Citations 3
Concurrent Versus Sequential Radiation Dose Escalation to the Surgical Cavity for Conservative Treatment of High-Risk Early Breast Cancer: NRG/RTOG 1005 Phase III Trial
Vicini, Frank A. , Winter, Kathryn, Freedman, Gary M., Arthur, Douglas W., Rosenstein, Barry S. , Li, X. Allen , Halyard, Michele Y. , Woodward, Wendy A. , LYONS, JANICE, Tomberlin, Janice K., Seaward, Samantha A. , Cheston, Sally B. , Hoover, A. , Perera, Francisco E. , Poppe, Matthew M. , Petersen, Ivy A., Jhawar, S., Moughan, Jennifer, Movsas, B, White, Julia , Li, X. Allen , Woodward, Wendy A , Bleicher, Richard J , Taghian, Alphonse , Lyons, Janice , Seaward, Samantha A , Hoover, Andrew C , Anderson, Bethany M , Perera, Francisco E , Jhawar, Sachin R , Hijal, Tarek , Movsas, Benjamin , White, Julia R , Freedman, Gary M. , Bentzen, Søren M. , Anderson, Bethany M. , Perera, Francisco E, Petersen, Ivy A. , Jhawar, Sachin R. , Hijal, Tarek , Movsas, Benjamin
Journal of Clinical Oncology | May 11, 2026 | Volume: 44 | Issue: 19 | Pages: 1798-1811
PURPOSE For patients with breast cancer undergoing breast conservation, escalating the dose (boost) of radiation to the lumpectomy cavity after whole-breast irradiation (WBI) reduces ipsilateral breast recurrence (IBR) but extends treatment duration. This phase III trial investigated whether boost delivery during WBI versus after WBI provides noninferior IBR and preserves cosmetic appearance. METHODS NRG/RTOG 1005 randomly assigned patients at higher risk for IBR after lumpectomy and axillary surgery to either a sequential boost of 12 Gy in six fractions(F) or 14 Gy in 7F after WBI of 50 Gy in 25F or 42.7 Gy in 16F (sequential arm) or a concurrent boost of 8 Gy in 15F of 0.53 Gy per day with WBI of 40 Gy in 15F (concurrent arm) using 3-dimensional conformal radiation therapy (RT) or intensity-modulated RT. Based on 1.59% 5-year IBR for the sequential arm, defining the noninferiority margin as a hazard ratio upper limit on the 90% CI of 2.12, 2,312 patients provide 80% power for noninferiority of IBR as first recurrence for the concurrent arm. Secondary end points included disease-free survival and overall survival, adverse events (AEs), and cosmetic outcomes. RESULTS Between May 24, 2011, and June 20, 2014, 2,354 patients were randomly assigned, with 2,255 eligible for analysis (sequential arm, n = 1,118; concurrent arm, n = 1,137). With median follow-up of 7.3 years, there were 56 IBR events; 5- and 7-year IBR were 2.1% and 2.2% on the sequential arm and 1.9% and 2.6% on the concurrent arm, respectively. The noninferiority criterion was met: HR (90% CI): 1.31 (0.84 to 2.04), P = .037. No differences were observed in AEs, cosmetic outcomes, or survival between arms. CONCLUSION Concurrent boost during WBI results in noninferior IBR compared with sequential boost without worsening toxicity or cosmetic outcomes and reduces overall treatment time.
