Effects of Palliative Radiation Therapy on Nonsplenic Hemangiosarcoma in Dogs

Medical records for 20 dogs with histologically confirmed nonsplenic hemangiosarcomas treated with palliative radiation therapy were reviewed to evaluate factors influencing tumor response and survival time. The Kaplan-Meier median survival time of dogs that received palliative radiation therapy was 95 days (range 6 to 500 days). Subjective reduction in tumor size was seen in 14 dogs, with four complete responses. Tumor location was a significant univariate prognostic factor for survival, and dogs with retroperitoneal masses had longer survival times.

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External Validation of the Bone Metastases Ensemble Trees for Survival (BMETS) Machine Learning Model to Predict Survival in Patients With Symptomatic Bone Metastases

JCO Clinical Cancer Informatics ◽

10.1200/cci.20.00128 ◽

2021 ◽

pp. 304-314

Author(s):

Christen R. Elledge ◽

Anna W. LaVigne ◽

Jacob Fiksel ◽

Jean L. Wright ◽

Todd McNutt ◽

...

Keyword(s):

Machine Learning ◽

Radiation Therapy ◽

Bone Metastases ◽

Survival Time ◽

Tertiary Care ◽

External Validation ◽

Data Set ◽

Palliative Radiation ◽

External Data ◽

Palliative Radiation Therapy

PURPOSE The Bone Metastases Ensemble Trees for Survival (BMETS) model uses a machine learning algorithm to estimate survival time following consultation for palliative radiation therapy for symptomatic bone metastases (SBM). BMETS was developed at a tertiary-care, academic medical center, but its validity and stability when applied to external data sets are unknown. PATIENTS AND METHODS Patients treated with palliative radiation therapy for SBM from May 2013 to May 2016 at two hospital-based community radiation oncology clinics were included, and medical records were retrospectively reviewed to collect model covariates and survival time. The Kaplan-Meier method was used to estimate overall survival from consultation to death or last follow-up. Model discrimination was estimated using time-dependent area under the curve (tAUC), which was calculated using survival predictions from BMETS based on the initial training data set. RESULTS A total of 216 sites of SBM were treated in 182 patients. Most common histologies were breast (27%), lung (23%), and prostate (23%). Compared with the BMETS training set, the external validation population was older (mean age, 67 v 62 years; P < .001), had more primary breast (27% v 19%; P = .03) and prostate cancer (20% v 12%; P = .01), and survived longer (median, 10.7 v 6.4 months). When the BMETS model was applied to the external data set, tAUC values at 3, 6, and 12 months were 0.82, 0.77, and 0.77, respectively. When refit with data from the combined training and external validation sets, tAUC remained > 0.79. CONCLUSION BMETS maintained high discriminative ability when applied to an external validation set and when refit with new data, supporting its generalizability, stability, and the feasibility of dynamic modeling.

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TOLERABILITY AND TUMOR RESPONSE OF A NOVEL LOW-DOSE PALLIATIVE RADIATION THERAPY PROTOCOL IN DOGS WITH TRANSITIONAL CELL CARCINOMA OF THE BLADDER AND URETHRA

Veterinary Radiology & Ultrasound ◽

10.1111/vru.12339 ◽

2016 ◽

Vol 57 (3) ◽

pp. 341-351 ◽

Cited By ~ 8

Author(s):

Kevin Choy ◽

Janean Fidel

Keyword(s):

Radiation Therapy ◽

Transitional Cell Carcinoma ◽

Cell Carcinoma ◽

Low Dose ◽

Tumor Response ◽

Transitional Cell ◽

Palliative Radiation ◽

Palliative Radiation Therapy ◽

Carcinoma Of The Bladder ◽

Therapy Protocol

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The utilization of palliative radiation therapy to the liver for hepatocellular carcinoma.

