Jeremy Laurence Millar

Jeremy Laurence Millar
Alfred Hospital · Department of Radiation Oncology

BMedSci, MB, ChB, FRANZCR, FACPMed

About

301
Publications
14,724
Reads
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6,630
Citations
Citations since 2016
145 Research Items
3717 Citations
20162017201820192020202120220100200300400500600
20162017201820192020202120220100200300400500600
20162017201820192020202120220100200300400500600
20162017201820192020202120220100200300400500600
Additional affiliations
March 2013 - present
Cancer Council Victoria
Position
  • Board Member & Chair Clinical Network
August 1993 - present
Alfred Hospital
Position
  • Managing Director
January 1982 - August 1991
Wellington Hospital
Position
  • Medical Doctor

Publications

Publications (301)
Article
Background and objective Radical prostatectomy (RP) is a common and widely used treatment for localized prostate cancer. Sequela following RP may include urinary incontinence and sexual dysfunction, outcomes which are recorded within a bi-national Prostate Cancer Outcomes Registry. The objective was to report population-wide urinary incontinence an...
Article
Introduction: Quality indicators (QIs) are metrics which seek to allow comparison of clinicians' and institutes' practice to best evidence-based practice. The Australia and New Zealand Prostate Cancer Outcomes Registry (PCOR-ANZ) is a bi-national clinical quality registry with coverage estimated to be over 60% of the men newly diagnosed with prost...
Article
Context: Positive surgical margin (PSM) on radical prostatectomy (RP) is associated with an increased risk of biochemical recurrence and use of salvage therapies. Given these adverse consequences, exploration of time trends and predictors of PSM will improve the patient outcomes following surgery for prostate cancer. Methods: Pathological data f...
Article
The use of PSA screening has led to downstaging and downgrading of prostate cancer at diagnosis, increasing detection of indolent disease. Active surveillance aims to reduce over-treatment by delaying or avoiding radical treatment and its associated morbidity. However there is not a consensus on the selection criteria and monitoring schedules that...
Article
Full-text available
Background and purpose We aimed to evaluate utilisation of brachytherapy (BT) boost in men who had external beam radiation therapy (EBRT) for prostate cancer, and to compare patient-reported functional outcomes (PRO) following each approach in a population-based setting in Australia. Materials and methods This is a population-based cohort of men w...
Article
Strict quality control and vigilance at every step is essential to maintain rigour and ensure quality and safety in radiation oncology. The scientific knowledge and technological capabilities we possess give us enormous power to deliver specialised and complex treatments and improve health outcomes for our cancer patients. However, this requires de...
Article
Full-text available
Quality Indicators, based on clinical practice guidelines, have been used in medicine and within oncology to measure quality of care for over twenty years. However, radiation oncology quality indicators are sparse. This article describes the background to the development of current national and international, general and tumour site‐specific radiat...
Article
Peer review is a part of high quality care within radiation oncology, designed to achieve the best outcomes for patients. We discuss the importance of and evidence for peer review in clinical practice. The Royal Australia and New Zealand College of Radiologists (RANZCR) has evolved a Peer Review Assessment Tool (PRAT) since 1999. We report the resu...
Article
Full-text available
Introduction: To describe the pattern of the use of advanced radiation therapy (RT) techniques, including intensity-modulated RT (IMRT), volumetric modulated arc therapy (VMAT), and stereotactic body RT (SBRT) for the management of bone metastases (BM), and the associated factors in Victoria. Methods: We used a population-based cohort of patient...
Article
Aim: To describe the establishment of a national prostate cancer clinical quality registry (PCOR-NZ) within the New Zealand healthcare system and discuss the challenges encountered and achievements obtained during its development. Additionally, to provide a descriptive snapshot of the patients enrolled thus far. Methods: A review of the processe...
Article
