Hopper, Brigid M. Lynch, Krasimira Aleksandrova, Alicja Wolk, Merete Ellingjord-Dale, Li Li, Bethany Van Guelpen, Sergi Castellví-Bel, Edward Giovannucci, Steven J Gallinger, Annika Lindblom, Cornelia M. Ulrich, Stephen B. Gruber, Stephanie L. Schmit, Jenny Chang-Claude, Lorena Moreno, Victor Moreno, Nikos Papadimitriou, Stephen N. Thibodeau, Elio Riboli, Sophia Harlid, Polly A. Newcomb, Pavel Vodicka, Demetrius Albanes, Bas Bueno-de-Mesquita, Maria J. Sánchez, Sarah J Lewis, Timothy Robinson, Daniel D Buchanan, Loic Le Marchand, Carlo La Vecchia, Robert E Schoen, Neil Murphy, Giovanna Masala, Evelyn M. Monninkhof, Jane C. Figueiredo, Andrea Gsur, Jochen Hampe, Vittorio Perduca, Li Hsu, Emily White, Peter T. Campbell, School of Public Health - Department of Epidemiology and Biostatistics, Imperial College London, University of Bristol [Bristol], National Cancer Institute [Bethesda] (NCI-NIH), National Institutes of Health [Bethesda] (NIH), Department of Epidemiology, German Institute of Human Nutrition, Division of Cancer Epidemiology and Genetics [Bethesda, MD, États-Unis], National Institutes of Health [Bethesda] (NIH)-National Institutes of Health [Bethesda] (NIH), Division of Clinical Epidemiology and Aging Research, German Cancer Research Center - Deutsches Krebsforschungszentrum [Heidelberg] (DKFZ), Department for Determinants of Chronic Diseases (DCD), National Institute for Public Health and the Environment [Bilthoven] (RIVM), The Cancer, Ageing and Somatic Mutation Programme [Cambridgeshire, UK], The Wellcome Trust Sanger Institute [Cambridge], Division of Cancer Epidemiology, Samuel Lunenfeld Research Institute, Mount Sinai Hospital [Toronto, Canada] (MSH), University of Melbourne, Harvard School of Public Health, Department of Internal Medicine, Epidemiology, Human Genetics, University of Michigan [Ann Arbor], University of Michigan System-University of Michigan System, Medical Department 1 [Dresden, Germany], Technische Universität Dresden = Dresden University of Technology (TU Dresden), Ohio State University [Columbus] (OSU), FESTO, Universität Stuttgart [Stuttgart], Centre for MEGA Epidemiology, The University of Melbourne, Victoria, Australia, CIBER de Epidemiología y Salud Pública (CIBERESP), Department of Medical Genetics, HMNC Brain Health, Department of Clinical Sciences and Community Health [Milan, Italy], Università degli Studi di Milano [Milano] (UNIMI), University of Hawai‘i [Mānoa] (UHM), Chinese Center for Disease Control and Prevention, Department of Clinical Genetics, Karolinska University Hospital [Stockholm], Mayo Clinic, Case Western Reserve University [Cleveland], Cancer Risk Factors and LifeStyle Epidemiology Unit, Cancer Research and Prevention Institute (ISPO), Julius Center for Health Sciences and Primary Care, University Medical Center [Utrecht], Cancer Epidemiology Centre, Cancer Council Victoria, Biomedical Research Centre Network for Rare Diseases, CIBER de Enfermedades Raras (CIBERER), Memorial Sloane Kettering Cancer Center [New York], Mathématiques Appliquées Paris 5 (MAP5 - UMR 8145), Université Paris Descartes - Paris 5 (UPD5)-Institut National des Sciences Mathématiques et de leurs Interactions (INSMI)-Centre National de la Recherche Scientifique (CNRS), Department of Oncology, University of Cambridge [UK] (CAM), Johns Hopkins Bloomberg School of Public Health [Baltimore], Johns Hopkins University (JHU), Department of Community Medicine and Epidemiology, CHS National Cancer Control Center, School of Public Health [London, UK] (Faculty of Medicine), Andalusian School of Public Health [Granada], Istituto Nazionale dei Tumori, Fred Hutchinson Cancer Research Center [Seattle] (FHCRC), Mayo Clinic [Rochester], University of Oxford [Oxford], WHO Collaborating Center for Nutrition and Health, Unit of Nutritional Epidemiology and Nutrition in Public Health, Dept of Hygiene, Epidemiology and Medical Statistics, University of Athens Medical School [Athens]-University of Athens Medical School [Athens], Helmholtz Centre for Ocean Research [Kiel] (GEOMAR), Department of Medical Biosciences and Pathology, Umeå University, Institute of Experimental Medicine, Czech Academy of Sciences [Prague] (CAS), Karolinska Institutet [Stockholm], Nutrition and Metabolism Section, International Agency for Research on Cancer, [Papadimitriou,N, Dimou,N, Gunter,MJ, Murphy,N] Section of Nutrition and Metabolism, International Agency for Research on Cancer, Lyon, France. [Tsilidis,KK] Department of Hygiene and Epidemiology, University of Ioannina School of Medicine, Ioannina, Greece. [Tsilidis,KK, Ellingjord-Dale,M, Riboli,E] Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK. [Banbury,B, Harrison,TA, Hsu,L, Huyghe,JR, Li,CI, Newcomb,PA, Potter,JD, White,E, Peters,U] Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA. [Martin,RM, Kazmi,N] MRC Integrative Epidemiology Unit (IEU), Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK. [Martin,RM, Lewis,SJ, Robinson,TM] Bristol Medical School, Department of Population Health Sciences, University of Bristol, Bristol, UK. [Martin,RM] National Institute for Health Research (NIHR) Bristol Biomedical Research Centre, University Hospitals Bristol NHS Foundation Trust and the University of Bristol, Bristol, UK. [Albanes,D, Berndt,SI] Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MA, USA. [Aleksandrova,K] German Institute of Human Nutrition Potsdam-Rehbruecke (DIfE), Nuthetal, Germany. [Bishop,DT] Leeds Institute of Cancer and Pathology, University of Leeds, Leeds, UK. [Brenner,H, Hoffmeister,M] Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Germany. [Brenner,H] Division of Preventive Oncology, German Cancer Research Center (DKFZ) and National Center for Tumor Diseases (NCT), Heidelberg, Germany. [Brenner,H] German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ), Heidelberg, Germany. [Buchanan,DD, Giles,GG, Hopper,JL, Jenkins,MA, Lynch,B, Milne,R] Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia. [Buchanan,DD] Colorectal Oncogenomics Group, Genetic Epidemiology Laboratory, Department of Pathology, The University of Melbourne, Parkville, VIC, Australia. [Buchanan,DD] Genetic Medicine and Family Cancer Clinic, The Royal Melbourne Hospital, Parkville, VIC, Australia [Bueno-de-Mesquita,B] Former