Addenbrooke’s to use Microsoft’s AI tool to speed up cancer treatment

Source: www.governmentcomputing.com Author: staff Microsoft said that Addenbrooke’s Hospital in Cambridge, UK, will use its artificial intelligence (AI) technology powered InnerEye tool for speeding up cancer treatment. Developed at its Cambridge Research Lab, the InnerEye project helps in developing AI models that leverage the hospital’s own data to automatically show tumours and healthy organs on patient scans. These are then checked and confirmed by a clinical oncologist prior to giving treatment to the patient, said Microsoft. According to the tech major, the process will reduce the otherwise lengthy treatment planning stage, which is crucial for head and neck cancers, which can multiply quickly if left untreated. Microsoft claims that InnerEye can help execute contouring process in complex cases 13 times faster than the current approach. Addenbrooke’s Hospital oncologist and InnerEye co-lead Dr Raj Jena said: “The results from InnerEye are a game-changer. To be diagnosed with a tumour of any kind is an incredibly traumatic experience for patients. “So as clinicians we want to start radiotherapy promptly to improve survival rates and reduce anxiety. Using machine learning tools can save time for busy clinicians and help get our patients into treatment as quickly as possible.” Run by Cambridge University Hospitals NHS Foundation Trust, Addenbrooke’s is a teaching hospital, research centre, and also a designated academic health science centre. Addenbrooke’s Hospital and Microsoft are said to have been collaborating over the last eight years to develop and pilot InnerEye. The hospital will become the first NHS facility to have introduced a [...]

2020-12-12T10:01:59-07:00December, 2020|Oral Cancer News|

Deep learning models for image-guided RT in head and neck and prostate cancers

Source: www.journalofclinicalpathways.com Author: Lisa Kuhns Machine learning models achieve clinically acceptable accuracy in image segmentation tasks in radiotherapy planning and reduce overall contouring time for head and neck and prostate cancers, according to a recent study in JAMA Network Open (2020;3[11]:e2027426. doi:10.1001/jamanetworkopen.2020.27426) Personalized radiotherapy planning requires large time commitments for oncologists and processes often vary among experts and institutions. Authors aimed to explore clinically acceptable autocontouring solutions that can be integrated into clinical practice and used in different radiotherapy areas. Researchers evaluated multicenter imaging data set made up of 519 pelvic and 242 head and neck computer tomography scans from 8 clinical sites. Patients in the study were diagnosed with either prostate or head and neck cancer. The models were trained to automatically delineate organs at risk and evaluated internal and external datasets. Models were compared against expert annotations in an interobserver variability (IOV) study. For 13 of the 15 structures, the models performed within the bounds of expert IOV. For internal vs external data sets, the models achieved mean [SD] Dice scores for left femur at 98.52% and 98.04% (P = .04), respectively. “In this study, the models achieved levels of clinical accuracy within expert IOV while reducing manual contouring time and performing consistently well across previously unseen heterogeneous data sets,” concluded the study authors. “With the availability of open-source libraries and reliable performance, this creates significant opportunities for the transformation of radiation treatment planning.”—Lisa Kuhns

2020-12-11T09:20:35-07:00December, 2020|Oral Cancer News|

Experts release new guidelines for studies into most effective treatments for HPV-positive throat cancer

Source: en.brinkwire.com Author: provided by University of Birmingham, United Kingdom Heightened caution is needed when considering de-escalation trials for patients with Human papillomavirus (HPV)-positive oropharyngeal cancer (OPC), to ensure minimal harm to patients, new guidelines from a group of international head and neck cancer experts have suggested. HPV-positive oropharyngeal cancer is a cancer of the throat caused by the human papillomavirus—a common, but symptomless group of sexually transmitted viruses. Instances of many throat and neck cancers have declined as smoking rates have fallen, whereas HPV-positive OPC has increased, largely affecting younger patients. The standard course of treatment for this disease is a combination of cisplatin (a common chemotherapy drug) and radiotherapy. The younger age of the patient population, significantly improved prognosis, and relatively minimal morbidities caused by the standard treatment pathway have led to the popularisation of the concept of treatment de-escalation as a way to improve the quality of life of patients by reducing dosage or frequency of treatment. These new recommendations, published today in the Journal of Clinical Oncology have been created by the Head and Neck Cancer International Group, a group of experts from nineteen countries, led by the University of Birmingham, UK. The guidelines have been prompted by the recent results of the first three randomised de-escalation trials which suggested a clear detriment in survival when cisplatin is omitted or substituted to minimise side effects. After a review of available HPV-positive OPC literature, the guidelines recommend an overall need for caution when considering de-escalation options, even [...]

