10 results on '"Madalena Liu"'
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2. Improving rectal dosimetry for patients with intermediate and high-risk prostate cancer undergoing combined high-dose-rate brachytherapy and external beam radiotherapy with hydrogel space
- Author
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Michael Chao, Darren Ow, Huong Ho, Yee Chan, Daryl Lim Joon, Sandra Spencer, Nathan Lawrentschuk, Mario Guerrieri, Trung Pham, Kevin McMillan, Alwin Tan, Farshad Foroudi, Johann Tang, Jason Wasiak, Madalena Liu, George Koufogiannis, Chee Wee Cham, and Damien Bolton
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prostate cancer ,hydrogel spacer ,high-dose-rate ,brachytherapy ,rectal protection ,Medicine - Published
- 2019
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3. Hyaluronic acid rectal spacer in EBRT: Usability, safety and symmetry related to user experience
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Jack Williams, Kevin Mc Millan, Damien Bolton, Alwin Tan, Chee Wee Cham, Trung Pham, David Pan, Madalena Liu, Yee Chan, Paul Manohar, Joe Thomas, George Koufogiannis, Huong Ho, Mario Guerrieri, Michael Ng, Thomas Boike, Craig Macleod, Daryl Lim Joon, Farshad Foroudi, and Michael Chao
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Male ,Radiological and Ultrasound Technology ,Fiducial Markers ,Rectum ,Prostate ,Humans ,Prostatic Neoplasms ,Radiology, Nuclear Medicine and imaging ,Hyaluronic Acid - Abstract
To report on the usability, safety, symmetry, and effectiveness of hyaluronic acid (HA) injected between the prostate and the rectum for patients undergoing treatment for prostate cancer with external beam radiotherapy (EBRT), and present a novel definition of rectal spacer symmetry that is reproducible and independent of patient anatomy.102 consecutive patients with clinical stage of T1c-3b prostate cancer underwent general anaesthesia for fiducial marker insertion and injection of HA into the perirectal space before EBRT. HA safety, symmetry, separation, and usability based on user experience were assessed.HA insertion was completed with a 100% success rate independent of user experience, rated as 'easy' or 'very easy' in all cases. There were no postoperative complications reported. The mean (SD) recto-prostatic separation for all patients at the base, midgland and apex were 12 (±2) mm, 11 (±2) mm, and 9 (±1) mm respectively. The mean sagittal length of the implant was 43 (±5) mm. The implant was rated as symmetrical in 98% of cases. The mean rV70Gy was 1.6% (IQR 0.8-3.3%) for patients receiving 78-80Gy. The mean rV53Gy was 2.8% (IQR 1.2-4.8%) for patients receiving 60-62Gy. The median prostate size was 43.5 cc (IQR 32-57).Injection of HA was able to achieve highly symmetrical recto-prostatic separation, with new users able to produce excellent separation, particularly at the apex, achieving similar dosimetry outcomes as competent and experienced users. HA is safe, easy to use, and significantly reduced mean rV70Gy and rV53Gy compared to non-spacer patients.
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- 2022
4. Improving rectal dosimetry for patients with intermediate and high-risk prostate cancer undergoing combined high-dose-rate brachytherapy and external beam radiotherapy with hydrogel space
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Damien M Bolton, Trung Pham, Yee Chan, Johann Tang, Alwin Tan, Sandra Spencer, Chee Wee Cham, Farshad Foroudi, Madalena Liu, Jason Wasiak, M. Guerrieri, Huong Ho, Darren Ow, Michael Chao, Daryl Lim Joon, Kevin McMillan, Nathan Lawrentschuk, and George Koufogiannis
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0106 biological sciences ,medicine.medical_specialty ,medicine.medical_treatment ,Brachytherapy ,hydrogel spacer ,brachytherapy ,Urology ,Rectum ,lcsh:Medicine ,01 natural sciences ,Prostate cancer ,medicine ,Dosimetry ,Radiology, Nuclear Medicine and imaging ,External beam radiotherapy ,rectal protection ,Original Paper ,business.industry ,010401 analytical chemistry ,high-dose-rate ,lcsh:R ,medicine.disease ,prostate cancer ,High-Dose Rate Brachytherapy ,0104 chemical sciences ,Radiation therapy ,medicine.anatomical_structure ,Oncology ,Toxicity ,business ,010606 plant biology & botany - Abstract
Purpose To report on rectal dosimetric and toxicity outcomes of intermediate and high-risk prostate cancer patients undergoing combined high-dose-rate (HDR) brachytherapy and external beam radiotherapy (EBRT) with or without hydrogel spacer (HS) insertion. Material and methods A total of 97 patients were analyzed in this study, with 32 patients (33%) who had HS insertion compared with a preceding group of 65 patients (67%) without HS. HS safety, the dosimetric effects on organs at risk (rectal, urethral, penile bulb, and bladder) as well as gastrointestinal (GI) and genitourinary toxicity were evaluated and compared between the two groups. Results The median prostate-rectal separation achieved with HS was 10 mm (range, 5-14 mm). There were no post-operative complications following HS insertion. Patients with HS had significantly lower radiation dose to the rectum across all rectal dose volumes from rV30 to rV80, whether in absolute volume (cc) or as percentage of contoured OAR (p < 0.001). There was also significantly less acute > grade 1 GI toxicity (12.5% vs. 30.8%, p = 0.05) and a trend towards less late grade 1 GI toxicity (0% vs. 7.7%; p = 0.11) in the HS group compared to the non-HS group. Conclusions Insertion of HS in prostate cancer patients receiving combined HDR and EBRT is safe and has resulted in a significant radiation dose reduction to the rectum, resulting in significantly less acute GI toxicity and a trend towards less late GI toxicity.