senior scientist, Dept. for Determinants of Chronic Diseases (DCD), National Institute for Public Health and the Environment (RIVM), BA Bilthoven, Netherlands. [Bueno-de-Mesquita,B] Former associate professor, Department of Gastroenterology and Hepatology, University Medical Centre, Utrecht, Netherlands. [Bueno-de-Mesquita,B] ormer visiting professor, Dept. of Epidemiology and Biostatistics, The School of Public Health, Imperial College London, St Mary’s Campus, Norfolk Place, London, London, UK. [Bueno-de-Mesquita,B] Former academic Icon / visiting professor, Dept. of Social & Preventive Medicine, Faculty of Medicine, University of Malaya, Pantai Valley, Kuala Lumpur, Malaysia. [Campbell,PT] Behavioral and Epidemiology Research Group, American Cancer Society, Atlanta, GA, USA. [Castellví-Bel,S, Moreno,L] Gastroenterology Department, Hospital Clínic, Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD), University of Barcelona, Barcelona, Spain. [Chan,AT, Song,M] Division of Gastroenterology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA. [Chan,AT, Song,M] Clinical and Translational Epidemiology Unit, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA. [Chang-Claude,J, Kühn,T] Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany. [Chang-Claude,J] University Medical Centre Hamburg-Eppendorf, University Cancer Centre Hamburg (UCCH), Hamburg, Germany. [Figueiredo,JC] Department of Medicine, Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA. [Figueiredo,JC] Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA. [Gallinger,SJ] Lunenfeld Tanenbaum Research Institute, Mount Sinai Hospital, University of Toronto, Toronto, ON, Canada. [Giles,GG, Milne,R] Cancer Epidemiology and Intelligence Division, Cancer Council Victoria, Melbourne, VIC, Australia. [Giovannucci,E, Song,M] Department of Epidemiology, Harvard T.H. Chan School of Public Health, Harvard University, Boston, MA, USA. [Giovannucci,E, Song,M] Department of Nutrition, T.H. H, Chan School of Public Health, Boston, MA, USA. [Giovannucci,E] Channing Division of Network Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, USA. [Gruber,SB, Schmit,SL] Department of Preventive Medicine, USC Norris Comprehensive Cancer Center, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA. [Gsur,A] Institute of Cancer Research, Department of Medicine I, Medical University Vienna, Vienna, Austria. [Hampe,J] Department of Medicine I, University Hospital Dresden, Technische Universität Dresden (TU Dresden), Dresden, Germany. [Hampel,H] Division of Human Genetics, Department of Internal Medicine, The Ohio State University Comprehensive Cancer Center, Columbus, OH, USA. [Harlid,S] Department of Radiation Sciences, Oncology, Umea University, Umea, Sweden. [Hopper,JL] Department of Epidemiology, School of Public Health and Institute of Health and Environment, Seoul National University, Seoul, South Korea. [Hsu,L] Department of Biostatistics, University of Washington, Seattle, WA, USA. [Huerta,JM, Moreno,V, Sánchez,MJ] CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain. [Huerta,JM] Department of Epidemiology, Murcia Regional Health Council, IMIB-Arrixaca, Murcia, Spain. [Keku,TO] Center for Gastrointestinal Biology and Disease, University of North Carolina, Chapel Hill, NC, USA. [La Vecchia,C, Trichopoulou,A] Hellenic Health Foundation, Athens, Greece. [La Vecchia,C] Dept. of Clinical Sciences and Community Health, Università degli Studi di Milano, Milano, Italy. [Le Marchand,L] University of Hawaii Cancer Center, Honolulu, HI, USA. [Li,L] Department of Family Medicine, University of Virginia, Charlottesville, VA, USA. [Lindblom,A] Department of Clinical Genetics, Karolinska University Hospital, Stockholm, Sweden. [Lindblom,A] Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden. [Lindor,NM] Department of Health Science Research, Mayo Clinic, Scottsdale, AZ, USA. [Lynch,B] Physical Activity Laboratory, Baker Heart and Diabetes Institute, Melbourne, VIC, Australia. [Markowitz,SD] Departments of Medicine and Genetics, Case Comprehensive Cancer Center, Case Western Reserve University, and University Hospitals of Cleveland, Cleveland, OH, USA. [Masala,G] Cancer Risk Factors and Life-Style Epidemiology Unit, Institute for Cancer Research, Prevention and Clinical Network - ISPRO, Florence, Italy. [May,AM, Monninkhof,E] Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, GA UTRECHT, Netherlands. [Milne,R] Genetic Epidemiology Laboratory, Department of Pathology, The University of Melbourne, Parkville, VIC, Australia. [Moreno,V] Cancer Prevention and Control Program, Catalan Institute of Oncology-IDIBELL, L’Hospitalet de Llobregat, Barcelona, Spain. [Moreno,V] Department of Clinical Sciences, Faculty of Medicine, University of Barcelona, Barcelona, Spain. [Newcomb,PA] School of Public Health, University of Washington, Seattle, WA, USA. [Offit,K] Clinical Genetics Service, Department of Medicine, Memorial Sloan-Kettering Cancer Center, New York, NY, USA. [Offit,K] Department of Medicine, Weill Cornell Medical College, New York, NY, USA. [Perduca,V, Severi,G] CESP, Fac. de médecine - Univ. ParisSud, Fac. de médecine - UVSQ I, Université Paris-Saclay, Villejuif, France. [Perduca,V, Severi,G] Gustave Roussy, Villejuif, France. [Perduca,V] Laboratoire de Mathématiques Appliquées MAP5 (UMR CNRS 8145), Université Paris Descartes, Paris, France. [Pharoah,PDP] Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK. [Platz,EA] Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA. [Rennert,G] Department of Community Medicine and Epidemiology, Lady Davis Carmel Medical Center, Haifa, Israel. [Rennert,G] 7Ruth and Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel. [Rennert,G] Clalit National Cancer Control Center, Haifa, Israel. [Sánchez,MJ] Andalusian School of Public Health, Biomedical Research Institute ibs.GRANADA, University of Granada, Granada, Spain. [Schmit,SL] Department of Cancer Epidemiology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA. [Schoen,RE] Department of Medicine and Epidemiology, University of Pittsburgh Medical Center, Pittsburgh, PA, USA. [Sieri,S] Epidemiology and Prevention Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy. [Slattery,ML] Department of Internal