Publications
310 results found
Yarnold JR, Price P, Steel GG, 1995, Non-surgical management of early breast cancer in the United Kingdom: radiotherapy fractionation practices. Clinical Audit Sub-committee of the Faculty of Clinical Oncology, Royal College of Radiologists, and the Joint Council for Clinical Oncology, Clin Oncol, Vol: 7, Pages: 223-226
A national survey of British radiotherapy schedules used in women with early breast cancer was undertaken to document variation in treatment practices and to consider its clinical significance. Although the variation is considerable, the analysis suggests that the majority of schedules in use are very similar in terms of treatment intensity when allowance is made for fraction size and overall time. Half the respondents used one of three dosage schedules, which probably differ very little in terms of late normal-tissue effects and tumour control from a conventional schedule giving 50 Gy in daily 2 Gy fractions. Eighty-two percent of respondents were using schedules that are equivalent to a dose of between 45 Gy and 50 Gy in 2 Gy fractions. The study suggests that the protocols in use by a minority of respondents may be unduly conservative or aggressive, and it leads to the proposal that oncologists should set up trials comparing commonly used schedules as a matter of urgency.
Price P, Jones T, 1995, Can positron emission tomography (PET) be used to detect subclinical response to cancer therapy? The EC PET Oncology Concerted Action and the EORTC PET Study Group, Eur J Cancer, Vol: 31A, Pages: 1924-1927
At the EORTC NCI New Drug Development Meeting in Amsterdam in 1994, a workshop, suggested by the EC PET (positron emission tomography) Oncology concerted action, was held to bring together many of those European PET centres investigating the use of [18F]FDG ([18F]2-fluoro-2 deoxyglucose) PET scanning as a measure of response to cancer therapy. Of the current 31 PET centres in Europe invited to contribute, 15 centres already had data and others expressed interest. Many of the groups were collaborating with local oncologists to measure tumour response to chemotherapy (12 groups) and radiotherapy (three groups) with this technique. Despite variations of methodology, and difficulties in data interpretation, assessment of tumour [18F]FDG uptake was thought to be a reasonable method for the functional imaging of tumours, assessing metabolic rate and providing a measure of tumour response. Broadly, pooling experience, it would appear that changes in [18F]FDG tumour uptake following one or two cycles of chemotherapy treatment was related to ultimate clinical responses. Patients showing most reduction in [18F]FDG uptake achieved the best clinical responses. Data were also available on the effect of chemotherapy on normal tissues and some data on the effect of radiotherapy and tumour response. It was concluded that changes in [18F]FDG uptake as measured with PET may provide useful information on clinical as well as subclinical response of tumours to anticancer therapy. This could be useful as a guide to early response to therapy as well as providing functional assessment of residual masses of disease. More specific markers of cellular proliferation e.g. [11C]thymidine, or [11C]- amino acids may provide even more accurate information. A strategy was outlined whereby PET scanning protocols could parallel EORTC early clinical trials so that [18F]FDG response information could supplement phase I and II clinical studies. Following these developments, an EORTC study group was forme
Price P, Yarnold JR, 1995, Non-surgical management of early breast cancer in the United Kingdom: the role and practice of radiotherapy. Clinical Audit Sub-committee of the Faculty of Clinical Oncology, Royal College of Radiologists, and the Joint Council for Clinical Oncology, Clin Oncol, Vol: 7, Pages: 219-222
This paper reports on the delivery of radiotherapy to the primary site and lymphatic pathways in the management of early stage breast cancer. Radiotherapists were clear that their aim of locoregional radiotherapy was to reduce local recurrence. However, variation in policies for delivery were seen: 80% of radiotherapists did not always give radiotherapy routinely following wide local excision as part of breast conserving management; instead they withheld it selectively for a number of reasons. Only 66% routinely used breast boosts. There was a range of indications for giving radiotherapy to the lymphatic pathways; there was also variation in the management of incompletely or marginally excised primary tumours. Most sources of variation in the practice of radiotherapy in the management of women with early stage breast cancer appeared to arise from scientific uncertainty. However, organizational issues influenced many decisions. These scientific uncertainties and organizational issues are best addressed in the context of multidisciplinary breast clinics.