Introduction The aim of this study was to evaluate the use of post-mastectomy hypofractionationed radiation therapy (HFRT) for breast cancer in Victoria, Australia. Methods This is a population-based cohort of women with breast cancer who received post-mastectomy RT to the chest wall with or without nodal irradiation between 2012 and 2017. HFRT wa...
Article
Objective: Feeling depressed and lethargic are common side effects of prostate cancer (PCa) and its treatments. We examined the incidence and severity of feeling depressed and lack of energy in patients in a population based PCa registry. Methods: We included men diagnosed with PCa between 2015 and 2019 in Victoria, Australia, and enrolled in th...
Article
Aims Radiation therapy is an effective treatment for bone metastases. Single-fraction conformal radiation therapy (SF-CRT) is equally effective as multifraction radiation therapy for the management of uncomplicated bone metastases. There has been a rapid development of advanced radiation therapy techniques (ART) in radiation oncology. We evaluated...
Article
Introduction: To evaluate the pattern of use of single-fraction conformal radiation therapy (SF-RT) and advanced radiation therapy techniques (ART), including stereotactic body radiation therapy (SBRT), for management of bone metastases (BM) in a population-based cohort of Australian men with prostate cancer (PCa) PATIENT AND METHODS: We reviewed...
Article
Introduction The Australian Council on Healthcare Standards (ACHS) sponsored an expert-led, consensus-driven, four-stage process, based on a modified Delphi methodology, to determine a set of clinical indicators as quality measures of cancer service provision in Australia. This was done in response to requests from institutional health care provide...
Article
e18531 Background: Prostate cancer patients generally have good survival outcomes, but some survivors have poor functional outcomes with persisting symptoms and poor quality of life (QoL). Socio-economic status (SES), access to specialist care and place of residence (including rural, remote areas) are associated with poor survival. These variables...
Article
Full-text available
Purpose: Androgen deprivation therapy (ADT) for prostate cancer (PCa) has multiple adverse effects on musculoskeletal health. This 12-month randomised controlled trial aimed to assess the effects of multi-component exercise training combined with whey protein, calcium and vitamin D supplementation on bone mineral density (BMD), structure and stren...
Article
Adding to the limited literature on the subject, this letter to the editor focuses on the trend in the use of stereotactic radiation therapy for metastatic renal cell carcinoma.
Article
Full-text available
Background The Movember funded TrueNTH Global Registry (TNGR) aims to improve care by collecting and analysing a consistent dataset to identify variation in disease management, benchmark care delivery in accordance with best practice guidelines and provide this information to those in a position to enact change. We discuss considerations of designi...
Article
Introduction There has been a growing body of evidence highlighting the improved sensitivity and specificity for prostate specific membrane antigen (PSMA) positron emission tomography (PET) in advanced prostate cancer imaging. We aimed to assess prostate cancer staging practice patterns in Australia using population‐based data. Subject and Methods...
Article
Full-text available
Background Docetaxel has emerged as a standard‐of‐care for metastatic hormone‐sensitive prostate cancer (mHSPC). Uptake of docetaxel for mHSPC in Australia has not previously been reported. Aims i) To investigate the real‐world uptake of docetaxel in mHSPC; and ii) To identify predictors of utilisation of Docetaxel in mHSPC. Methods Men diagnosed...
Article
Introduction: To evaluate the adoption of hypofractionated radiotherapy (HFRT) for breast cancer (BC) in Victoria, Australia. Methods: This is a population-based cohort of women with BC who had breast RT as captured in the Victorian Radiotherapy Minimum Data Set between 2012 and 2017. We defined HFRT as < 25 fractions of RT. The pattern of HFRT...
Article
Objectives The objective of this study was to evaluate geographical and temporal variations in prostate cancer incidence in Victoria, Australia. Study design & methods This study analysed 105,349 cases of incident prostate cancer between 1982 and 2016 from the population-based Victorian Cancer Registry. We performed Poisson regression analyses to...
Article