Medicine, University of Utah, Salt Lake City, UT, USA. [Tangen,CM] SWOG Statistical Center, Fred Hutchinson Cancer Research Center, Seattle, WA, USA. [Thibodeau,SN] Division of Laboratory Genetics, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA. [Travis,RC] Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK. [Ulrich,CM] Huntsman Cancer Institute and Department of Population Health Sciences, University of Utah, Salt Lake City, UT, USA. [van Duijnhoven,FJB] Division of Human Nutrition, Wageningen University and Research, Wageningen, Netherlands. [Van Guelpen,B] Department of Radiation Sciences, Oncology Unit, Umeå University, Umeå, Sweden. [Van Guelpen,B] Wallenberg Centre for Molecular Medicine, Umeå University, Umeå, Sweden. [Vodicka,P] Department of Molecular Biology of Cancer, Institute of Experimental Medicine of the Czech Academy of Sciences, Prague, Czech Republic. [Vodicka,P] Faculty of Medicine and Biomedical Center in Pilsen, Charles University, Pilsen, Czech Republic. [Vodicka,P] Institute of Biology and Medical Genetics, First Faculty of Medicine, Charles University, Prague, Czech Republic. [White,E, Peters,U] Department of Epidemiology, University of Washington, Seattle, WA, USA. [Wolk,A] Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden. [Woods,MO] Memorial University of Newfoundland, Discipline of Genetics, St. John’s, Canada. [Wu,AH] University of Southern California, Preventative Medicine, Los Angeles, CA, USA., This work was supported by the National Cancer Institute, the International Agency for Research on Cancer and a Cancer Research UK program grant (C18281/A19169 to RMM, SJL & NK). RMM was supported by the National Institute for Health Research (NIHR) Bristol Biomedical Research Centre. The views expressed are those of the author(s) and not necessarily those of the NIHR or the Department of Health and Social Care. The funding sources for BCAC, CCFR, GECCO, and CORECT consortia are presented in detail in the appendix in the Supplementary material., Tsilidis, Konstantinos K [0000-0002-8452-8472], Martin, Richard M [0000-0002-7992-7719], Lewis, Sarah J [0000-0003-4311-6890], Robinson, Timothy M [0000-0003-0933-646X], Timothy Bishop, D [0000-0002-8752-8785], Buchanan, Daniel D [0000-0003-2225-6675], Chan, Andrew T [0000-0001-7284-6767], Giles, Graham G [0000-0003-4946-9099], Gsur, Andrea [0000-0002-9795-1528], Hampe, Jochen [0000-0002-2421-6127], Hampel, Heather [0000-0001-7558-9794], Harlid, Sophia [0000-0001-8540-6891], Harrison, Tabitha A [0000-0002-4173-7530], María Huerta, José [0000-0002-9637-3869], Huyghe, Jeroen R [0000-0001-6027-9806], Jenkins, Mark A [0000-0002-8964-6160], La Vecchia, Carlo [0000-0003-1441-897X], Masala, Giovanna [0000-0002-5758-9069], Milne, Roger [0000-0001-5764-7268], Moreno, Victor [0000-0002-2818-5487], Newcomb, Polly A [0000-0001-8786-0043], Perduca, Vittorio [0000-0003-0339-0473], Pharoah, Paul D P [0000-0001-8494-732X], Potter, John D [0000-0001-5439-1500], Rennert, Gad [0000-0002-8512-068X], Riboli, Elio [0000-0001-6795-6080], Schmit, Stephanie L [0000-0001-5931-1194], Schoen, Robert E [0000-0001-7153-2766], Van Guelpen, Bethany [0000-0002-9692-101X], Wolk, Alicja [0000-0001-7387-6845], Peters, Ulrike [0000-0001-5666-9318], Murphy, Neil [0000-0003-3347-8249], Apollo - University of Cambridge Repository, Tsilidis, Konstantinos K. [0000-0002-8452-8472], Martin, Richard M. [0000-0002-7992-7719], Lewis, Sarah J. [0000-0003-4311-6890], Timothy Bishop, D. [0000-0002-8752-8785], Buchanan, Daniel D. [0000-0003-2225-6675], Chan, Andrew T. [0000-0001-7284-6767], Giles, Graham G. [0000-0003-4946-9099], Harrison, Tabitha A. [0000-0002-4173-7530], Huyghe, Jeroen R. [0000-0001-6027-9806], Jenkins, Mark A. [0000-0002-8964-6160], Newcomb, Polly A. [0000-0001-8786-0043], Pharoah, Paul D. P. [0000-0001-8494-732X], Potter, John D. [0000-0001-5439-1500], Schmit, Stephanie L. [0000-0001-5931-1194], Schoen, Robert E. [0000-0001-7153-2766], and Pharoah, Paul DP [0000-0001-8494-732X]
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Oncology ,Epidemiology ,Colorectal cancer ,Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Accelerometry [Medical Subject Headings] ,Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Molecular Epidemiology::Mendelian Randomization Analysis [Medical Subject Headings] ,Organisms::Eukaryota::Animals::Chordata::Vertebrates::Mammals::Primates::Haplorhini::Catarrhini::Hominidae::Humans [Medical Subject Headings] ,0302 clinical medicine ,Breast cancer ,Epidemiology of cancer ,Accelerometry ,Odds Ratio ,lcsh:Science ,skin and connective tissue diseases ,Cancer genetics ,ComputingMilieux_MISCELLANEOUS ,Cancer ,0303 health sciences ,Biobank ,3. Good health ,030220 oncology & carcinogenesis ,ICEP ,Factores de riesgo ,medicine.medical_specialty ,Science ,631/67/2324 ,Diseases::Neoplasms::Neoplasms by Site::Digestive System Neoplasms::Gastrointestinal Neoplasms::Intestinal Neoplasms::Colorectal Neoplasms::Colorectal Neoplasms, Hereditary Nonpolyposis [Medical Subject Headings] ,Breast Neoplasms/genetics ,General Biochemistry, Genetics and Molecular Biology ,03 medical and health sciences ,SDG 3 - Good Health and Well-being ,Càncer colorectal ,Anthropology, Education, Sociology and Social Phenomena::Human Activities::Exercise [Medical Subject Headings] ,Humans ,Epidemiologia ,Exercise ,VLAG ,Cancer och onkologi ,45 ,631/67/1347 ,Odds ratio ,Mendelian Randomization Analysis ,medicine.disease ,Colorectal Neoplasms/genetics ,030104 developmental biology ,Analyses ,Risk factors ,Check Tags::Female [Medical Subject Headings] ,Cancer and Oncology ,lcsh:Q ,Breast neoplasms ,0301 basic medicine ,631/67/1504/1885 ,Nutrition and Disease ,General Physics and Astronomy ,Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Statistics as Topic::Probability::Risk::Risk Factors [Medical Subject Headings] ,Risk Factors ,Neoplasias colorrectales ,Voeding en Ziekte ,Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Statistics as Topic::Probability::Odds Ratio [Medical Subject Headings] ,Multidisciplinary ,article ,Public Health, Global Health, Social Medicine and Epidemiology ,Polymorphism, Single Nucleotide/genetics ,Ejercicio físico ,Neoplasias de la mama ,Female ,Colorectal Neoplasms ,631/67 ,141 ,Breast Neoplasms ,45/23 ,Polymorphism, Single Nucleotide ,Colorectal neoplasms ,Càncer de mama ,Diseases::Pathological Conditions, Signs and Symptoms::Pathologic Processes::Disease Attributes::Disease Susceptibility::Genetic Predisposition to Disease [Medical Subject Headings] ,Cancer epidemiology ,631/67/68 ,Internal medicine ,Mendelian randomization ,medicine ,Journal Article ,Life Science ,Genetic Predisposition to Disease ,Diseases::Neoplasms::Neoplasms by Site::Breast Neoplasms [Medical Subject Headings] ,030304 developmental biology ,Phenomena and Processes::Genetic Phenomena::Genetic Variation::Polymorphism, Genetic::Polymorphism, Single Nucleotide [Medical Subject Headings] ,business.industry ,General Chemistry ,Physical fitness ,Confidence interval ,Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi ,[SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie ,business ,Condició física - Abstract
