2003 Annual Report
Division of Radiation Oncology
Dr. Alexander Chan, Acting Division Head
There has been steady growth within the division in 2003. The division has seen 3621 consultations in 2003 (3580 new consults and 41 repeated consults) and 3058 patients required radiation treatment. With the return of Drs. Doll and Kurien from their maternity leaves, the division has regained the full complement of 14 radiation oncologists for a short period till September when Dr. Craighead takes up the acting director position for the cancer center. Active recruitment effort has brought the 15th radiation oncologist, Dr. Elizabeth Yan to Calgary. Dr. Yan is a graduate of University of Alberta and the Cross Cancer Institute. She has just completed a fellowship in stereotactic radiosurgery at the University of California, San Francisco. She is expected to join the department in July 2004. Her experience in UCSF will be very valuable in the development of the stereotactic radiosurgery program in Calgary.
KEY DEVELOPMENTS DURING 2003
- Through the collaborative effort of the Alberta Cancer Board, the Calgary Health Region, divisions of Radiation Oncology, Neuroscience and Medical Physics, an Alberta stereotactic radiosurgery program has now become a reality. With funding from private donations, a Novalis system dedicated for stereotactic radiosurgery will be installed in 2004. This unit will be the first system to be installed in Canada. It will provide significant opportunities for collaborative research in the divisions of Radiation Oncology, Neurosurgery and Medical Physics in the treatment of cranial and extra-cranial tumors and benign diseases.
- With limited funding, an after-loading brachytherapy program for localized prostate cancers was started in 2003. 27 patients were treated in 2003 with satisfactory outcomes. We are hopeful that continuing funding will be available to expand the program in 2004.
- The residency program was reviewed by the Royal College in 2003 and the program was accredited for 6 years till 2009. Currently we have 6 residents in the program.
ACADEMIC EVENTS OF 2003
The department continues to be a popular venue for undergraduate medical students. There were 20 students taking electives in radiation oncology. Dr. Angyalfi continues his involvement in undergraduate education, serving as the undergraduate coordinator for the department of Oncology. He has received an award for his effort in undergraduate education. Four physicians participated as preceptors for the 440 course. There were continued rotation of medical, surgical, gynecological and palliative care fellows and residents through the department.
Dr. Smith takes on the responsibility of coordinator of the clinical research unit in TBCC in September. Dr. Wu is coordinating the grand rounds for the center and Dr. Lau is coordinating rounds for the division. Dr. Chan was promoted to the rank of clinical associate professor. Several members of the division serve as tumor group leaders of center and Dr. Smith was appointed provincial leader for the lung tumor group.
Several members had presentations in local (Cancer Care Conference, ACB Annual Research meeting), national (Canadian Association of Radiation Oncologists annual meeting) and international conferences (European Conference of Clinical Oncology, American Society for Therapeutic Radiology and Oncology annual meeting).
As suggested in the review of the department by Professor MacKillop, several interest groups were formed to stimulate collaborative research activities between departments of Radiation Oncology and Medical Physics.
ACADEMIC DEPARTMENTAL RESPONSIBILITIES 2003
Dr Steve Angyalfi – Undergraduate coordinator, Tumour Group leader for GU
Dr Alex Balogh – Director of Residency program
Dr Alex Chan – Acting Division Head, Leader of Stereotactic radiosurgery and GI tumour groups
Dr Peter Craighead – Acting TBCC Director, Acting Head, Department of Oncology.
Dr Corinne Doll – Leader of Hypoxia working group, Teaching advisory council
Dr Siraj Husain – Leader of Prostate Brachytherapy implementation team
Dr Harold Lau – Leader of conformal radiotherapy working group, RO rounds
Dr Jack MacKinnon – Head and Neck tumour group leader
Dr Colum Smith – Local coordinator of RTOG studies, investigator in Lung
Dr. Theresa Trotter – Leader, Southern Alberta Breast Tumor Group
Dr Jackson Wu – Leads palliative think tank, Continuing education coordinator
Dr Don Yee – Leader of IMRT working group
All department members participate in core curriculum lectures, and lectures for RTT training school
PRESENTATIONS
Dr. Alexander Chan
Adjuvant Therapy – Colorectal Cancer. Cancer Care Conference, Calgary, Alberta, May 2003.
