Leeds Cancer Centre Research Articles

P1.05-030 Lung SABR for Early Stage Lung Cancer: Outcomes and Toxicity of 803 Patients Treated at the Leeds Cancer Centre

SABR is an established treatment for early peripheral stage non-small cell lung cancer (NSCLC) in medically inoperable patients. We present the outcomes 803 patients, a large prospective series of patients, with a minimum 12 months follow-up after undergoing SABR treatment in Leeds, UK, between May 2009 and May 2015. Patients with a pathological or clinical diagnosis of peripheral stage I lung cancer, and deemed medically inoperable, were treated with SABR at the Leeds Cancer Centre, using a dose fractionation of 54Gy/3#, 55Gy/5#, or 60Gy/8# depending on proximity of organs at risk. Patient follow-up was assessed using an electronic patient record and radiology reports. Survival analysis was performed using Kaplein-Meier estimation and log rank test was used to compare survival distributions including performance status, histology, tumor T stage, tumor location, post-SABR fibrosis, and toxicity. 803 patients were treated with SABR and had at least 12 months follow-up. Mean age at treatment was 73.9 years (39 to 94 years). Median follow-up was 23.3 Months, from time of last treatment fraction to last medical contact or death. Median overall survival estimate was 33.3 Months (95% C.I. 29.54-27.1 Months) 1 year OS – 80.1% (SE 1.4%), 3 year OS – 46.4% (SE 2%), 5 year OS – 29.5% (SE 2.6%) Local control (LC) 1 year LC – 99.2% (SE 0.3%), 2 year LC – 97.2% (SE 0.7%), 3 year LC – 95.1% (SE 0.9%) Both performance status and tumor size were associated with a worse overall survival, Log rank p<0.001 (PS), p=0.035 (T stage). Toxicity: Only 4 patients had documented grade 3 toxicity. 3 pneumonitis requiring admission, and 1 patient developed a bronchopulmonary fistula 2 years post-treatment. 44 Patients had a rib fracture recorded, of these 16 patients were symptomatic, and were treated with analgesia or neuropathic adjuncts. 156 patients had documented radiological pneumonitis (gd 1), with 331 developing fibrotic change in the treatment area. Of interest the presence of radiological pneumonitis and fibrotic changes was associated with an improved overall survival, Log rank P=0.009 (Rad pneum), P<0.001 (Fibrosis). SABR for early stage lung cancer is a safe and effective treatment even in medically inoperable patients, with excellent local control. In our cohort, we found radiological pneumonitis and fibrosis was associated with an improved overall survival, which may be indicative of the patient response to SABR, and will need further evaluation. Performance status and tumor size were associated with a poorer overall survival.

124: Outcomes following concurrent chemoradiotherapy for stage II and III non small cell lung cancer (NSCLC) at Leeds Cancer Centre (LCC) in 2014

124: Outcomes following concurrent chemoradiotherapy for stage II and III non small cell lung cancer (NSCLC) at Leeds Cancer Centre (LCC) in 2014

Undergraduate oncology teaching OSCEs (objective structured clinical examinations): an effective method of delivering oncology education to medical students

This article was migrated. The article was not marked as recommended. Rising cancer incidence and increasing complexity of cancer treatments are major challenges for health professionals. Teaching of acute oncology emergencies is an important aspect of undergraduate medical training. At the Leeds Cancer Centre (LCC) we have run medical undergraduate Oncology teaching OSCE sessions for fourth year medical students for the past 6 years. These sessions provide valuable formative assessment and immediate feedback on performance for the students at the end of their oncology and palliative care attachment. Feedback for facilitators from students has consistently been excellent. We feel teaching OSCEs are a useful method of delivering teaching about acute oncology emergencies and assessing performance following a placement within our cancer centre.

EP-1254: Updated outcomes for patients treated with SABR for lung cancer at the Leeds Cancer Centre

EP-1254: Updated outcomes for patients treated with SABR for lung cancer at the Leeds Cancer Centre

A development framework for the consultant radiographer in oncology: the Leeds experience

AbstractThe role of the consultant radiographer in radiotherapy is a relatively new concept and to date the number of post holders in these roles remains low. Despite challenges to role creation for the non-medical consultant, the benefits of role development and skill mix within the national health service are evident. Among these challenges is the need to ensure appropriate and credible training of the consultant radiographer. This case study focusses on the local experience of developing a suitable competency framework for the first Consultant Radiographer at the Leeds Cancer Centre. It highlights elements of the framework that equip the post holder to carry out the role and how the governance underpinning such a framework could be used by other radiotherapy centres across the United Kingdom.

