A Royal College of Radiologists National Audit of Radiotherapy in the Treatment of Metastatic Spinal Cord Compression and Implications for the Development of Acute Oncology Services

McGivern, U.; Drinkwater, K.; Clarke, J.; Locke, Imogen

doi:10.1016/j.clon.2014.04.032

Cited by 10 publications

(5 citation statements)

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“…The annual incidence of anal cancer in the UK is about 1000 patients [46] , as such we have captured over a 6 month period about half of all presenting patients. Although response rates to the audit, per centre, were 71%, which is comparable with other national RCR audits, the submission of 50% of all cases treated over the audit period is less than previous audits [47] , [48] . The authors hypothesise that as the audit was entitled ‘The implementation of IMRT in anal cancer’, centres probably submitted more IMRT cases than conformal or palliative cases.…”

Section: Discussionsupporting

confidence: 56%

Initial Results from the Royal College of Radiologists' UK National Audit of Anal Cancer Radiotherapy 2015

et al. 2017

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AimsUK guidance was recently developed for the treatment of anal cancer using intensity-modulated radiotherapy (IMRT). We audited the current use of radiotherapy in UK cancer centres for the treatment of anal cancer against such guidance. We describe the acute toxicity of IMRT in comparison with patient population in the audit treated with two-phase conformal radiotherapy and the previous published data from two-phase conformal radiotherapy, in the UK ACT2 trial.Materials and methodsA Royal College of Radiologists' prospective national audit of patients treated with radiotherapy in UK cancer centres was carried out over a 6 month period between February and July 2015.ResultsTwo hundred and forty-two cases were received from 40/56 cancer centres (71%). In total, 231 (95%) underwent full dose radiotherapy with prophylactic nodal irradiation. Of these, 180 (78%) received IMRT or equivalent, 52 (22%) two-phase conformal (ACT2) technique. The number of interruptions in radiotherapy treatment in the ACT2 trial was 15%. Interruptions were noted in 7% (95% confidence interval 0–14%) of courses receiving two-phase conformal and 4% (95% confidence interval 1–7%) of those receiving IMRT. The percentage of patients completing the planned radiotherapy dose, irrelevant of gaps, was 90% (95% confidence interval 82–98%) and 96% (95% confidence interval 93–99%), in two-phase conformal and IMRT respectively. The toxicity reported in the ACT2 trial, in patients receiving two-phase conformal in the audit and in patients receiving IMRT in the audit was: any toxic effect 71%, 54%, 48%, non-haematological 62%, 49%, 40% and haematological 26%, 13%, 18%, respectively.ConclusionsIMRT implementation for anal cancer is well underway in the UK with most patients receiving IMRT delivery, although its usage is not yet universal. This audit confirms that IMRT results in reduced acute toxicity and minimised treatment interruptions in comparison with previous two-phase conformal techniques.

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Section: Discussionsupporting

confidence: 56%

Initial Results from the Royal College of Radiologists' UK National Audit of Anal Cancer Radiotherapy 2015

et al. 2017

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“…The return from centres was high, similar to that from previous Royal College of Radiologists audits [12]. Although we were reliant on recording by individual clinicians, the data fields had a high degree of completion with, for example, performance status being recorded in 97% and stage in 99%.…”

Section: Discussionmentioning

confidence: 51%

The Quality of Curative-intent Radiotherapy for Non-small Cell Lung Cancer in the UK

McAleese¹,

Baluch²,

Drinkwater³

2015

Clinical Oncology

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“…The previous literature on the predictive nature of SC signal change for the clinical baseline and outcome in patients with SCI is sparse. A detailed literature search of SCI and MRI signal change was performed with a systematic review [ 5 , 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 ] ( Table 1 and Table 5 ). Fourteen studies met the inclusion criteria, as defined as being prospective and examining acute SCI, MRI, and adverse events [ 5 , 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 ...…”

Section: Discussionmentioning

confidence: 99%

Spinal Cord Signal Change on Magnetic Resonance Imaging May Predict Worse Clinical In- and Outpatient Outcomes in Patients with Spinal Cord Injury: A Prospective Multicenter Study in 459 Patients

Jentzsch

Cadotte

Wilson

et al. 2021

JCM

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Prognostic factors for clinical outcome after spinal cord (SC) injury (SCI) are limited but important in patient management and education. There is a lack of evidence regarding magnetic resonance imaging (MRI) and clinical outcomes in SCI patients. Therefore, we aimed to investigate whether baseline MRI features predicted the clinical course of the disease. This study is an ancillary to the prospective North American Clinical Trials Network (NACTN) registry. Patients were enrolled from 2005–2017. MRI within 72 h of injury and a minimum follow-up of one year were available for 459 patients. Patients with American Spinal Injury Association impairment scale (AIS) E were excluded. Patients were grouped into those with (n = 354) versus without (n = 105) SC signal change on MRI T2-weighted images. Logistic regression analysis adjusted for commonly known a priori confounders (age and baseline AIS). Main outcomes and measures: The primary outcome was any adverse event. Secondary outcomes were AIS at the baseline and final follow-up, length of hospital stay (LOS), and mortality. A regression model adjusted for age and baseline AIS. Patients with intrinsic SC signal change were younger (46.0 (interquartile range (IQR) 29.0 vs. 50.0 (IQR 20.5) years, p = 0.039). There were no significant differences in the other baseline variables, gender, body mass index, comorbidities, and injury location. There were more adverse events in patients with SC signal change (230 (65.0%) vs. 47 (44.8%), p < 0.001; odds ratio (OR) = 2.09 (95% confidence interval (CI) 1.31–3.35), p = 0.002). The most common adverse event was cardiopulmonary (186 (40.5%)). Patients were less likely to be in the AIS D category with SC signal change at baseline (OR = 0.45 (95% CI 0.28–0.72), p = 0.001) and in the AIS D or E category at the final follow-up (OR = 0.36 (95% CI 0.16–0.82), p = 0.015). The length of stay was longer in patients with SC signal change (13.0 (IQR 17.0) vs. 11.0 (IQR 14.0), p = 0.049). There was no difference between the groups in mortality (11 (3.2%) vs. 4 (3.9%)). MRI SC signal change may predict adverse events and overall LOS in the SCI population. If present, patients are more likely to have a worse baseline clinical presentation (i.e., AIS) and in- or outpatient clinical outcome after one year. Patients with SC signal change may benefit from earlier, more aggressive treatment strategies and need to be educated about an unfavorable prognosis.

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A Royal College of Radiologists National Audit of Radiotherapy in the Treatment of Metastatic Spinal Cord Compression and Implications for the Development of Acute Oncology Services

Cited by 10 publications

References 10 publications

Initial Results from the Royal College of Radiologists' UK National Audit of Anal Cancer Radiotherapy 2015

Initial Results from the Royal College of Radiologists' UK National Audit of Anal Cancer Radiotherapy 2015

The Quality of Curative-intent Radiotherapy for Non-small Cell Lung Cancer in the UK

Spinal Cord Signal Change on Magnetic Resonance Imaging May Predict Worse Clinical In- and Outpatient Outcomes in Patients with Spinal Cord Injury: A Prospective Multicenter Study in 459 Patients

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