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  1. Article ; Online: Rectal cancer treatment: an embarrassment of riches?

    Glyn, Tamara / Oar, Andrew / Vatandoust, Sina / Heriot, Alexander / Jain, Ankit

    ANZ journal of surgery

    2023  Volume 93, Issue 10, Page(s) 2293–2294

    MeSH term(s) Humans ; Embarrassment ; Rectal Neoplasms/surgery
    Language English
    Publishing date 2023-07-28
    Publishing country Australia
    Document type Journal Article
    ZDB-ID 2050749-5
    ISSN 1445-2197 ; 1445-1433 ; 0004-8682
    ISSN (online) 1445-2197
    ISSN 1445-1433 ; 0004-8682
    DOI 10.1111/ans.18634
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  2. Article ; Online: Definitive Stereotactic Body Radiation Therapy in Early-Stage Solitary Hepatocellular Carcinoma: An Australian Multi-Institutional Review of Outcomes.

    Liu, H Y-H / Lee, Y-Y D / Sridharan, S / Wang, W / Khor, R / Chu, J / Oar, A / Choong, E S / Le, H / Shanker, M / Wigg, A / Stuart, K / Pryor, D

    Clinical oncology (Royal College of Radiologists (Great Britain))

    2023  Volume 35, Issue 12, Page(s) 787–793

    Abstract: Aims: Standard curative options for early-stage, solitary hepatocellular carcinoma (HCC) are often unsuitable due to liver dysfunction, comorbidities and/or tumour location. Stereotactic body radiation therapy (SBRT) has shown high rates of local ... ...

    Abstract Aims: Standard curative options for early-stage, solitary hepatocellular carcinoma (HCC) are often unsuitable due to liver dysfunction, comorbidities and/or tumour location. Stereotactic body radiation therapy (SBRT) has shown high rates of local control in HCC; however, limited data exist in the treatment-naïve, curative-intent setting. We report the outcomes of patients with solitary early-stage HCC treated with SBRT as first-line curative-intent therapy.
    Materials and methods: A multi-institutional retrospective study of treatment-naïve patients with Barcelona Clinic Liver Cancer stage 0/A, solitary ≤5 cm HCC, Child-Pugh score (CPS) A liver function who underwent SBRT between 2010 and 2019 as definitive therapy. The primary end point was freedom from local progression. Secondary end points were progression-free survival, overall survival, rate of treatment-related clinical toxicities and change in CPS >1.
    Results: In total, 68 patients were evaluated, with a median follow-up of 20 months (range 3-58). The median age was 68 years (range 50-86); 54 (79%) were men, 62 (91%) had cirrhosis and 50 (74%) were Eastern Cooperative Oncology Group 0. The median HCC diameter was 2.5 cm (range 1.3-5) and the median prescription biologically effective dose with a tumour a/b ratio of 10 Gy (BED10) was 93 Gy (interquartile range 72-100 Gy). Two-year freedom from local progression, progression-free survival and overall survival were 94.3% (95% confidence interval 86.6-100%), 59.5% (95% confidence interval 46.3-76.4%) and 88% (95% confidence interval 79.2-97.6%), respectively. Nine patients (13.2%) experienced grade ≥2 treatment-related clinical toxicities. A rise >1 in CPS was observed in six cirrhotic patients (9.6%).
    Conclusion: SBRT is an effective and well-tolerated option to consider in patients with solitary, early-stage HCC. Prospective, randomised comparative studies are warranted to further refine its role as a first-line curative-intent therapy.
    MeSH term(s) Male ; Humans ; Middle Aged ; Aged ; Aged, 80 and over ; Female ; Carcinoma, Hepatocellular/surgery ; Liver Neoplasms/surgery ; Retrospective Studies ; Prospective Studies ; Radiosurgery/adverse effects ; Treatment Outcome ; Australia/epidemiology
    Language English
    Publishing date 2023-09-05
    Publishing country England
    Document type Multicenter Study ; Journal Article
    ZDB-ID 1036844-9
    ISSN 1433-2981 ; 0936-6555
    ISSN (online) 1433-2981
    ISSN 0936-6555
    DOI 10.1016/j.clon.2023.08.012
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    Zs.A 2774: Show issues Location:
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  3. Article ; Online: Management of rectal cancer in the era of total neoadjuvant therapy and watch and wait: A multidisciplinary team discussion at the Australasian Gastro-Intestinal Trials Group (AGITG) Annual Scientific Meeting 2022.

