Anne Lee - Academia.edu (original) (raw)
Papers by Anne Lee
International Journal of Radiation Oncology*Biology*Physics, 2019
Annals of Palliative Medicine, 2020
International Journal of Radiation Oncology*Biology*Physics, 2019
Hong Kong medical journal = Xianggang yi xue za zhi / Hong Kong Academy of Medicine, 2002
To study the clinical outcomes of patients with invasive or non-invasive breast cancer after brea... more To study the clinical outcomes of patients with invasive or non-invasive breast cancer after breast conservation treatment. Retrospective study. Clinical oncology department of a public hospital, Hong Kong. Two hundred and three patients who received postlumpectomy radiotherapy at the Pamela Youde Nethersole Eastern Hospital between January 1994 and June 1999. Adjuvant radiotherapy with or without systemic adjuvant treatment. Actuarial local control rate, progression-free survival rate, disease-specific survival rate, and cosmetic score. The median follow-up was 3.5 years. Two of the 25 patients with carcinoma in situ only developed local recurrence; the 5-year actuarial local control rate was 91.3%. Among the 178 patients with invasive cancer, seven had a local recurrence and 12 developed distant metastases without local failure. The 5-year actuarial local control, progression-free survival, and disease-specific survival rates for patients with invasive cancer were 95.5%, 85.8%, an...
Hong Kong medical journal = Xianggang yi xue za zhi / Hong Kong Academy of Medicine, 2010
Delayed presentation is an important obstacle to improving cancer treatment outcomes. We aimed to... more Delayed presentation is an important obstacle to improving cancer treatment outcomes. We aimed to study the magnitude of this problem in Hong Kong and the factors associated with delayed presentation of patients with symptomatic breast cancers. Retrospective study using self-administered questionnaires. Clinical Oncology Department in a regional public hospital in Hong Kong. A total of 158 Chinese women with breast cancer referred to our hospital between October 2006 and December 2007 consented to participate in this study. Among these, 59 (37%) patients were referred after having surgery in private sector. The mean total delay (from first symptom to treatment) was 22 weeks. The mean patient delay (from first symptom to first consultation) was 13 weeks, constituting the largest component (60%) of the total delay. After symptom onset, the delay exceeded 12 weeks for consulting a doctor in 29%, and for receipt of treatment in 52% of them. Low family income (<HK$5000 per month; P<...
Hong Kong medical journal = Xianggang yi xue za zhi / Hong Kong Academy of Medicine, 2012
OBJECTIVE. To evaluate the clinical outcome and safety of stereotactic ablative radiotherapy for ... more OBJECTIVE. To evaluate the clinical outcome and safety of stereotactic ablative radiotherapy for medically inoperable stage I non-small-cell lung carcinoma. DESIGN. Retrospective case series. SETTING. Pamela Youde Nethersole Eastern Hospital, Hong Kong. PATIENTS. All patients with medically inoperable stage I non-small-cell lung carcinoma receiving stereotactic ablative radiotherapy since its establishment in 2008. MAIN OUTCOME MEASURES. Disease control rate, overall survival, and treatment toxicities. RESULTS. Sixteen stage I non-small-cell lung carcinoma patients underwent the procedure from June 2008 to November 2011. The median patient age was 82 years and the majority (81%) had moderate-to-severe co-morbidity based on the Adult Comorbidity Evaluation 27 index. With a median follow-up of 22 months, the 2-year primary tumour control rate, disease-free survival and overall survival rates were 91%, 71% and 87%, respectively. No grade 3 (National Cancer Institute Common Terminology ...
BMC Cancer, 2011
Background XELOX (capecitabine + oxaliplatin) and FOLFOX 4 (5-FU + folinic acid + oxaliplatin) ha... more Background XELOX (capecitabine + oxaliplatin) and FOLFOX 4 (5-FU + folinic acid + oxaliplatin) have shown similar improvements in survival in patients with metastatic colorectal cancer (MCRC). A US cost-minimization study found that the two regimens had similar costs from a healthcare provider perspective but XELOX had lower costs than FOLFOX4 from a societal perspective, while a Japanese cost-effectiveness study found XELOX had superior cost-effectiveness. This study compared the costs of XELOX and FOLFOX4 in patients with MCRC recently treated in two oncology departments in Hong Kong. Methods Cost data were collected from the medical records of 60 consecutive patients (30 received XELOX and 30 FOLFOX4) from two hospitals. Drug costs, outpatient visits, hospital days and investigations were recorded and expressed as cost per patient from the healthcare provider perspective. Estimated travel and time costs were included in a societal perspective analysis. All costs were classed as e...