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- 2019
5. The use of hydrogel spacer in men undergoing high-dose prostate cancer radiotherapy: results of a prospective phase 2 clinical trial
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George Koufogiannis, Alwin Tan, Yee Chan, Trung Pham, Damien M Bolton, Chee Wee Cham, Farshad Foroudi, Nathan Lawrentschuk, Michael Chao, Shomik Sengupta, Huong Ho, Sandra Spencer, Madalena Liu, Kevin McMillan, Daryl Lim Joon, and Vincent Khoo
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Male ,medicine.medical_specialty ,Urology ,030232 urology & nephrology ,Rectum ,Phases of clinical research ,Adenocarcinoma ,Gastroenterology ,03 medical and health sciences ,Prostate cancer ,0302 clinical medicine ,Prostate ,Internal medicine ,medicine ,Clinical endpoint ,Humans ,Prospective Studies ,Radiation Injuries ,Adverse effect ,Prospective cohort study ,Aged ,Aged, 80 and over ,Radiotherapy ,business.industry ,Prostatic Neoplasms ,Hydrogels ,Radiotherapy Dosage ,Middle Aged ,medicine.disease ,medicine.anatomical_structure ,030220 oncology & carcinogenesis ,Toxicity ,business - Abstract
The purpose of this study was to determine whether the degree of prostate to rectal separation using a hydrogel spacer (HS) and its effect on decreasing rectal dose can be reproduced in the community setting. Thirty one patients with cT1-3aN0M0 prostate adenocarcinoma receiving radical radiotherapy to 78 Gy were recruited to the study. The primary endpoint was the proportion of patients achieving at least 25% reduction in volume of rectum receiving 70 Gy (rV70). Other endpoints included degree of prostate to rectum separation, HS insertion-related adverse events and the proportion of patients with grade 1 or worse acute or late gastrointestinal (GI) and genitourinary (GU) toxicity. All patients had successful insertion of their HS with no peri-operative toxicity. The mean prostate–rectal separation achieved was 10.5 mm. Twenty nine (93.5%) patients achieved a reduction in rV70 of at least 25%. Acute grade 1 GI toxicity was reported in 3 patients. All symptoms had resolved by 3 months post RT. Late grade 1 GI toxicity was reported in one patient (3.2%) with bowel frequency occurring at 6 months and resolving by 12 months post RT. There was no grade 2 or 3 acute or late GI toxicity seen. In conclusion, this study illustrates that the application and benefits of HS on reducing GI rectal dose endpoints and toxicities during prostate cancer RT can be reliably replicated in a community setting similar to centres participating in the randomised trial under high quality assurance trial monitoring.