Post-operative TNM Staging is a Prognostic Indicator of Survival and Recurrence in Tethered or Fixed Rectal Carcinoma after Preoperative Chemotherapy and Radiation, Presentation at the 45th American Society for Therapeutic Radiology and Oncology (ASTRO) Annual Meeting, October 21, 2003, Salt Lake City, Utah.
Dr. Peter Craighead
Patients with stage 1 papillary serous and clear cell cancer of the endometrium should receive postoperative therapy. Key note speaker, Controversies in Gynecological Cancer Management Symposium, Chicago Marriott, December 12-14th,
How much is enough in Node positive breast cancer? Grand Rounds, TBCC. September 2003. Craighead and Paterson
State of the Art in Management of DCIS. Craighead. Cancer Care Conference, Delta Bow Valley Calgary Canada, May 2003
Combined chemotherapy and radiation in locally advanced cervix cancer and new directions. Craighead. Invited rounds at University of Southern California (Norris) Santa Monica, February 25th 2003
Illustrating the importance of outcomes collection in the clinic. Craighead, Chan, Wu. Department of Oncology Grand Rounds, January 2003
Dr. Siraj Husain
Update on Temodal’s Role in Brain Tumors: Can it get the Brain out of the frying pan. Presented both in Calgary and Edmonton Jan 2003
Cancer: Myths, facts and information on Breast, Colon, and ProstateCancer. Presented in Edmonton. Part of a symposium on General health and prevention April 2003
Prostate 125Iodine Permanent Seed Implant. The Calgary Program Initiative. Presented to the prostate group in Calgary February 2003.
Prostate Cancer Treatment: Brachytherapy. Update on the Calgary Program. Grand Rounds at TBCC. May 2003
Prostate Cancer and the TBCC Brachytherapy Program. Cancer Care 2003, University of Calgary, June 2003
Prostate Cancer Treatment: Update on the TBCC Program and the role of brachytherapy in curative treatment. September 2003, Presented in Banff at the GU Treatment Update and Guidelines in Alberta Meeting
Prostate Cancer: The role of External Beam and Brachytherapy in Prostate Cancer Treatment. Presented at the Hyatt in Calgary October 2003.
Cancer: Screening guidelines for Prostate and Colon Cancer. University of Calgary CME Update November 2003
Update on Brain Tumor Management. Presented in Islamabad, Pakistan at the Advances in Neurology Meeting. December 2003
Dr. Harold Lau
Analysis of Late Rectal Toxicity after Radiotherapy for Localized Prostate Cancer, presented at Alberta Cancer Board Annual Research Meeting, November 13-14, 2003, Banff, AB.
Dr. Jackson Wu
Wu J, Breitman K, Song W. Estimation of Dose Constraints using Biologically-Normalized Dose-Volume Histograms for Hypofractionated Radiotherapy in the Treatment of Prostate Cancer. Oral presentation at the 17th Canadian Association of Radiation Oncologists annual scientific meeting, Oct 3-5, 2003. Poster presentation at the European Conference of Clinical Oncology (ECCO 12) meeting, Sept 21-25, 2003.
Wu J, Monk G, Clark T, Wong R. Improvements in pain and functional interference following palliative radiotherapy for painful bone metastases: an analysis of Brief Pain Inventory assessments. Poster presentation at the ECCO 12 meeting, Sept 21-25, 2003.
SUPERVISORY PANELS, REVIEWERS
Dr. Peter Craighead
Supervised Joanna Tan in 440 course. August to October.
Oral PhD examination board (University of Calgary): Thesis – The validation of CT scans to determine the dynamic pulmonary effects of radiotherapy. Parminder Basran (Physics)
Oral PhD examination board (University of Calgary): Thesis – The use of particle intensity modulated radiotherapy Collins Yehboah (Physics) March 2003
Coordinated fellowships with Dr. John Allan Toews, for Drs, Ardythe Taylor and Lesley Coulter, within the Breast Tumour Group, TBCC.
ABSTRACTS AND PUBLICATIONS
Balogh A. Multileaf Collimation for large fields: simple IMRT treating the mantle Radiotherapy and Oncology vol 69 (supplement 1) Abstract 39 PG s10 CARO 2003
Chan A, Wong A. et al. Post-operative TNM Staging is a Prognostic Indicator of Survival and Recurrence in Tethered or Fixed Rectal Carcinoma after Preoperative Chemotherapy and Radiation Int J Rad Oncol Biol Phys. 57(2) Supplement, S96, 2003.