Physical activity has been associated with lower risks of breast and colorectal cancer in epidemiological studies; however, it is unknown if these associations are causal or confounded. In two-sample Mendelian randomisation analyses, using summary genetic data from the UK Biobank and GWA consortia, we found that a one standard deviation increment in average acceleration was associated with lower risks of breast cancer (odds ratio [OR]: 0.51, 95% confidence interval [CI]: 0.27 to 0.98, P-value = 0.04) and colorectal cancer (OR: 0.66, 95% CI: 0.48 to 0.90, P-value = 0.01). We found similar magnitude inverse associations for estrogen positive (ER+ve) breast cancer and for colon cancer. Our results support a potentially causal relationship between higher physical activity levels and lower risks of breast cancer and colorectal cancer. Based on these data, the promotion of physical activity is probably an effective strategy in the primary prevention of these commonly diagnosed cancers., United States Department of Health & Human Services National Institutes of Health (NIH) - USA NIH National Cancer Institute (NCI), International Agency for Research on Cancer, Cancer Research UK C18281/A19169, National Institute for Health Research (NIHR)
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- 2020
40. Theoretical potential for endometrial cancer prevention through primary risk factor modification: Estimates from the EPIC cohort
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Patrick Arveux, Elio Riboli, Carla H. van Gils, Marina Kvaskoff, Rudolf Kaaks, María José Sánchez, Kim Overvad, Pilar Amiano, Naomi E. Allen, Elisabete Weiderpass, Christina C. Dahm, Catalina Bonet, Carlo La Vecchia, Giovanna Masala, Amalia Mattiello, José Ramón Quirós, Manuela M. Bergmann, Matthias B. Schulze, Marc J. Gunter, Anna Karakatsani, Daniel Ángel Rodríguez-Palacios, Vivian Viallon, Valeria Pala, Ruth C. Travis, Renée T. Fortner, Fulvio Ricceri, Rosario Tumino, Antonia Trichopoulou, Evelyn M. Monninkhof, Anne Tjønneland, Laure Dossus, Agnès Fournier, Aurelio Barricarte Gurrea, Anika Hüsing, Centre de recherche en épidémiologie et santé des populations (CESP), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris-Saclay, Cancer Research Foundation in Northern Sweden Ministerie van Volksgezondheid, Welzijn en Sport, VWS Deutsche Krebshilfe Cancer Research UK, CRUK: C8221/A19170, C570/A16491 Vetenskapsrådet, VR Ministerie van Volksgezondheid, Welzijn en Sport, VWS Ligue Contre le Cancer German Cancer Research Center, DKFZ Bundesministerium für Bildung und Forschung, BMBF Bundesministerium für Bildung und Forschung, BMBF Kræftens Bekæmpelse, DCS German Cancer Research Center, DKFZ Associazione Italiana per la Ricerca sul Cancro, AIRC National Research Council, NRC Mutuelle Générale de l'Education Nationale, MGEN Hellenic Health Foundation, HHF Institut National de la Santé et de la Recherche Médicale, Inserm Fondation Gustave Roussy European Commission, EC Centre International de Recherche sur le Cancer, IARC RD06/0020 German Cancer Research Center, DKFZ Deutsche Krebshilfe Cancerfonden World Cancer Research Fund, WCRF: ERC‐2009‐AdG 232997 PI13/01162, PI13/00061 NordForsk Medical Research Council, MRC: MR/M012190/1, The coordination of EPIC is financially supported by the European Commission (DG‐SANCO) and the International Agency for Research on Cancer. The national cohorts are supported by Danish Cancer Society (Denmark), Ligue Contre le Cancer, Institut Gustave Roussy, Mutuelle Générale de l'Education Nationale, Institut National de la Santé et de la Recherche Médicale (INSERM) (France), German Cancer Aid, German Cancer Research Center (DKFZ), Federal Ministry of Education and Research (BMBF), Deutsche Krebshilfe, Deutsches Krebsforschungszentrum and Federal Ministry of Education and Research (Germany), the Hellenic Health Foundation (Greece), Associazione Italiana per la Ricerca sul Cancro‐AIRC‐Italy and National Research Council (Italy), Dutch Ministry of Public Health, Welfare and Sports (VWS), Netherlands Cancer Registry (NKR), LK Research Funds, Dutch Prevention Funds, Dutch ZON (Zorg Onderzoek Nederland), World Cancer Research Fund (WCRF), Statistics Netherlands (The Netherlands), ERC‐2009‐AdG 232997 and Nordforsk, Nordic Centre of Excellence programme on Food, Nutrition and Health (Norway), Health Research Fund (FIS), PI13/00061 to Granada, PI13/01162 to EPIC‐Murcia), Regional Governments of Andalucía, Asturias, Basque Country, Murcia and Navarra, ISCIII RETIC (RD06/0020) (Spain), Swedish Cancer Society, Swedish Research Council and County Councils of Skåne and Västerbotten, The Cancer Research Foundation of Northern Sweden (Sweden), Cancer Research UK (C570/A16491 and C8221/A19170), Medical Research Council (MR/M012190/1) (EPIC‐Oxford, and United Kingdom). The EPIC‐Norfolk study (doi: 10.22025/2019.10.105.00004) has received funding from the Medical Research Council (MR/N003284/1 and MC‐UU_12015/1) and Cancer Research UK (C864/A14136). We are grateful to all the participants who have been part of the project and to the many members of the study teams at the University of Cambridge who have enabled this research. For information on how to submit an application for gaining access to EPIC data and/or biospecimens, please follow the instructions at http://epic.iarc.fr/access/index.php .
