Background/objectives: Patients with breast cancer who do not achieve a complete response to neoadjuvant chemotherapy (NAC) may benefit from intensified adjuvant systemic therapy. However, such treatment escalation is typically delayed until after tumour resection, which occurs several months into the treatment course. Quantitative ultrasound (QUS) can detect early microstructural changes in tumours and may enable timely identification of non-responders during NAC, allowing for earlier treatment intensification.
View Article and Find Full Text PDFRadiation therapy (RT) is a common component of breast cancer treatment. Chronic radiation dermatitis (CRD), defined as occurring after or extending beyond 90 days following the completion of RT, can be progressive and irreversible and manifest as changes in skin pigmentation, fibrosis, telangiectasia, ulceration, necrosis, and contribute to the development of cutaneous malignancy. There is limited existing research on the incidence, management approaches, and prevention strategies for CRD.
View Article and Find Full Text PDFClin Transl Radiat Oncol
July 2025
Acute radiation dermatitis (ARD) is a common adverse effect experienced by patients undergoing radiation therapy. Effective assessment tools to accurately measure and manage ARD's impact on patients' quality of life and treatment outcomes is needed. The aim of this study was to evaluate the diverse tools and outcome measures used in the assessment of ARD.
View Article and Find Full Text PDFThis work was conducted in order to validate a pre-treatment quantitative ultrasound (QUS) and texture derivative analyses-based prediction model proposed in our previous study to identify responders and non-responders to neoadjuvant chemotherapy in patients with breast cancer. The validation cohort consisted of 56 breast cancer patients diagnosed between the years 2018 and 2021. Among all patients, 53 were treated with neoadjuvant chemotherapy and three had unplanned changes in their chemotherapy cycles.
View Article and Find Full Text PDFAm J Hosp Palliat Care
April 2025
Anemia is common in cancer patients receiving palliative care, causing significant symptom burden and transfusion requirement. While intravenous (IV) iron is recognized for its role in chemotherapy-induced anemia, its efficacy in broader palliative oncology settings is underexplored. Our study provides real-world experience with IV iron in cancer patients, particularly those receiving supportive care alone.
View Article and Find Full Text PDFPain from spinal metastases can result in significant impact to patients' quality of life. Conventional external beam radiation therapy (cEBRT) has long been shown to be effective in the pain control of patients with spinal metastases. With the advancement in radiation therapy, stereotactic body radiation therapy (SBRT) has been increasingly adopted for the treatment of spinal metastases.
View Article and Find Full Text PDFIntroduction: Acute radiation dermatitis (ARD) is a common side effect experienced during radiation therapy (RT) for cancer. Published clinical trials for ARD use a myriad of assessment tools and outcomes to measure ARD severity, which limits the comparability of clinical trial results. Our study utilized a modified Delphi consensus survey to gather expert opinions on commonly used tools for ARD severity.
View Article and Find Full Text PDFPurpose: Stereotactic body radiation therapy (SBRT) is an effective treatment for spinal metastases; however, outcomes specific to a geriatric population have not been described. This study aims to investigate the efficacy and safety of spine SBRT, in particular the rate of iatrogenic vertebral compression fracture (VCF), in patients aged 70 and older.
Patients And Methods: From a prospectively maintained single-institutional database of 976 patients and 2407 spinal segments treated with SBRT for vertebral metastases between 2008 and 2021, all patients aged 70 or above were retrospectively reviewed.
Purpose: Surface guided radiation therapy (SGRT) in breast cancer radiation therapy (RT) may decrease the need for image guidance such as cone beam computed tomography (CBCT). The goal of this study was to evaluate the impact of CBCT image guidance on the cumulative and interfractional variation of mean heart dose (MHD) during breath-hold RT in patients with breast cancer. We hypothesized that weekly CBCT is not necessary for SGRT-assisted breath-hold but is still needed in patients treated with voluntary deep inspiration breath-hold (vDIBH) and active breathing control (ABC) to maintain a stable MHD.
View Article and Find Full Text PDFBackground And Objective: Breast cancer is the most prevalent cancer among women worldwide, with 45% of them over 65 years old. Older breast cancer patients tend to be underrepresented and understudied in major clinical trials. This narrative review provides a comprehensive overview of the current evidence regarding treatment decision-making, treatment toxicities, and proposed survivorship management recommendations for geriatric cancer patients.
View Article and Find Full Text PDFUveal melanoma is the most common primary intraocular malignancy in adults. Treatment options for localized, early-stage disease include enucleation, brachytherapy, and proton beam therapy. This review aims to evaluate the role of proton therapy in the definitive management of uveal melanoma, focusing on its physics, radiobiology, treatment techniques, and associated outcomes.
