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Featured researches published by K. Rock.


International Journal of Radiation Oncology Biology Physics | 2018

Long-Term Late Toxicity, Quality of Life, and Emotional Distress in Patients With Nasopharyngeal Carcinoma Treated With Intensity Modulated Radiation Therapy

Lachlan J. McDowell; K. Rock; Wei Xu; B. Chan; John Waldron; Lin Lu; Shereen Ezzat; David D. Pothier; Lori J. Bernstein; N. So; Shao Hui Huang; Meredith Giuliani; Andrew Hope; Brian O’Sullivan; Scott V. Bratman; J. Cho; John Kim; Raymond Woo-Jun Jang; A. Bayley; Jolie Ringash

PURPOSE To report long-term (>4 years) toxicity and quality of life (QoL) among patients with nasopharyngeal carcinoma (NPC) treated with intensity modulated radiation therapy (IMRT) in a nonendemic center. METHODS AND MATERIALS A cross-sectional cohort study enrolled patients with NPC who were disease-free and ≥4 years after IMRT ± chemotherapy. Physician-reported adverse events (Common Terminology Criteria for Adverse Events, version 4.03) and patient-reported QoL (Functional Assessment of Cancer Therapy-Head and Neck, Functional Assessment of Chronic Illness Therapy-Fatigue), utilities (EuroQOL-5D), head and neck symptoms (MD Anderson Symptom Inventory-Head and Neck), and emotional distress (Hospital Anxiety and Depression Scale) were collected. Consenting patients also underwent endocrine screening and audiometry. RESULTS Among 107 patients enrolled, median age at enrollment and time since treatment were 57 (32-81) and 7.5 years (4.2-11.1), respectively. Most patients (99%) received 70 Gy in 35 fractions; the majority (93%) received concurrent chemotherapy. Mean scores for the Functional Assessment of Cancer Therapy-Head and Neck, Functional Assessment of Chronic Illness Therapy-Fatigue, and EuroQOL-5D were 105.0 (46-148), 116.6 (44-160), and 0.85 (0.29-1.00), respectively. Dry mouth, mucus, swallowing/chewing, memory, and teeth/gum problems were scored highest on the MD Anderson Symptom Inventory-Head and Neck; mean symptom severity and symptom interference scores were 2.3 and 2.4, respectively. Grade 3 or higher physician-reported adverse events were noted in 50 patients (47%), most frequently hearing problems (46, 43%). Audiometry revealed significant bilateral hearing loss (grade ≥3) in 68 patients (72%). Depression (25%), anxiety (37%), and fatigue (28%) were common and strongly correlated with QoL. Most patients (69%) developed hypothyroidism; 1 patient (1%) developed pituitary dysfunction requiring hormone replacement. V50 >90 and V45 >99 to the thyroid correlated with significantly higher rates of hypothyroidism. CONCLUSIONS Despite the implementation of IMRT, survivors of NPC still experience many physical symptoms that affect long-term QoL many years after treatment. Depression, anxiety, and fatigue remain common in long-term survivors and are highly correlated with QoL.


Current Otorhinolaryngology Reports | 2018

Surgery- vs Radiation-Based Therapy for p16+/HPV-Related Oropharyngeal Cancers

K. Rock; Brian O’Sullivan; Zhi-Jian Chen; Zhi-Yuan Xu; Ji-Shi Li; Shao Hui Huang

Purpose of ReviewOropharyngeal cancer (OPC) has traditionally been managed by radiotherapy (RT)-based approaches. Minimally invasive surgery [transoral robotic surgery (TORS)/transoral laser microsurgery (TLMS)] is gaining popularity in T1-T2 HPV+ OPC. However, there is lack of high level evidence to guide practice. We summarize ongoing research regarding outcomes and investigational strategies for TORS/TLM- and RT-based treatments for this disease.Recent FindingsLiterature published in 2012–2017 demonstrated comparable exemplary outcomes with TORS/TLM and IMRT for selected HPV+ T1-T2 OPC. However, many TORS/TLM-treated patients also require adjuvant treatment, which impacts quality of life. Emerging RT-based de-intensification trial data suggest promising results. Ongoing investigation include indications for postoperative (chemo-)radiotherapy following TORS/TLM- and optimal RT-based de-intensification strategies.SummaryA contemporary literature review demonstrates equal efficacy for TORS/TLM and IMRT as primary treatment for selected HPV+ T1-T2 OPC. TORS/TLM is an attractive approach when the opportunity for single modality treatment is high.


