Medicine and Health Sciences Commons^™

Phase Iii Randomized Pair Comparison Of A Barrier Film Vs. Standard Skin Care In Preventing Radiation Dermatitis In Postlumpectomy Patients With Breast Cancer Receiving Adjuvant Radiation Therapy, Andrew Lam, Edward Yu, Danielle Vanwynsberghe, Melissa O'Neil, David D'Souza, Jeffrey Cao, Michael Lock

Edward Yu

Editorial Updates For Chest Tumors, Patricia Tai, Edward Yu

Edward Yu

No abstract provided.

Lung Sbrt Guideline 2017.Pdf, Conrad B. Falkson, E Vella, Edward Yu, M El-Mallah, R Mackenzie, P Ellis, Y Ung

Edward Yu

Editorial Current Treatments For Skin Cancer, Edward Yu, Patricia Tai

Edward Yu

Radiation Therapy: Types,Procedures And Outcomes The Role Of Prophylactic Cranial Irradiation In Limited Stage Small Cell Lung Cancer, Chapter 4, In Encyclopedia Of Lung Cancer, Patricia Tai, Edward Yu

Edward Yu

Male Breast Cancer Prognostic Factors Versus Female Counterparts With Propensity Scores And Matched-Pair Analysis, Edward Yu, Larry Stitt, Olga Vujovic, Kurian Joseph, Avi Assouline, Jawaid Younus, Francisco Perera, Patricia Tai

Edward Yu

Objective: To assess the effect of prognostic factors and their impact on survival in male and female breast cancer. Methods: Medical records for men and women diagnosed with breast cancer referred to the cancer center for treatment were reviewed. Patients with distant metastatic diseases were excluded. Data on prognostic factors including age, nodal status, resection margin, use of hormonal therapy, chemotherapy with and without hormone and radiation therapy (RT), survival, and recurrence were analyzed. Survival estimates were obtained using Kaplan-Meier methodology. The Cox regression interaction was used to compare male and female differences in prognostic factors. Male breast cancer (MBC) …

Dosimetric Planning Study Of Respiratory-Gated Volumetric Modulated Arc Therapy For Early-Stage Lung Cancer With Stereotactic Body Radiation Therapy, Ilma Xhaferllari, Jeff Chen, Michael Macfarlane, Edward Yu, Stewart Gaede

Edward Yu

Purpose: To evaluate the dosimetric potential of respiratory-gated volumetric modulated arc therapy (VMAT) to reduce the dose to normal lung when treating early-stage non-small cell lung cancer (NSCLC) with stereotactic body radiation therapy (SBRT). Methods and materials: Twenty patients with inoperable stage I/II NSCLC with motion greater than 5 mm were retrospectively planned with 4-dimensional computed tomography–based gated and nongated VMAT. Each plan was optimized using two 225° arcs with 10-MV flattening filter– free beams with maximum dose rate of 2400 MU/min. A host script was generated and used to optimize all 40 plans to minimize dosimetric bias. The main …

Radiation-Induced Second Malignancies, Shazia Mahmood, Khanh Vu, Patricia Tai, Kurian Joseph, Rashmi Koul, Arbind Dubey, Edward Yu

Edward Yu

Background: The number of patients with second malignancies is growing and they represent about one in six out of all new cancers. Second malignancies can be categorized into three major groups according to the predominant etiological factor(s): (i) treatment-related, (ii) part of a syndrome and (iii) those due to shared etiologic exposures. Patients and Methods: This article focuses on radiation-induced malignancies with illustrative cases of thyroid, rectal cancer and sarcoma. Results: The detection and management of radiation-induced malignancies of some case scenarios are presented. Second malignancies are detected within previous radiation field and the time intervals from previous tumor vary …

Mesothelioma - Update On Management, Patricia Tai, Kurian Joseph, Avi Assouline, Joseph Au, Edward Yu

Edward Yu

Mesothelioma is an often fatal cancer arising from the lining of pleura, peritoneum, pericardium and tunica vaginalis (of the testis). In the past decade, investigators have met with limited or minimal success in demonstrating improvements in survival compared to supportive care or observation. Radical surgery such as extrapulmonary pleurectomy is associated with perioperative mortality rates of 6-30% by different institutions, compared to 3% with extended pleurectomy and decortication. Talc pleurodesis is preferred over video-assisted thorascopic partial pleurectomy in the setting of pleural effusion due to fewer complications and shorter hospital stay. To spare normal tissues, radiotherapy with IMRT (intensity-modulated radiation …

