Digital Commons Network^™

Higher Breakfast Glycaemic Load Is Associated With Increased Metabolic Syndrome Risk, Including Lower Hdl-Cholesterol Concentrations And Increased Tag Concentrations, In Adolescent Girls, Analise Nicholl, Mary Du Heaume, Trevor A. Mori, Lawrence J. Beilin, Wendy H. Oddy, Alexandra P. Bremner, Therese A. O'Sullivan

Research outputs 2014 to 2021

Almost all previous studies examining the associations between glycaemic load (GL) and metabolic syndrome risk have used a daily GL value. The daily value does not distinguish between peaks of GL intake over the day, which may be more closely associated with the risk of the metabolic syndrome. The aim of the present study was to investigate the cross-sectional associations between daily and mealtime measures of GL and metabolic syndrome risk, including metabolic syndrome components, in adolescents. Adolescents participating in the 14-year follow-up of the Western Australian Pregnancy Cohort (Raine) Study completed 3 d food records and metabolic assessments. Breakfast …

General Practitioners' Experiences Of Bereavement Care And Their Educational Support Needs: A Qualitative Study, Moira O'Connor, Lauren J. Breen

Research outputs 2014 to 2021

Background: General Practitioners (GPs) are well-positioned to provide grief support to patients. Most GPs view the provision of bereavement care as an important aspect of their role and the GP is the health professional that many people turn to when they need support. We aimed to explore GPs' understandings of bereavement care and their education and professional development needs in relation to bereavement care. Methods. An in-depth qualitative design was adopted using a social constructionist approach as our aims were exploratory and applied. Nineteen GPs (12 women and 7 men) living in Western Australia were interviewed; 14 were based in …

Low Back Pain Beliefs Are Associated To Age, Location Of Work, Education And Pain-Related Disability In Chinese Healthcare Professionals Working In China: A Cross Sectional Survey, B K. Tan, Anne J. Smith, Peter B. O'Sullivan, Gang Chen, Angus F. Burnett, Andrew M. Briggs

Research outputs 2014 to 2021

Background: Low back pain (LBP) is the leading cause of disability worldwide. Evidence pointing towards a more efficacious model of care using a biopsychosocial approach for LBP management highlights the need to understand the pain-related beliefs of patients and those who treat them. The beliefs held by healthcare professionals (HCPs) are known to influence the treatment advice given to patients and consequently management outcomes. Back pain beliefs are known to be influenced by factors such as culture, education, health literacy, place of work, personal experience of LBP and the sequelae of LBP such as disability. There is currently a knowledge …

Monitoring Changes In Circulating Tumour Cells As A Prognostic Indicator Of Overall Survival And Treatment Response In Patients With Metastatic Melanoma, Dragana Klinac, Elin S. Gray, James B. Freeman, Anna Reid, Samantha Bowyer, Michael Millward, Mel Ziman

Research outputs 2014 to 2021

Background: New effective treatments for metastatic melanoma greatly improve survival in a proportion of patients. However biomarkers to identify patients that are more likely to benefit from a particular treatment are needed. We previously reported on a multimarker approach for the detection of heterogenous melanoma circulating tumour cells (CTCs). Here we evaluated the prognostic value of this multimarker quantification of CTCs and investigated whether changes in CTC levels during therapy can be used as a biomarker of treatment response and survival outcomes.Methods: CTCs were captured by targeting the melanoma associated markers MCSP and MCAM as well as the melanoma stem …

Reducing Depression During The Menopausal Transition: Study Protocol For A Randomised Controlled Trial, Osvaldo P. Almeida, Kylie Marsh, Leon Flicker, Martha Hickey, Andrew Ford, Moira Sim

Research outputs 2014 to 2021

Background: The menopausal transition (MT) is a biological inevitability for all ageing women that can be associated with changes in mood, including depressive symptoms. There is tentative evidence that women who develop depression during the MT have greater risk of subsequent depressive episodes, as well as increased health morbidity and mortality. Thus, preventing depression during the MT could enhance both current and the future health and well-being of women. This study aims to test the efficacy of a client-centred health promotion intervention to decrease the 12-month incidence of clinically significant symptoms of depression among women undergoing the MT.Methods/Design: This randomised …

