ORCID Profile
0009-0009-9411-153X
Current Organisation
Peter MacCallum Cancer Centre
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Publisher: Elsevier BV
Date: 05-2017
Publisher: Oxford University Press (OUP)
Date: 20-12-2022
Abstract: Wide variation exists globally in the treatment and outcomes of stage III patients with non–small cell lung cancer (NSCLC). We conducted an up-to-date patterns of care analysis in the state of Victoria, Australia, with a particular focus on the proportion of patients receiving treatment with radical intent, treatment trends over time, and survival. Stage III patients with NSCLC were identified in the Victorian Lung Cancer Registry and categorized by treatment received and treatment intent. Logistic regression was used to explore factors predictive of receipt of radical treatment and the treatment trends over time. Cox regression was used to explore variables associated with overall survival (OS). Covariates evaluated included age, sex, ECOG performance status, smoking status, year of diagnosis, Australian born, Aboriginal or Torres Strait Islander status, socioeconomic status, rurality, public rivate status of notifying institution, and multidisciplinary meeting discussion. A total of 1396 patients were diagnosed between 2012 and 2019 and received treatment with radical intent 67%, palliative intent 23%, unknown intent 5% and no treatment 5%. Radical intent treatment was less likely if patients were & years, ECOG ≥1, had T3-4 or N3 disease or resided rurally. Surgery use decreased over time, while concurrent chemoradiotherapy and immunotherapy use increased. Median OS was 38.0, 11.1, and 4.4 months following radical treatment, palliative treatment or no treatment, respectively. Almost a third of stage III patients with NSCLC still do not receive radical treatment. Strategies to facilitate radical treatment and better support decision making between increasing multimodality options are required.
Publisher: Elsevier BV
Date: 04-2019
DOI: 10.1016/J.EJMP.2019.03.019
Abstract: Synchrotron Microbeam Radiation Therapy (MRT) is a pre-clinical modality characterised by spatial dose fractionation on a microscopic scale. Treatment planning studies using clinical datasets have not yet been conducted. Our aim was to investigate MRT dose-distributions in scenarios refractory to conventional treatment and to identify optimal settings for a future Phase I trial. MRT plans were generated for seven scenarios where re-irradiation was performed clinically. A hybrid algorithm, combining Monte Carlo and convolution-based methods, was used for dose-calculation. The valley dose to organs at risk had to respect the single fraction tolerance doses achieved in the corresponding re-irradiation plans. The resultant peak dose and the peak-to-valley dose ratio (PVDR) at the tumour target volume were assessed. Peak doses greater than 80 Gy in a single fraction, and PVDRs greater than 10, could be achieved for plans with small (<35 cm Our findings suggest that head and neck sites will be optimal scenarios for MRT.
Publisher: Elsevier BV
Date: 10-2017
Publisher: Elsevier BV
Date: 05-2022
Publisher: American Society of Clinical Oncology (ASCO)
Date: 20-05-2017
DOI: 10.1200/JCO.2017.35.15_SUPPL.E18013
Abstract: e18013 Background: Surgery is the standard of care treatment for stage I NSCLC. Improvements in surgical techiques and perioperative care over time are developed to facilitate surgery for more patients. We assessed the factors influencing the use of surgery, the interaction of these with time and the impact on population survival. Methods: Patients enrolled into SEER between 2004 and 2012, aged at least 18 years with a first malignant primary stage I NSCLC were retrospectively assessed. Patients diagnosed on the basis of autopsy or death certificate only were excluded.Time was catergorized into three periods 2004-6, 2007-9 and 2010-12. Age, gender, marital status, race, geographic location and time were all considered exposure variables influencing surgical use and were adjusted for using logistic regression. Impact of variables with time was assessed using interaction terms between them. The impact of time on population survival was assessed using cox regression. Results: Sex, age, marital status, race, location and time all significantly influenced whether surgery was performed (all p 0.001). The proportion undergoing sugery declined from 68.0% during 2004-6 to 62.7% during 2010-12 (adjusted HR 0.88, p 0.001 between subsequent periods). Patients were less likely to have surgery with increasing age (adjusted HR 0.94 per year, p 0.001) and if they were Black or Hispanic (adjusted HR 0.58, p 0.001 and 0.87, p = 0.008 repectively) relative to Non-Hispanic Whites. There were significant differences with location. Relative to San-Fransisco-Oakland, the greatest adjusted differences were between Louisiana (HR 0.51, p 0.001) and New Jersey (HR 1.57, p 0.001). Age significantly interacted with time (p = 0.007). Surgical use declined from 75.5% during 2004-6 to 71.5% during 2010-12 when less than 75 years. For those older, the decline was greater, 55.3% to 46.5%. The risk of death declined with time (adjusted HR 0.94, p 0.001 between periods). Conclusions: Since 2004, the use of surgery for stage I NSCLC has declined and done more so with increasing age. Despite this overall population survival has improved.