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Cancer Research ,primary prevention ,Overweight ,Body Mass Index ,COLORECTAL-CANCER ,Cohort Studies ,0302 clinical medicine ,Endometrial cancer ,Medicine ,risk factors ,endometrial cancer ,2. Zero hunger ,Framingham Risk Score ,Incidence ,Incidence (epidemiology) ,Middle Aged ,3. Good health ,Europe ,Menopause ,Oncology ,030220 oncology & carcinogenesis ,Cohort ,Female ,NUTRITION ,medicine.symptom ,Cancer Epidemiology ,Adult ,Pes corporal ,[SDV.CAN]Life Sciences [q-bio]/Cancer ,Context (language use) ,BREAST ,OVARIAN-CANCER ,03 medical and health sciences ,Humans ,Risk factor ,Hormone therapy ,Aged ,Models, Statistical ,business.industry ,ORAL-CONTRACEPTIVE USE ,Body weight ,medicine.disease ,Endometrial Neoplasms ,Càncer d'endometri ,business ,Body mass index ,Hormonoteràpia ,Contraceptives, Oral ,Demography - Abstract
Endometrial cancer (EC) incidence rates vary ~10‐fold worldwide, in part due to variation in EC risk factor profiles. Using an EC risk model previously developed in the European EPIC cohort, we evaluated the prevention potential of modified EC risk factor patterns and whether differences in EC incidence between a European population and low‐risk countries can be explained by differences in these patterns. Predicted EC incidence rates were estimated over 10 years of follow‐up for the cohort before and after modifying risk factor profiles. Risk factors considered were: body mass index (BMI, kg/m2), use of postmenopausal hormone therapy (HT) and oral contraceptives (OC) (potentially modifiable); and, parity, ages at first birth, menarche and menopause (environmentally conditioned, but not readily modifiable). Modeled alterations in BMI (to all ≤23 kg/m2) and HT use (to all non‐HT users) profiles resulted in a 30% reduction in predicted EC incidence rates; individually, longer duration of OC use (to all ≥10 years) resulted in a 42.5% reduction. Modeled changes in not readily modifiable exposures (i.e., those not contributing to prevention potential) resulted in ≤24.6% reduction in predicted EC incidence. Women in the lowest decile of a risk score based on the evaluated exposures had risk similar to a low risk countries; however, this was driven by relatively long use of OCs (median = 23 years). Our findings support avoidance of overweight BMI and of HT use as prevention strategies for EC in a European population; OC use must be considered in the context of benefits and risks., What's new? Endometrial cancer rates vary considerably around the world, with incidence rates higher in Europe and North America than in parts of Asia and Africa. Here, the authors investigated how much of the risk disparity arises from modifiable factors, and how much modifying these factors could reduce cancer incidence. The 10% of European women with lowest risk had similar incidence to women in low‐risk countries, they found. Their model predicted that in European women, maintaining BMI below 23 kg/m2 and avoiding postmenopausal hormone use could reduce risk by 30%. Long‐term use of oral contraceptives could reduce risk by 42.5%.
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- 2020
41. Primary endpoint analysis of the multicentre phase II hypo-FLAME trial for intermediate and high risk prostate cancer
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Evelyn M. Monninkhof, Linda G W Kerkmeijer, Jochem R.N. van der Voort van Zyp, Sofie Isebaert, Robert Jan Smeenk, Floris J. Pos, Tom Depuydt, Hans C. J. de Boer, Uulke A. van der Heide, Karin Haustermans, M. Kunze-Busch, V. Groen, Cédric Draulans, and Robin De Roover
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Male ,medicine.medical_specialty ,Stereotactic body radiotherapy ,medicine.medical_treatment ,Urology ,Extreme hypofractionation ,Radiosurgery ,030218 nuclear medicine & medical imaging ,03 medical and health sciences ,Prostate cancer ,0302 clinical medicine ,Prostate ,Clinical endpoint ,Medicine ,Humans ,Radiology, Nuclear Medicine and imaging ,Prospective Studies ,Radiotherapy ,business.industry ,Genitourinary system ,Prostatic Neoplasms ,Hematology ,Focal boost ,medicine.disease ,Acute toxicity ,Radiation therapy ,medicine.anatomical_structure ,Oncology ,030220 oncology & carcinogenesis ,Urological cancers Radboud Institute for Health Sciences [Radboudumc 15] ,Toxicity ,Radiation Dose Hypofractionation ,Radiotherapy, Intensity-Modulated ,Prostatic neoplasms ,Neoplasm Recurrence, Local ,business ,Rare cancers Radboud Institute for Health Sciences [Radboudumc 9] - Abstract
Contains fulltext : 220466.pdf (Publisher’s version ) (Closed access) BACKGROUND AND PURPOSE: Local recurrences after radiotherapy for prostate cancer (PCa) often originate at the location of the macroscopic tumour(s). Since PCa cells are known to be sensitive to high fraction doses, hypofractionated whole gland stereotactic body radiotherapy (SBRT) in conjunction with a simultaneous ablative microboost to the macroscopic tumour(s) within the prostate could be a way to reduce the risk of local failure. We investigated the safety of this treatment strategy. MATERIALS AND METHODS: Patients with intermediate or high risk PCa were enrolled in a prospective phase II trial, called hypo-FLAME. All patients were treated with extreme hypofractionated doses of 35 Gy in 5 weekly fractions to the whole prostate gland with an integrated boost up to 50 Gy to the multiparametric (mp) MRI-defined tumour(s). Treatment-related toxicity was measured using the CTCAE v4.0. The primary endpoint of the trial was treatment-related acute toxicity. RESULTS: Between April 2016 and December 2018, 100 men were treated in 4 academic centres. All patients were followed up for a minimum of 6 months. The median mean dose delivered to the visible tumour nodule(s) on mpMRI was 44.7 Gy in this trial. No grade ≥3 acute genitourinary (GU) or gastrointestinal (GI) toxicity was observed. Furthermore, 90 days after start of treatment, the cumulative acute grade 2 GU and GI toxicity rates were 34.0% and 5.0%, respectively. CONCLUSION: Simultaneous focal boosting to the macroscopic tumour(s) in addition to whole gland prostate SBRT is associated with acceptable acute GU and GI toxicity.