Use Of Protoporphyrin Fluorescence To Determine Clinical Target Volume For Non-Melanotic Skin Cancers Treated With Primary Radiotherapy, Stephanie Casey, Lara Best, Olga Vujovic, Kevin Jordan, Barbara Fisher, Deborah Carey, Deborah Bourdeau, Edward Yu

Edward Yu

Esophageal Cancer Management Controversies: Radiation Oncology Point Of View, Patricia Tai, Edward Yu

Edward Yu

Esophageal cancer treatment has evolved from single modality to trimodality therapy. There are some controversies of the role, target volumes and dose of radiotherapy (RT) in the literature over decades. The present review focuses primarily on RT as part of the treatment modalities, and highlight on the RT volume and its dose in the management of esophageal cancer. The randomized adjuvant chemoradiation (CRT) trial, intergroup trial (INT 0116) enrolled 559 patients with resected adenocarcinoma of the stomach or gastroesophageal junction. They were randomly assigned to surgery plus postoperative CRT or surgery alone. Analyses show robust treatment benefit of adjuvant CRT …

Brain Metastasis After Prophylactic Cranial Irradiation In Patients With Small Cell Lung Cancer, Patricia Tai, Avi Assouline, Kurian Joseph, Joseph S-K Au, Edward Yu

Edward Yu

No abstract provided.

Prognostic Factors For Male Breast Cancer: Similarity To Female Counterparts, Edward Yu, Larry Stitt, Olga Vujovic, Kurian Joseph, Avi Assouline, Joseph Au, Jawaid Younus, Francisco Perera, Patricia Tai

Edward Yu

Objective: To assess whether prognostic factors in male breast cancer (MBC) and female breast cancer (FBC) have similar impact on survival. Patients and Methods: Charts for men and women diagnosed with breast cancer referred to the London Regional Cancer Program (LRCP) were reviewed. Patients with distant metastatic diseases were excluded. Data on prognostic factors including age, nodal status, resection margin, use of hormonal therapy, chemotherapy with/without hormone and radiation therapy (RT), overall survival (OS), cancer-specific survival (CSS), and disease-free survival (DFS) were analyzed. Survival estimates were obtained using Kaplan-Meier methodology. The Cox regression interaction was used to compare male and …

Prognostic Factors For Male Breast Cancer: Similarity To Female Counterparts, Edward Yu, Larry Stitt, Olga Vujovic, Kurian Joseph, Avi Assouline, Joseph Au, Jawaid Younus, Francisco Perera, Patricia Tai

Edward Yu

Abstract. Aim: To assess whether prognostic factors in male (MBC) and female (FBC) breast cancer have similar impact on survival. Patients and Methods: Charts for men and women diagnosed with breast cancer referred to the London Regional Cancer Program (LRCP) were reviewed. Patients with distant metastatic diseases were excluded. Data on prognostic factors including age, nodal status, resection margin, use of hormonal therapy, chemotherapy with/without hormone and radiation therapy (RT), overall survival (OS), cancer-specific survival (CSS), and disease-free survival (DFS) were analyzed. Survival estimates were obtained using Kaplan-Meier methodology. The Cox regression interaction was used to compare male and female …

Adjuvant Concurrent Chemoradiation Using Intensity-Modulated Radiotherapy And Simultaneous Integrated Boost For Resected High-Risk Adenocarcinoma Of The Distal Esophagus And Gastro-Esophageal Junction., Brian Yaremko, David Palma, Abigail Erickson, Gregory Pierce, Richard Malthaner, Richard Inculet, Rashid Dar, George Rodrigues, Edward Yu

Edward Yu

Purpose: Multimodality therapy leads to improved outcomes for adenocarcinoma of the distal esophagus and gastroesophageal junction (GEJ) over surgery alone. At our institution, adjuvant chemoradiation (chemoRT) using IMRT and SIB is standard of care for resected high-risk disease. In this study, we review our experience with a recent cohort of patients treated in this manner. Methods and materials: We identified 18 patients with resected T3 and/or N1 adenocarcinoma of the distal esophagus and GEJ who received adjuvant chemoRT. A large elective volume (PTV1) and a smaller high-risk volume (PTV2) were irradiated simultaneously using IMRT and an SIB technique. All patients …

Prophylactic Cranial Irradiation For Patients With Limited-Stage Small-Cell Lung Cancer With Response To Chemoradiation, Patricia Tai, Avi Assouline, Kurian Joseph, Larry Stitt, Edward Yu

Edward Yu

Background Previous clinical studies have generally reported that prophylactic cranial irradiation (PCI) was given to patients with a complete response (CR) to chemotherapy and chest radiotherapy in limited-stage small-cell lung cancer (SCLC). It is not clear if those with incomplete response (IR) would benefit from PCI. Patients and Methods The Saskatchewan experience from 1981 through 2007 was reviewed. Patients were treated with chest radiotherapy and chemotherapy with or without PCI (typical doses: 2500 cGy in 10 fractions over 2 weeks, 3000 cGy in 15 fractions over 3 weeks, or 3000 cGy in 10 fractions over 2 weeks). Results There were …

Male Breast Cancer, Edward Yu

Edward Yu

No abstract provided.