International Journal of Radiation Oncology Biology Physics | 2016

Screening for Mild Cognitive Impairment in English- and Chinese-Speaking Survivors of Nasopharyngeal Carcinoma

Lachlan J. McDowell; Lori J. Bernstein; Wei Xu; Jolie Ringash; Y. Song; K. Rock; N. So; Meredith Giuliani; Andrew Hope; Brian O'Sullivan; Scott V. Bratman; J. Cho; J. Kim; Raymond Woo-Jun Jang; A. Bayley; John Waldron


Radiotherapy and Oncology | 2018

PO-0710: Brain dose from IMRT is associated with neurocognitive function in nasopharyngeal cancer survivors

Lachlan J. McDowell; Jolie Ringash; B. Chan; Wei Xu; Lin Lu; John Waldron; K. Rock; Shao-Ching Huang; N. So; Meredith Giuliani; Andrew Hope; B. O'Sullivan; Scott V. Bratman; J. Cho; J. Kim; Raymond Woo-Jun Jang; A. Bayley; Lori J. Bernstein


Radiotherapy and Oncology | 2018

A cross sectional study in cognitive and neurobehavioral impairment in long-term nasopharyngeal cancer survivors treated with intensity-modulated radiotherapy

Lachlan J. McDowell; Jolie Ringash; Wei Xu; B. Chan; Lin Lu; John Waldron; K. Rock; N. So; Shao Hui Huang; Meredith Giuliani; Andrew Hope; Brian O'Sullivan; Scott V. Bratman; J. Cho; John Kim; Raymond Woo-Jun Jang; A. Bayley; Lori J. Bernstein


International Journal of Radiation Oncology Biology Physics | 2018

A Comprehensive Analysis of Late Toxicity, Quality Of Life and Emotional Distress In Nasopharyngeal Carcinoma Patients Treated with Intensity-Modulated Radiation Therapy At A Non-Endemic Center

Lachlan J. McDowell; K. Rock; Wei Xu; B. Chan; John Waldron; Lin Lu; Shereen Ezzat; David D. Pothier; Lori J. Bernstein; N. So; Shao Hui Huang; Meredith Giuliani; Andrew Hope; B. O'Sullivan; Scott V. Bratman; J. Cho; J.H. Kim; Raymond Woo-Jun Jang; A. Bayley; Jolie Ringash


International Journal of Radiation Oncology Biology Physics | 2018

Partial Laryngeal IMRT for T2N0 Glottic Cancer: Impact of Image Guidance and Radiation Therapy Intensification

K. Rock; Shao Hui Huang; Albert Tiong; Lin Lu; Wei Xu; Jolie Ringash; Scott V. Bratman; L. Tong; B. Chan; J. Cho; Meredith Giuliani; Andrew Hope; A. Bayley; John Kim; John R. de Almeida; Brian O'Sullivan; John Waldron


Radiotherapy and Oncology | 2017

PO-0620: Partial Laryngeal IMRT for T2N0 Glottic Cancer: Impact of Image Guidance and Radiotherapy Regimen

K. Rock; Shao-Ching Huang; A. Tiong; Lin Lu; Wei Xu; A. Bayley; Scott V. Bratman; J. Cho; Meredith Giuliani; Andrew Hope; J. Kim; Jolie Ringash; Brian O’Sullivan; John Waldron


International Journal of Radiation Oncology Biology Physics | 2017

Cognitive and Neurobehavioral Impairment in Long-Term Survivors Treated for Nasopharyngeal Cancer with Intensity-Modulated Radiation Therapy

Lachlan J. McDowell; Jolie Ringash; Wei Xu; Lin Lu; John Waldron; K. Rock; N. So; B. Chan; Shao Hui Huang; Meredith Giuliani; Andrew Hope; B. O'Sullivan; Scott V. Bratman; J. Cho; J.H. Kim; Raymond Woo-Jun Jang; A. Bayley; Lori J. Bernstein


International Journal of Radiation Oncology Biology Physics | 2016

Automated Quality Assurance at Breast Cancer Rounds—a Process to Improve Efficiency and Quality of Patient Care

K. Rock; A.S. Barry; Chris McIntosh; Thomas G. Purdie; C.A. Koch

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A. Bayley

Princess Margaret Cancer Centre

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Andrew Hope

Princess Margaret Cancer Centre

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J. Cho

University of Toronto

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John Waldron

Princess Margaret Cancer Centre

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Jolie Ringash

Princess Margaret Cancer Centre

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Meredith Giuliani

Princess Margaret Cancer Centre

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Scott V. Bratman

Princess Margaret Cancer Centre

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Lin Lu

Princess Margaret Cancer Centre

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B. Chan

Princess Margaret Cancer Centre

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Lachlan J. McDowell

Princess Margaret Cancer Centre

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