K. Rock
Princess Margaret Cancer Centre
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Featured researches published by K. Rock.
International Journal of Radiation Oncology Biology Physics | 2018
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
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
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
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
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
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
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
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
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
K. Rock; A.S. Barry; Chris McIntosh; Thomas G. Purdie; C.A. Koch