    Jain, Ankit / Gormly, Kirsten L / Glyn, Tamara / Sammour, Tarik / Koay, Eugene J / Oar, Andrew / Jameson, Michael B / Smyth, Elizabeth C / Vatandoust, Sina

    Asia-Pacific journal of clinical oncology

    2023  Volume 20, Issue 1, Page(s) 71–80

    Abstract: Rectal cancer is a common malignancy. The management of rectal cancer has recently evolved and has undergone a paradigm shift with the advent of treatment approaches such as total neoadjuvant therapy and the watch-and-wait approach. However, despite the ... ...

    Abstract Rectal cancer is a common malignancy. The management of rectal cancer has recently evolved and has undergone a paradigm shift with the advent of treatment approaches such as total neoadjuvant therapy and the watch-and-wait approach. However, despite the recently available evidence, there is no consensus on the optimal management approach in the setting of locally advanced rectal cancer. To address some of the controversies, a joint multidisciplinary panel discussion was conducted at the Australasian Gastro-Intestinal Trials Group (AGITG) Annual Scientific Meeting in November 2022. Members from different subspecialties formed two panels and discussed three clinical cases in a debate format. Each case represented some of the complex issues faced by clinicians in this setting. The discussion is now presented in this manuscript, which depicts the different available management approaches and reiterates the importance of a multidisciplinary approach.
    MeSH term(s) Humans ; Neoadjuvant Therapy ; Rectal Neoplasms/therapy ; Rectal Neoplasms/pathology ; Patient Care Team ; Neoplasm Recurrence, Local/pathology ; Treatment Outcome ; Chemoradiotherapy
    Language English
    Publishing date 2023-06-21
    Publishing country Australia
    Document type Journal Article
    ZDB-ID 2187409-8
    ISSN 1743-7563 ; 1743-7555
    ISSN (online) 1743-7563
    ISSN 1743-7555
    DOI 10.1111/ajco.13974
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  4. Article ; Online: Postgraduate Global Health Competency Profile for Radiation Oncology.

    Oar, A / Yap, M L / Rodin, D / McNiven, A / Papadakos, J / Giuliani, M

    Clinical oncology (Royal College of Radiologists (Great Britain))

    2018  Volume 30, Issue 12, Page(s) 810–816

    Abstract: Aims: To identify core competencies for postgraduate radiation oncology trainees in global health and cancer that may inform revisions across radiation oncology residency specialty training curricula.: Materials and methods: A review of the ... ...

    Abstract Aims: To identify core competencies for postgraduate radiation oncology trainees in global health and cancer that may inform revisions across radiation oncology residency specialty training curricula.
    Materials and methods: A review of the literature was conducted to identify all potential global health competency items. An international two-phase Delphi process was conducted with experts in oncology. In phase 1, all experts scored, on a nine-point Likert scale, the degree to which they agreed an item should be included in the competency profile. Items with a mean score ≥7 were included, those scoring 4-6 were reviewed in phase 2, and items scored ≤3 were excluded. In phase 2, items were discussed and subsequently ranked for inclusion or exclusion in the competency profile. Items with >75% voting for inclusion were included in the final competency profile.
    Results: In total, 142 potential global health competency items were identified. Sixty-one items were removed as redundant or irrelevant, leaving 81 items for the Delphi process. Eighteen specialists were invited to participate, with 10 (56%) agreeing to participate in phase 1 of the Delphi process. Participants represented 10 centres in seven countries. Of the 81 items ranked in phase 1, 72 items (89%) had a mean score ≥7 and were automatically included in the final competency profile. The remaining nine items received a score of 4-6 and were discussed in phase 2 of the Delphi process, of which three received <75% agreement for inclusion and were excluded. The result was a final list of 78 enabling competency items.
    Conclusions: The radiation oncology global health competency profile represents an international consensus on the items that can inform radiation oncology training requirements.
    MeSH term(s) Clinical Competence/standards ; Delphi Technique ; Education, Medical, Continuing/standards ; Female ; Global Health ; Health Knowledge, Attitudes, Practice ; Humans ; Internship and Residency/standards ; Male ; Neoplasms/therapy ; Physicians/standards ; Radiation Oncology/education ; Surveys and Questionnaires
    Language English
    Publishing date 2018-09-18
    Publishing country England
    Document type Journal Article
    ZDB-ID 1036844-9
    ISSN 1433-2981 ; 0936-6555
    ISSN (online) 1433-2981
    ISSN 0936-6555
    DOI 10.1016/j.clon.2018.08.019
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    Zs.A 2774: Show issues Location:
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  5. Article ; Online: The first real-time intrafraction target position monitoring in pancreas SBRT on an Elekta linear accelerator.