59 Management of ALK rearranged non-small cell lung cancer (NSCLC) diagnosed at the Leeds Cancer Centre between 2013 and 2015

59 Management of ALK rearranged non-small cell lung cancer (NSCLC) diagnosed at the Leeds Cancer Centre between 2013 and 2015

EP-1210: Treatment and outcomes with intra-luminal oesophageal brachytherapy at the Leeds Cancer Centre from 2010 to 2014

EP-1210: Treatment and outcomes with intra-luminal oesophageal brachytherapy at the Leeds Cancer Centre from 2010 to 2014

A force for progress.

I work for the Leeds Cancer Centre as a nurse consultant for clinical research and as a Cancer Research UK senior nurse. I am also the operations manager for the National Institute for Health Research (NIHR) Leeds Clinical Research Facility. Here I manage a team of about 50 clinical and administrative staff to deliver 200 cancer clinical trials each year.

The clinical value of quality of life assessment in oncology practice—a qualitative study of patient and physician views

Patients' self-reported questionnaires measuring symptoms, functioning and quality of life (QOL) can help physicians to screen and monitor patient problems in oncology practice. Although many self-reported questionnaires have been developed, their role in clinical practice remains unclear. This study explores what oncologists and patients need from QOL questionnaires, what their clinical value is and generates recommendations how to improve the questionnaires for use in oncology practice. Focus groups were conducted in the Leeds Cancer Centre (St James's and Cookridge hospitals, UK), with 31 patients (9 groups) and 16 oncologists (4 groups). Twenty patients completed a questionnaire. Framework analysis was employed for the analysis. Patients and physicians wanted the questionnaires to cover: common symptoms and problems (e.g. pain, fatigue), disease and treatment-specific issues (common for patients with similar diagnosis and/or treatment), individual patient-specific issues (usually non-physical, e.g. prognosis, family issues, sexuality) were important to some patients and relevant at specific points in the cancer journey. The timing and scope of enquiry should be flexible and correspond to disease and treatment stages. A model for measurement in clinical practice is proposed combining standard questionnaires with disease/treatment-specific items and a prompt list of items, aiming to facilitate discussion of individual-specific issues and minimize patient burden. Patients' and physicians' views on the clinical value of this approach are described. The findings emphasized the need for individualized assessment alongside standard measures, for flexible measurement adapted to treatment and follow-up, for clear interpretation of scores and decision guidelines.

Sphincter saving is the primary objective for local treatment of cancer of the lower rectum

In 2002, more than 1 million patients developed colorectal cancer worldwide, accounting for about a tenth of all cancers. By 2030, the total number of new cases of cancer per year is estimated to rise to about twice that in 2002. Fortunately, for colorectal cancer, these alarming statistics are tempered by advances in surgery, surgical training and expertise, postoperative pathology, and adjuvant treatment, which together have contributed towards a substantial increase in patients’ survival. Indeed, many surgeons now believe that an oncologically safe procedure might also be possible without sacrifi cing the patient’s long-term quality of life, especially continence and sexual function. Parallels can be drawn in this shift in emphasis with the surgical developments in breast-cancer treatment, in which many centres now place equal weight on oncological and cosmetic considerations in their surgical planning. In this Debate, Eric Rullier from University of Victor Segalen, Bordeaux, France, and David Sebag-Montefi ore from the Leeds Cancer Centre, Leeds, UK, argue the case for and against surgery for cancer of the lower rectum where the primary objective is no longer oncological, but that of sphincter preservation. The primary endpoints for rectal-cancer management have been local control and long-term survival, with surgery still used as the main treatment. During the past decade, optimisation of surgery with the introduction of the total mesorectal excision technique has greatly aff ected the oncological outcome of patients. 1 Local control has been achieved in 90% of patients, and survival can be expected in up to 70% of the patients. 2 In highly specialised teams of surgeons, these results can be obtained without neoadjuvant treatment, whereas preoperative radiotherapy remains the standard for locally advanced (stage III) disease. 3 This exceptional improvement of local control and survival in patients treated for rectal cancer modifi ed the objectives for treatment. Goals are focusing on patients’ functional abilities and quality of life rather than oncological outcomes. Indeed, the quality of life can be altered by an abdominal colostomy and by sexual dysfunctions, especially after treatment of cancer of the lower rectum. 4