Hong Kong medical journal = Xianggang yi xue za zhi / Hong Kong Academy of Medicine, 1998
This is a descriptive study of 168 patients with nasopharyngeal carcinoma who were referred to pu... more This is a descriptive study of 168 patients with nasopharyngeal carcinoma who were referred to public oncology departments for primary treatment between July and September 1996. The mean duration from the onset of the symptoms to histological diagnosis was 5.0 months; the duration ranged from 6.1 months (for patients presenting with nasal symptoms) to 1.8 months (for those with cranial nerve dysfunction). The mean period between the onset of symptoms and the seeking of medical advice was 2.9months. For 54% of the patients, there was a further delay of up to 2.4 months between the initial medical consultation and referral to the appropriate specialist. The majority (84%) of patients attended public institutions for histological confirmation. The mean total time taken from the onset of symptoms to the commencement of radiotherapy was 6.5 months (range, 1.3-74.0 months)---45% of the delay was attributed to the patient, 20% to initial consultations, 14% to diagnostic arrangement, and 21...
American Journal of Clinical Oncology, 2005
Chinese clinical oncology, 2016
Since its establishment in 1957, the International Atomic Energy Agency (IAEA) has striven to pro... more Since its establishment in 1957, the International Atomic Energy Agency (IAEA) has striven to promote global access to reliable and affordable radiotherapy, with much of its latest focus being in developing countries. While nasopharyngeal cancer (NPC) is highly curable by radiotherapy with excellent outcomes in developed countries, the outcomes in low- and middle-income countries (LMICs) are disappointing. Although the reasons for this are complex and multifactorial, improving the accessibility and quality of radiotherapy in these countries is fundamental. With concerted effort from experts and advocates around the world, ongoing initiatives are supported by the IAEA to combat the challenges in LMICs.
Hong Kong medical journal = Xianggang yi xue za zhi / Hong Kong Academy of Medicine, 2009
It has been proposed that young women should not be treated by breast conservation treatment beca... more It has been proposed that young women should not be treated by breast conservation treatment because of a higher risk of local recurrences and worse survival. We therefore examined whether breast conservation treatment in young Chinese women yielded inferior clinical outcomes compared to modified radical mastectomy. Retrospective study. Clinical oncology department in a public hospital in Hong Kong. A total of 258 Chinese women with invasive breast cancer, aged below 40 years, and referred between January 1994 and July 2006. A total of 124 (48%) and 134 (52%) patients were treated by breast conservation treatment and modified radical mastectomy, respectively. Mastectomy patients tended to have larger primary tumours (P<0.001) and more nodal involvement (P<0.001). At a median follow-up of 6.5 years, there was no significant difference in the local failure-free survival rate (92% vs 93%, P=0.324) and loco-regional failure-free survival rate (89% vs 88%, P=0.721) in patients havi...
Journal of Clinical Oncology, 2005
Purpose This randomized study compared the results achieved by concurrent chemoradiotherapy (CRT)... more Purpose This randomized study compared the results achieved by concurrent chemoradiotherapy (CRT) versus radiotherapy (RT) alone for nasopharyngeal carcinoma (NPC) with advanced nodal disease. Patients and Methods Patients with nonkeratinizing/undifferentiated NPC staged T1-4N2-3M0 were randomized to CRT or RT. Both arms were treated with the same RT technique and dose fractionation. The CRT patients were given cisplatin 100 mg/m2 on days 1, 22, and 43, followed by cisplatin 80 mg/m2 and fluorouracil 1,000 mg/m2/d for 96 hours starting on days 71, 99, and 127. Results From 1999 to January 2004, 348 eligible patients were randomly assigned; the median follow-up was 2.3 years. The two arms were well-balanced in all prognostic factors and RT parameters. The CRT arm achieved significantly higher failure-free survival (72% v 62% at 3-year, P = .027), mostly as a result of an improvement in locoregional control (92% v 82%, P = .005). However, distant control did not improve significantly ...
Radiotherapy and Oncology, 2014
Frontiers in oncology, 2018
Strahlentherapie und Onkologie : Organ der Deutschen Rontgengesellschaft ... [et al], Aug 20, 2018
To review the current aspects of knowledge related to the risk of cerebrovascular events in patie... more To review the current aspects of knowledge related to the risk of cerebrovascular events in patients receiving head and neck radiotherapy. A literature search was performed in PubMed. Papers meeting selection criteria were reviewed. We provide an update on the problem by identifying key studies that have contributed to our current understanding of the epidemiology, radiologic features, pathogenesis, and treatment of the disease. The incidence of carotid artery stenosis ranged from 18 to 38% in patients who underwent radiotherapy for head and neck cancer versus from 0 to 9.2% among the nonirradiated patients. Neck irradiation increases the intima-media thickness of the carotid artery wall. These changes are the earliest visible alteration in the carotid wall and are also detected with color Doppler ultrasonography. Endovascular treatment with a carotid angioplasty and stenting is the first-line treatment for most symptomatic patients. Radiation-induced atherosclerosis is a different ...
