Highlights of Research Publications

MEASURING RADIOTHERAPY SETUP ERRORS AT MULTIPLE NECK LEVELS IN NASOPHARYNGEAL CANCER (NPC): A CASE FOR DIFFERENTIAL PTV EXPANSION


What is the setup uncertainty in nasopharyngeal cancer treatments and can modern imaging technology reduce it?


We looked at cone beam CT (CBCT) data of patients undergoing nasopharyngeal carcinoma to determine setup uncertainty in the head and neck. The average uncertainty ranged from 1.88 to 3.35mm, and tended to be higher in the lower neck because of weight loss during radiotherapy. The uncertainty could be reduced with the use of CBCT to as low as 0.30mm. This will allow safer treatment to areas of tumor that almost touch critical organs like the brainstem.

 

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SURGERY OR RADIOSURGERY PLUS WHOLE BRAIN RADIOTHERAPY VERSUS SURGERY OR RADIOSURGERY ALONE FOR BRAIN METASTASES

 

Does whole brain radiotherapy after brain surgery or
radiosurgery help patients who have cancer spread to brain?

 

Previous studies done on patients who have cancer spread to brain were reviewed and summarised. There was some evidence that adding whole brain radiotherapy (WBRT) did not improve survival, but did lower the risk of recurrence in the brain one year after treatment. The impact of WBRT on neurocognitive function, neurological adverse events or quality of life was not clear, as results were inconsistent.


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POSTOPERATIVE CHEMO-RADIOTHERAPY VERSUS CHEMOTHERAPY FOR RESECTED GASTRIC CANCER: A SYSTEMATIC REVIEW AND META-ANALYSIS


Should patients receive chemo-radiotherapy or chemotherapy after surgery for gastric cancer? 

 

We summarised previous studies on patients with gastric cancer who had been treated with surgery. There was some evidence that chemo-radiotherapy improved survival compared to chemotherapy alone, though the chemotherapy used in most of these studies were older regimens. The degree of chemo-radiotherapy and radiotherapy side effects were similar.


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EFFICACY OF PALLIATIVE RADIATION THERAPY FOR SYMPTOMATIC RECTAL CANCER

 

How effective is radiotherapy to rectum in controlling symptoms
of advanced rectal cancer?

 

This study showed that radiation is effective in the treatment of advanced rectal cancer, particularly for controlling symptoms such as pain, bleeding or obstruction. At the time of publication, this was the largest series of patients studied for this specific indication. 

 

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STRATEGIES FOR BILATERAL BREAST AND COMPREHENSIVE NODAL IRRADIATION IN BREAST CANCER - A COMPARISON OF IMRT AND 3D CONFORMAL RADIATION THERAPY

 

What is the best radiotherapy technique for patients requiring treatment to both breasts?

 

This study was the first to explore the feasibility of bilateral breast and regional lymph node irradiation. Radiation to bilateral breasts and regional lymphatics is particularly challenging due to the large radiation areas involved. This study demonstrated that Intensity Modulated Radiation Therapy (IMRT) to bilateral breasts and regional lymph nodes can potentially be used to significantly reduce the risk of toxicity and side effects. 

 

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CLINICAL OUTCOMES OF FUNGATING BREAST CANCER TREATED WITH PALLIATIVE RADIOTHERAPY

 

Is radiotherapy effective for controlling symptoms caused by advanced breast cancers that have eroded through the skin?

 

This study showed that radiation is effective in the treatment of advanced breast cancer, particularly for the control of pain and bleeding. We also showed that short courses of radiation can be just as effective as longer courses. 

 

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GLIOBLASTOMA MULTIFORME OUTCOMES OF 107 PATIENTS TREATED IN TWO SINGAPORE INSTITUTIONS

 

How is Glioblastoma Multiforme (GBM) treated locally and what are the outcomes?

 

We looked at patients who underwent GBM treatment in 2 hospitals in Singapore. Patients usually receive various combinations of surgery, radiotherapy and chemotherapy. Those who receive radiotherapy and chemotherapy after surgery do better. Our outcomes are similar to other international institutions. Nonetheless, GBM remains challenging to treat because of its tendency to recur.

 

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ACCURACY OF (18)F-FLURODEOXYGLUCOSE-POSITRON EMISSION TOMOGRAPHY/COMPUTED TOMOGRAPHY IN THE STAGING OF NEWLY DIAGNOSED NASOPHARYNGEAL CARCINOMA: A SYSTEMATIC REVIEW AND META-ANALYSIS

 

What is the accuracy of FDG-PET/CT in the staging of nasopharyngeal carcinoma, compared to conventional modalities?

 

We summarised previous studies which used FDG-PET/CT for the staging of NPC. We showed that PET/CT is more accurate than normal CT and MRI for spread to the lymph glands and other organs. MRI was still more superior than PET/CT in determing the local extension of the nose cancer. 


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FEASIBILITY STUDY OF TOXICITY OUTCOMES USING GEC-ESTRO CONTOURING GUIDELINES ON CT BASED INSTEAD OF MRI-BASED PLANNING IN LOCALLY ADVANCED CERVICAL CANCER PATIENTS

 

How accurate is CT planning in cervical cancer?

 

Internal radiation allows high doses to be delivered to a cervical tumour. The planning of these doses is essential. In this study, we used a CT scan to plan the patient’s treatment. CT scans are easily obtainable and cheaper than MRI. This study shows they can be used effectively in planning treatment. 

 

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ACCELERATED PARTIAL BREAST IRRADIATION IN AN ASIAN POPULATION: DOSIMETRIC FINDINGS AND PRELIMINARY RESULTS OF A MULTICATHETER INTERSTITIAL PROGRAM

 

How effective is Accelerated partial breast irradiation (APBI) for treatment of early breast cancer?

 

Accelerated partial breast irradiation (APBI) is a procedure that allows breast radiation to be delivered to over 1 week instead of over a few weeks. Current studies of this procedure have been conducted only in Western populations. This study looks at the effectiveness of this therapy in our population.

 

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