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Celebration of the work of a pioneer: The Frank Ellis medal
Clinical Oncology (1995) 7:71 © 1995 The Royal College of Radiologists
1 4. JUN 95
Editorial
Clinical Oncology
S
Celebration of the W o r k of a Pioneer: The Frank Ellis Medal G. M. Duchesne Assistant Editor (Editorials), The Middlesex Hospital, London, UK
During the London Part I FRCR course in the early 1980s, we prospective radiotherapists were introduced to the concept of the nominal standard dose and its associated formula, bearing the eponym 'Ellis', which provided a rational basis to explain the relationships between time, dose and fractionation. I think that few of us realized, at the time we were struggling to come to grips with the concept, the significance of the name attached to it, but, as persistant effort brought a degree of enlightenment, we discerned that it was not just a name or a formula. Despite retirement, Frank Ellis continued, and continues to lead, lively debate on all matters radiobiological, and his name is frequently to be seen in the correspondence columns of the relevant journals. Last year, it was suggested that the most appropriate way the Faculty of Clinical Oncologists could honour Frank Ellis would be to create an annual award in his name. This will be awarded to the authors of the paper judged to have made the best contribution to advancing the cause of science in
cancer treatment (excluding reviews and case reports) published in Clinical Oncology over the preceding year. The award will be made to all the authors of the paper, and will be accompanied by a medal inscribed with the name of the first author, who will be invited to receive the award at the November 'Admission of New Fellows' ceremony. The first award was made to K. H. Pigott, S. Dische and M. I. Saunders in November 1994, for their paper 'The long term outcome after radical radiotherapy for advanced head and neck cancer' [1]. The abstract of his paper is presented below. This paper sets a most fitting standard for this prestigious award, and will encourage the increasing submission of first class articles to the Journal.
Abstract. The patterns of local failure, salvage treatment, metastasis, second primary tumour and intercurrent disease are observed in 99 patients with advanced head and neck tumours, who were entered into the pilot study of CHART. The patients were treated between January 1985 and March 1990 and have a median follow-up of 59 months. All patients presented with squamous cell carcinoma of one of the major sites in the head and neck region, with 85% having T3-4 and/or N3 stage disease. Complete regression of locoregional disease was achieved in 89% of patients, but this fell to 49% at 5 years, 95% of those relapsing did so in the first 24 months. Using univariant analysis, N-stage influenced local tumour control, with No disease having a 5-year local tumour control rate of 62% compared with 33% for N+ disease. Local tumour control was not influenced by T-stage due to the disporportionate number of patients with T1-2 tumours who had nodal disease.
Three of the 11 patients with residual disease underwent salvage therapy with surgery or further radiation; but failed to obtain local tumour control. Of the 39 patients judged to have recurrent diease two had no histological evidence of tumour when surgery was performed. Of the 21 who had salvage surgery 13 maintained local tumour control to last follow-up or death. Distant metastases occurred in 11 patients, all of whom also showed local failure. Thirteen of the 99 patients developed second primary tumours; these occurred most frequently after treatment for oral cavity tumours. Life-table analysis showed that the overall 5-year survival rate was 36%, with a diseasefree survival of 57 %. Local recurrence and metastases were responsible for 54% of deaths, and intercurrent disease or second primary tumours for 41%. Careful follow-up of patients with head and neck cancer allows early diagnosis of local recurrence, second primaries and intercurrent disease.
References 1. Pigott KH, Dische S, Saunders MI. The long term outcome after radical radiotherapy for advanced head and neck cancer. Clin Oncol 1993;5:343-9.
1 4. JUN 95
Editorial
Clinical Oncology
S
Celebration of the W o r k of a Pioneer: The Frank Ellis Medal G. M. Duchesne Assistant Editor (Editorials), The Middlesex Hospital, London, UK
During the London Part I FRCR course in the early 1980s, we prospective radiotherapists were introduced to the concept of the nominal standard dose and its associated formula, bearing the eponym 'Ellis', which provided a rational basis to explain the relationships between time, dose and fractionation. I think that few of us realized, at the time we were struggling to come to grips with the concept, the significance of the name attached to it, but, as persistant effort brought a degree of enlightenment, we discerned that it was not just a name or a formula. Despite retirement, Frank Ellis continued, and continues to lead, lively debate on all matters radiobiological, and his name is frequently to be seen in the correspondence columns of the relevant journals. Last year, it was suggested that the most appropriate way the Faculty of Clinical Oncologists could honour Frank Ellis would be to create an annual award in his name. This will be awarded to the authors of the paper judged to have made the best contribution to advancing the cause of science in
cancer treatment (excluding reviews and case reports) published in Clinical Oncology over the preceding year. The award will be made to all the authors of the paper, and will be accompanied by a medal inscribed with the name of the first author, who will be invited to receive the award at the November 'Admission of New Fellows' ceremony. The first award was made to K. H. Pigott, S. Dische and M. I. Saunders in November 1994, for their paper 'The long term outcome after radical radiotherapy for advanced head and neck cancer' [1]. The abstract of his paper is presented below. This paper sets a most fitting standard for this prestigious award, and will encourage the increasing submission of first class articles to the Journal.
Abstract. The patterns of local failure, salvage treatment, metastasis, second primary tumour and intercurrent disease are observed in 99 patients with advanced head and neck tumours, who were entered into the pilot study of CHART. The patients were treated between January 1985 and March 1990 and have a median follow-up of 59 months. All patients presented with squamous cell carcinoma of one of the major sites in the head and neck region, with 85% having T3-4 and/or N3 stage disease. Complete regression of locoregional disease was achieved in 89% of patients, but this fell to 49% at 5 years, 95% of those relapsing did so in the first 24 months. Using univariant analysis, N-stage influenced local tumour control, with No disease having a 5-year local tumour control rate of 62% compared with 33% for N+ disease. Local tumour control was not influenced by T-stage due to the disporportionate number of patients with T1-2 tumours who had nodal disease.
Three of the 11 patients with residual disease underwent salvage therapy with surgery or further radiation; but failed to obtain local tumour control. Of the 39 patients judged to have recurrent diease two had no histological evidence of tumour when surgery was performed. Of the 21 who had salvage surgery 13 maintained local tumour control to last follow-up or death. Distant metastases occurred in 11 patients, all of whom also showed local failure. Thirteen of the 99 patients developed second primary tumours; these occurred most frequently after treatment for oral cavity tumours. Life-table analysis showed that the overall 5-year survival rate was 36%, with a diseasefree survival of 57 %. Local recurrence and metastases were responsible for 54% of deaths, and intercurrent disease or second primary tumours for 41%. Careful follow-up of patients with head and neck cancer allows early diagnosis of local recurrence, second primaries and intercurrent disease.
References 1. Pigott KH, Dische S, Saunders MI. The long term outcome after radical radiotherapy for advanced head and neck cancer. Clin Oncol 1993;5:343-9.