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- 2020
42. Lifestyle factors and risk of multimorbidity of cancer and cardiometabolic diseases: A multinational cohort study
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Manuela M. Bergmann, Elio Riboli, Christina C. Dahm, Marc J. Gunter, Christina Bamia, David C. Muller, Pauline Bazelle, Antonio Agudo, Isabelle Romieu, Heather Ward, Pietro Ferrari, Patrick Arveux, Anja Olsen, Tammy Y.N. Tong, Elin Thysell, Julie A. Schmidt, María José Sánchez, Adam S. Butterworth, Aurelio Barricarte Gurrea, Peter Nilsson, Pilar Amiano, Kim Overvad, Fulvio Ricceri, Rosario Tumino, Salvatore Panico, Michael J. Sweeting, Evelyn M. Monninkhof, Anne Tjønneland, Marina Kvaskoff, Vincenzo Bagnardi, Olov Rolandsson, Konstantinos K. Tsilidis, Mazda Jenab, H. Susan J. Picavet, Paolo Vineis, Tilman Kühn, Heinz Freisling, Gianluca Severi, John Danesh, Claudia Agnoli, Hannah Lennon, Marije F. Bakker, Vivian Viallon, Virginia Menéndez, Rudolf Kaaks, Nicholas J. Wareham, Heiner Boeing, Carmen Santiuste, Jonas Manjer, Elisabete Weiderpass, Domenico Palli, Ioanna Tzoulaki, Cristian Ricci, Centre de recherche en épidémiologie et santé des populations (CESP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris-Sud - Paris 11 (UP11)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Versailles Saint-Quentin-en-Yvelines (UVSQ), 2018-1-PL SHS-06-CIRC-1 LSHM_CT_2006_037197 HEALTH24 F2-2012-279233 PI13/00061, PI13/01162 2018-123 RD06/0020 G0800270, MR/ L003120/1 Kræftens Bekæmpelse, DCS German Cancer Research Center, DKFZ Centre International de Recherche sur le Cancer, IARC National Research Council, NRC Medical Research Council, MRC: MR/M012190/1 British Heart Foundation, BHF: 26 RG/08/014, RG13/ 13/30194, SP/09/002 Cancer Research UK, CRUK: C570/A16491, C8221/A19170 World Cancer Research Fund, WCRF European Commission, EC European Research Council, ERC: 268834 Bundesministerium für Bildung und Forschung, BMBF Cancerfonden Ministerie van Volksgezondheid, Welzijn en Sport, VWS Vetenskapsrådet, VR Ministère des Affaires Sociales et de la Santé: GR-IARC-2003-09-12-01 Direction Générale de la Compétitivité, de l’Industrie et des Services, DGCIS Associazione Italiana per la Ricerca sul Cancro, AIRC Deutsche Krebshilfe, This work was supported by the Direction Générale de la Santé (French Ministry of Health) (Grant GR-IARC-2003-09-12-01) and by the French National Cancer Institute (INCA_N°2018-123), and the Cancéropôle Ile-de-France (N°2018-1-PL SHS-06-CIRC-1). Funding for the InterAct project was provided by the EU FP6 programme (grant no. LSHM_CT_2006_037197). EPIC-CVD has been supported by the European Union Framework 7 (HEALTH24 F2-2012-279233), the European Research Council (268834), the UK Medical Research 25 Council (G0800270 and MR/ L003120/1), the British Heart Foundation (SP/09/002 and 26 RG/08/014 and RG13/ 13/30194), and the UK National Institute of Health Research. The coordination of EPIC is financially supported by the European Commission (DG-SANCO) and the International Agency for Research on Cancer. The national cohorts are supported by Danish Cancer Society (Denmark), German Cancer Aid, German Cancer Research Center (DKFZ), Federal Ministry of Education and Research (BMBF), Deutsche Krebshilfe, Deutsches Krebsforschungszentrum and Federal Ministry of Education and Research (Germany), Associazione Italiana per la Ricerca sul Cancro-AIRC-Italy and National Research Council (Italy), Dutch Ministry of Public Health, Welfare and Sports (VWS), Netherlands Cancer Registry (NKR), LK Research Funds, Dutch Prevention Funds, Dutch ZON (Zorg Onderzoek Nederland), World Cancer Research Fund (WCRF), Statistics Netherlands (The Netherlands), Health Research Fund (FIS), PI13/00061 to Granada, PI13/01162 to EPIC-Murcia), Regional Governments of Andalucía, Asturias, Basque Country, Murcia and Navarra, ISCIII RETIC (RD06/0020) (Spain), Swedish Cancer Society, Swedish Research Council and County Councils of Skåne and Västerbotten (Sweden), Cancer Research UK (14136 to EPIC-Norfolk, C570/A16491 and C8221/A19170 to EPIC-Oxford), Medical Research Council (1000143 to EPIC-Norfolk, MR/M012190/1 to EPIC-Oxford) (UK). The funder of the study had no role in study design, data collection, data analysis, data interpretation, or writing of the report., Butterworth, Adam [0000-0002-6915-9015], Danesh, John [0000-0003-1158-6791], Wareham, Nicholas [0000-0003-1422-2993], Apollo - University of Cambridge Repository, Cancer Research UK, Freisling, H, Viallon, V, Lennon, H, Bagnardi, V, Ricci, C, Butterworth, A, Sweeting, M, Muller, D, Romieu, I, Bazelle, P, Kvaskoff, M, Arveux, P, Severi, G, Bamia, C, Kuhn, T, Kaaks, R, Bergmann, M, Boeing, H, Tjonneland, A, Olsen, A, Overvad, K, Dahm, C, Menendez, V, Agudo, A, Sanchez, M, Amiano, P, Santiuste, C, Gurrea, A, Tong, T, Schmidt, J, Tzoulaki, I, Tsilidis, K, Ward, H, Palli, D, Agnoli, C, Tumino, R, Ricceri, F, Panico, S, Picavet, H, Bakker, M, Monninkhof, E, Nilsson, P, Manjer, J, Rolandsson, O, Thysell, E, Weiderpass, E, Jenab, M, Riboli, E, Vineis, P, Danesh, J, Wareham, N, Gunter, M, Ferrari, P, 29790514 - Ricci, Cristian, Overvad, Kim [0000-0001-6429-7921], Dahm, Christina C [0000-0003-0481-2893], and Tong, Tammy Y N [0000-0002-0284-8959]
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Male ,lcsh:Medicine ,Disease ,Diabete ,Body Mass Index ,Cohort Studies ,0302 clinical medicine ,Risk Factors ,Neoplasms ,030212 general & internal medicine ,Prospective Studies ,Prospective cohort study ,Càncer ,11 Medical and Health Sciences ,Cancer ,2. Zero hunger ,Medicine(all) ,Incidence ,Hazard ratio ,Diabetes ,General Medicine ,Middle Aged ,Cardiovascular disease ,3. Good health ,Cardiovascular diseases ,Cardiovascular Diseases ,030220 oncology & carcinogenesis ,Obesitat ,Female ,Type 2 ,Cohort study ,Research Article ,Adult ,Alcohol Drinking ,Cancer and cardiometabolic multimorbidity ,Healthy lifestyle ,Obesity ,Prevention ,Diabetes Mellitus, Type 2 ,Humans ,Proportional Hazards Models ,Risk Reduction Behavior ,Life Style ,Multimorbidity ,03 medical and health sciences ,Environmental health ,General & Internal Medicine ,medicine ,Journal Article ,Diabetes Mellitus ,Cancer och onkologi ,business.industry ,Proportional hazards model ,Malalties cardiovasculars ,lcsh:R ,medicine.disease ,Cancer and Oncology ,[SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie ,business ,Body mass index - Abstract
Background Although lifestyle factors have been studied in relation to individual non-communicable diseases (NCDs), their association with development of a subsequent NCD, defined as multimorbidity, has been scarcely investigated. The aim of this study was to investigate associations between five lifestyle factors and incident multimorbidity of cancer and cardiometabolic diseases. Methods In this prospective cohort study, 291,778 participants (64% women) from seven European countries, mostly aged 43 to 58 years and free of cancer, cardiovascular disease (CVD), and type 2 diabetes (T2D) at recruitment, were included. Incident multimorbidity of cancer and cardiometabolic diseases was defined as developing subsequently two diseases including first cancer at any site, CVD, and T2D in an individual. Multi-state modelling based on Cox regression was used to compute hazard ratios (HR) and 95% confidence intervals (95% CI) of developing cancer, CVD, or T2D, and subsequent transitions to multimorbidity, in relation to body mass index (BMI), smoking status, alcohol intake, physical activity, adherence to the Mediterranean diet, and their combination as a healthy lifestyle index (HLI) score. Cumulative incidence functions (CIFs) were estimated to compute 10-year absolute risks for transitions from healthy to cancer at any site, CVD (both fatal and non-fatal), or T2D, and to subsequent multimorbidity after each of the three NCDs. Results During a median follow-up of 11 years, 1910 men and 1334 women developed multimorbidity of cancer and cardiometabolic diseases. A higher HLI, reflecting healthy lifestyles, was strongly inversely associated with multimorbidity, with hazard ratios per 3-unit increment of 0.75 (95% CI, 0.71 to 0.81), 0.84 (0.79 to 0.90), and 0.82 (0.77 to 0.88) after cancer, CVD, and T2D, respectively. After T2D, the 10-year absolute risks of multimorbidity were 40% and 25% for men and women, respectively, with unhealthy lifestyle, and 30% and 18% for men and women with healthy lifestyles. Conclusion Pre-diagnostic healthy lifestyle behaviours were strongly inversely associated with the risk of cancer and cardiometabolic diseases, and with the prognosis of these diseases by reducing risk of multimorbidity.