Publisher: Elsevier BV
Date: 11-2015
Publisher: Elsevier BV
Date: 05-2017
Publisher: Elsevier BV
Date: 10-2019
DOI: 10.1016/J.JOCN.2019.07.005
Abstract: We analysed the long-term outcomes of patients with primary optic nerve sheath meningioma (ONSM) treated with stereotactic radiotherapy (SRT). 26 patients with primary ONSM were treated with SRT between 2004 and 2013 at a single institution. SRT was delivered with image guidance to a median dose of 50.4 Gy in 28 fractions. 4 patients had prior surgical debulking. At a median radiological follow-up of 68 months, the MRI based tumour control was 100%. Visual acuity improved in 10 (38.4%), remained stable in 10 (38.4%) and was reduced in 6 (23.1%) patients following treatment. Stable or improved vision post-treatment was seen in 92.3% of patients with good pre-treatment vision (best corrected visual acuity 6/18 or better), compared to only 61.5% of patients with poor pre-treatment vision (best corrected visual acuity 6/24 or worse). Overall, the treatment was well tolerated with no Grade 2 or greater acute toxicity. Minimal other ophthalmic complications were seen with only one patient developing late onset Grade 3 radiation retinopathy.
Publisher: AME Publishing Company
Date: 05-2016
Publisher: Wiley
Date: 12-2007
Publisher: Elsevier BV
Date: 09-2022
Publisher: Elsevier BV
Date: 04-2018
Publisher: Elsevier BV
Date: 2017
Publisher: Springer Science and Business Media LLC
Date: 14-11-2021
DOI: 10.1186/S13014-021-01946-8
Abstract: To determine the optimal volume of barium for oesophageal localisation on cone-beam CT (CBCT) for locally-advanced non-small cell lung cancers (NSCLC) and quantify the interfraction oesophageal movement relative to tumour. Twenty NSCLC patients with mediastinal and/or hilar disease receiving radical radiotherapy were recruited. The first five patients received 25 ml of barium prior to their planning CT and alternate CBCTs during treatment. Subsequent five patient cohorts, received 15 ml, 10 ml and 5 ml. Six observers contoured the oesophagus on each of the 107 datasets and consensus contours were created. Overall 642 observer contours were generated and interobserver contouring reproducibility was assessed. The kappa statistic, dice coefficient and Hausdorff Distance (HD) were used to compare barium-enhanced CBCTs and non-enhanced CBCTs. Oesophageal displacement was assessed using the HD between consensus contours of barium-enhanced CBCTs and planning CTs. Interobserver contouring reproducibility was significantly improved in barium-enhanced CBCTs compared to non-contrast CBCTs with minimal difference between barium dose levels. Only 10 mL produced a significantly higher kappa (0.814, p = 0.008) and dice (0.895, p = 0.001). The poorer the reproducibility without barium, the greater the improvement barium provided. The median interfraction HD between consensus contours was 4 mm, with 95% of the oesophageal displacement within 15 mm. 10 mL of barium significantly improves oesophageal localisation on CBCT with minimal image artifact. The oesophagus moves substantially and unpredictably over a course of treatment, requiring close daily monitoring in the context of hypofractionation.
Publisher: Elsevier BV
Date: 12-2019
No related grants have been discovered for Katrina Woodford.