    Arumugam, Sankar / Pavey, Darren / Oar, Andrew / Holloway, Lois / Sidhom, Mark / Lee, Mark

    Physical and engineering sciences in medicine

    2021  Volume 44, Issue 3, Page(s) 625–638

    Abstract: To perform implanted fiducial based real-time target position monitoring in pancreas stereotactic body radiotherapy (SBRT) using the x-ray imaging system available in a Elekta linear accelerator. An in-house system was developed and clinically utilised ... ...

    Abstract To perform implanted fiducial based real-time target position monitoring in pancreas stereotactic body radiotherapy (SBRT) using the x-ray imaging system available in a Elekta linear accelerator. An in-house system was developed and clinically utilised for real-time target position monitoring of pancreas SBRT delivery. The developed system was used for the target position monitoring of a pancreas cancer patient treated in free breathing treatment within the study entitled 'Mfolfirinox And STEreotactic Radiotherapy for Patients with Locally Advanced paNcreas cancer (MASTERPLAN): a feasibility study' (ACTRN 12617001642370) consisting of five treatment fractions. The clinical efficacy of the system was studied by performing a retrospective cumulative dose assessment of delivered dose using observed position deviations. The developed system identified two events of baseline shifts in target position that exceeded the accepted tolerance level of ± 3 mm from reference planned position. The retrospective dose assessment study showed that if the position deviations were not detected and corrected for, the maximum dose to duodenum would have increased from 34.6 to 38.8 Gy. The first real-time position monitoring in pancreas SBRT on an Elekta linear accelerator was successfully performed. The developed system was shown to improve the safety and accuracy of SBRT delivery.
    MeSH term(s) Humans ; Pancreas ; Particle Accelerators ; Radiosurgery ; Radiotherapy Planning, Computer-Assisted ; Retrospective Studies
    Language English
    Publishing date 2021-05-21
    Publishing country Switzerland
    Document type Journal Article
    ISSN 2662-4737
    ISSN (online) 2662-4737
    DOI 10.1007/s13246-021-01007-0
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  6. Article ; Online: Equity should know no borders: The role of Australasian radiation oncologists in supporting radiation oncology services in low- and middle-income countries in the Asia-Pacific.

    Hassan, Sean / Oar, Andrew / Ward, Iain / Koh, Eng-Siew / Shakespeare, Thomas P / Yap, Mei Ling

    Journal of medical imaging and radiation oncology

    2021  Volume 65, Issue 4, Page(s) 410–417

    Abstract: The rapid rise in cancer incidence within the world's poorest nations highlights the need for equitable access to evidence-based cancer care. It has been previously demonstrated that radiotherapy is a cost-effective and necessary tool in cancer treatment. ...

    Abstract The rapid rise in cancer incidence within the world's poorest nations highlights the need for equitable access to evidence-based cancer care. It has been previously demonstrated that radiotherapy is a cost-effective and necessary tool in cancer treatment. However, globally there is a growing divide between demand and supply of radiotherapy services. In low- and middle-income countries, this resource gap is particularly problematic. By region, the Asia-Pacific has been demonstrated to have the highest absolute deficit in radiotherapy services. Radiation oncologists in Australia and New Zealand are geographically well positioned to assist departments within the Asia-Pacific to help to reduce these inequities. The Asia-Pacific Radiation Oncology Special Interest Group (APROSIG) aims to support oncology professionals in the Asia-Pacific to develop safe and sustainable cancer services. Members have already contributed to multiple projects throughout the region, supported by grants and departmental funding. However, the backbone of support comes from volunteers sharing their time and expertise. The Australasian oncological community has the skills and knowledge to help not only those within our borders but also beyond. Such efforts provide the potential to develop valuable clinical, educational, research and leadership experiences whilst establishing networking opportunities throughout the most populated regions of the world. More options for growth and work in global health must be investigated, encouraging future trainees to consider a role within the global cancer community. Without prompt and continued action, the resource deficit is likely to grow and the inequity in accessing radiotherapy and other cancer services further magnified.
    MeSH term(s) Asia ; Developing Countries ; Humans ; Neoplasms/radiotherapy ; Radiation Oncologists ; Radiation Oncology
    Language English
    Publishing date 2021-05-10
    Publishing country Australia
    Document type Journal Article
    ZDB-ID 2389687-5
    ISSN 1754-9485 ; 1440-1673 ; 1754-9477 ; 0004-8461
    ISSN (online) 1754-9485 ; 1440-1673
    ISSN 1754-9477 ; 0004-8461
    DOI 10.1111/1754-9485.13191
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  7. Article ; Online: Patterns of curative treatment for non-small cell lung cancer in New South Wales, Australia.