Kelly SA, Lampert I, Jantet G, et al., 1995, Malignant teratoma undifferentiated (MTU) metastasising solely as differentiated teratoma: implications for the aetiology of residual differentiated disease following successful chemotherapy, Eur J Cancer, Vol: 31A, Pages: 2120-2121
Steel CJ, Brady F, Luthra SK, et al., 1994, An automated synthesis of 2-[11C] thymidine utilising [11C] phosgene., J Label Cmpds Radiopharm, Vol: 35, Pages: 324-326
Price P, McMillan TJ, 1994, The use of non-clonogenic assays in measuring the response of cells in vitro to ionising radiation, Eur J Cancer, Vol: 30A, Pages: 838-841
Price P, Griffiths J, 1994, Tumour pharmacokinetics? - We do need to know., Lancet, Vol: 343, Pages: 1174-1175
Brown G, Turton DR, Waters SL, et al., 1994, Synthesis of [11C-methyl] methylisocyanate and application with microwave heating to labelling of the novel antitumour agent temozolomide., J Label Cmpds Radiopharm, Vol: 35, Pages: 100-102
Brown GD, Khan HR, Steel CJ, et al., 1993, A practical synthesis of 5-[18F] Fluorouracil using HPLC and a study of its metabolic profile in rats., J Label Cmpds Radiopharm, Vol: 32, Pages: 521-522
Harrington KJ, Price PM, Fry L, et al., 1993, Erythroplasia of Queyrat treated with isotretinoin, Lancet, Vol: 342, Pages: 994-995
Tilsley DW, Harte RJ, Jones T, et al., 1993, New techniques in the pharmacokinetic analysis of cancer drugs. IV. Positron emission tomography, Cancer Surv, Vol: 17, Pages: 425-442
Positron emission tomography is a powerful tool for the absolute quantification of injected positron emitting radiotracer concentration within tissues in vivo. Very detailed spatiotemporal data can be obtained without biopsy sampling. Most chemotherapeutic agents can be labelled with a positron emitter, and human tissue and tumour pharmacokinetics can be obtained non-invasively. Its main limitations are the inability to discriminate metabolites, the short half-life of the isotopes used and the specialized equipment required. Despite this, PET has the potential to make a major contribution in the study of the pharmacokinetics of anti-cancer drugs.
Kelly SB, Price P, Williamson RC, 1993, Non-Hodgkin's lymphoma presenting with jaundice and hypercalcaemia, Clin Oncol, Vol: 5, Pages: 122-123
A patient is reported with B-cell lymphoma (centroblastic high grade non-Hodgkin's) with pancreatic involvement, who presented with jaundice and hypercalcaemia. Particularly unusual features include the presentation with a pancreatic mass and the association of hypercalcaemia with centroblastic lymphoma.
McLoughlin J, Foster CS, Price P, et al., 1993, Evaluation of Ki-67 monoclonal antibody as prognostic indicator for prostatic carcinoma, Br J Urol, Vol: 72, Pages: 92-97
Prostate tissue containing either primary adenocarcinoma (45 patients) or benign hyperplasia (15 patients) was immunostained with the monoclonal antibody Ki-67, which recognises a human nuclear antigen expressed by human cycling cells. The percentage of cells staining positive was considered a measure of proliferation. This derived Ki-67 index was higher for carcinomas than for hyperplastic glands. Within the group of carcinomas, Ki-67 indices in patients with metastatic disease were significantly higher than in those without and there was a trend towards increasing Ki-67 indices with increasing Gleason grade. When patients with prostate cancer were prospectively followed up, the Ki-67 index did not predict either disease progression or hormone responsiveness. Ki-67 immunostaining may define a group of patients with prostate cancer of poor prognosis.
O'Rourke N, Price PM, Kelly S, et al., 1993, Tumour inoculation during laparoscopy, Lancet, Vol: 342
Goldin R, Sayer J, Wilkins M, et al., 1993, Primary liver lymphoma associated with primary biliary cirrhosis, Histopathology, Vol: 22, Pages: 184-185
COKER RJ, LAU R, ISAACSON PG, et al., 1992, MUCOSA-ASSOCIATED GASTRIC LYMPHOMA OCCURRING IN AN HIV-ANTIBODY-POSITIVE PATIENT, AIDS, Vol: 6, Pages: 336-337, ISSN: 0269-9370
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Coker RJ, Lau R, Isaacson PG, et al., 1992, Mucosa-associated gastric lymphoma occurring in an HIV-antibody-positive patient, Aids, Vol: 6, Pages: 336-337
Hoskin PJ, Price P, Easton D, et al., 1992, A prospective randomised trial of 4 Gy or 8 Gy single doses in the treatment of metastatic bone pain, Radiother Oncol, Vol: 23, Pages: 74-78
270 patients with painful bone metastases requiring palliative radiotherapy were randomised to receive single fractions of 4 Gy or 8 Gy in a randomised trial. Pain scores and analgesic usage were recorded before treatment and at 2, 4, 8 and 12 weeks. Pain was assessed by patients on a 4 point graded scale using pain charts administered by a central trials office. Response was defined as an improved rating compared to the pretreatment value. Compliance with the pain chart was 72% at 4 weeks. At 4 weeks, the actual response rates were 69% for 8 Gy and 44% for 4 Gy (p less than 0.001), but there was no difference in complete response (no pain) rates at 4 weeks or duration of response between the two arms. It is concluded that 8 Gy gives a higher probability of pain relief than 4 Gy, but that 4 Gy can be an effective alternative in situations of reduced tolerance.