International Journal of Radiation Oncology*Biology*Physics, 2019
Annals of Palliative Medicine, 2020
International Journal of Radiation Oncology*Biology*Physics, 2019
Hong Kong medical journal = Xianggang yi xue za zhi / Hong Kong Academy of Medicine, 2002
To study the clinical outcomes of patients with invasive or non-invasive breast cancer after brea... more To study the clinical outcomes of patients with invasive or non-invasive breast cancer after breast conservation treatment. Retrospective study. Clinical oncology department of a public hospital, Hong Kong. Two hundred and three patients who received postlumpectomy radiotherapy at the Pamela Youde Nethersole Eastern Hospital between January 1994 and June 1999. Adjuvant radiotherapy with or without systemic adjuvant treatment. Actuarial local control rate, progression-free survival rate, disease-specific survival rate, and cosmetic score. The median follow-up was 3.5 years. Two of the 25 patients with carcinoma in situ only developed local recurrence; the 5-year actuarial local control rate was 91.3%. Among the 178 patients with invasive cancer, seven had a local recurrence and 12 developed distant metastases without local failure. The 5-year actuarial local control, progression-free survival, and disease-specific survival rates for patients with invasive cancer were 95.5%, 85.8%, an...
Hong Kong medical journal = Xianggang yi xue za zhi / Hong Kong Academy of Medicine, 2010
Delayed presentation is an important obstacle to improving cancer treatment outcomes. We aimed to... more Delayed presentation is an important obstacle to improving cancer treatment outcomes. We aimed to study the magnitude of this problem in Hong Kong and the factors associated with delayed presentation of patients with symptomatic breast cancers. Retrospective study using self-administered questionnaires. Clinical Oncology Department in a regional public hospital in Hong Kong. A total of 158 Chinese women with breast cancer referred to our hospital between October 2006 and December 2007 consented to participate in this study. Among these, 59 (37%) patients were referred after having surgery in private sector. The mean total delay (from first symptom to treatment) was 22 weeks. The mean patient delay (from first symptom to first consultation) was 13 weeks, constituting the largest component (60%) of the total delay. After symptom onset, the delay exceeded 12 weeks for consulting a doctor in 29%, and for receipt of treatment in 52% of them. Low family income (<HK$5000 per month; P<...
Hong Kong medical journal = Xianggang yi xue za zhi / Hong Kong Academy of Medicine, 2012
OBJECTIVE. To evaluate the clinical outcome and safety of stereotactic ablative radiotherapy for ... more OBJECTIVE. To evaluate the clinical outcome and safety of stereotactic ablative radiotherapy for medically inoperable stage I non-small-cell lung carcinoma. DESIGN. Retrospective case series. SETTING. Pamela Youde Nethersole Eastern Hospital, Hong Kong. PATIENTS. All patients with medically inoperable stage I non-small-cell lung carcinoma receiving stereotactic ablative radiotherapy since its establishment in 2008. MAIN OUTCOME MEASURES. Disease control rate, overall survival, and treatment toxicities. RESULTS. Sixteen stage I non-small-cell lung carcinoma patients underwent the procedure from June 2008 to November 2011. The median patient age was 82 years and the majority (81%) had moderate-to-severe co-morbidity based on the Adult Comorbidity Evaluation 27 index. With a median follow-up of 22 months, the 2-year primary tumour control rate, disease-free survival and overall survival rates were 91%, 71% and 87%, respectively. No grade 3 (National Cancer Institute Common Terminology ...
BMC Cancer, 2011
Background XELOX (capecitabine + oxaliplatin) and FOLFOX 4 (5-FU + folinic acid + oxaliplatin) ha... more Background XELOX (capecitabine + oxaliplatin) and FOLFOX 4 (5-FU + folinic acid + oxaliplatin) have shown similar improvements in survival in patients with metastatic colorectal cancer (MCRC). A US cost-minimization study found that the two regimens had similar costs from a healthcare provider perspective but XELOX had lower costs than FOLFOX4 from a societal perspective, while a Japanese cost-effectiveness study found XELOX had superior cost-effectiveness. This study compared the costs of XELOX and FOLFOX4 in patients with MCRC recently treated in two oncology departments in Hong Kong. Methods Cost data were collected from the medical records of 60 consecutive patients (30 received XELOX and 30 FOLFOX4) from two hospitals. Drug costs, outpatient visits, hospital days and investigations were recorded and expressed as cost per patient from the healthcare provider perspective. Estimated travel and time costs were included in a societal perspective analysis. All costs were classed as e...
