Four projects totaling $327,671 were awarded funding in the 2021 edition of the Rossy Cancer Network's CQI Research Fund competition.
Radiation Oncology - Prostate Cancer
Stool volume and flatulance-reducing diet in patients with prostate cancer undergoing pelvis radiotherapy. A Randomized phase II study
Radiotherapy is an effective treatment for patients with localized prostate cancer. One potential consequence of pelvic radiotherapy is the effect it may have in the gastro-intestinal tract and, in particular, the rectal region. Although accurate and precise radiotherapy delivery is planned prior to initiation of radiotherapy, changes in rectal volume due to stool or gas accumulation during the radiotherapy course introduce important variation in the volume of the organ that ultimately receives a higher dose of irradiation than originally planned leading to a higher, unexpected rate of rectal toxicity. Controlling this variation of the rectal volume via a stool and gas-reducing diet may limit the rectal volume variation with subsequent improvement in rectal toxicity. This project will study whether stabilization of rectal volume with a balanced diet reduces gastro-intestinal toxicity with a positive impact on patients’ quality of life.
Fabio Cury will lead an MUHC-JGH team including co-investigators, Tamim Niazi, Nancy Heppell and John Kildea as well as collaborators, Heather Nathens and Luis Souhami.
Survivorship and Symptom Control - Breast Cancer
A prospective, observational registry of breast cancer survivors with chemotherapy-induced peripheral neuropathy: the medical cannabis and exercise study (CANNEX)
Chemotherapy-induced peripheral neuropathy (CIPN) affects nearly 80% of women following treatment for breast cancer. Patients may experience pain and/or numbness in the hands and feet and usually try a series of analgesics, which are only partially effective. Exercise and medical cannabis may improve pain and symptoms related to CIPN. Therefore, patients from both the McGill University Health Center and the Jewish General Hospital, will have access to both medical cannabis and exercise if they have received optimal medical management without sufficient relief from CIPN. The goal of this observational study is to document the safety and effectiveness of both medical cannabis and exercise offered to breast cancer survivors who failed to have their taxane-induced peripheral neuropathy symptoms controlled by standard pharmacological treatment. Inflammatory mediators and the stool microbiome will be assessed pre- and post-implementation of a medical cannabis and exercise program.
Antonio Vigano will lead an MUHC-JGH-McGill team including co-investigators, Cecilia Costiniuk, Houman Farzin, Jianguo (Jeff) Xia, Jordi Perez, Anna Towers and Claude Cyr, as well as Robert Kilgour from Concordia University.
Medical Physics/Radiation Oncology - Head and Neck Cancer
Development and evaluation of a novel artificial intelligence model to predict radiotherapy replanning for head and neck cancer
Radiotherapy is an established and effective modality for the treatment of head and neck cancer that has advanced over recent decades due to important technological improvements. But these improvements render radiotherapy more sensitive to anatomical changes in the head and neck region, often necessitating resource-intensive replanning as the tumour shrinks and the patient loses weight. If replanning decisions are made ad hoc, as is currently standard practice, ill-timed replanning can result in sub-optimal treatments for the individual patient and cause knock-on workflow disruptions that affect multiple other patients. Therefore, a solution to predict when head and neck cancer patients will require radiotherapy replanning, allowing it to be pre-emptively scheduled, is needed. In this project, we will harness the unique expertise and preliminary work of our multi-professional team to develop and evaluate such a solution in the form of a novel machine learning predictive model. Our solution offers the potential not only to improve the treatment of individual head and neck cancer patients within the RCN but to improve the overall radiotherapy planning workflows at the Cedars and Segal Cancer Centres.
John Kildea will lead an MUHC-JGH team including co-investigators, George Shenouda, Khalil Sultanem and Julia Khriguian.
Psychosocial Oncology
Adoption and Diffusion of Clinical Practice Guidelines in Psychosocial Oncology
Stakeholders in psychosocial oncology have voiced concerns over the failure to use evidence-based interventions. Clinical practice guidelines synthesize the available evidence into recommendations for clinical practice. But they are only beneficial if the guideline is accessible and of good quality. Little is known about the accessibility and quality of practice guidelines for psychosocial oncology and about barriers to guideline use at the clinician level. We will determine effective search strategies for locating guidelines. Guideline quality will be assessed with an internationally endorsed, valid tool. Guidelines and quality results will be made available at our ‘one-stop-shop’ online platform. We will survey clinicians regarding usage of and barriers to guideline adoption. We will develop clinician-focused education materials on how to find future guidelines, how to estimate their quality, and how to implement them into their best-practice care. Training workshops and online resources in multiple engaging and interactive formats will empower clinicians and promote best practices locally and across Canada. Identifying potential shortcomings of current guidelines will inform the development of future high-quality guidelines. Access to guidelines and quality evaluations will facilitate the uptake of more effective interventions and as such improve patient outcomes at the Rossy Cancer Network and beyond.
Annett Körner will lead an MUHC-JGH-McGill team including co-investigator, Carmen Loiselle, and collaborators, Martin Drapeau, Christine Bouchard and Karine Lepage.