Jones T, Tilsley DW, Wilson CB, et al., 1992, Positron emission tomography for tumour assessment, NMR Biomed, Vol: 5, Pages: 265-269
As positron emission tomography (PET) is outside of the main theme of this conference, it is necessary to outline what it offers as a method for assessing tissue function in vivo. This is followed by illustrations of how PET has and is being used to study the physiology and biochemistry of tumours and pharmacokinetics and pharmacology of anticancer agents. Strategies are offered as to how PET may be used for the development of new chemotherapeutic agents.
Price P, Hogan SJ, Horwich A, 1991, Growth rate of metastatic non-seminomatous germ cell testicular tumours: a reply., Eur J Cancer, Vol: 27, Pages: 1067-1068
Price P, Bush C, Parkins CS, et al., 1991, Evaluation of cell attachment matrix (CAM) coated plates for primary culture of human tumour biopsies., Radiother. Oncol., Vol: 21, Pages: 282-285
Parkins CS, Bush C, Price P, et al., 1991, Cell proliferation in human tumour xenografts: measurement using antibody labelling against bromodeoxyuridine and Ki-67, Cell Prolif, Vol: 24, Pages: 171-179
Cell proliferation was investigated in human tumour xenografts using bromodeoxyuridine (BrdUrd) labelling, evaluated either by flow cytometry or in tissue sections, and also using the proliferation marker Ki-67. BrdUrd labelling was found to increase when cryostat tumour sections were digested with an enzymic solution. This yielded a labelling index up to four times higher than that obtained using the flow cytometer. Ki-67 indices were found to be higher than those reported for human tumour biopsies, as may be expected due to the enhanced growth rate of the xenografts. Significant heterogeneity was observed in the results for cervix, breast and bladder tumours, and the results of the three methods were poorly correlated. However, three of the four tumour types showed that the tumour with the lowest Ki-67 index also had the longest potential doubling time. Since the measurement of Ki-67 index was found technically easier to perform, and also adequately reflects relative tumour cell proliferation, it is preferred over the other techniques.
Bush C, Price P, Norton J, et al., 1991, Proliferation in human bladder carcinoma measured by Ki-67 antibody labelling: its potential clinical importance, Br J Cancer, Vol: 64, Pages: 357-360
Ki-67 is a monoclonal antibody which recognises a human nuclear antigen expressed in proliferating cells. The antibody was used to assess proliferation in primary human bladder tumours from 64 patients. Ki-67 index (the number of Ki-67 positive tumour cells divided by the total number of tumour cells %) was derived from 59 tumours. A wide range of Ki-67 indices were recorded, range 3.0-65.8%, mean 20.2%. The Ki-67 index correlated with known prognostic factors: T stage (P = 0.002) and histological grade (P less than 0.001), early stage disease and more differentiated tumours having lower Ki-67 indices. Patients with invasive disease (21 patients) had significantly higher Ki-67 indices than those with non-invasive disease (P = 0.01). Patients with metastatic disease at presentation (four cases) all had a Ki-67 index of greater than or equal to 29%. Ki-67 antibody staining is a simple technique for assessing the proliferation fraction than can be performed on a small amount of tissue taken at routine biopsy without prior injection of thymidine analogues.