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- 2020
43. Five-Year Toxicity after EBRT for Localized Prostate Cancer with or without a Simultaneously Integrated Focal Boost up to 95Gy: Results of a Randomized Controlled Trial
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Linda G W Kerkmeijer, Sofie Isebaert, Robert Jan Smeenk, K. Haustermans, M. Kunze-Busch, L. Van den Bergh, H. de Boer, J. Van der Voort vanZyp, Floris J. Pos, Evelyn M. Monninkhof, U.A. Van der Heide, M. van Vulpen, V. Groen, and Cédric Draulans
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Oncology ,Cancer Research ,medicine.medical_specialty ,Radiation ,business.industry ,medicine.disease ,law.invention ,Prostate cancer ,Randomized controlled trial ,law ,Internal medicine ,Toxicity ,medicine ,Radiology, Nuclear Medicine and imaging ,business - Published
- 2020
44. PH-0114: Dose-volume effects for GI toxicity following EBRT for prostate cancer in the FLAME trial
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K. Haustermans, Floris J. Pos, Linda G W Kerkmeijer, Sofie Isebaert, Robert Jan Smeenk, M. Kunze-Busch, M. Van Schie, U.A. Van der Heide, Helena M. Verkooijen, Evelyn M. Monninkhof, P. Zuithoff, H. de Boer, V. Groen, Tom Depuydt, and J. Van der Voort van Zijp
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Prostate cancer ,medicine.medical_specialty ,Oncology ,Volume (thermodynamics) ,business.industry ,Toxicity ,Urology ,Medicine ,Radiology, Nuclear Medicine and imaging ,Hematology ,business ,medicine.disease - Published
- 2020
45. OC-0209: 'SBRT and the Boost', a love story: primary endpoint analysis of the phase II hypo-FLAME trial
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Sofie Isebaert, H. de Boer, Robert Jan Smeenk, J.R.N. Van der Voort van Zyp, Evelyn M. Monninkhof, Linda G W Kerkmeijer, Tom Depuydt, Floris J. Pos, Cédric Draulans, K. Haustermans, R. De Roover, U.A. Van der Heide, M. Kunze-Busch, and V. Groen
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Oncology ,business.industry ,Clinical endpoint ,Phase (waves) ,Medicine ,Radiology, Nuclear Medicine and imaging ,Hematology ,Love story ,Nuclear medicine ,business - Published
- 2020
46. OC-0612: The FLAME trial: benefit of a focal boost for prostate cancer on biochemical disease-free survival
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M.C. Kunze-Busch, Sofie Isebaert, Robert Jan Smeenk, Cédric Draulans, Linda G W Kerkmeijer, Floris J. Pos, V. Groen, Evelyn M. Monninkhof, L. Van den Bergh, M. van Vulpen, U.A. Van der Heide, K. Haustermans, H. de Boer, and J.R.N. Van der Voort van Zyp
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Oncology ,medicine.medical_specialty ,Disease free survival ,Prostate cancer ,business.industry ,Internal medicine ,medicine ,Radiology, Nuclear Medicine and imaging ,Hematology ,business ,medicine.disease - Published
- 2020
47. OC-0315: Quality of life after EBRT with or without focal boost for prostate cancer in the FLAME trial
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U.A. Van der Heide, Evelyn M. Monninkhof, Floris J. Pos, Linda G W Kerkmeijer, K. Haustermans, Tom Depuydt, J. Van der Voort van Zijp, M. Kunze-Busch, Sofie Isebaert, Robert Jan Smeenk, Helena M. Verkooijen, H. de Boer, and V. Groen
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Oncology ,medicine.medical_specialty ,Prostate cancer ,Quality of life ,business.industry ,Internal medicine ,Medicine ,Radiology, Nuclear Medicine and imaging ,Hematology ,business ,medicine.disease - Published
- 2020
48. Effect of physical exercise on cognitive function after chemotherapy in patients with breast cancer: A randomized controlled trial (PAM study)
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Miranda J. Velthuis, Anne Maria May, Mirjam I. Geerlings, Lenja Witlox, Jan J. Jobsen, Gabe S. Sonke, Michiel B. de Ruiter, Martijn M. Stuiver, Job van der Palen, Evelyn M. Monninkhof, Emmie W Koevoets, Elsken van der Wall, and Sanne B. Schagen
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Cancer Research ,Chemotherapy ,medicine.medical_specialty ,business.industry ,medicine.medical_treatment ,Physical exercise ,Cognition ,medicine.disease ,law.invention ,Breast cancer ,Oncology ,Randomized controlled trial ,law ,Intervention (counseling) ,Cognitive problems ,medicine ,Physical therapy ,In patient ,business - Abstract
12015 Background: Chemotherapy is associated with cognitive problems. Physical exercise is a promising intervention. We investigated whether exercise improves cognition in chemotherapy-exposed breast cancer (BC) patients 2-4 years after diagnosis. Methods: In the PAM study, we randomized chemotherapy-exposed BC patients with self-reported and test-confirmed cognitive problems to an exercise or control group. The 6-month exercise intervention consisted of 2 hours of supervised aerobic and resistance training and two hours of Nordic/power walking. Memory function measured with the Hopkins Verbal Learning Test-Revised (HVLT-R) was our primary outcome. Further measurements included online neuropsychological tests (Amsterdam Cognition Scan; ACS), self-reported cognitive complaints (MDASI-MM, EORTC QLQ C-30 cognitive functioning), physical fitness (VO2peak), fatigue (MFI, EORTC fatigue), quality of life (QoL; EORTC), anxiety (HADS) and depression (HADS, PHQ9). HVLT-R total recall was analyzed with a Fisher exact test for clinically relevant improvement of ≥5 words. Other outcomes were analyzed using multiple regression analyses adjusted for baseline and stratification factors. An hypothesis driven but not pre-specified analysis in patients with high baseline EORTC fatigue levels (≥39) was performed. Results: We randomized 181 patients to the exercise (n = 91) or control group (n = 90). Two-third of the patients attended ≥ 80% of the exercise program and physical fitness significantly improved compared to the control patients ( VO2peak1.4 ml/min/kg, 95% CI 0.6; 2.2). No difference in favor of the intervention group was seen on the primary cognitive outcome or other cognitive tests. However, significant beneficial intervention effects were found for self-reported cognition (MDASI-MM Severity (-0.7, -1.2;-0.1)), fatigue (general fatigue (-2.2, -3.3; -1.1), physical fatigue (-3.3, -4.4; -2.2), mental fatigue (-1.0, -2.0; 0.0), reduced motivation (-1.1, -2.0; -0.2) and reduced activity (-2.1, -3.2; -1.1)), QoL (summary score (4.0, 1.2; 6.7), global health status (5.8, 1.1; 10.6), role functioning (7.2, 1.3; 13.1) and social functioning (5.9, 0.2; 11.6)) and depression (PHQ9 (-1.16, -2.19; -0.13)). In high-fatigued patients, exercise did show significant positive effects on objective cognitive function (ACS Reaction Time (-26.8, -52.9; -0.6) and ACS Wordlist Learning (4.4, 0.5; 8.3)). Conclusions: A 6-month exercise intervention did not improve objectively measured cognitive function in chemotherapy-exposed BC patients with cognitive problems. However, self-reported cognitive function, physical fitness, fatigue, QoL and depression did improve. Unplanned analysis indicated a small positive effect of exercise on cognitive functioning in high-fatigued patients. Clinical trial information: NTR6104.