Journal of Clinical Oncology ◽

10.1200/jco.2017.35.4_suppl.474 ◽

2017 ◽

Vol 35 (4_suppl) ◽

pp. 474-474

Author(s):

Sara-Jane N. Onyeama ◽

Abdulrahman Y Hammad ◽

Fabian McCartney Johnston ◽

T. Clark Gamblin ◽

Jared Rex Robbins

Keyword(s):

Hepatocellular Carcinoma ◽

Overall Survival ◽

Radiation Therapy ◽

Cox Regression ◽

Intensity Modulated Radiation Therapy ◽

Treatment Schedule ◽

Palliative Radiation ◽

Palliative Intent ◽

Kaplan Meier ◽

Palliative Radiation Therapy

474 Background: Despite retrospective and prospective clinical trials conveying the efficacy of palliative radiation therapy (RT) to the liver, this modality is not commonly used. The purpose of this project is to evaluate trends, dose schemas, and techniques of palliative RT to the liver in current practice. We aim to identify factors associated with overall survival using patient data from the National Cancer Database (NCDB). Methods: Using the NCDB, we analyzed patients with hepatocellular carcinoma (HCC) diagnosed from 2004-2012 treated with palliative RT. Various patient factors were reviewed and survival analyses were performed. Doses were converted to biological effective dose (BED) to compare the different fractionation schemas. Univariate and multivariate analyses were performed with Kaplan Meier and Cox regression tests. Results: A total of 3,267 HCC patients were identified who were treated with palliative intent. Of these 877 (27%) received radiation therapy and only 138 (4% of total, 16% of RT) received radiation therapy to the liver. For those treated with palliative radiation to the liver, the median age was 61 years. Patients with stages I, II, III and IV disease comprised 15%, 15%, 45%, and 25% respectively. Various dose schema and techniques were used. 38% were treated with advanced radiation techniques (24% stereotactic body radiation therapy (SBRT), 14% Intensity-modulated radiation therapy (IMRT). A total of 79 (57%) patients received 10 or fewer fractions, but 32 (40%) of those were SBRT. The median survival was 4.7 months with 16% mortality at 1 month. On multivariate analysis, stage 3 (HR 2.625, p = 0,013) and stage 4 tumors (HR 2.701, p = 0.018), no chemotherapy (HR 1.743, p = 0.025), and lower radiation dose (HR 0.982, p = 0.003) was associated with worse overall survival. Conclusions: Palliative radiation to the liver is not frequently used in patients with HCC. As a result, there is minimal standardization of dose, modality, or treatment schedule. Better understanding of prognostic factors may help better determine the most appropriate plan for each patient to coordinate treatment length with projected survival.

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The Impact of Pamidronate and Chemotherapy on Survival Times in Dogs with Appendicular Primary Bone Tumors Treated with Palliative Radiation Therapy

Veterinary Surgery ◽

10.1111/j.1532-950x.2012.00968.x ◽

2012 ◽

Vol 41 (3) ◽

pp. 430-435 ◽

Cited By ~ 18

Author(s):

Michelle L. Oblak ◽

Sarah E. Boston ◽

Geraldine Higginson ◽

Steven G. Patten ◽

Gabrielle J. Monteith ◽

...

Keyword(s):

Radiation Therapy ◽

Bone Tumors ◽

Survival Times ◽

Primary Bone Tumors ◽

Palliative Radiation ◽

Palliative Radiation Therapy ◽

Primary Bone ◽

The Impact

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RESULTS OF TREATMENT OF LOCALLY RECURRING SOFT TISSUES SARCOMAS OF EXTREMITIES

Problems in oncology ◽

10.37469/0507-3758-2018-64-3-408-413 ◽

2018 ◽

Vol 64 (3) ◽

pp. 408-413

Author(s):

Grigoriy Zinovev ◽

Georgiy Gafton ◽

Sergey Novikov ◽

Ivan Gafton ◽

Yekaterina Busko ◽

...