Effect Of Bdnf Val66met On Memory Decline And Hippocampal Atrophy In Prodromal Alzheimer's Disease: A Preliminary Study, Yen Y. Lim, Victor L. Villemagne, Simon M. Laws, David Ames, Robert H. Pietrzak, Kathryn A. Ellis, Karra Harrington, Pierrick Bourgeat, Ashley I. Bush, Ralph N. Martins, Colin L. Masters, Christopher C. Rowe, Paul Maruff

Research outputs 2014 to 2021

Objective: Cross-sectional genetic association studies have reported equivocal results on the relationship between the brain-derived neurotrophic factor (BDNF) Val66Met and risk of Alzheimer's disease (AD). As AD is a neurodegenerative disease, genetic influences may become clearer from prospective study. We aimed to determine whether BDNF Val66Met polymorphism influences changes in memory performance, hippocampal volume, and Aβ accumulation in adults with amnestic mild cognitive impairment (aMCI) and high Aβ. Methods: Thirty-four adults with aMCI were recruited from the Australian, Imaging, Biomarkers and Lifestyle (AIBL) Study. Participants underwent PiB-PET and structural MRI neuroimaging, neuropsychological assessments and BDNF genotyping at baseline, 18 month, …

Strong Relationship Between Oral Dose And Tenofovir Hair Levels In A Randomized Trial: Hair As A Potential Adherence Measure For Pre-Exposure Prophylaxis (Prep)., Albert Y. Liu, Qiyun Yang, Yong Huang, Peter Bacchetti, Peter L. Anderson, Chengshi Jin, Kathy Goggin, Kristefer Stojanovski, Robert Grant, Susan P. Buchbinder, Ruth M. Greenblatt, Monica Gandhi

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND: Pre-exposure prophylaxis (PrEP) trials using tenofovir-based regimens have demonstrated that high levels of adherence are required to evaluate efficacy; the incorporation of objective biomarkers of adherence in trial design has been essential to interpretation, given the inaccuracy of self-report. Antiretroviral measurements in scalp hair have been useful as a marker of long-term exposure in the HIV treatment setting, and hair samples are relatively easy and inexpensive to collect, transport, and store for analysis. To evaluate the relationship between dose and tenofovir concentrations in hair, we examined the dose proportionality of tenofovir in hair in healthy, HIV-uninfected adults.

METHODS: A …

Metals In Commonly Eaten Groceries In Western Australia: A Market Basket Survey And Dietary Assessment, Anna Callan, Andrea Hinwood, Amanda Devine

Research outputs 2014 to 2021

Children’s dietary exposure to metals has received limited attention in Australia. This study undertook a market basket survey and analysed 253 food and beverages for metals. These data were used in conjunction with recent average diet data for children in Western Australia to model dietary metals exposure, with mean metals intakes calculated for boys and girls aged 8, 12, 13 and 16 years. Results show that for some metals, including cadmium, nickel and manganese, dietary intake guidelines have been exceeded in younger children. The mean modelled cadmium intake in children aged 8 years was almost 60% of the World Health …

Positive Correlation Between The Expression Of Heag1 And Hif-1Α In Breast Cancers: An Observational Study, Qingxuan Lai, Ting Wang, Qingqing Guo, Yuxiang Zhang, Youxin Wang, Li Yuan, Rui Ling, Yan He, Wei Wang

Research outputs 2014 to 2021

Objectives: To explore the expression patterns of Eag1 (ether á go-go 1) and HIF-1α (hypoxia-inducible factor 1α) in a cohort of patients with breast cancer. Setting: Department of general surgery in an upper first-class hospital in Xi'an, China. Participants: A total of 112 female Han Chinese patients with a diagnosis of invasive ductal carcinoma were included. Patients with main internal diseases, such as cardiovascular, endocrine, gastroenterological, haematological, infectious diseases, etc, were excluded. Primary and secondary outcome measures: Expression profiles of Eag1 and HIF-1α. Results: Eag1 and HIF-1α were overexpressed in the tumour tissues compared with the pair-matched control tissues, p=0.002 …

Risk Factors For Cerebrovascular Disease Mortality Among The Elderly In Beijing: A Competing Risk Analysis, Zhe Tang, Tao Zhou, Yanxia Luo, Changchun Xie, Da Huo, Lixin Tao, Lei Pan, Fei Sun, Huiping Zhu, Xinghua Yang, Wei Wang, Aoshuang Yan, Xia Li, Xiuhua Guo