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- 2018
6. Prospective analysis of hydrogel spacer for patients with prostate cancer undergoing radiotherapy
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Nathan Lawrentschuk, Alwin Tan, Trung Pham, Damien M Bolton, Michael Chao, Shomik Sengupta, Jason Wasiak, Kevin McMillan, Huong Ho, B. Subramanian, Yee Chan, Daryl Lim Joon, Andrew Troy, Chee Wee Cham, Catherine Temelcos, Wei Ding, Sandra Spencer, and Madalena Liu
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Male ,medicine.medical_specialty ,Urology ,medicine.medical_treatment ,Rectum ,030218 nuclear medicine & medical imaging ,03 medical and health sciences ,Prostate cancer ,0302 clinical medicine ,Fiducial Markers ,Prostate ,medicine ,Humans ,General anaesthesia ,Prospective Studies ,Stage (cooking) ,Radiation Injuries ,Radiometry ,Prospective cohort study ,Aged ,Aged, 80 and over ,business.industry ,Radiotherapy Planning, Computer-Assisted ,Prostatic Neoplasms ,Hydrogels ,Radiotherapy Dosage ,Middle Aged ,medicine.disease ,Radiation therapy ,medicine.anatomical_structure ,030220 oncology & carcinogenesis ,Toxicity ,Radiotherapy, Intensity-Modulated ,business ,Follow-Up Studies - Abstract
Objective To report on the dosimetric benefits and late toxicity outcomes after injection of hydrogel spacer (HS) between the prostate and rectum for patients treated with prostate radiotherapy (RT). Patients and methods In all, 76 patients with a clinical stage of T1-T3a prostate cancer underwent general anaesthesia for fiducial marker insertion plus injection of the HS into the perirectal space before intensity-modulated RT (IMRT) or volumetric-modulated arc RT (VMAT). HS safety, dosimetric benefits, and the immediate- to long-term effects of gastrointestinal (GI) toxicity were assessed. Results There were no postoperative complications reported. The mean (range) prostate size was 66.0 (25.0-187.0) mm. Rectal dose volume parameters were observed and the volume of rectum receiving 70 Gy (rV70 ), 75 Gy (rV75 ) and 78 Gy (rV78 ) was 7.8%, 3.6% and 0.4%, respectively. In all, 21% of patients (16/76) developed acute Grade 1 GI toxicities, but all were resolved completely by 3 months after treatment; whilst, 3% of patients (2/76) developed late Grade 1 GI toxicities. No patients had acute or late Grade ≥2 GI toxicities. Conclusion Injection of HS resulted in a reduction of irradiated rectal dose volumes along with minimal GI toxicities, irrespective of prostate size.
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- 2018
7. Impact of Hydrogel and Hyaluronic Acid Rectal Spacer on Rectal Dosimetry and Toxicity in Low-Dose-Rate Prostate Brachytherapy: A Multi-Institutional Analysis of Patient Outcomes
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D. Lim Joon, M. Guerrieri, Mark Tacey, Kevin McMillan, George Koufogiannis, Michael Chao, Alwin Tan, Yee Chan, Chee Wee Cham, Farshad Foroudi, Huong Ho, Y.H. Lin, Paul Manohar, D. Bolton, Trung Pham, Wee Loon Ong, and Madalena Liu
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Cancer Research ,medicine.medical_specialty ,rectal dosimetry ,medicine.medical_treatment ,rectal toxicity ,Brachytherapy ,Urology ,Rectum ,Prostate cancer ,Prostate ,medicine ,Radiology, Nuclear Medicine and imaging ,rectal spacer ,Original Paper ,Radiation ,business.industry ,Genitourinary system ,prostate cancer ,medicine.disease ,low-dose-rate brachytherapy ,Urethra ,medicine.anatomical_structure ,Oncology ,Toxicity ,business ,Prostate brachytherapy - Abstract
PURPOSE/OBJECTIVE(S) To report on rectal dosimetry and toxicity outcomes in men with prostate cancer (PCa) treated with I125 low-dose rate brachytherapy (LDR-BT) with or without hydrogel (HS) or hyaluronic acid (HA) rectal spacer (RS) insertion. The working hypothesis is the increased retroprostatic distance achieved from RS insertion results in reduced rectal dosimetry and subsequent reduction in rectal toxicity outcomes. MATERIALS/METHODS Seventy consecutive men treated with LDR-BT between December 2017 and July 2019 were included in this study, twenty-eight (40%) men had RS insertion according to the preference of the referring urologist, compared to a group of forty-two men (60%) without RS. Descriptive statistics were used to compare the RS safety, dosimetric effects on organs at risk (rectum and urethra), as well as gastrointestinal (GI) and genitourinary (GU) toxicities (assessed using the CTCAEv4) between the two groups. RESULTS The mean prostate-rectal separation with RS at mid prostate was 9.9mm (SD 2.8mm). There were no post-operative complications for RS insertion. There was significantly reduced rectal dosimetry in RS group vs non-RS group, the median RV100 was 0cc (IQR = 0-0.0cc) vs 0.4cc (IQR = 0.1-1.1cc) (P < 0.001) respectively. Mean rectal D1cc and D2cc were 52.4% vs 84.2% (P < 0.001) and 45.7% vs. 70.0% (P < 0.001) for RS and non-RS group respectively. There were no discernible differences in the mean urethral D20, D5, and D1. There were significantly less ≥ grade 1 acute and late GI toxicities in the RS group when compared to the non-RS group (0% vs 24% P = 0.004 for acute GI toxicity: 4% vs 33%, P = 0.003 for late GI toxicity). Strong association remained for RS with late GI toxicity (odds ratios < 0.2) even after accounting for the confounding effects of post-implant RV100, D1cc and D2cc. CONCLUSION Insertion of RS in men treated with LDR-BT is safe and results in significantly lower values in rectal dosimetry. The reduction in rectal dosimetry with RS insertion translates into significantly reduced rates of acute and late GI toxicities.