A new tool to predict delays in post-surgical radiotherapy for head and neck cancer

Source: www.eurekalert.org Author: Medical University of South Carolina news release More than 65,000 Americans are diagnosed annually with head and neck cancer, which most often occurs inside the mouth and throat. For patients who undergo surgery to treat this cancer, guidelines recommend that prompt initiation of radiotherapy -- within six weeks -- is critical for best outcomes. Unfortunately, delays in initiating post-operative radiotherapy (PORT) are far too common. Patients do not always understand the importance of prompt initiation of radiotherapy and may have to overcome other barriers, such as lack of social support and insurance. In addition, health care providers do not always communicate with one another or coordinate care. These avoidable delays have a negative impact on outcomes in a disease that claims almost 15,000 lives in the U.S. each year. To ameliorate this crisis, a research team at the Medical University of South Carolina has developed and validated tools known as nomograms to help predict treatment delays in high-risk patients based on individualized risk factors. The team was led by Evan Graboyes, M.D., an assistant professor in the Department of Otolaryngology-Head & Neck Surgery at MUSC and a member of the Cancer Control Program at Hollings Cancer Center. The results of the nomogram study were reported in JAMA Otolaryngology-Head & Neck Surgery. "A nomogram is a graphical representation of a mathematical model that we are using to predict how likely it is that a patient with head and neck cancer may have a treatment delay," explained Graboyes. "We [...]

Insurance coverage key to timely care in head and neck cancer cases

Source: www.eurekalert.org Author: Medical University of South Carolina A study published in the JAMA Otolaryngology-Head & Neck Surgery examines the effect of Medicaid expansion on head and neck cancer patients, finding that the expansions under the Affordable Care Act (ACA) were associated with improved access to care for these patients and selective Medicaid expansion may worsen existing regional disparities in terms of access to care and outcomes. Medicaid expansion refers to a provision in the ACA that called for expansion of Medicaid eligibility to cover more low-income Americans. It was determined that each state would decide whether to participate in the expansion - accept federal funds - or not. As of 2020, 37 states including the District of Columbia accepted Medicaid expansion. South Carolina is one of 14 states that has not. As a result, there are gaps in coverage for adults who have incomes above Medicaid eligibility limits yet still below the poverty level, exacerbating challenges with access to care, which is vital in the early detection of cancer. "We performed the study because delivering timely head and neck cancer care is critical for optimal outcomes," said Evan Graboyes, M.D., a researcher at Hollings Cancer Center at the Medical University of South Carolina and senior author on the study. The surgeon at MUSC Health specializes in the treatment of head and neck cancers. The team analyzed data from a national sample of nearly 91,000 adults with newly diagnosed head and neck cancer who were identified from the National Cancer [...]

Fewer side effects with proton beam vs traditional radiotherapy

Source: www.medscape.com Author: Roxanne Nelson, RN, BSN One of the main advantages claimed for proton beam radiotherapy is that it has fewer adverse effects than traditional radiotherapy. A new study suggests that that is so. The retrospective comparative effectiveness study involved 1483 patients with nonmetastatic cancer (various types, including brain, head and neck, lung, gastrointestinal, gynecologic) who were treated with curative intent. Slightly less than a third of these patients (n = 391) were treated with proton beam radiotherapy; the remaining patients (n = 1092) underwent traditional radiotherapy. The results show that among the patients who were treated with proton therapy, there was a significantly lower risk for serious side effects: 11.5% experienced events of grade 3 or higher within 90 days of treatment, compared to 27.6% of patients in the traditional radiotherapy group. "We know from our clinical experience that proton therapy can have this benefit, but even we did not expect the effect to be this sizeable," said senior author James Metz, MD, chair of radiation oncology, leader of the Roberts Proton Therapy Center at the University of Pennsylvania, and a member of Penn's Abramson Cancer Center. Importantly, there was no difference in cancer outcomes between the two groups; both disease-free and overall survival were similar. "It shows that proton therapy offers a way for us to reduce the serious side effects of chemoradiation and improve patient health and well-being without sacrificing the effectiveness of the therapy," said lead author Brian Baumann, MD. He is an adjunct assistant [...]

Psychological impact of head and neck cancers

Source: pharmafield.co.uk Author: Emma Morriss Bristol-Myers Squibb (BMS), in partnership with patient groups The Swallows and the Mouth Cancer Foundation, have announced the results from a patient survey into the psychological impact of head and neck cancers. The research explored the long-term burden of treatment on head and neck cancer patients. After undergoing treatment for head and neck cancer, which can include surgery, chemotherapy or radiotherapy, many patients report an ongoing impact on their day-to-day life. However, 55% of the 118 patients surveyed indicated they did not receive the right level of information in preparation for the complications encountered from treatment. There are around 11,900 new head and neck cancer cases in the UK every year and the incidence of head and neck cancer has increased by 32% since the early 1990s. Following treatment, the survey showed 56% of patients had problems with simple things like swallowing, often experiencing severe pain, while two-thirds of patients experienced changes in their voice or speech. The survey also showed self-reported change from pre- to post- treatment in vital areas including a drop in the ability to communicate (37%), memory loss (21%), and trouble sleeping (20%). As well as physical symptoms, treatment can have severe implications on mental health too. 52% of patients reported feelings of anxiety before treatment, which only reduced to 48% following treatment. However, emotional and psychological support was only offered to 46% of patients. A majority of patients did receive access to a clinical nurse specialist, however there was still [...]