Long-Term Outcome Of Breast Cancer Patients With One To Two Nodes Involved-Application Of Nodal Ratio, Patricia Tai, Kurian Joseph, Ali El-Gayed, Edward Yu

Edward Yu

Abstract: Nodal ratio (NR) is defined as the number of involved nodes to the number of nodes examined. There is limited information on the application of NR on population data. Previous reports in breast cancer generally analyzed one to three positive axillary nodes as a single group. This study investigates whether one to three positive axillary nodes is a homogeneous group in prognosis by comparing one to two positive nodes to three positive nodes. The population-based registry of a Canadian province from 1981 through 1995 was searched. As the reliability of nodal assessment depends on the number of nodes sampled, …

Optimal Strategy For Prophylactic Cranial Irradiation In Limited Stage Small Cell Lung Cancer, Edward Yu, Patricia Tai, Avi Assouline, Kurian Joseph

Edward Yu

No abstract provided.

Mesothelioma - Epidemiology And Management, Patricia Tai, Edward Yu, Avi Assouline, Kurian Joseph

Edward Yu

Mesothelioma is an uncommon tumor. It has a latency period of 20-40 years. The most important risk factor is asbestos exposure. Prognosis of mesothelioma is generally poor with high case-fatality rate, and research to improve the outcome of this disease is on-going worldwide. Due to its rarity, management by a multidisciplinary team with experience is recommended. Carefully selected patients may benefit from tri-modality (surgery, radiotherapy and chemotherapy) treatment. The management of pleural and peritoneal mesothelioma is summarized in this review. Recent advances in chemotherapy and biologic response modifiers are promising.

Lung Cancer Epidemiology – A Global View, Patricia Tai, Edward Yu, Rashmi Koul, Arbind Dubey

Edward Yu

Smoking, air pollution and radon exposure are causally related to lung cancer. This review analyzes trends of smoking habits by age, sex and ethnicity and their correlation with incidence and mortality of lung cancer. Unfortunately the use of tobacco by adolescents is on the rise. Most developed countries are still showing the rising trend of mortality in female smokers. In Asia, cigarette smoking has become a major health risk with one in three of all cigarettes in the world today are smoked in China. Estimated one hundred million young ( < 29 years old) Chinese smokers will eventually die from lung …

Lung Cancer Brachytherapy: Robotics-Assisted Minimally Invasive Approach, Edward Yu, Craig Lewis, Ana Trejos, Rajni Patel, Richard Malthaner

Edward Yu

New technological concepts have been evolving to manage the relative poor prognosis of lung cancer. Brachytherapy is becoming an option for both unresectable and early resectable lung cancer. Three-dimensional ultrasound (US) of lung tumours and image-guided minimally invasive robotics-assisted brachytherapy are feasible for dosimetry planning and management of lung tumours. The present article reviews the current knowledge of lung brachytherapy and discusses its potential in future management of lung cancer.

The Impact Of Post-Mastectomy Radiation Therapy On Male Breast Cancer Patients--A Case Series, Edward Yu, Hiromichi Suzuki, Jawaid Younus, Tarek Elfiki, Larry Stitt, Gary Yau, Olga Vujovic, Francisco Perera, Michael Lock, Patricia Tai

Edward Yu

OBJECTIVE: To assess the impact of radiation management on male breast cancer (MBC) at London Regional Cancer Program (LRCP). METHODS AND MATERIALS: Men with a diagnosis of breast cancer referred to LRCP were reviewed. The seventh American Joint Committee on Cancer staging system was used. Patients treated with and without post-mastectomy radiation therapy (PMRT) were analyzed. Disease-free survival (DFS) was defined as time duration from diagnosis to first recurrence. Overall survival (OS) was defined as time duration from pathologic diagnosis to death or last follow-up with any death defined as an event. Survival estimates were obtained using Kaplan-Meier methodology. RESULTS: …

Editorial Lung Cancer, What Is New ?, Edward Yu

Edward Yu

Issues Related To Sentinel Lymph Node Assessment In The Management Of Breast Cancer—What Are Relevant In Pathology Reports?, Patricia Tai, Kurian J. Joseph, Edward Yu