Circulating Metabolic Biomarkers of Screen-Detected Prostate Cancer in the ProtecT Study
Adams, Charleen D. , Richmond, Rebecca C. , Ferreira, Diana L. Santos , Spiller, Wes , Tan, Vanessa Y. , Würtz, Peter , Donovan, Jenny , Hamdy, Freddie C. , Neal, David E. , Lane, J. Athene , Smith, George Davey , Relton, Caroline L. , Eeles, Rosalind A. , Haiman, Christopher A. , Schumacher, Fredrick R. , Olama, Ali Amin Al , Benlloch, Sara, Muir, Kenneth , Berndt, Sonja I., Conti, David V. , Gapstur, Susan M. , Stevens, Victoria L. , Batra, Jyotsna , Grönberg, Henrik , Pashayan, Nora , Schleutker, Johanna , West, Catharine , Mucci, Lorelei A. , Koutros, Stella , Sørensen, Karina D. , Mæhle, Lovise, Travis, Ruth C. , Rosenstein, Barry S. , Lu, Yong‐Jie , Kibel, Adam S. , Vega, Ana , Stanford, Janet L. , Nordestgaard, Børge G. , Maier, Christiane, Kim, Jeri , John, Esther M. , Teixeira, Manuel R. , Newcomb, Lisa F., Lessel, Davor , Kaneva, Radka , Usmani, Nawaid , Claessens, Frank , Townsend, Paul A. , Dominguez, Manuela Gago, Roobol, Monique J. , Ménégaux, F. , Pandha, Hardev , Thibodeau, Stephen N. , Martin, Richard M. , Teixeira, Manuel R , Vega, Ana , Eeles, Rosalind A , John, Esther M , Donovan, Jenny L , Muir, Kenneth , Schleutker, Johanna , Travis, Ruth C , Pashayan, Nora , Lessel, Davor , Koutros, Stella , Martin, Richard M , Conti, David V , Batra, Jyotsna , Davey Smith, George , Zheng, Jie , Kote‐Jarai, Zsofia , Berndt, Sonja I. , Wiklund, Fredrik E. , Chanock, Stephen Jacob , Tangen, Catherine M. , Clements, Judith A. , Albanes, Demetrius , Wolk, Alicja , Cancel‐Tassin, Géraldine , Hamilton, Robert J , Ingles, Sue A. , Giles, Graham G. , Kogevinas, Manolis , Penney, Kathryn , Park, Jong Y. , Cybulski, Cezary , Brenner, Hermann , Neuhausen, Susan L. , Ruyck, Kim De , Razack, Azad Hassan Abdul , Khaw, Kay‐Tee , Cannon‐Albright, Lisa , Claessens, Frank
Cancer Epidemiology, Biomarkers & Prevention | October 23, 2018 | Volume: 28 | Issue: 1 | Pages: 208-216
Abstract Background: Whether associations between circulating metabolites and prostate cancer are causal is unknown. We report on the largest study of metabolites and prostate cancer (2,291 cases and 2,661 controls) and appraise causality for a subset of the prostate cancer–metabolite associations using two-sample Mendelian randomization (MR). Methods: The case–control portion of the study was conducted in nine UK centers with men ages 50–69 years who underwent prostate-specific antigen screening for prostate cancer within the Prostate Testing for Cancer and Treatment (ProtecT) trial. Two data sources were used to appraise causality: a genome-wide association study (GWAS) of metabolites in 24,925 participants and a GWAS of prostate cancer in 44,825 cases and 27,904 controls within the Association Group to Investigate Cancer Associated Alterations in the Genome (PRACTICAL) consortium. Results: Thirty-five metabolites were strongly associated with prostate cancer (P < 0.0014, multiple-testing threshold). These fell into four classes: (i) lipids and lipoprotein subclass characteristics (total cholesterol and ratios, cholesterol esters and ratios, free cholesterol and ratios, phospholipids and ratios, and triglyceride ratios); (ii) fatty acids and ratios; (iii) amino acids; (iv) and fluid balance. Fourteen top metabolites were proxied by genetic variables, but MR indicated these were not causal. Conclusions: We identified 35 circulating metabolites associated with prostate cancer presence, but found no evidence of causality for those 14 testable with MR. Thus, the 14 MR-tested metabolites are unlikely to be mechanistically important in prostate cancer risk. Impact: The metabolome provides a promising set of biomarkers that may aid prostate cancer classification.
Performance/outcomes data and physician process challenges for practical big data efforts in radiation oncology
Matuszak, M.M. , Fuller, Clifton D. , Yock, Torunn I. , McNutt, Todd , Jolly, Shruti , Mayo, Charles S. , Thor, Maria, Caissie, Amanda, Rao, Arvind , Owen, Dawn , Smith, W. P., Palta, Jatinder , Kapoor, Rishabh , Hayman, James A. , Waddle, Mark R. , Rosenstein, Barry S. , Miller, Robert C. , Moreno, Amy C. , Herman, Joseph M. , Feng, Mary, Waddle, Mark, Hess, Clayton Burnett , Gabriel, Peter , Choi, Seungtaek L. , Fuller, Clifton David
Medical Physics | September 19, 2018 | Volume: 45 | Issue: 10 | Pages: No page available
It is an exciting time for big data efforts in radiation oncology. The use of big data to help aid both outcomes and decision‐making research is becoming a reality. However, there are true challenges that exist in the space of gathering and utilizing performance and outcomes data. Here, we summarize the current state of big data in radiation oncology with respect to outcomes and discuss some of the efforts and challenges in radiation oncology big data.