Research outputs 2014 to 2021

Objective: To examine the associations of combined lifestyle factors and physical conditions with cerebrovascular diseases (CBVD) mortality, after accounting for competing risk events, including death from cardiovascular diseases, cancers and other diseases. Methods: Data on 2010 subjects aged over 55 years were finally analyzed using competing risk models. All the subjects were interviewed by the Beijing Longitudinal Study of Aging (BLSA), in China, between 1 January 1992 and 30 August 2009. Results: Elderly females were at a lower risk of death from CBVD than elderly males (HR = 0.639, 95% CI = 0.457-0.895). Increasing age (HR = 1.543, 95% CI …

Acute Hospital-Based Services Utilisation During The Last Year Of Life In New South Wales, Australia: Methods For A Population-Based Study, Dianne L. O'Connell, David E. Goldsbury, Patricia Davidson, Afaf Girgis, Jane L. Phillips, Michael Piza, Anne Wilkinson, Jane M. Ingham

Research outputs 2014 to 2021

Objectives: The aim of this study is to describe healthcare utilisation in the last year of life for people in Australia, to help inform health services planning. The methods and datasets that are being used are described in this paper. Design/Setting: Linked, routinely collected administrative health data are being analysed for all people who died in New South Wales (NSW), Australia's most populous state, in 2007. The data comprised linked death records (2007), hospital admissions and emergency department presentations (2006-2007) and cancer registrations (1994-2007). Participants: There were 46 341 deaths in NSW in 2007. The initial analyses include 45 760 …

Contourlet Textual Features: Improving The Diagnosis Of Solitary Pulmonary Nodules In Two Dimensional Ct Images, Jingjing Wang, Tao Sun, Ni Gao, Desmond D. Menon, Yanxia Luo, Qi Gao, Xia Li, Wei Wang, Huiping Zhu, Pingxin Lv, Zhigang Liang, Lixin Tao, Xiangtong Liu, Xiuhua Guo

Research outputs 2014 to 2021

Materials and Methods: A total of 6,299 CT images were acquired from 336 patients, with 1,454 benign pulmonary nodule images from 84 patients (50 male, 34 female) and 4,845 malignant from 252 patients (150 male, 102 female). Further to this, nineteen patient information categories, which included seven demographic parameters and twelve morphological features, were also collected. A contourlet was used to extract fourteen types of textural features. These were then used to establish three support vector machine models. One comprised a database constructed of nineteen collected patient information categories, another included contourlet textural features and the third one contained both …

Reaching Perinatal Women Online: The Healthy You, Healthy Baby Website And App, Lydia Hearn, Margaret Miller, Leanne Lester

Research outputs 2014 to 2021

Overwhelming evidence reveals the close link between unwarranted weight gain among childbearing women and childhood adiposity. Yet current barriers limit the capacity of perinatal health care providers (PHCPs) to offer healthy lifestyle counselling. In response, today's Internet savvy women are turning to online resources to access health information, with the potential of revolutionising health services by enabling PHCPs to guide women to appropriate online resources. This paper presents the findings of a project designed to develop an online resource to promote healthy lifestyles during the perinatal period. The methodology involved focus groups and interviews with perinatal women and PHCPs to …

Iron Status And The Acute Post-Exercise Hepcidin Response In Athletes, Peter Peeling, Marc Sim, Claire E. Badenhorst, Brian Dawson, Andrew D. Govus, Chris R. Abbiss, Dorine W. Swinkels, Debbie Trinder

Research outputs 2014 to 2021

This study explored the relationship between serum ferritin and hepcidin in athletes. Baseline serum ferritin levels of 54 athletes from the control trial of five investigations conducted in our laboratory were considered; athletes were grouped according to values 100 mg/L (SF>100). Data pooling resulted in each athlete completing one of five running sessions: (1) 8x3 min at 85% vVO2peak; (2) 5x4 min at 90% vVO2peak; (3) 90 min continuous at 75% vVO2peak; (4) 40 min continuous at 75% vVO 2peak; (5) 40 min continuous at 65% vVO2peak. Athletes from each running session were represented amongst all four groups; hence, …

Pulmonary Function In Patients With Huntington's Disease, Alvaro Reyes, Travis Cruickshank, Mel Ziman, Ken Nosaka

Research outputs 2014 to 2021

Background: Huntington's disease (HD) is a neurodegenerative disorder characterized by progressive motor, cognitive and psychiatric disturbances. Chest muscle rigidity, respiratory muscle weakness, difficulty in clearing airway secretions and swallowing abnormalities have been described in patients with neurodegenerative disorders including HD. However limited information is available regarding respiratory function in HD patients. The purpose of this study was to investigate pulmonary function of patients with HD in comparison to healthy volunteers, and its association with motor severity.Methods: Pulmonary function measures were taken from 18 (11 male, 7 female) manifest HD patients (53 ± 10 years), and 18 (10 male, 8 female) …

