Browsing by Author "Chua, Melvin L. K."

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International Recommendations on Reirradiation by Intensity Modulated Radiation Therapy for Locally Recurrent Nasopharyngeal Carcinoma
(ELSEVIER SCIENCE INC, 2021-01-01) Ng, Wai Tong; Soong, Yoke Lim; Ahn, Yong Chan; AlHussain, Hussain; Choi, Horace C. W.; Corry, June; Gregoire, Vincent; Harrington, Kevin J.; Hu, Chao Su; Jensen, Kenneth; Kwong, Dora L.; Langendijk, Johannes A.; Le, Quynh Thu; Lee, Nancy Y.; Lin, Jin Ching; Lu, Tai Xiang; Mendenhall, William M.; O'Sullivan, Brian; Ozyar, Enis; Pan, Jian Ji; Peters, Lester J.; Poh, Sharon S.; Rosenthal, David I.; Sanguineti, Giuseppe; Tao, Yungan; Wee, Joseph T.; Yom, Sue S.; Chua, Melvin L. K.; Lee, Anne W. M.
Purpose: Reirradiation for locally recurrent nasopharyngeal carcinoma (NPC) is challenging because prior radiation dose delivered in the first course is often close to the tolerance limit of surrounding normal structures. A delicate balance between achieving local salvage and minimizing treatment toxicities is needed. However, high-level evidence is lacking because available reports are mostly retrospective studies on small series of patients. Pragmatic consensus guidelines, based on an extensive literature search and the pooling of opinions by leading specialists, will provide a useful reference to assist decision-making for these difficult decisions. Methods and Materials: A thorough review of available literature on recurrent NPC was conducted. A set of questions and preliminary draft guideline was circulated to a panel of international specialists with extensive experience in this field for voting on controversial areas and comments. A refined second proposal, based on a summary of the initial voting and different opinions expressed, was recirculated to the whole panel for review and reconsideration. The current guideline was based on majority voting after repeated iteration for final agreement. Results: The initial round of questions showed variations in clinical practice even among the specialists, reflecting the lack of high-quality supporting data and the difficulties in formulating clinical decisions. Through exchange of comments and iterative revisions, recommendations with high-to-moderate agreement were formulated on general treatment strategies and details of reirradiation (including patient selection, targets contouring, dose prescription, and constraints). Conclusion: This paper provides useful reference on radical salvage treatment strategies for recurrent NPC and optimization of reirradiation through review of published evidence and consensus building. However, the final decision by the attending clinician must include full consideration of an individual patient's condition, understanding of the delicate balance between risk and benefits, and acceptance of risk of complications. (C) 2021 Elsevier Inc. All rights reserved.
Managing advanced prostate cancer in the Asia Pacific region: ``Real-world'' application of Advanced Prostate Cancer Consensus Conference 2019 statements
(WILEY, 2022-01-01) Chiong, Edmund; Murphy, Declan G.; Buchan, Nicholas C.; Chua, Melvin L. K.; Hakim, Lukman; Hamid, Agus Rizal; Hong, Sung K.; Horvath, Lisa G.; Kanesvaran, Ravi; Khochikar, Makarand; Letran, Jason; Lojanapiwat, Bannakij; Malek, Rohan; Ng, Anthony C. F.; Vinh, Nguyen Tuan; Pang, See-Tong; Poon, Darren M. C.; Ong, Teng Aik; Saad, Marniza; Schubach, Kathryn; Shiroki, Ryoichi; Turkeri, Levent; Williams, Scott; Wong, Alvin; Ye, Dingwei; Davis, Ian D.; Grp, A.N.Z.U.P. Canc Trials
Aim The second Asia-Pacific Advanced Prostate Cancer Consensus Conference (APAC APCCC 2020) gathered insights into the real-world application in the Asia-Pacific (APAC) region of consensus statements from the 3rd Advanced Prostate Cancer Consensus Conference (APCCC 2019). Methods The 4-h our virtual meeting in October 2020 brought together 26 experts from 14 APAC countries to discuss APCCC 2019 recommendations. Presentations were prerecorded and viewed prior to the meeting. A postmeeting survey gathered views on current practice. Results The meeting and survey highlighted several developments since APAC APCCC 2018. Increased access and use in the region of PSMA PET/CT imaging is providing additional diagnostic and staging information for advanced prostate cancer and influencing local and systemic therapy choices. Awareness of oligometastatic disease, although not clearly defined, is increasing. Novel androgen receptor pathway antagonists are expanding treatment options. Cost and access to contemporary treatments and technologies continue to be a significant factor influencing therapeutic decisions in the region. With treatment options increasing, multidisciplinary treatment planning, shared decision making, and informed choice remain critical. A discussion on the COVID-19 pandemic highlighted challenges for diagnosis, treatment, and clinical trials and new service delivery models that will continue beyond the pandemic. Conclusion APAC-specific prostate cancer research and data are important to ensure that treatment guidelines and recommendations reflect local populations and resources. Facilitated approaches to collaboration across the region such as that achieved through APAC APCCC meetings continue to be a valuable mechanism to ensure the relevance of consensus guidelines within the region.