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  • Radiotherapy and Oncology
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  • 1
    Language: English
    In: PSYCHOTHERAPY AND PSYCHOSOMATICS, Vol.84, pp.20-20
    Description: BACKGROUNDKnowledge of hatha yogic exercises, the most used yoga style, for increasing functional capacity in patients with obstructive pulmonary diseases remains limited. AIMThe aim was to evaluate the effects and feasibility of hatha yoga (HY) compared to a conventional training program (CTP) on functional capacity, lung function and quality of life in patients with obstructive pulmonary diseases. DESIGNRandomized clinical trial. SETTINGThe study was performed at the Karolinska University Hospital, Stockholm, among outpatients. POPULATIONThirty-six patients with obstructive pulmonary disease. METHODSForty patients were randomized with 36 (24 women, median age =64, age range: 40-84 years) participating in HY (N.=19) or CTP (N.=17). Both HY and CTP involved a 12-week program with a 6-month follow-up. Functional capacity (using the 6-Minute Walk Test), lung function (spirometry), respiratory muscle strength (respiratory pressure meter), oxygen saturation (SpO2), breathlessness (Borg), respiratory rate (f) and disease-specific quality of life (CRQ) were measured at baseline, at 12 weeks and at a 6-month follow-up. RESULTSTesting for interactions (group x time) with ANOVAs showed significant effects on the CRQ fatigue (P=0.04) and emotional (P=0.02) domains, with improvements in the CTP group after the 12-week intervention (P=0.02 and 0.01, respectively) but not in the HY group. No between group effects emerged, however, within each group, significant improvements emerged for the six-minute walk distance (6MWD) after 12-week intervention (HY: mean difference 32.6 m; CI: 10.1-55.1, P=0.014; CTP: mean difference 42.4 m; CI: 17.9-67.0, P=0.006). SECONDARY OUTCOMESwithin-group improvements in CRQ appeared in both groups. Within the HY group, f decreased and SpO2 increased. Improved effects after follow-up emerged only for the CTP group for diastolic blood pressure (P=0.05) and CRQ emotional and fatigue domain (P=0.01). CONCLUSIONSThere were no between-group differences. After 12 weeks, 6MWD improved significantly within both groups. Within the HY group, improvements in the CRQ mastery domain, f and SpO2 emerged. Within the CTP group, there were improvements in lung function parameter forced vital capacity, respiratory muscle strength and all CRQ-domains. The CTP also exhibited effects on CRQ after the 6months follow-up. CLINICAL REHABILITATION IMPACTLimited effects of HY and CTP emerged. HY seems feasible and safe as a form of physical exercise for pulmonary disease patients. As part of the rehabilitation, HY may constitute an alternative to other physical training activities and may be a useful addition to formal rehabilitation programs.
    Keywords: Adult–Methods ; Aged–Complications ; Aged, 80 and Over–Physiopathology ; Exercise Therapy–Rehabilitation ; Exercise Tolerance–Rehabilitation ; Feasibility Studies–Rehabilitation ; Female–Rehabilitation ; Humans–Rehabilitation ; Male–Rehabilitation ; Middle Aged–Rehabilitation ; Pulmonary Disease, Chronic Obstructive–Rehabilitation ; Quality of Life–Rehabilitation ; Treatment Outcome–Rehabilitation ; Vital Capacity–Rehabilitation ; Yoga–Rehabilitation;
    ISSN: 0033-3190
    ISSN: 11184841
    E-ISSN: 19739095
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  • 2
    Language: English
    In: Radiotherapy and Oncology, 2010, Vol.97(2), pp.294-300
    Description: Radiation proctitis is a side effect which can occur after pelvic radiation therapy. Currently available questionnaires do not comprehensively assess the range of problems, nor impact on quality of life associated with proctitis. This article reports on the cultural testing phase of an EORTC module (QLQ-PRT21) developed to assess radiation proctitis specific issues and designed to be used in conjunction with the EORTC core quality of life questionnaire (QLQ-C30). The previously developed 21-item module, pre-tested in Australia, was translated into Norwegian, German, French and Italian. Patients completed the EORTC QLQ-C30 and module questionnaires towards the end of their radical pelvic radiation treatment to target acute side effects. Patients experiencing chronic proctitis were also surveyed. Patients also participated in structured interviews to determine issues of comprehensibility, coverage and relevance. Results were compared with Australian data. Questionnaires were completed by 64 European patients. The module was found to be relevant and culturally acceptable to participants. Feedback has led to minor translation modifications and the inclusion of two additional questions. This module is ready for Phase IV testing which will consist of large scale field testing with the aim to perform psychometric analysis and finalise a module that will be suitable in the assessment of radiation induced proctitis.
