• Anaesthesia for phaeochromocytoma: does a single high blood pressure reading in the anaesthetic room matter?

  Jackson, T.; Adam, Safwaan; Gulamhusein, Aziz; Beards, Susan; The Christie NHS Foundation Trust, Manchester, United Kingdom (2024)

  BackgroundRacial and ethnic inequities exist in cancer clinical trial participation. Low recruitment across ethnically diverse communities contributes to health inequalities further disproportionately affecting these groups. Understanding barriers and enablers to clinical trial participation for ethnic minorities is key to developing strategies to address this problem.ObjectiveTo explore, evaluate, and synthesize qualitative research surrounding patients' lived experiences and perceptions of participating in cancer clinical trials from ethnically diverse groups.MethodsNoblit and Hare's 7-stage metaethnography was used. Seven databases were searched. Inclusion criteria were as follows: qualitative studies published in English from January 1, 2012, to January 31, 2022; patients from any ethnic minority 18 years and older with a cancer diagnosis; and cancer patients' carers and healthcare professionals (HCPs)/healthcare leaders involved in the delivery of cancer clinical trials.ResultsThe majority of included articles were conducted in the United States. Interpretive qualitative synthesis resulted in 7 categories including patient perceptions and beliefs and HCP perception of trial burden and social determinants of health. Four lines of argument were established.ConclusionsThe findings capture the experience and perceptions of ethnic minority patients, their carers, HCPs, and healthcare leaders in this area of research. Incongruities exist between patient-reported barriers and those perceived by HCPs. Published empirical research outside the United States is limited.Implications for PracticeWhen developing strategies to increase clinical trial participation, research literacy, cultural safety, and unconscious biases within healthcare need to be addressed. Further research to examine intersectionality and the role of faith in decision-making among ethnic groups is warranted.
• Rapid early progression in glioblastoma: a comprehensive review of clinical, imaging and histopathological features

  Waqar, M.; Roncaroli, F.; O'Leary, C.; Forte, G.; Wright, J.; Parikh, Shefali; Sudell, Lindsay; Coope, D.; Djoukhadar, I.; Borst, Gerben; et al. (2024)

  Background and Purpose: Radiotherapy for paediatric posterior fossa tumours may cause complications in the brainstem and upper spinal cord due to high doses. With proton therapy (PT) this risk may increase due to higher relative biological effectiveness (RBE) from elevated linear energy transfer (LET). This study assesses variations in LET in the brainstem and spinal cord in proton treatment plans from European centres. Materials and Methods: Ten European PT centres using spot-scanning PT planned two paediatric posterior fossa cases: One overlapping partly with the brainstem and upper spinal cord, prescribed 54 Gy(RBE), and the second wrapping around these organs, prescribed 59.4 Gy(RBE). Dose-averaged LET distributions were assessed in volumes of the brainstem and spinal cord irradiated to over 50 Gy(RBE = 1.1). The maximum hinge angle effect on near-maximum RBE-weighted doses using the Unkelbach RBE model was also investigated. Results: In the first case, the mean LET in brainstem volumes receiving more than 50 Gy(RBE = 1.1) ranged from 2.8 keV/mu m to 3.6 keV/mu m across centres (median: 3.3 keV/mu m). In the second case, treatment plans showed a narrower range of mean LET in the brainstem, from 2.5 keV/mu m to 2.8 keV/mu m (median: 2.7 keV/mu m). There was no statistically significant impact of the maximum hinge angle. Conclusions: LET distributions vary across centres due to different techniques but are also influenced significantly by factors like shape and position of the target volume.
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  Neurofibromatosis type 2 presenting as symptomatic gallbladder hydrops: a rare case report and literature review

  Hafez, B.; Alwan, J. S.; El Hout, Walid; Koussa, K.; El Annan, T.; Noun, D.; Zaghal, A.; The Christie NHS Foundation Trust, Manchester, United Kingdom (2024)
• Health-related quality of life and cognitive functioning in survivors of oligodendroglioma: an international cross-sectional investigation

  Boele, F.; Frances, S.; Darlix, A.; Ducray, F.; Tabouret, E.; Burger, M.; Ryden, I.; Malmstrom, A.; Vauleon, E.; Kazda, T.; et al. (2024)
• Metastatic bifocal germinoma: a case highlighting dramatic early radiological response to steroids and rebound following discontinuation, and the utility of circulating mir-371a-3p quantification and vinblastine monotherapy prior to definitive craniospinal irradiation

  Scarpini, C.; Ward, D.; Phyu, P.; Jalloh, I.; Thorp, Nicky; Fisher, B.; Hendriks, E.; Salisbury, L.; Nicholson, J.; Ajithkumar, T.; et al. (2024)

  Background: High-grade serous ovarian cancer (HGSOC) can be treated with platinum-based neoadjuvant chemotherapy (NACT) and delayed primary surgery (DPS). Histopathological response to NACT can be assessed using B & ouml;hm's chemotherapy response score (CRS). We investigated whether germline BRCA1/2 (gBRCA1/2) genotype associated with omental CRS phenotype. Methods: A retrospective study of patients with newly diagnosed FIGO stage IIIC/IV HGSOC prescribed NACT and tested for gBRCA1/2 pathogenic variants (PVs) between September 2017 and December 2022 at The Christie Hospital. The Cox proportional hazards model evaluated the association between survival and key clinical factors. The chi-square test assessed the association between CRS3 (no/minimal residual tumour) and gBRCA1/2 status. Results: Of 586 eligible patients, 393 underwent DPS and had a CRS reported. Independent prognostic factors by multivariable analysis were gBRCA1/2 status (PV versus wild type [WT]), CRS (3 versus 1 + 2), surgical outcome (complete versus optimal/suboptimal) and first-line poly (ADP-ribose) polymerase-1/2 inhibitor maintenance therapy (yes versus no) (all P < 0.05). There was a non-significant trend for tumours with a gBRCA2 PV having CRS3 versus WT (odds ratio [OR] = 2.13, 95% confidence intervals [CI] 0.95-4.91; P = 0.0647). By contrast, tumours with a gBRCA1 PV were significantly less likely to have CRS3 than WT (OR = 0.35, 95%CI 0.14-0.91; P = 0.0291). Conclusions: Germline BRCA1/2 genotype was not clearly associated with superior omental CRS. Further research is required to understand how HGSOC biology defines CRS.

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