Staff Publication

Accelerated versus standard epirubicin followed by cyclophosphamide, methotrexate, and fluorouracil or capecitabine as adjuvant therapy for breast cancer in the randomised UK TACT2 trial (CRUK/05/19): a multicentre, phase 3, open-label, randomised, controlled trial (2017)

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Type of publication:
Randomised controlled trial

Author(s):
David Cameron, James P Morden, Peter Canney, Galina Velikova, Robert Coleman, John Bartlett, *Rajiv Agrawal, Jane Banerji, Gianfilippo Bertelli, David Bloomfield, A Murray Brunt, Helena Earl, Paul Ellis, Claire Gaunt, Alexa Gillman, Nicholas Hearfield, Robert Laing, Nicholas Murray, Niki Couper, Robert C Stein, Mark Verrill, Andrew Wardley, Peter Barrett-Lee, Judith M Bliss, on behalf of the TACT2 Investigators

Citation:
Lancet Oncology; Jul 2017; vol. 18 (no. 7); p. 929-945

Abstract:
Adjuvant chemotherapy for early breast cancer has improved outcomes but causes toxicity. The UK TACT2 trial used a 2 × 2 factorial design to test two hypotheses: whether use of accelerated epirubicin would improve time to tumour recurrence (TTR); and whether use of oral capecitabine instead of cyclophosphamide would be non-inferior in terms of patients’ outcomes and would improve toxicity, quality of life, or both.

Link to full-text [Open access]

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Partial-breast radiotherapy after breast conservation surgery for patients with early breast cancer (UK IMPORT LOW trial): 5-year results from a multicentre, randomised, controlled, phase 3, non-inferiority trial (2017)

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Type of publication:
Randomised controlled trial

Author(s):
Charlotte E Coles, Clare L Griffin, Anna M Kirby, Jenny Titley, *Rajiv K Agrawal, Abdulla Alhasso, Indrani S Bhattacharya, Adrian M Brunt, Laura Ciurlionis, Charlie Chan, Ellen M Donovan, Marie A Emson, Adrian N Harnett, Joanne S Haviland, Penelope Hopwood, Monica L Jefford, Ronald Kaggwa, Elinor J Sawyer, Isabel Syndikus, Yat M Tsang, Duncan A Wheatley, Maggie Wilcox, John R Yarnold, Judith M Bliss, on behalf of the IMPORT Trialists

Citation:
Lancet, Sep 2017; vol. 390 (no. 10099); p. 1048-1060

Abstract:
Local cancer relapse risk after breast conservation surgery followed by radiotherapy has fallen sharply in many countries, and is influenced by patient age and clinicopathological factors. We hypothesise that partial-breast radiotherapy restricted to the vicinity of the original tumour in women at lower than average risk of local relapse will improve the balance of beneficial versus adverse effects compared with whole-breast radiotherapy.

Link to full-text [Open access]

The SGLT2 inhibitors - where are we now? (2017)

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Type of publication:
Journal article

Author(s):
*Morris, David

Citation:
Journal of Diabetes Nursing; Jun 2017; vol. 21 (no. 5); p. 162-167

Abstract:
Sodium–glucose cotransporter 2 (SGLT2) inhibitors are once-daily oral agents effective in treating hyperglycaemia in people with type 2 diabetes, with additional benefits including weight loss and a low risk of hypoglycaemia. This review provides a basic guide to the SGLT2 inhibitors licensed in the UK, including their mechanism of action, benefits, adverse effects and limitations, and place in treatment. Advice on avoiding the rare but serious adverse effect of diabetic ketoacidosis is also provided.

Link to full-text: http://www.thejournalofdiabetesnursing.co.uk/media/content/_master/4984/files/pdf/jdn_21-5_162-7.pdf

Obstetric complications on deployed operations: a guide for the military surgeon (2017)

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Type of publication:
Journal article

Author(s):
*Faulconer E.R.; Irani S.; Dufty N.; Bowley D.

Citation:
Journal of the Royal Army Medical Corps; Oct 2016; vol. 162 (no. 5); p. 326-329

Abstract:
Modern military general surgeons tend to train and then practice in 'conventional' surgical specialties in their home nation; however, the reality of deployed surgical practice, either in a combat zone or on a humanitarian mission, is that they are likely to have to manage patients with a broad range of ages, conditions and pathologies. Obstetric complications of war injury include injury to the uterus and fetus as well as the mother and both placental abruption and uterine rupture are complications that military surgeons may have little experience of recognising and managing. On humanitarian deployments, fetomaternal complications are a common reason for surgical intervention. We report a recent patient's story to highlight the obstetric training needs of military surgeons.

Long-term follow-up of KTP laser turbinate reduction for the treatment of obstructive rhinopathy (2017)

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Type of publication:
Journal article

Author(s):
Raja H.; Mitchell S.; Barrett G.; Sharma A.; *Skinner D.W.

Citation:
Ear, Nose and Throat Journal; 2017; vol. 96 (no. 4); p. 170-182

Abstract:
We investigated the subjective, long-term, patient-reported symptom control after endoscopic potassium titanyl phosphate (KTP) laser reduction of the inferior turbinates. Symptoms were listed preoperatively and patients were asked, via telephone interview, the status of their symptoms. Chi-square analysis was used to assess statistical significance of the surgical intervention. Thirty-six patients (male:female ratio: 5:4) aged 13 to 80 years (mean: 37.2) were available for follow-up. The mean follow-up time was 68.47 months (range: 44 to 92). The principal symptom patients experienced was nasal obstruction (94.4%); postoperative improvement in this symptom at 44 months and beyond was reported by 85.3% of patients (chi-square 16.94, p < 0.001). Other symptoms, such as rhinorrhea and sneezing, showed no significant improvement at long-term follow-up. This study adds evidence to the long-term improvements in obstructive nasal symptoms using KTP laser reduction of the turbinates.