Projects
Name
The impact of proton pump inhibitors and statins on pathological response of rectal cancer patients treated with neo-adjuvant chemoradiation followed by surgery.
University
University of Alberta
Domain
Oncology
Departement
Department of Oncology
Head
Dr. Wilson Roa
Tutor
Dr. Kurian Joseph
Languages
English
Duration
8 weeks
Availability
Cities/Months Jan Feb Mar Apr May Jun Jul Augt Sep Oct Nov Dec
No No No Yes Yes No Yes No Yes No No No
Type of Research Project
- Clinical Project without Laboratory work
What is the background of the project?
Description: In the case of colorectal cancer, surgery is the standard primary approach and has resulted in cure in approximately 50% of patients. However, neo-adjuvant Chemotherapy with concurrent radiotherapy followed by surgery is the standard treatment for locally advanced or inoperable non-metastatic rectal cancer. Generally 2 different radiotherapy treatment regimens are used at Cross Cancer Institute (CCI) (50.4 Gray over 28 days vs. 54 Gray over 30 days.). There is no study yet to define which fractionation is the best in terms of disease control and treatment related toxicity. Recent reports indicating that patients using statin for hypercholesterolemia and proton pump inhibitors for Gastroesophageal Reflux Disease (GERD) also affect outcome of treatment. We hypothesize that higher dose of radiation, use of Statin and Proton Pump Inhibitors (PPI) could improve disease control and disease outcome. This is a level III retrospective cohort study in which we retrospectively review the charts of patients with rectal cancer, treated in the province of Alberta during the period 2005-2016. Aim: 1.find out the impact of proton pump inhibitors or statins on treatment outcome . 2. to find out whether we can standardize our practice to 54 Gy over 6 weeks, provided there is no advantage of using lower doses such as 50.4Gy over 51/2 weeks Techniques: The study received research ethics approval from Local ethics board. The study has several steps. Our cancer registry provides details of patients with locally advanced or inoperable non-metastatic rectal cancer treated with neo-adjuvant chemo-radiation followed by surgery. The details include: 1. Patient demographics 2. Pathology of rectal cancer details 3. Colonoscopy details 4. Medications; special emphasis on statins, PPI intake 5. Treatment received, toxicities, radiotherapy (External Beam Radiation Therapy (EBRT)) technique, radiation dose, treatment duration, chemotherapy details include type and dose of chemotherapy, treatment breaks. 6. Surgical details, hospitalization, surgical complications, 7. Pathology details and clinical outcomes (rates of sphincter-preserving operations
What is the aim of the project?
1. To find out the impact of proton pump inhibitors or statins on treatment outcome . 2. To find out whether we can standardize our practice to 54 Gy over 6 weeks, provided there is no advantage of using lower doses such as 50.4Gy over 51/2 weeks
What techniques and methods are used?
The study received research ethics approval from Local ethics board. The study has several steps. Our cancer registry provides details of patients with locally advanced or inoperable non-metastatic rectal cancer treated with neo-adjuvant chemo-radiation followed by surgery. The details include: 1. Patient demographics 2. Pathology of rectal cancer details 3. Colonoscopy details 4. Medications; special emphasis on statins, PPI intake 5. Treatment received, toxicities, radiotherapy (External Beam Radiation Therapy (EBRT)) technique, radiation dose, treatment duration, chemotherapy details include type and dose of chemotherapy, treatment breaks. 6. Surgical details, hospitalization, surgical complications, 7. Pathology details and clinical outcomes (rates of sphincter-preserving operations Once all the information available, our statistician will analyze the data to identify the impact of Radiation dose, Statin and PPI use on outcome of patient in terms of disese control and survival.
What is the role of the student?
What are the tasks expected to be accomplished by the student?
The student is expected to familiarize with clinical or electronic charts and also how to collect vital information from clinical charts. They are expected to collect radiation dose, use of Statin and PPI of each patient during the entire period of treatment and follow up after radiotherapy and enter into the Excel data sheet. The research student also will review the electronic chart of each patient and verify the following information. A paper chart is also available. • whether patient has hypercholesterolemia and on any Statin medications • Whether patient has GERD and on PPI • Also verify the exact dose of radiotherapy received. There is no Lab work is associated.
Will there be any theoretical teaching provided (preliminary readings, lectures, courses, seminars etc)
During the period of research,we encourage the student to attend clinical rounds at the Cross Cancer Institute.
What is expected from the student at the end of the research exchange? What will be the general outcome of the student?
- The student’s name will be mentioned in a future publication
What skills are required of the student? Is there any special knowledge or a certain level of studies needed?
Previous experience with Microsoft Excel.
Are there any legal limitations in the student’s involvement
Yes
Student has to follow Alberta Health Services recommondation on medical ethics and confidentiality about patient data handling.
Hours
8
Type of students accepted
This project accepts:
- Medical students
Articles
- Banerjee R; Roxin G; Eliasziw M; Joseph K; Maclean A; Buie WD; Doll C.. The prognostic significance of pre-treatment leukocytosis in patients with anal cancer treated with radical chemoradiotherapy or radiotherapy. Dis Colon Rectum. 2013 Sep; 56(9):1036-42.