    Batumalai, Vikneswary / Descallar, Joseph / Gabriel, Gabriel / Delaney, Geoff P / Oar, Andrew / Barton, Michael B / Vinod, Shalini K

    Asia-Pacific journal of clinical oncology

    2022  Volume 19, Issue 2, Page(s) e149–e159

    Abstract: Introduction: There is a lack of large population-based studies examining patterns of curative treatment for non-small cell lung cancer (NSCLC) in Australia. This study aimed to evaluate the utilization of curative treatment for NCSLC at a population ... ...

    Abstract Introduction: There is a lack of large population-based studies examining patterns of curative treatment for non-small cell lung cancer (NSCLC) in Australia. This study aimed to evaluate the utilization of curative treatment for NCSLC at a population level and identify factors associated with its use in New South Wales (NSW), Australia.
    Methods: Patients diagnosed with localized or locoregional NSCLC between 2009 and 2014 were identified from the NSW Central Cancer Registry. Curative treatment was defined as surgery or radiotherapy with a 45 Gy minimum dose. Univariate and multivariable analyses were performed to investigate factors associated with the receipt of curative treatment. A Cox proportional-hazards regression model was used to analyze the factors associated with 2-year overall survival (OS).
    Results: Of the 5722 patients diagnosed with NSCLC in the study period, 3355 (59%) patients received curative treatment and 2367 (41%) patients did not receive curative treatment. The receipt of curative treatment was significantly associated with younger patients, female gender, localized disease, and Charlson Comorbidity Index (CCI) = 0. The use of curative treatment increased significantly over time from 2009 (55%) to 2014 (63%) and varied significantly from 24% to 70% between local health districts (LHDs) of residence. Younger age, female gender, localized disease, CCI = 0, and overseas country of birth were significantly associated with 2-year OS. The 2-year OS significantly improved from 70% in 2009 to 77% in 2014 for patients who received curative treatment.
    Conclusion: The use of curative treatment for patients with potentially curable NSCLC was low at 59%. However, the use of curative treatment and survival have increased over time. Significant variation was noted in the use of curative treatment between LHDs.
    MeSH term(s) Humans ; Female ; Carcinoma, Non-Small-Cell Lung/pathology ; Lung Neoplasms/drug therapy ; New South Wales/epidemiology ; Australia ; Proportional Hazards Models ; Neoplasm Staging
    Language English
    Publishing date 2022-07-17
    Publishing country Australia
    Document type Journal Article
    ZDB-ID 2187409-8
    ISSN 1743-7563 ; 1743-7555
    ISSN (online) 1743-7563
    ISSN 1743-7555
    DOI 10.1111/ajco.13811
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  8. Article ; Online: Response from Batumalai V et al.

    Batumalai, Vikneswary / Descallar, Joseph / Gabriel, Gabriel / Delaney, Geoff P / Oar, Andrew / Barton, Michael B / Vinod, Shalini K

    Asia-Pacific journal of clinical oncology

    2022  Volume 19, Issue 3, Page(s) 415

    Language English
    Publishing date 2022-10-27
    Publishing country Australia
    Document type Letter ; Comment
    ZDB-ID 2187409-8
    ISSN 1743-7563 ; 1743-7555
    ISSN (online) 1743-7563
    ISSN 1743-7555
    DOI 10.1111/ajco.13891
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  9. Article ; Online: Assessing tumor centrality in lung stereotactic ablative body radiotherapy (SABR): the effects of variations in bronchial tree delineation and potential for automated methods.

    Ghandourh, Wsam / Dowling, Jason / Chlap, Phillip / Oar, Andrew / Jacob, Susannah / Batumalai, Vikneswary / Holloway, Lois

    Medical dosimetry : official journal of the American Association of Medical Dosimetrists

    2020  Volume 46, Issue 1, Page(s) 94–101

    Abstract: Accurate delineation of the proximal bronchial tree (PBT) is crucial for appropriate assessment of lung tumor centrality and choice of Stereotactic Ablative Body Radiotherapy (SABR) dose prescription. Here, we investigate variabilities in manual PBT ... ...

