Predicting Response To Chemoradiotherapy In Patients With Advanced Rectal Cancer.
Funder
National Health and Medical Research Council
Funding Amount
$461,605.00
Summary
Many cancer patients receive expensive and unpleasant therapies that actually do not benefit them. This project will use a new technology that can simultaneously assess the level of expression of thousands of genes. We will test if the pattern of gene expression in tumours can predict the patients' response to therapy. Success will significantly improve the clinical management of advanced cancer patients and provide a rational basis upon which to tailor individualized treatment regimes.
A Randomised Trial Of Preoperative Radiotherapy For Stage T3 Adenocarcinoma Of Rectum
Funder
National Health and Medical Research Council
Funding Amount
$521,220.00
Summary
The most appropriate management of locally advanced rectal cancer is controversial as evident by various treatment options available and used. It remains unclear whether pre-operative radiotherapy, and if so what form of therapy, is required for this group of patients. The first aim of this trial is to see whether a long course of radiotherapy with chemotherapy is superior to a short course of radiotherapy. The second aim is to see whether the advantage of pre-operative radiotherapy remains with ....The most appropriate management of locally advanced rectal cancer is controversial as evident by various treatment options available and used. It remains unclear whether pre-operative radiotherapy, and if so what form of therapy, is required for this group of patients. The first aim of this trial is to see whether a long course of radiotherapy with chemotherapy is superior to a short course of radiotherapy. The second aim is to see whether the advantage of pre-operative radiotherapy remains with modern surgical technique. Colorectal cancer is the commonest cancer in Australia and local recurrence leads to severe morbidity with no effective treatment for permanent control. It is important, therefore, to establish treatment regimens that will minimize the risk of local recurrence and it will be significant if this trial can establish that pre-operative radiotherapy can achieve this with minimal toxicity. The quality of life associated with each of the three arms of the trial has not been adequately addressed and will be studied here. The result of this trial will influence designs of future trials if one or other of the pre-operative regimens is shown to be effective. The two regimens, Short Course and Long Course , represent opposing philosophies: minimize the overall treatment time (2 weeks from start of radiotherapy to surgery) to avoid accelerated repopulation versus give more intensive therapy and utilise the sensitising effect from 5-FU on radiotherapy to obtain greater tumour cell kill probability. If one regimen proves more effective than the other, the design of future trials and the way of thinking about the biology will be influenced. There may be implications for the cost of treatment of this disease: Long Course is much about five times more expensive to deliver than Short Ccourse.Read moreRead less
Measuring Patient Preferences For Treatment Of Colorectal Cancer Using Discrete Choice Modelling
Funder
National Health and Medical Research Council
Funding Amount
$188,912.00
Summary
Around the world, governments, medical professional bodies, individual clinicians and patients are trying to make decisions in health care more rationally. More of these decisions are 'informed' by evidence-based medicine, which depends on a systematic review of all relevant evidence of acceptable scientific rigour. This kind of systematic review has been conducted for the management of colorectal cancer. Patients making choices about possible treatment for colorectal cancer will then have the b ....Around the world, governments, medical professional bodies, individual clinicians and patients are trying to make decisions in health care more rationally. More of these decisions are 'informed' by evidence-based medicine, which depends on a systematic review of all relevant evidence of acceptable scientific rigour. This kind of systematic review has been conducted for the management of colorectal cancer. Patients making choices about possible treatment for colorectal cancer will then have the best 'evidence-based' information to hand. But not enough is known about what aspects of the treatment options matter most to patients. Choosing between different treatment options involves weighing up or trading-off different factors associated with each therapy. Depending on the clinical stage of their cancer, patients may have to choose between the type and size of surgical operation, whether or not to have chemotherapy and-or radiotherapy, the side effects of treatment, the chance of a recurrence of the disease and an early death as well as their quality of life. This research project will ask patients who have already been treated for their colorectal cancer what kind of tradeoffs they make between factors such as disease-free survival, toxicity of treatment and longer term quality of life. This will be done using hypothetical clinical scenarios comparing one type of treatment to another. In this way, the hypothetical choices will be informed by the patient's experience with treatment without asking them to reflect or dwell directly on their own treatment choices. The answers to the hypothetical choice questions can be used to assess what factors in treatment are most important to patients and by how much. This information can then be used by clinicians when presenting evidence-based information on treatment for patients newly diagnosed colorectal cancer.Read moreRead less