Hong Kong medical journal = Xianggang yi xue za zhi / Hong Kong Academy of Medicine, 1998
This is a descriptive study of 168 patients with nasopharyngeal carcinoma who were referred to pu... more This is a descriptive study of 168 patients with nasopharyngeal carcinoma who were referred to public oncology departments for primary treatment between July and September 1996. The mean duration from the onset of the symptoms to histological diagnosis was 5.0 months; the duration ranged from 6.1 months (for patients presenting with nasal symptoms) to 1.8 months (for those with cranial nerve dysfunction). The mean period between the onset of symptoms and the seeking of medical advice was 2.9months. For 54% of the patients, there was a further delay of up to 2.4 months between the initial medical consultation and referral to the appropriate specialist. The majority (84%) of patients attended public institutions for histological confirmation. The mean total time taken from the onset of symptoms to the commencement of radiotherapy was 6.5 months (range, 1.3-74.0 months)---45% of the delay was attributed to the patient, 20% to initial consultations, 14% to diagnostic arrangement, and 21...
American Journal of Clinical Oncology, 2005
Chinese clinical oncology, 2016
Since its establishment in 1957, the International Atomic Energy Agency (IAEA) has striven to pro... more Since its establishment in 1957, the International Atomic Energy Agency (IAEA) has striven to promote global access to reliable and affordable radiotherapy, with much of its latest focus being in developing countries. While nasopharyngeal cancer (NPC) is highly curable by radiotherapy with excellent outcomes in developed countries, the outcomes in low- and middle-income countries (LMICs) are disappointing. Although the reasons for this are complex and multifactorial, improving the accessibility and quality of radiotherapy in these countries is fundamental. With concerted effort from experts and advocates around the world, ongoing initiatives are supported by the IAEA to combat the challenges in LMICs.
Hong Kong medical journal = Xianggang yi xue za zhi / Hong Kong Academy of Medicine, 2009
It has been proposed that young women should not be treated by breast conservation treatment beca... more It has been proposed that young women should not be treated by breast conservation treatment because of a higher risk of local recurrences and worse survival. We therefore examined whether breast conservation treatment in young Chinese women yielded inferior clinical outcomes compared to modified radical mastectomy. Retrospective study. Clinical oncology department in a public hospital in Hong Kong. A total of 258 Chinese women with invasive breast cancer, aged below 40 years, and referred between January 1994 and July 2006. A total of 124 (48%) and 134 (52%) patients were treated by breast conservation treatment and modified radical mastectomy, respectively. Mastectomy patients tended to have larger primary tumours (P<0.001) and more nodal involvement (P<0.001). At a median follow-up of 6.5 years, there was no significant difference in the local failure-free survival rate (92% vs 93%, P=0.324) and loco-regional failure-free survival rate (89% vs 88%, P=0.721) in patients havi...
Journal of Clinical Oncology, 2005
Purpose This randomized study compared the results achieved by concurrent chemoradiotherapy (CRT)... more Purpose This randomized study compared the results achieved by concurrent chemoradiotherapy (CRT) versus radiotherapy (RT) alone for nasopharyngeal carcinoma (NPC) with advanced nodal disease. Patients and Methods Patients with nonkeratinizing/undifferentiated NPC staged T1-4N2-3M0 were randomized to CRT or RT. Both arms were treated with the same RT technique and dose fractionation. The CRT patients were given cisplatin 100 mg/m2 on days 1, 22, and 43, followed by cisplatin 80 mg/m2 and fluorouracil 1,000 mg/m2/d for 96 hours starting on days 71, 99, and 127. Results From 1999 to January 2004, 348 eligible patients were randomly assigned; the median follow-up was 2.3 years. The two arms were well-balanced in all prognostic factors and RT parameters. The CRT arm achieved significantly higher failure-free survival (72% v 62% at 3-year, P = .027), mostly as a result of an improvement in locoregional control (92% v 82%, P = .005). However, distant control did not improve significantly ...
Radiotherapy and Oncology, 2014
Frontiers in oncology, 2018
Strahlentherapie und Onkologie : Organ der Deutschen Rontgengesellschaft ... [et al], Aug 20, 2018
To review the current aspects of knowledge related to the risk of cerebrovascular events in patie... more To review the current aspects of knowledge related to the risk of cerebrovascular events in patients receiving head and neck radiotherapy. A literature search was performed in PubMed. Papers meeting selection criteria were reviewed. We provide an update on the problem by identifying key studies that have contributed to our current understanding of the epidemiology, radiologic features, pathogenesis, and treatment of the disease. The incidence of carotid artery stenosis ranged from 18 to 38% in patients who underwent radiotherapy for head and neck cancer versus from 0 to 9.2% among the nonirradiated patients. Neck irradiation increases the intima-media thickness of the carotid artery wall. These changes are the earliest visible alteration in the carotid wall and are also detected with color Doppler ultrasonography. Endovascular treatment with a carotid angioplasty and stenting is the first-line treatment for most symptomatic patients. Radiation-induced atherosclerosis is a different ...