Publications by authors named "R Paul Symonds"

140 Publications

External Validation of a Predictive Model for Acute Skin Radiation Toxicity in the REQUITE Breast Cohort.

Front Oncol 2020 30;10:575909. Epub 2020 Oct 30.

Translational Radiobiology Group, Division of Cancer Sciences, University of Manchester, Manchester Academic Health Science Centre, The Christie NHS Foundation Trust, Manchester, United Kingdom.

Acute skin toxicity is a common and usually transient side-effect of breast radiotherapy although, if sufficiently severe, it can affect breast cosmesis, aftercare costs and the patient's quality-of-life. The aim of this study was to develop predictive models for acute skin toxicity using published risk factors and externally validate the models in patients recruited into the prospective multi-center REQUITE (validating pREdictive models and biomarkers of radiotherapy toxicity to reduce side-effects and improve QUalITy of lifE in cancer survivors) study. Patient and treatment-related risk factors significantly associated with acute breast radiation toxicity on multivariate analysis were identified in the literature. These predictors were used to develop risk models for acute erythema and acute desquamation (skin loss) in three Radiogenomics Consortium cohorts of patients treated by breast-conserving surgery and whole breast external beam radiotherapy ( = 2,031). The models were externally validated in the REQUITE breast cancer cohort ( = 2,057). The final risk model for acute erythema included BMI, breast size, hypo-fractionation, boost, tamoxifen use and smoking status. This model was validated in REQUITE with moderate discrimination (AUC 0.65), calibration and agreement between predicted and observed toxicity (Brier score 0.17). The risk model for acute desquamation, excluding the predictor tamoxifen use, failed to validate in the REQUITE cohort. While most published prediction research in the field has focused on model development, this study reports successful external validation of a predictive model using clinical risk factors for acute erythema following radiotherapy after breast-conserving surgery. This model retained discriminatory power but will benefit from further re-calibration. A similar model to predict acute desquamation failed to validate in the REQUITE cohort. Future improvements and more accurate predictions are expected through the addition of genetic markers and application of other modeling and machine learning techniques.
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http://dx.doi.org/10.3389/fonc.2020.575909DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7664984PMC
October 2020

Video consultations in UK primary care in response to the COVID-19 pandemic.

Br J Gen Pract 2020 05 30;70(694):228-229. Epub 2020 Apr 30.

Liskeard; Cornwall Clinical Research Group, Cornwall. Email:

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http://dx.doi.org/10.3399/bjgp20X709505DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7194766PMC
May 2020

The FPM International Awards for Medical Writing in Social Media: a step in the right direction.

Postgrad Med J 2020 05 2;96(1135):304. Epub 2020 Apr 2.

Oak Tree Surgery, Liskeard, Cornwall, UK.

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http://dx.doi.org/10.1136/postgradmedj-2020-137772DOI Listing
May 2020

Building research capacity in primary care.

Br J Gen Pract 2020 04 26;70(693):168. Epub 2020 Mar 26.

Oak Tree Surgery.

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http://dx.doi.org/10.3399/bjgp20X709313DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7098529PMC
April 2020