Predictors Of Grandparental Investment Decisions In Contemporary Europe: Biological Relatedness And Beyond, David A. Coall, Sonja Hilbrand, Ralph Hertwig

Research outputs 2014 to 2021

Across human cultures, grandparents make a valued contribution to the health of their families and communities. Moreover, evidence is gathering that grandparents have a positive impact on the development of grandchildren in contemporary industrialized societies. A broad range of factors that influence the likelihood grandparents will invest in their grandchildren has been explored by disciplines as diverse as sociology, economics, psychology and evolutionary biology. To progress toward an encompassing framework, this study will include biological relatedness between grandparents and grandchildren, a factor central to some discipline's theoretical frameworks (e.g., evolutionary biology), next to a wide range of other factors in …

Effect Of Head And Limb Orientation On Trunk Muscle Activation During Abdominal Hollowing In Chronic Low Back Pain, Kevin Parfrey, Sean G. Gibbons, Eric J. Drinkwater, David G. Behm

Research outputs 2014 to 2021

Background: Individuals with chronic low back pain (CLBP) have altered activations patterns of the anterior trunk musculature when performing the abdominal hollowing manœuvre (attempt to pull umbilicus inward and upward towards the spine). There is a subgroup of individuals with CLBP who have high neurocognitive and sensory motor deficits with associated primitive reflexes (PR). The objective of the study was to determine if orienting the head and extremities to positions, which mimic PR patterns would alter anterior trunk musculature activation during the hollowing manoeuvre. Methods. This study compared surface electromyography (EMG) of bilateral rectus abdominis (RA), external oblique (EO), and …

Positive Patient Experiences In An Australian Integrative Oncology Centre, Bonnie J. Furzer, Anna S. Petterson, Kemi E. Wright, Karen E. Wallman, Timothy R. Ackland, David J. Joske

Research outputs 2014 to 2021

Background: The purpose of this study was to explore the experiences of cancer patients' utilising complementary and integrative therapies (CIT) within integrative oncology centres across Western Australia.Methods: Across four locations 135 patients accessed CIT services whilst undergoing outpatient medical treatment for cancer. Of the 135 patients, 66 (61 ± 12 y; female n = 45; male n = 21) agreed to complete a personal accounts questionnaire consisting of open-ended questions designed to explore patients' perceptions of CIT. All results were transcribed into nVivo (v9) and using thematic analysis, key themes were identified.Results: Of the 66 participants, 100% indicated they would …

Day Occupation Is Associated With Psychopathology For Adolescents And Young Adults With Down Syndrome, Kitty-Rose R. Foley, Peter Jacoby, Stewart Einfeld, Sonya Girdler, Jenny Bourke, Vivienne Riches, Helen Leonard

Research outputs 2014 to 2021

Background: Young adults with Down syndrome experience increased rates of emotional and behavioural problems compared with the general population. Most adolescents with Down syndrome living in Western Australia participate in sheltered employment as their main day occupation. Relationship between day occupation and changes in behaviour has not been examined. Therefore, the aim of this research was to explore any relationship between post school day occupations and changes in the young person's behaviour.Methods: The Down syndrome Needs Opinion Wishes database was used for case ascertainment of young adults aged 15 to 32 years with Down syndrome. Families of 118 young people …

An Anemia Of Alzheimer's Disease, N G. Faux, A Rembach, J Wiley, K A. Ellis, D Ames, C J. Fowler, Ralph N. Martins, K K. Pertile, R L. Rumble, B Trounson, C L. Masters, A I. Bush

Research outputs 2014 to 2021

Lower hemoglobin is associated with cognitive impairment and Alzheimer's disease (AD). Since brain iron homeostasis is perturbed in AD, we investigated whether this is peripherally reflected in the hematological and related blood chemistry values from the Australian Imaging Biomarker and Lifestyle (AIBL) study (a community-based, cross-sectional cohort comprising 768 healthy controls (HC), 133 participants with mild cognitive impairment (MCI) and 211 participants with AD). We found that individuals with AD had significantly lower hemoglobin, mean cell hemoglobin concentrations, packed cell volume and higher erythrocyte sedimentation rates (adjusted for age, gender, APOE-ε4 and site). In AD, plasma iron, transferrin, transferrin saturation …

