Melissa L James

Hypofractionated radiation treatment following mastectomy in early breast cancer: The Christchurch experience

Although hypofractionated radiotherapy (HFRT) has become an accepted option for whole‐breast irradiation after breast‐conserving surgery, there is limited evidence to support HFRT to the chest wall following mastectomy. We retrospectively analysed post‐mastectomy patients treated with HFRT in Christchurch to determine whether HFRT yields acceptable efficacy and toxicity.

Faculty of Radiation Oncology 2014 workforce census.

This paper reports the key findings of the Faculty of Radiation Oncology 2014 workforce census and compares the results with earlier surveys.

Ischaemic heart disease following conventional and hypofractionated radiation treatment in a contemporary breast cancer series

We report the incidence of ischaemic cardiac toxicity in a contemporary cohort of patients receiving conventional (CFRT) or hypofractionated (HFRT) radiation after surgery for early breast cancer and investigate the interplay of cardiac risk factors and fractionation.

Complications of curative radiation treatment for early prostate cancer

To report the incidence of urological complications following curative radiation treatment for early prostate cancer, including minimally invasive urological procedures (MUIP), hospital admissions and open surgical procedures. Second malignancies following radiation are also reported and compared with patients undergoing a prostatectomy.

Intervention quality is not routinely assessed in Cochrane systematic reviews of radiation therapy interventions

The aim of this study was to maximise the benefits from clinical trials involving technological interventions such as radiation therapy. High compliance to the quality assurance protocols is crucial. We assessed whether the quality of radiation therapy intervention was evaluated in Cochrane systematic reviews.

Employment for radiation oncologists in Australia and New Zealand: Recent graduates survey of experiences and perspectives

This paper reports the key findings of the first survey of recent Radiation Oncology graduates in Australia, New Zealand (ANZ) and Singapore. It explores their experiences in entering the workforce, challenges and perspectives.

Outcomes for Patients with Non-metastatic Triple-negative Breast Cancer in New Zealand

AIMS Triple-negative breast cancer (TNBC) has inferior outcomes to other subtypes of breast cancer. We studied the demographics and baseline breast cancer characteristics of patients in New Zealand with TNBC and assessed survival outcomes and prognostic/predictive factors. MATERIALS AND METHODS We searched the New Zealand breast cancer registry database and identified patients with TNBC without distant metastatic disease. We retrieved demographic, tumour characteristic and treatment information. Locoregional recurrence-free survival, breast cancer-specific survival (BSS), metastasis-free survival (MRFS) and overall survival were determined. Predefined univariate and multivariate analyses were carried out investigating the association of survival outcomes with treatment and tumour characteristics. RESULTS In total, 1390 patients were identified, with a median follow-up of 3.5 years. The median age was 55 years. Thirty-eight per cent were node positive and 79% were grade III. Mastectomy was carried out in 53%, adjuvant radiation delivered in 66% and chemotherapy in 69%. The significant predictive factors for overall survival, BSS and MRFS were radiotherapy, chemotherapy and neoadjuvant chemotherapy. The significant prognostic indicators were lymphovascular invasion, nodal status and tumour size. On Kaplan-Meier analysis, the 5 year overall survival was 72%. The median time to death for those who died was 3.55 years with 92% of deaths within 5 years. Seventy-four per cent of patients had distant metastasis as a first recurrence and isolated local recurrences occurred in only 4.5%. Metastatic disease occurred in lung (55.9%) and was in multiple sites in 51%. CONCLUSION We report a large population-based series of TBNC without distant metastatic disease at diagnosis highlighting the unique behavioural characteristics of TNBC. Traditional therapies are positively associated with survival outcomes, and yet, particularly in the setting of recurrent disease, prognosis remains poor. Increased research into more effective systemic agents and the most effective timing of delivery of these may result in improved outcomes.

Hypofractionated radiation treatment in early breast cancer: Results in a New Zealand setting

High‐quality evidence supports that hypofractionated radiation treatment (HFRT) is as effective and safe in early breast cancer as conventionally fractionated radiation treatment. HFRT with fewer treatments has potential benefits for both patients and radiation departments. Despite this, concerns about local control and toxicity with HFRT persist, such that many eligible patients do not receive HFRT. The local recurrence rates and acute toxicity after HFRT was analyzed in our center in Christchurch, New Zealand.