Price P, Sinnett HD, Gusterson B, et al., 1990, Duct carcinoma in situ: predictors of local recurrence and progression in patients treated by surgery alone, Br J Cancer, Vol: 61, Pages: 869-872
Between 1972 and 1982, 60 patients with histologically proven duct carcinoma in situ (DCIS) without evidence of invasive disease were treated by surgery alone. Treatment was not randomised and was total mastectomy (19), subcutaneous mastectomy (6) or local excision (35). Follow-up was by clinical examination and mammography with a median follow-up of 9 years (range 4-16 years). Twenty-six patients (43%) have recurred locally. The estimated proportion recurrence free at 7 years is 59% (95% CI 46-72%). Local recurrence on the chest wall occurred in one patient having total mastectomy and in the chest wall or nipple in three patients having subcutaneous mastectomy. Twenty-two patients recurred locally in the breast after conservative surgery. The 7-year recurrence-free rates were 94%, 44% and 45% respectively in the three groups. Of those patients who recurred locally 14/26 (54%) did so with invasive disease. Of the 34 who did not develop local recurrence, two developed metastases. The only factor which correlated with local recurrence and invasive local recurrence on multivariate analysis was conservative surgery (hazard ratio 4.71 (1.59-14.0), P = 0.001, and 4.05 (1.00-18.7), P = 0.03, respectively). DCIS can be an aggressive local disease and local excision may be inadequate treatment.
Price P, McMillan TJ, 1990, Use of the tetrazolium assay in measuring the response of human tumor cells to ionizing radiation, Cancer Res, Vol: 50, Pages: 1392-1396
Three human tumor cell lines of widely differing radiosensitivity were used to examine the characteristics of the 3-[4,5-dimethyl(thiazol-2-yl)-3,5-diphery]tetradium bromide (MTT) assay and to select suitable conditions for its use in assessing the response of cells to ionizing radiation. The optimal concentration of MTT and the time of incubation of the cells with MTT were individualized for each cell line. The relationship between absorbance and cell number was not linear over the wide range of cell numbers that were used. A calibration curve of absorbance against cell number for each cell line was therefore used. Using the assay to quantify metabolically viable cells, growth curves of irradiated and unirradiated cells were constructed on days 0-14 after irradiation. Accurate surviving fractions could be calculated only when cells were in exponential growth. Using this modification to its interpretation, the MTT assay was able to provide a reproducible measure of survival, which compared well with clonogenic cell survival measurements. However, the necessity to optimize conditions of the MTT assay for each cell line severely limits its usefulness in determining the radiosensitivity of cells in primary human tumor cultures.
Price P, McKinna JA, 1990, Ductal carcinoma in situ detected by screening, BMJ, Vol: 301
Price P, Hogan SJ, Bliss JM, et al., 1990, The growth rate of metastatic nonseminomatous germ cell testicular tumours measured by marker production doubling time--II. Prognostic significance in patients treated by chemotherapy, Eur J Cancer, Vol: 26, Pages: 453-457
Tumour growth rates have been measured in metastatic non-seminomatous germ cell testicular tumours (NSGCTT) by estimating the rate of rise of tumour marker production (TMP). TMP was calculated for the time between orchidectomy and the start of chemotherapy in a group of 58 patients with metastatic NSGCTT treated with BEP combination chemotherapy (bleomycin, etoposide and cisplatin). Calculation of TMP (iu/l/day) took account of the continuing clearance of marker from the serum. TMP increased with time in 51 patients and this rise generally appeared to be exponential. The rate of this increase was expressed as the marker production doubling time (MPDT) and is a measure of the tumour growth rate. MPDT varied from 0.5 to greater than 80 days (45 cases) for AFP + ve patients and from 1.8 to greater than 80 days (34 cases) for HCG + ve patients. Patients who failed BEP first line therapy had shorter MPDTs than those who responded (AFP P = 0.08, HCG P = 0.003). It was found that patients with a MPDT less than or equal to 4 days were more likely to fail treatment than those who had a MPDT greater than 4 days (AFP P = 0.009, HCG P = 0.005). MPDTs were independent of initial serum marker concentration. Patients with small volume disease had longer MPDTs than patients with large volume disease (AFP P = 0.02, HCG P = 0.04). Rapid tumour growth rate reflected by short MPDT carries a poor prognosis in patients with NSGCTT treated by BEP chemotherapy.
Parkins CS, Begg AC, Bush C, et al., 1989, In vivo bromodeoxyuridine labelling in human tumour xenografts, Int J Radiat Biol, Vol: 56, Pages: 787-791
Price P, Sinnett HD, Gusterson B, et al., 1989, Duct carcinoma-in-situ: can we predict recurrence after surgery?, Lancet, Vol: 334, Pages: 671-672
Price P, Bush C, Parkins CS, et al., 1989, Ki67 in the assessment of tumour growth rate: a study on xenografts, Int J Radiat Biol, Vol: 56, Pages: 797-800
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