Keyword(s):

Radiation Therapy ◽

Soft Tissues ◽

Cox Regression ◽

Disease Free Survival ◽

Tumor Location ◽

Long Term Results ◽

Clinical Feature ◽

National Medical ◽

Results Of Treatment ◽

Kaplan Meier

Background: The most striking clinical feature of soft tissues sarcomas (STS) is their ability to recur. At present disputes about the clinical and morphological factors of STS recurrence such as the degree of malignancy, size, location, depth of tumor location, patient’s age and the presence of previous relapses in the anamnesis do not subside. It also requires clarification of the effect of the volume of tissues removed on the long-term results of treatment of STS as well as indications for the application of various regimes of remote radiation therapy. Materials and methods: Of 1802 registered cases of STS of extremities at the N.N. Petrov National Medical Research Center of Oncology from 2004 to 2016 there were selected data on 213 patients who suffered from at least one relapse of the disease. There was performed an assessment of overall, non-metastatic and disease-free survival using a single-factor (the Kaplan-Meier method) and multivariate analysis (the Cox regression model). Conclusion: The detection of various prognostic factors of locally recurrent STS allows determining the necessary treatment tactics (the vastness and traumatism of surgery and the advisability of radiation therapy).

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Safety and clinical activity of intratumoral MEDI9197 alone and in combination with durvalumab and/or palliative radiation therapy in patients with advanced solid tumors

Journal for ImmunoTherapy of Cancer ◽

10.1136/jitc-2020-001095 ◽

2020 ◽

Vol 8 (2) ◽

pp. e001095 ◽

Cited By ~ 1

Author(s):

Lillian Siu ◽

Joshua Brody ◽

Shilpa Gupta ◽

Aurélien Marabelle ◽

Antonio Jimeno ◽

...

Keyword(s):

Radiation Therapy ◽

Solid Tumors ◽

Phase 1 ◽

Objective Response ◽

Clinical Activity ◽

Advanced Solid Tumors ◽

Palliative Radiation ◽

Cell Counts ◽

Palliative Radiation Therapy ◽

Grade 3

BackgroundMEDI9197 is an intratumorally administered toll-like receptor 7 and 8 agonist. In mice, MEDI9197 modulated antitumor immune responses, inhibited tumor growth and increased survival. This first-time-in-human, phase 1 study evaluated MEDI9197 with or without the programmed cell death ligand-1 (PD-L1) inhibitor durvalumab and/or palliative radiation therapy (RT) for advanced solid tumors.Patients and methodsEligible patients had at least one cutaneous, subcutaneous, or deep-seated lesion suitable for intratumoral (IT) injection. Dose escalation used a standard 3+3 design. Patients received IT MEDI9197 0.005–0.055 mg with or without RT (part 1), or IT MEDI9197 0.005 or 0.012 mg plus durvalumab 1500 mg intravenous with or without RT (part 3), in 4-week cycles. Primary endpoints were safety and tolerability. Secondary endpoints included pharmacokinetics, pharmacodynamics, and objective response based on Response Evaluation Criteria for Solid Tumors version 1.1. Exploratory endpoints included tumor and peripheral biomarkers that correlate with biological activity or predict response.ResultsFrom November 2015 to March 2018, part 1 enrolled 35 patients and part 3 enrolled 17 patients; five in part 1 and 2 in part 3 received RT. The maximum tolerated dose of MEDI9197 monotherapy was 0.037 mg, with dose-limiting toxicity (DLT) of cytokine release syndrome in two patients (one grade 3, one grade 4) and 0.012 mg in combination with durvalumab 1500 mg with DLT of MEDI9197-related hemorrhagic shock in one patient (grade 5) following liver metastasis rupture after two cycles of MEDI9197. Across parts 1 and 3, the most frequent MEDI9197-related adverse events (AEs) of any grade were fever (56%), fatigue (31%), and nausea (21%). The most frequent MEDI9197-related grade ≥3 events were decreased lymphocytes (15%), neutrophils (10%), and white cell counts (10%). MEDI9197 increased tumoral CD8+ and PD-L1+ cells, inducing type 1 and 2 interferons and Th1 response. There were no objective clinical responses; 10 patients in part 1 and 3 patients in part 3 had stable disease ≥8 weeks.ConclusionIT MEDI9197 was feasible for subcutaneous/cutaneous lesions but AEs precluded its use in deep-seated lesions. Although no patients responded, MEDI9197 induced systemic and intratumoral immune activation, indicating potential value in combination regimens in other patient populations.Trial registration numberNCT02556463.

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