Lee RC, Dunscombe P, Mobit P, Kelly K, Brand K, Gray G, Currie G, Craighead P. An analytic framework for assessment of rare, catastrophic risks to radiation oncology patients. Proc. Annual Meeting of Int. Society for Risk Analysis, Baltimore, 2003.
Craighead P. Postoperative therapy should be applied to stage 1 uterine papillary serous and clear cell carcinoma patients who have been surgically staged. Controversies in Gynaecological Cancer Management, Chicago. December 12-13th, 2003
Lackman F, Craighead P. Management Dilemmas in the treatment of Patients with Uterine Papillary Serous Carcinoma Current Opinion in Oncology, Volume 4 (3), 2003.
Craighead P. Public Scepticism in Health Care: The real cause of inertia? Hospital Quarterly 6(4): 63-65, 2003
Doll C, Milosevic M, Pintilie M, Hill R, Fyles A. Estimating hypoxic status in human tumours: a simulation using Eppendorf oxygen probe data in cervical cancer patients. International Journal of Radiation Oncology, Biology, and Physics. 55(5); 1239-1246, 2003.
Chan P, Doll C, Milosevic M, et al. A prospective phase I/II trial of the cyclooxygenase-2 inhibitor Celecoxib in patients with carcinoma of the cervix – acute toxicity and biomarker response analysis. Abstract and poster presentation, 12th International Congress of Radiation Research, Brisbane, Australia, August 2003.
Chan P, Doll C, Milosevic M. et al. A prospective phase I/II trial of the cyclooxygenase-2 inhibitor Celecoxib in patients with carcinoma of the cervix – acute toxicity and biomarker response analysis. Proceedings of the American Association for Cancer Research, Vol 44, 1st Ed., March 2003.
Husain S, Angyalfi S, Carlson R, Husain A. Population-based Evaluation of Prostatectomy as Primary Treatment for Prostate Cancer: Characteristics, Prognostic factors and Evaluation of Trends between 1993 and 1997.
Mack LA, Temple WJ, DeHaas WG, Schachar N, Morris DG, and Kurien E. Groin Soft Tissue Tumours – A challenge for Local Control and reconstruction: A Prospective Cohort Analysis. Submitted to Journal of Surgical Oncology November 2003.
Gluck S, MacKinnon J, Lau H, Syme R, Dort J, Gluck D. Metronomic therapy in recurrent and metastatic chemo-resistant SCCHN: Data from a pilot study. ASCO 2003 Abstracts, 22: 2066.
Wu J, Bezjak A, Chow E. et al: A consensus development approach to define national research priorities in bone metastases – Proceedings from NCIC CTG workshop. Clinical Oncology Dec 2003; 15:496-499
Chow E, Wu J, Loblaw A, Perez C. Radiotherapeutic approaches to metastatic disease. World J Urol 2003 Aug 9.
Wu J, Wong R, Johnston M, Bezjak A, Whelan T. Meta-Analysis of Single-Fraction versus Multi-fraction radiotherapy trials for palliation of painful bone metatases. International J of Radiation Oncology, Biology, Physics 2003; 55(3) 594-605.
Wu J, Monk G, Clark T, Wong R. Improvements in pain and functional interference following palliative radiotherapy for painful bone metastases: an analysis of Brief Pain Inventory assessments. Eur J Cancer Supp. Sept 2003: vol 1(No. 5), abstract No. 934.
Wu J, Breitman K, Song W. Estimation of Dose Constraints using Biologically-Normalized Dose-Volume Histograms for Hypofractionated Radiotherapy in the Treatment of Prostate Cancer. Radiotherapy & Oncology Oct 2003: 69(supp 1): S6, abstract No. 23. Eur J Cancer Supp. Sept 2003: vol 1 (No. 5), abstract No. 520.
GRANTS
2003 ACURA Award – $10,000 to Jackson Wu from the Canadian Association of Radiation Oncologists 2003 for project titled: Bladder filling and prostate motion during conformal radiotherapy for prostate cancer: a randomized study of empty vs. full bladder patient set-up instructions.
2003 ACURA - $12,000 to Don Yee from the TBCC Clinical research Unit for Cervix CA IMRT project.