    Keywords: Radiotherapy ; Proctitis ; Quality of Life ; Pelvic Cancer ; Rectal Bleeding ; Treatment Side Effects ; Medicine
    ISSN: 0167-8140
    E-ISSN: 1879-0887
    Source: ScienceDirect Journals (Elsevier)
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  • 3
    Language: English
    In: Radiotherapy and Oncology, September 2018, Vol.128(3), pp.557-563
    Description: The advent of less radical surgical approaches has generated concern about leaving locoregional lymph node metastases (LNM) unresected that could lead to adverse outcome. We examined the prognostic role of clinicopathological factors for ypN-positivity in patients with ypT0-2 rectal carcinoma treated within the CAO/ARO/AIO-94 and CAO/ARO/AIO-04 randomized phase 3 trials. The correlation of clinicopathological factors with ypN-status (ypN0 vs ypN1/2) was examined in  = 776 patients with ypT0-2 rectal carcinoma after preoperative CRT and total mesorectal excision surgery using Pearson’s Chi-squared test for categorical variables and Kruskal–Wallis’ test for continuous variables. Multivariable analysis was performed using binary logistic regression to identify independent prognosticators for ypN-positivity. Residual LNM (ypN+) were found in 6%, 20.8% and 21.4% of patients with ypT0, ypT1 and ypT2 carcinomas, respectively. Independent prognosticators for LNM were advanced ypT category (  = 0.002) and lymphatic invasion (  = 0.020). In a separate multivariable analysis performed upon exclusion of ypT-category due to multicollinearity with residual tumor diameter (RTD), lymphatic invasion (  = 0.015) and RTD ≥10 mm (  = 0.005) demonstrated strong correlation with LNM. Advanced ypT-stage, lymphatic invasion and RTD ≥10 mm were prognostic factors for LNM in patients ypT0-2 rectal carcinoma treated with CRT and surgery within both phase 3 trials. The high incidence of LNM in the ypT1-2 group needs to be taken into consideration in the context of oncological safety and indicate that LE should be advocated with great caution in this patient subgroup. The prognostic pathological factor identified here could help guide decision of LE vs TME after standard CRT.
    Keywords: Lymph Node Metastases ; Rectal Cancer ; Ypt0-2 ; Pathologic Parameters ; Prognosis ; Medicine
    ISSN: 0167-8140
    E-ISSN: 1879-0887
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  • 4
    Language: English
    In: Lancet (London, England), 08 September 2007, Vol.370(9590), pp.826; author reply 826-7
    Keywords: Evidence-Based Medicine ; Health Policy ; Health Services Needs and Demand ; World Health Organization ; Practice Guidelines As Topic -- Standards
    E-ISSN: 1474-547X
    Source: MEDLINE/PubMed (U.S. National Library of Medicine)
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  • 5
    Language: English
    In: Radiotherapy and Oncology, April 2018, Vol.127(1), pp.121-127
    Description: Reirradiation (reRT) is a valid option with considerable efficacy in patients with recurrent high-grade glioma, but it is still not known which patients might be optimal candidates for a second course of irradiation. This study validated a newly developed prognostic score independently in an external patient cohort. The reRT risk score (RRRS) is based on a linear combination of initial histology, clinical performance status, and age derived from a multivariable model of 353 patients. This score can predict post-recurrence survival (PRS) after reRT. The validation dataset consisted of 212 patients. The RRRS differentiates three prognostic groups. Discrimination and calibration were maintained in the validation group. Median PRS times in the development cohort for the good/intermediate/poor risk categories were 14.2, 9.1, and 5.3 months, respectively. The respective groups within the validation cohort displayed median PRS times of 13.8, 8.8, and 3.8 months, respectively. Uno’s C for development data was 0.64 (CI: 0.60–0.69) and for validation data 0.63 (CI: 0.58–0.68). The RRRS has been successfully validated in an independent patient cohort. This linear combination of three easily determined clinicopathological factors allows for a reliable classification of patients and may be used as stratification factor for future trials.
    Keywords: Score ; Rrrs ; Reirradiation ; High-Grade Glioma ; Glioblastoma ; Medicine
    ISSN: 0167-8140
    E-ISSN: 1879-0887
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