    Abstract Accurate delineation of the proximal bronchial tree (PBT) is crucial for appropriate assessment of lung tumor centrality and choice of Stereotactic Ablative Body Radiotherapy (SABR) dose prescription. Here, we investigate variabilities in manual PBT delineation and their potential to influence assessing lesion centrality. A fully automatic, intensity-based tool for PBT contouring and measuring distance to the target is also described. This retrospective analysis included a total of 61 patients treated with lung SABR. A subset of 41 patients was used as a training dataset, containing clinical PBT contour and additional subsequently generated manual contours. The tool was optimized and compared against manual contours in terms of volume, distance to the target and various overlap/similarity metrics. The remaining 20 patients were used as a validation dataset to investigate the dosimetric effects of variations between manual and automatic PBT contours. Considerable interobserver variability was observed, particularly in identifying the superior and inferior borders of the PBT. Automatic PBT contours were comparable to manual contours with average Dice of 0.63 to 0.79 and mean distance to agreement of 1.78 to 3.34 mm. No significant differences in dosimetric parameters were found between automatically and manually generated contours. A moderate negative correlation was found between PBT maximum dose and distance to the lesion (p < 0.05). Variability in manual PBT delineation may result in inconsistent assessment of tumor centrality. Automatic contouring can help standardize clinical practice, support investigations into the link between SABR outcomes and lesion proximity to central airways and the development of predictive toxicity models that incorporate precise measurements of tumor location in relation to high-risk organs.
    MeSH term(s) Humans ; Lung ; Lung Neoplasms/radiotherapy ; Organs at Risk ; Radiotherapy Planning, Computer-Assisted ; Retrospective Studies
    Language English
    Publishing date 2020-10-13
    Publishing country United States
    Document type Journal Article
    ZDB-ID 645065-9
    ISSN 1873-4022 ; 0958-3947 ; 0739-0211
    ISSN (online) 1873-4022
    ISSN 0958-3947 ; 0739-0211
    DOI 10.1016/j.meddos.2020.09.004
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    Zs.A 2448: Show issues Location:
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  10. Article ; Online: Core elements of national cancer control plans: a tool to support plan development and review.

    Oar, Andrew / Moraes, Fabio Y / Romero, Yannick / Ilbawi, Andre / Yap, Mei Ling

    The Lancet. Oncology

    2019  Volume 20, Issue 11, Page(s) e645–e652

    Abstract: When developed and implemented effectively, national cancer control plans (NCCPs) improve cancer outcomes at the population level. However, many countries do not have a high-quality, operational NCCP, contributing to disparate cancer outcomes globally. ... ...

    Abstract When developed and implemented effectively, national cancer control plans (NCCPs) improve cancer outcomes at the population level. However, many countries do not have a high-quality, operational NCCP, contributing to disparate cancer outcomes globally. Until now, a standard reference of NCCP core elements has not been available to guide development and evaluation across diverse countries and contexts. In this Policy Review, we describe the methods, process, and outcome of an initiative to develop an itemised and evidence-based comprehensive checklist of core elements for NCCP formulation. The final list provides a ready-to-use guide to support NCCP development and to facilitate internal and external critical appraisal of existing NCCPs for countries of all income levels and settings. Governments, policy makers, and stakeholders can utilise this checklist, while considering their own unique contexts and priorities, from the drafting through to the implementation of NCCPs.
    MeSH term(s) Checklist ; Delivery of Health Care, Integrated/legislation & jurisprudence ; Delivery of Health Care, Integrated/organization & administration ; Global Health/legislation & jurisprudence ; Health Planning/legislation & jurisprudence ; Health Planning/organization & administration ; Health Policy/legislation & jurisprudence ; Humans ; Medical Oncology/legislation & jurisprudence ; Medical Oncology/organization & administration ; Models, Organizational ; Neoplasms/diagnosis ; Neoplasms/mortality ; Neoplasms/therapy ; Policy Making
    Language English
    Publishing date 2019-11-14
    Publishing country England
    Document type Journal Article ; Research Support, Non-U.S. Gov't ; Review
    ZDB-ID 2049730-1
    ISSN 1474-5488 ; 1470-2045
    ISSN (online) 1474-5488
    ISSN 1470-2045
    DOI 10.1016/S1470-2045(19)30404-8
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