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Coleman R.E.,Park University | Winter M.C.,Park University | Cameron D.,University of Leeds | Bell R.,Andrew Love Cancer Center | And 9 more authors.
British Journal of Cancer | Year: 2010

Background:Pre-clinical studies have demonstrated synergistic anti-tumour effects of chemotherapy (CT) and zoledronic acid (ZOL). Within the AZURE trial, designed to determine whether the addition of ZOL to neoadjuvant therapy improves disease outcomes, a subgroup received neoadjuvant CT. We report a retrospective evaluation comparing pathological response in the primary tumour between treatment groups.Methods:In total, 205 patients received neoadjuvant CTZOL (CTZOL, n102; CT, n103). The primary end point was pathologically assessed residual invasive tumour size (RITS) at surgery. Secondary end points were pathological complete response (pCR) rate and axillary nodal involvement. Following review of surgical pathology reports (n195), outcome differences between groups were assessed adjusting for potential response modifiers.Results:Baseline characteristics and CT treatments were similar. In multivariate analysis, allowing for biological and clinical factors known to influence tumour response, the adjusted mean RITS in CT and CTZOL groups were 27.4 and 15.5 mm, respectively, giving a difference in means of 12 mm (95% confidence interval: 3.5-20.4 mm; P0.006). The pCR rate was 6.9% in the CT group and 11.7% in the CTZOL group (P0.146). There was no difference in axillary nodal involvement (P0.6315).Conclusion:These data suggest a possible direct anti-tumour effect of ZOL in combination with CT, warranting formal evaluation in prospective studies. © 2010 Cancer Research UK All rights reserved.

Hall P.S.,University of Leeds | Hall P.S.,St James Institute Of Oncology | Edlin R.,University of Leeds | Kharroubi S.,University of York | And 2 more authors.
Medical Decision Making | Year: 2012

The Expected Value of Information Framework has been proposed as a method for identifying when health care technologies should be immediately reimbursed and when any reimbursement should be withheld while awaiting more evidence. This framework assesses the value of obtaining additional evidence to inform a current reimbursement decision. This represents the burden of not having the additional evidence at the time of the decision. However, when deciding whether to reimburse now or await more evidence, decision makers need to know the value of investing in more research to inform a future decision. Assessing this value requires consideration of research costs, research time, and what happens to patients while the research is undertaken and after completion. The investigators describe a development of the calculation of the expected value of sample information that assesses the value of investing in further research, including an only-in-research strategy and an only-with-research strategy.

Kanatas A.,St James Institute Of Oncology | Ghazali N.,University of Liverpool | Lowe D.,Edge Hill University | Rogers S.N.,University of Liverpool | Rogers S.N.,Edge Hill University
International Journal of Oral and Maxillofacial Surgery | Year: 2012

The aim of this study was to investigate the concurrent use of the Patient Concerns Inventory (PCI) and the University of Washington Quality of life instruments (UW-QOL), as a means of identifying mood and anxiety concerns in patients following head and neck cancer treatment. From August 2007 to July 2009, 204 patients (454 clinic appointments) attending one consultant's oncology review clinic completed the UW-QOLv4 and PCI prior to their consultation. Before entering consultations, 17% (79/454) of patients reported problems with mood and 20% (89/454) reported problems with anxiety on the UW-QOL. Regarding the items raised by patients using the PCI prior to consultation, 'mood' was raised in 10% (46/454), 'anxiety' in 13% (58/454) and 'depression' in 10% (44/454) of cases. In 32% (145/454) of consultations, 44% (89/204) patients had reported significant anxiety or mood problems on the UW-QOL, or highlighted issues of anxiety, mood and/or depression on the PCI for discussion. Patients completing the PCI were more often referred to the clinical psychologist and to the emotional support worker. The results showed that the combination of the UW-QOL questionnaire and the PCI provide a practical means of screening for psychological distress in clinics. © 2011 International Association of Oral and Maxillofacial Surgeons.

Snee M.,St James Institute Of Oncology
Clinical Oncology | Year: 2014

The place of bevacizumab in the management of advanced non-small cell lung cancer (NSCLC) was reviewed. Particular reference has been made to the recent research on the systemic treatment of NSCLC indicating that treatment tailored to specifically identified morphology or genetic profile has recently changed practice. The result of this recent research means that bevacizumab has little, if any, place in the treatment of NSCLC. © 2014 The Royal College of Radiologists.

Loch T.,University of Kiel | Carey B.,St James Institute Of Oncology | Walz J.,Institute Paoli Calmettes Cancer Center | Fulgham P.F.,Texas Health Presbyterian Hospital Dallas
European Urology | Year: 2015

Background The terminology and abbreviations used in urologic imaging have generally been adopted on an ad hoc basis by different speciality groups; however, there is a need for shared nomenclature to facilitate clinical communication and collaborative research. Objective This work reviews the current nomenclature for urologic imaging used in clinical practice and proposes a taxonomy and terminology for urologic imaging studies. Design, setting, and participants A list of terms used in urologic imaging were compiled from guidelines published by the European Association of Urology and the American Urological Association and from the American College of Radiology Appropriateness Criteria. Outcome measurements and statistical analysis Terms searched were grouped into broad categories based on technology, and imaging terms were further stratified based on the anatomic extent, contrast or phases, technique or modifiers, and combinations or fusions. Terms that had a high degree of utilisation were classified as accepted. Results and limitations We propose a new taxonomy to define a more useful and acceptable nomenclature model acceptable to all health professionals involved in urology. The major advantage of a taxonomic approach to the classification of urologic imaging studies is that it provides a flexible framework for classifying the modifications of current imaging modalities and allows the incorporation of new imaging modalities. The adoption of this hierarchical classification model ranging from the most general to the most detailed descriptions should facilitate hierarchical searches of the medical literature using both general and specific terms. This work is limited in its scope, as it is not currently all-inclusive. This will hopefully be addressed by future modification as others embrace the concept and work towards uniformity in nomenclature. Conclusions This paper provides a noncomprehensive list of the most widely used terms across different specialties. This list can be used as the basis for further discussion, development, and enhancement. Patient summary In this paper we describe a classification system for urologic imaging terms with the aim of aiding health professionals and ensuring that the terms used are more consistent. © 2014 European Association of Urology. Published by Elsevier B.V. All rights reserved.

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