Edward Yu

Most cancer centers now perform sentinel node (SN) biopsies. The limited number of SNs sampled compared with an axillary dissection has allowed more comprehensive lymph node analysis resulting in increased detection of micrometastases. Many node-negative cases are now reclassified as micrometastatic. Recent research on SN biopsy focuses on whether axillary dissection is always necessary when the SN is positive. Some subgroups of patients have a higher risk of more nodal metastases when completion axillary dissections were performed. This paper summarizes the different studies and examines what are the clinically relevant items to report on SN node pathology: volume or size …

What Are The Factors That Predict Outcome At Relapse After Previous Esophagectomy And Adjuvant Therapy In High-Risk Esophageal Cancer?, Edward Yu, P. Tai, R. Malthaner, L. Stitt, G. Rodrigues, R. Dar, B. Yaremko, J. Younus, M. Sanatani, M. Vincent, B. Dingle, D. Fortin, R. Inculet

Edward Yu

OBJECTIVES: The present study investigated factors affecting outcome at relapse after previous surgery and adjuvant chemoradiation (crt) in high-risk esophageal cancer patients. PATIENTS AND METHODS: From 1989 to 1999, we followed high-risk resected esophageal cancer patients who had completed postoperative crt therapy. Patients who relapsed with a disease-free interval of less than 3 months were treated with palliative crt when appropriate. Patients with a disease-free interval of 3 months or more were treated with best supportive care. Post-recurrence survival was estimated using the Kaplan-Meier technique, and statistical comparisons were made using log-rank chi-square tests and Cox regression. RESULTS: Of the …

A Review Of Autoimmune Diseases Associated With Cancer, Patricia Tai, Edward Yu, Kurian Joseph, Thomas Miale

Edward Yu

The focus of this review is on the relationships between autoimmune diseases and cancer from two closely related perspectives: 1.Those autoimmune diseases which are often associated with malignancies. 2.Those prevalent cancers which may increase the risks of developing autoimmune disorders. The review concludes with a brief discussion of some selected innovative approaches to cancer immunotherapy.

Is Extended Volume Of External Beam Irradiation Beneficial In Post-Esophagectomy High Risk Patients Receiving Combined Chemoradiation Therapy?, E. Yu, A. R. Dar, R. Ash, G. Videtic, P. Truong, L. Stitt, A. Tomiak, M. Vincent, R. Malthaner, I. Craig, E. Brecevic, W. Kocha, R. Inculet, M. Lefcoe

Edward Yu

OBJECTIVE: To assess the value of extended volume irradiation with anastomotic coverage in high risk resected esophageal cancer patients. METHOD: A retrospective study was undertaken at LRCC from 1989-1999 for high risk resected esophageal cancer patients. Adjuvant treatments consisted of 4 cycles of chemotherapy (epirubicin/fluorouracil/cisplatin or cisplatin/fluorouracil), and local regional irradiation with or without coverage of the anastomotic site. Radiation dose ranged from 45-60Gy at 1.8-2.0 Gy/fraction given with initial anterior-posterior/posterior-anterior arrangement with either extended (with anastomotic coverage) or small (without anastomotic coverage) field followed by oblique fields for boost. RESULT: One hundred eighty-eight charts were reviewed. Seventy-two patients were …

Robot Assisted Ultrasound Imaged Guided Interstitial Lung Brachytherapy In A Porcine Model, Richard A. Malthaner, Edward Yu, Jerry J. Battista, Chris Blake, Donal Downey, Aaron Fenster

Edward Yu

We set out to see if permanent interstitial brachytherapy seeds could be safely and reproducibly inserted thoracoscopicaly with the ZEUS Robotic system and intraoperative ultrasound into in-vivo porcine lungs.

Post-Operative Extended Volume External Beam Radiation Therapy Is Safe For High Risk Esophageal Cancer Patients, Edward Yu, Patricia Tai, Jawaid Younus, Richard Malthaner, Larry Stitt, Pauline Truong, George Rodrigues, Robert Ash, Rashid Dar, Anna Tomiak, Mark Vincent, Walter Kocha, Brian Dingle, Richard Inculet

Edward Yu

Post-operative radiation therapy (RT) (1) and post-operative chemoradiation (2) have been used for esophageal cancer patients deemed high risk for recurrence after esophagectomy. Defining opitmal RT target volume after esophagectomy is difficult due to significant changes in patient anatomy and function. Some radiationon cologists advocated the inclusion of the anastomotic site within the irradiation volume due to concerns for potential increased relapse risk, while others did not subscribe to this practice due to concerns for increased treatment related toxicity. We have previously reported patient outcome benefit using extended volume RT In management with high risk esophageal cancer patients underwent esopagectomy(3). …