Standard chemotherapy treatment for HPV-positive throat cancer remains the most effective, study finds

Source: www.eurekalert.org Author: press release, University of Birmingham A new study funded by Cancer Research UK and led by the University of Birmingham has found that the standard chemotherapy used to treat a specific type of throat cancer remains the most effective. The findings of the trial, which aimed to compare for the first time the outcomes of using two different kinds of treatment for patients with Human papillomavirus (HPV)-positive throat cancer, are published today (November 15th) in The Lancet. Throat cancer is one of the fastest rising cancers in Western countries. In the UK, incidence was unchanged between 1970 and 1995, then doubled between 1996 and 2006, and doubled again between 2006 and 2010. The rise has been attributed to HPV, which is often a sexually transmitted infection. Most throat cancers were previously caused by smoking and alcohol and affected 65 to 70 year old working class men. Today, HPV is the main cause of throat cancer and patients are middle class, working, have young children and are aged around 55. HPV-positive throat cancer responds well to a combination of cisplatin chemotherapy and radiotherapy, and patients can survive for 30 to 40 years, but the treatment causes lifelong side effects including dry mouth, difficulty swallowing, and loss of taste. The De-ESCALaTE HPV study, which was sponsored by the University of Warwick, compared the side effects and survival of 164 patients who were treated with radiotherapy and cisplatin, and 162 who were given radiotherapy and cetuximab. The patients were enrolled [...]

2018-11-16T09:36:03-07:00November, 2018|Oral Cancer News|

No De-escalation of Therapy for HPV+ Throat Cancer

Source: www.medscape.com Author: Alexander M. Castellino, PhD Another trial has shown that de-escalating therapy does not work in patients with good prognosis human papillomavirus-positive (HPV+) oropharyngeal squamous cell carcinoma or throat cancers. Results from the De-ESCALaTE HPV study show that using the targeted drug cetuximab with radiotherapy does not improve side effects and, more importantly, has worse survival compared with the standard of care — chemotherapy with cisplatin and radiotherapy. The finding echoes the results from the US National Cancer Institute's Radiation Therapy Oncology Group (RTOG) 1016 trial, the top-line results of which were released earlier this year, and details of which were presented this week at the American Society of Radiation Oncology (ASTRO) 2018 meeting. "Do not change your clinical practice of using cisplatin with radiotherapy in these patients," cautioned Hisham Mehanna, MBChB, PhD, chair of head and neck surgery at the University of Birmingham, United Kingdom, and lead investigator of the De-ESCALaTe study. He presented the results during a presidential session here at the European Society for Medical Oncology (ESMO) 2018 Congress (abstract LBA9). "Cetuximab did not cause less toxicity and resulted in worse overall survival and more cancer recurrence than cisplatin. This was a surprise — we thought it would lead to the same survival rates but better toxicity. Patients with throat cancer who are HPV+ should be given cisplatin, and not cetuximab, where possible," Mehanna said in a statement. Hope for Fewer Side Effects Cetuximab with radiation is already approved by the US Food and Drug [...]

2018-10-28T11:45:33-07:00October, 2018|OCF In The News, Oral Cancer News|

Patients with HPV-positive oropharynx cancer should receive chemoradiation

Source: medicalxpress.com Author: provided by European Society for Medical Oncology Patients with human papilloma virus (HPV)-positive throat cancer should receive chemoradiotherapy rather than cetuximab with radiotherapy, according to late-breaking research reported at the ESMO 2018 Congress in Munich. "Many patients have been receiving cetuximab with radiotherapy on the assumption that it was as effective as chemotherapy with radiotherapy and caused less side effects but there has been no head-to-head comparison of the two treatments," said study author Prof Hisham Mehanna, Chair, Head and Neck Surgery, Institute of Cancer and Genomic Sciences, University of Birmingham, UK. Throat cancer is rapidly becoming more common in Western countries. For example in the UK, incidence was unchanged in 1970 to 1995, then doubled in 1996 to 2006, and doubled again in 2006 to 2010.The rise has been attributed to HPV, a sexually transmitted infection. Most throat cancer was previously caused by smoking and alcohol and affected 65-70 year-old working class men. Today HPV is the main cause and patients are around 55, middle class, working, and have young children. HPV-positive throat cancer responds well to a combination of cisplatin chemotherapy and radiotherapy, and patients can survive for 30-40 years, but the treatment causes lifelong side effects including dry mouth, difficulty swallowing, and loss of taste. Patients deemed unable to tolerate chemotherapy, for example because of poor kidney function or older age, receive cetuximab, an epidermal growth factor receptor (EGFR) inhibitor, and radiotherapy. This study compared side effects and survival with the two treatments in [...]

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