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- 2021
49. The ethics of ‘Trials within Cohorts’ (TwiCs): 2nd international symposium
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Clare Relton, Maarten Burbach, Clive Collett, James Flory, Sophie Gerlich, Soren Holm, Amanda Hunn, Scott Y. Kim, Linda Kwakkenbos, Anne May, Jon Nicholl, Danny Young-Afat, Shaun Treweek, Rudolf Uher, Tjeerd van Staa, Joanne van der Velden, Helena Verkooijen, Andrew Vickers, Sophie Welch, Merrick Zwarenstein, Scott Kim, Zachary Goodman, Søren Holm, Anne M. May, Danny A. Young-Afat, Johannes P. Burbach, Carla H. van Gils, Rieke van der Graaf, Helena M. Verkooijen, Laura C. Coates, William Tillett, David Torgerson, Neil McHugh, Peter Taylor, Lesley Brown, Anne Heaven, John Young, Andrew Clegg, Kate Chatfield, Roxanne Gal, Evelyn M. Monninkhof, Danny A. Young Afat, Rolf H. H. Groenwold, Marie-Eve Carrier, Brett D. Thombs, the SPIN investigators, Joanne M. van der Velden, A. Sophie Gerlich, Jorrit-Jan Verlaan, Alice M. Couwenberg, Johannes P. M. Burbach, Emily Peckham, Suzanne Crossland, Tom Hughes, Alisha O’Connor, Imogen Sargent, and Simon Gilbody
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lcsh:R5-920 ,lcsh:Medicine (General) - Published
- 2017
50. Association between changes in fat distribution and biomarkers for breast cancer
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Anne M. May, Evelyn M. Monninkhof, Maaike Stapper, Wouter B. Veldhuis, Sjoerd G. Elias, Petra H.M. Peeters, Rebecca K. Stellato, Willemijn A.M. van Gemert, Jantine A. Schuit, and Job van der Palen
- Subjects
Leptin ,Cancer Research ,Endocrinology, Diabetes and Metabolism ,postmenopausal women ,Overweight ,LONG EXERCISE INTERVENTION ,breast cancer risk ,0302 clinical medicine ,Endocrinology ,Sex hormone-binding globulin ,Risk Factors ,Weight loss ,Sex Hormone-Binding Globulin ,Body Fat Distribution ,Testosterone ,METABOLIC RISK ,skin and connective tissue diseases ,Abdominal obesity ,education.field_of_study ,Estradiol ,biology ,11 Medical And Health Sciences ,Middle Aged ,Postmenopause ,RANDOMIZED CLINICAL-TRIAL ,body fat ,C-Reactive Protein ,Adipose Tissue ,Oncology ,ABDOMINAL OBESITY ,030220 oncology & carcinogenesis ,Female ,CIRCULATING ADIPONECTIN ,Adiponectin ,SUBCUTANEOUS ADIPOSE-TISSUE ,medicine.symptom ,Life Sciences & Biomedicine ,hormones, hormone substitutes, and hormone antagonists ,medicine.medical_specialty ,Population ,BODY-FAT ,WEIGHT-LOSS ,Breast Neoplasms ,030209 endocrinology & metabolism ,Endocrinology & Metabolism ,03 medical and health sciences ,Classification of obesity ,Internal medicine ,Weight Loss ,medicine ,Journal Article ,Humans ,Oncology & Carcinogenesis ,TANDEM MASS-SPECTROMETRY ,education ,Exercise ,Aged ,Science & Technology ,Interleukin-6 ,business.industry ,abdominal fat ,biomarkers ,06 Biological Sciences ,n/a OA procedure ,Diet ,biology.protein ,business - Abstract
We assessed the associations between changes in total and abdominal fat and changes in biomarkers for breast cancer risk using data of the SHAPE-2 trial. In the SHAPE-2 trial, 243 postmenopausal overweight women were included. The intervention in this trial consisted of 5-6 kg weight loss either by diet only or exercise plus diet. After 16 weeks, we measured serum sex hormones, inflammatory markers, total body fat (measured by DEXA scan) and intra and subcutaneous abdominal fat (measured by MRI). Associations between changes in different body fat depots and biomarkers were analysed by linear regression using the study cohort irrespective of randomisation to make maximal use of the distribution of changes in fat measures. We found that a loss in total body fat was associated with favourable changes in free oestradiol, free testosterone, leptin and sex hormone binding globulin (SHBG). The loss of intra-abdominal fat was associated with a decrease in free testosterone, hsCRP and leptin, and an increase in SHBG. In the multivariable analysis, the best fitted models for the biomarkers free oestradiol, SHBG leptin and adiponectin included only total body fat. For free testosterone, this was subcutaneous abdominal fat, and for hsCRP and IL-6, only intra-abdominal fat change was important. For IL-6 and adiponectin, however, associations were weak and not significant. We conclude that, in our population of healthy overweight postmenopausal women, loss of fat at different body locations was associated with changes in different types of biomarkers, known to be related to risk of breast cancer.
- Published
- 2017
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