A Comparison Of Aphasia Therapy Outcomes Before And After A Very Early Rehabilitation Programme Following Stroke, Erin Godecke, Natalie A. Ciccone, Andrew S. Granger, Tapan Rai, Deborah West, Angela Cream, Jade Cartwright, Graeme J. Hankey

Research outputs 2014 to 2021

Background Very early aphasia rehabilitation studies have shown mixed results. Differences in therapy intensity and therapy type contribute significantly to the equivocal results. Aims To compare a standardized, prescribed very early aphasia therapy regimen with a historical usual care control group at therapy completion (4-5 weeks post-stroke) and again at follow-up (6 months). Methods & Procedures This study compared two cohorts from successive studies conducted in four Australian acute/sub-acute hospitals. The studies had near identical recruitment, blinded assessment and data-collection protocols. The Very Early Rehabilitation (VER) cohort (N = 20) had mild-severe aphasia and received up to 20 1-h sessions …

Young Australian Adults’ Reactions To Viewing Personalised Uv Photoaged Photographs, Lori L. Presti, Paul Chang, Myra F. Taylor

Research outputs 2014 to 2021

Background: Despite two nationwide sun-protection awareness campaigns, young Australian adults continue to sunbathe. Since their primary motivation for tanning is appearance enhancement, it may well be that campaigns that highlight the negative effects of tanning on appearance are more effective than campaigns that emphasise the health risks associated with sun exposure.Aims: This study aims to explore young adults’ reactions to viewing a photoaged photograph of the sun damage already visible in their facial image.Methods: Semi-structured interviews were conducted with seven females and three males aged 20-30 years. The interview transcripts were transcribed verbatim and were then subjected to Interpretive Phenomenological …

The Reliability Of An Adolescent Dietary Pattern Identified Using Reduced-Rank Regression: Comparison Of A Ffq And 3 D Food Record, Geeta Appannah, Gerda K. Pot, Therese A. O'Sullivan, Wendy H. Oddy, Susan A. Jebb, Gina L. Ambrosini

Research outputs 2014 to 2021

Despite the increasing use of dietary patterns (DP) to study diet and health outcomes, relatively few studies have examined the reliability of DP using different dietary assessment methods. Reduced-rank regression (RRR) is an emerging statistical method that incorporates a priori information to characterise DP related to specific outcomes of interest. The aim of the present study was to compare DP identified using the RRR method in a FFQ with those in a 3 d food record (FR). Participants were 783 adolescents from the Western Australian Pregnancy (Raine) Cohort Study who completed both a FFQ and FR at 14 years of …

A Biological, Latent Variable Model Of Health (Earlybird 68)., Michael E. Hyland, Alison N. Jeffery, Terence J. Wilkin

School of Psychology

OBJECTIVE: To determine whether factor analysis of a set of health-related biomarkers provides evidence of an underlying common dimension of variation, and to explore the relationship between this dimension of variation with positive and negative affect. METHOD: Twelve health-related metabolic, immune and body-composition biomarkers at ages 5, 7, 9, 11, 14 and 16years were obtained from the EarlyBird longitudinal cohort of 347 children and supplemented by positive affect (PA) and negative affect (NA) measured at age 16years. RESULTS: At each age, principal factor analysis revealed that nine of the 12 biomarkers consistently loaded on the first extracted factor, accounting for …

Comparison Of Corded And Cordless Handpieces On Forearm Muscle Activity, Procedure Time And Ease Of Use During Simulated Tooth Polishing, Gayle Mccombs, Daniel M. Russell

Dental Hygiene Faculty Publications

Purpose: Dental professionals suffer from a high prevalence of work-related musculoskeletal disorders (MSD). Dental hygienists in particular have a high prevalence of pain in the forearms and hands. The objective of this study was to compare 1 cordless handpiece to 2 corded handpieces during simulated tooth polishing in terms of the muscle loads (recorded as electromyography (EMG) activity), duration of polishing procedure, and dental hygienist opinion about ease of use. Methods: EMG was used to quantify muscle electrical activity of 4 forearm muscles during simulated dental polishing with 2 corded handpieces (HP-A and HP-B) and 1 cordless handpiece (HP-C). A …

Birth Control: To What Extent Do Women Report Being Informed And Involved In Decisions About Pregnancy And Birth Procedures?, Rachel Thompson, Yvette D. Miller

Dartmouth Scholarship

Background: Health policy, guidelines, and standards advocate giving patients comprehensive information and facilitating their involvement in health-related decision-making. Routine assessment of patient reports of these processes is needed. Our objective was to examine decision-making processes, specifically information provision and consumer involvement in decision-making, for nine pregnancy, labour, and birth procedures, as reported by maternity care consumers in Queensland, Australia.