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- 2021
8. FPMRS challenges on behalf of the Collaborative Research in Pelvic Surgery Consortium (CoRPS): managing complicated cases : Series 3: Challenging recurrent prolapse in a medically complicated patient
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Madalena Liu, Ladin A. Yurteri-Kaplan, Danielle D. Antosh, David Shveiky, Chris Heisler, Cara L. Grimes, and Aparna Hegde
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Adult ,congenital, hereditary, and neonatal diseases and abnormalities ,medicine.medical_specialty ,Urology ,030232 urology & nephrology ,Pelvic Organ Prolapse ,03 medical and health sciences ,0302 clinical medicine ,Gynecologic Surgical Procedures ,Recurrence ,Medicine ,Humans ,Spinal Dysraphism ,Pelvic surgery ,030219 obstetrics & reproductive medicine ,business.industry ,Spina bifida ,General surgery ,Obstetrics and Gynecology ,Plastic Surgery Procedures ,Surgical Mesh ,medicine.disease ,Vaginal mesh ,nervous system diseases ,Obesity, Morbid ,Patient population ,Female ,business - Abstract
This case presents the work-up and management of a spina bifida patient with recurrent prolapse. Four international experts also provide their evaluation of and approach to this complex case. According to the literature, little is known regarding the approach to the management of this specific patient population.
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- 2019
9. Low Dose Rate Brachytherapy and Long-Term Treatment Outcomes In Patients Less Than 60 Years of Age
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D. Bolton, M. Cokelek, Wei Ding, George Koufogiannis, D. Lim Joon, Alwin Tan, Richard Khor, Nathan Lawrentschuk, Michael Chao, Sandra Spencer, Madalena Liu, Trung Pham, M. Ng, Mark Tacey, M. Guerrieri, Shomik Sengupta, Kevin McMillan, Yee Chan, Chee Wee Cham, Farshad Foroudi, B. Subramanian, and Huong Ho
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Cancer Research ,medicine.medical_specialty ,Radiation ,Long term treatment ,Oncology ,business.industry ,Medicine ,Radiology, Nuclear Medicine and imaging ,In patient ,Radiology ,business ,Low-Dose Rate Brachytherapy - Published
- 2020
10. Apoptosis in tracheoesophageal embryogenesis in rat embryos with or without adriamycin treatment
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John M. Hutson, Suzanne Hasthorpe, N. A. Myers, Pamela J. Farmer, Madalena Liu, and Baiyun Zhou
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Pathology ,medicine.medical_specialty ,Tracheoesophageal fistula ,Apoptosis ,Biology ,Rats, Sprague-Dawley ,Embryonic and Fetal Development ,Esophagus ,Pregnancy ,medicine ,Animals ,Esophageal Atresia ,TUNEL assay ,Embryogenesis ,Foregut ,Embryo ,General Medicine ,medicine.disease ,Rats ,Trachea ,medicine.anatomical_structure ,Doxorubicin ,Atresia ,embryonic structures ,Pediatrics, Perinatology and Child Health ,Surgery ,Female ,Tracheoesophageal Fistula - Abstract
The aim of this study was to determine whether apoptosis participates in separation of the foregut into trachea and esophagus and to evaluate the potential role of apoptosis in the development of esophageal atresia and tracheoesophageal fistula (EA + TEF) induced by Adriamycin.Timed-pregnant rats were injected daily with either saline or Adriamycin (2 mg/kg) intraperitoneally on days 6 to 9 of gestation. Paraffin sections were prepared from 31 experimental and 31 control embryos at days 12 and 13 of gestation. Condensed nuclei were identified on the paraffin sections using the TUNEL method. Apoptosis was quantified by counting the positively stained cell nuclei in transverse sections of embryos.In day 12 control embryos the number of apoptotic nuclei in both lateral ridges of the foregut was high (15.67 +/- 1.38) but relatively low (4.17 +/- 0.80) in Adriamycin-treated embryos (P.0001). In day 13 Adriamycin-treated embryos, the number of apoptotic nuclei in the region of the upper esophageal pouch was extremely high (23.78.5 +/- 2.20) compared with no detectable apoptotic nuclei in the control embryos.Apoptosis is required for normal tracheoesophageal embryogenesis and may be an important mechanism to be involved in the embryological development of esophageal atresia and tracheoesophageal fistula.
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- 1999
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