View Article and Find Full Text PDFSupport Care Cancer
October 2024
Purpose: Ductal carcinoma in situ (DCIS) of the breast is one of the most common pre-invasive cancers diagnosed in women. Quality of life (QoL) is extremely important to assess in studies including these patients due to the favorable prognosis of the disease. The primary objective of this systematic review was to compile a comprehensive list of QoL issues, all existing QoL assessment tools, and patient-reported outcome measures used to assess DCIS.
View Article and Find Full Text PDFBackground: Barrier films or dressings were reported to be effective in preventing radiation dermatitis (RD) in breast cancer patients, but their comparative efficacy is unknown.
Methods: A systematic literature search was performed on Embase, MEDLINE and Cochrane CENTRAL Registry of Clinical Trials from inception to October 20, 2023. Randomised controlled trials (RCTs) comparing barrier films or dressings to the standard of care (SOC) or other interventions were included.
Support Care Cancer
April 2024
Chemotherapy-induced nausea and vomiting (CINV) is a common toxicity that may impair the quality of life of patients with various malignancies ranging from early to end stages. In light of frequent changes to the guidelines for optimal management of CINV, we undertook this narrative review to compare the most recent guidelines published by ASCO (2020), NCCN (2023), MASCC/ESMO (2023), and CCO (2019). The processes undertaken by each organization to evaluate existing literature were also described.
View Article and Find Full Text PDFEClinicalMedicine
February 2024
Background: Developing strategies to prevent breast cancer-related arm lymphoedema (BCRAL) is a critical unmet need because there are no effective interventions to eradicate it once it reaches a chronic state. Certain strategies such as prospective surveillance programs and prophylactic lymphatic reconstruction have been reported to be effective in clinical trials. However, a large variation exists in practice based on clinician preference, organizational standards, and local resources.
View Article and Find Full Text PDFSupport Care Cancer
December 2023
Introduction: Bones are frequent sites of metastatic disease, observed in 30-75% of advanced cancer patients. Quality of life (QoL) is an important endpoint in studies evaluating the treatments of bone metastases (BM), and many patient-reported outcome tools are available. The primary objective of this systematic review was to compile a list of QoL issues relevant to BM and its interventions.
View Article and Find Full Text PDFSupport Care Cancer
December 2023
Introduction: Malignant spinal cord compression (MSCC) is an oncological emergency that may result in a devastating combination of malignancy and disability. Existing quality of life (QoL) questionnaires commonly used in MSCC literature (EORTC QLQ-C30, BM-22, Brief Pain Inventory, and Spine Oncology Study Group Outcomes) may not capture all the commonly reported symptoms and lack specificity to MSCC. The primary objective of this systematic review is to determine unmet patient needs and underreported QoL issues and compile a comprehensive list of QoL issues.
View Article and Find Full Text PDFAnn Palliat Med
November 2023
Background And Objective: Leptomeningeal disease (LMD) is associated with poor survival and health-related quality of life (HRQoL). There is an urgent need for clinical research in this area to improve the outcomes. The purpose of this study is to summarize the areas of active clinical research in LMD, identify the knowledge gap, and suggest future research directions.
View Article and Find Full Text PDFPurpose: This systematic review and meta-analysis evaluates the efficacy of Mepitel Film in preventing acute radiation dermatitis (RD) in patients with head and neck cancer (HNC) across randomized controlled trials (RCTs).
Methods: Embase, MEDLINE, and Cochrane Central Register of Controlled Trials were searched on 5 March 2023 to identify relevant RCTs. RD assessment tools and outcomes were compared across studies.
Support Care Cancer
August 2023
Purpose: This systematic review and meta-analysis aimed to evaluate the efficacy of Mepitel film in preventing or treating acute radiation dermatitis (RD) in patients with breast cancer in randomized controlled trials (RCTs).
Methods: Embase, APA PsychInfo, Journals@Ovid Full Text, Ovid MEDLINE, PubMed, and Cochrane Trials were searched until December 12, 2022, to identify RCTs on the use of Mepitel film for preventing or treating acute RD from breast cancer radiotherapy. Per-protocol analysis was used to compare outcomes, calculate pooled effect sizes, odds ratio (OR), and 95% confidence intervals (CI), and to create forest plots using random effects analysis in RevMan 5.
Radiotherapy is an important treatment modality for pain control in patients with bone metastases. Stereotactic body radiation therapy (SBRT), which allows delivering a much higher dose per fraction while sparing critical structures compared to conventional external beam radiotherapy (cEBRT), has become more widely used, especially in the oligometastatic setting. Randomized controlled trials (RCTs) comparing the pain response rate of SBRT and cEBRT for bone metastases have shown conflicting results, as have four recent systematic reviews with meta-analyses of these trials.
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