Methods: Participants were women who had a live birth in Queensland in a specified time period and were not found to have had a baby that died since birth, who completed the extended Having a Baby in Queensland Survey, 2010 about …

Primary Stroke In A Woman With Sickle Cell Anemia Responsive To Hydroxyurea Therapy., Samir K. Ballas, Ubaldo E. Martinez-Outshoorn, Michael P. Savage

Cardeza Foundation for Hematologic Research

The most common cause of stroke in children with sickle cell anemia is infarction due to ischemia. In adults, however, stroke is most commonly hemorrhagic in nature. Other causes of stroke in patients with sickle cell disease are very rare. In this short communication, we describe a woman with sickle cell anemia responsive to hydroxyurea (HU) therapy who had primary stroke due to paradoxical embolization caused by a large atrial septal defect. Successful management of the stroke included surgical closure of the defect with trans-esophageal echocardiographic guidance. To the best of our knowledge, this is the first patient with sickle …

Understanding The Role Of Communication Anxiety/Uncertainty Management (Aum) Among Female Teenage Bloggers, Heather Carleston

Communication & Leadership Dissertations and Theses

This study examines how and what female teenagers communicate through blogging; how they manage uncertainty and anxiety within their posts and/or comments; the role communication anxiety/uncertainty plays in self-presentation and self-disclosure for this population; and how, when faced with bullying, flaming and adverse responses, they express and manage anxiety and uncertainty online. Using both Buber’s (1970) I-It and I-Thou philosophy and Gudykunst’s (2005) Anxiety and Uncertainty Management theory, this study examined the blog sites of three female U.S. teenagers. Examining the five most recently published blog posts, the study analyzed the details and self-disclosure levels, from site design and development; …

Extending The Indications Of Flow Diversion To Small, Unruptured, Saccular Aneurysms Of The Anterior Circulation., Nohra Chalouhi, Md, Robert M Starke, Steven Yang, Cory D Bovenzi, Stavropoula Tjoumakaris, David Hasan, L. Fernando Gonzalez, Robert H. Rosenwasswer Md, Pascal Jabbour Md

Department of Neurosurgery Faculty Papers

BACKGROUND AND PURPOSE: Flow diverters are currently indicated for treatment of large and complex intracranial aneurysms. The purpose of this study was to determine whether the indications of flow diversion can be safely extended to unruptured, small, saccular aneurysms (<10 >mm) of the anterior circulation.

METHODS: Forty patients treated with the pipeline embolization device (PED) were matched in a 1:4 fashion with 160 patients treated with stent-assisted coiling based on patient age, sex, aneurysm location, and aneurysm size. Procedural complications, angiographic results, and clinical outcomes were analyzed and compared.

RESULTS: The rate of periprocedural complications was 5% in the PED …

E5501: Phase Ii Study Of Topotecan Sequenced With Etoposide/Cisplatin, And Irinotecan/Cisplatin Sequenced With Etoposide For Extensive-Stage Small-Cell Lung Cancer., Taofeek K. Owonikoko, Joseph Aisner, Xin Victoria Wang, Suzanne E. Dahlberg, Eric H. Rubin, Suresh S. Ramalingam, Murugesan Gounder, Paul Gregory Rausch, Rita S. Axelrod, Md, Joan H. Schiller

Department of Medical Oncology Faculty Papers

PURPOSE: Sequence-dependent improved efficacy of topoisomerase I followed by topoisomerase 2 inhibitors was assessed in a randomized phase II study in extensive-stage small-cell lung cancer (SCLC).

METHODS: Patients with previously untreated extensive-stage SCLC with measurable disease, ECOG performance status of 0-3 and stable brain metastases were eligible. Arm A consisted of topotecan (0.75 mg/m(2)) on days 1, 2 and 3, etoposide (70 mg/m(2)) and cisplatin (20 mg/m(2)) (PET) on days 8, 9 and 10 in a 3-week cycle. Arm B consisted of irinotecan (50 mg/m(2)) and cisplatin (20 mg/m(2)) on days 1 and 8 followed by etoposide (85 mg/m(2) PO …