Background: Adjuvant radiotherapy has been shown to halve the risk of biochemical progression for patients with high-risk disease after radical prostatectomy. Early salvage radiotherapy could result in similar biochemical control with lower treatment toxicity. We aimed to compare biochemical progression between patients given adjuvant radiotherapy...
Article
Full-text available
Background: Benchmarking outcomes across settings commonly requires risk-adjustment for co-morbidities that must be derived from extant sources that were designed for other purposes. A question arises as to the extent to which differing available sources for health data will be concordant when inferring the type and severity of co-morbidities, how...
Article
Full-text available
Background: ASPirin in Reducing Events in the Elderly (ASPREE), a randomized double-blind placebo-controlled trial (RCT) of daily low-dose aspirin (100 mg) in older adults, showed an increase in all-cause mortality, primarily due to cancer. In contrast prior RCTs, mainly involving younger individuals, demonstrated a delayed cancer benefit with asp...
Article
Full-text available
Prostate cancer is a heterogeneous cancer with widely varying levels of morbidity and mortality. Approaches to prostate cancer screening, diagnosis, surveillance, treatment and management differ around the world. To identify the highest priority research needs across the prostate cancer biomedical research domain, Movember conducted a landscape ana...
Article
Full-text available
Purpose: For prostate cancer treatment, comparable or superior biochemical control was reported when using External-Beam-Radiotherapy (EBRT) with High-Dose-Rate-Brachytherapy (HDRB)-boost, compared to dose-escalation with EBRT alone. The conformal doses produced by HDRB could allow further beneficial prostate dose-escalation, but increase in dose i...
Article
Full-text available
INTRODUCTION AND OBJECTIVE: Men with localized prostate cancer (CaP) face several treatment options. While multinational studies typically focus on variations in CaP incidence and morbidity, limited data have been published on differing treatment patterns across countries. This study investigated variations in treatment patterns and baseline tumor...
Article
Background and Purpose To identify a PSA threshold value at an intermediate follow-up time after low dose rate (LDR) prostate brachytherapy associated with cure, defined as long-term (10 to 15 year) freedom from prostate cancer. Materials and Methods Data from 7 institutions for 14,220 patients with localized prostate cancer treated with LDR brach...
Preprint
Full-text available
Background Benchmarking outcomes across settings commonly requires risk-adjustment for co-morbidities that must be derived from extant sources that were designed for other purposes. A question arises as to the extent to which differing available sources for health data will be concordant when inferring the type and severity of co-morbidities, how c...
Article
Full-text available
Purpose Diet and body size may affect the risk of aggressive prostate cancer (APC), but current evidence is inconclusive. Methods A case–control study was conducted in men under 75 years of age recruited from urology practices in Victoria, Australia; 1,254 with APC and 818 controls for whom the presence of prostate cancer had been excluded by biop...
Article
Full-text available
Objectives Psychosocial interventions that mitigate psychosocial distress in cancer patients are important. The primary aim of this study was to examine the feasibility and acceptability of an adaptation of the Mindful Self-Compassion (MSC) program among adult cancer patients. A secondary aim was to examine pre–post-program changes in psychosocial...
Preprint
Background Benchmarking outcomes across settings commonly requires risk-adjustment for co-morbidities that must be derived from extant sources that were designed for other purposes. A question arises as to the extent to which differing available sources for health data will be concordant when inferring the type and severity of co-morbidities, how c...
Article
Purpose: To evaluate the use of single-fraction palliative radiation therapy (SFRT) for the management of bone metastases (BM) in Victoria, Australia. Methods and materials: This is a population-based cohort of patients with cancer who received radiation therapy for BM between 2012 and 2017 as captured in the Victorian Radiotherapy Minimum Data...
Article
There has been a shift in the management of brain metastasis (BM), with increasing use of stereotactic radiosurgery (SRS) and delaying/avoiding whole‐brain radiotherapy (WBRT), given the concern regarding the long‐term neurocognitive effect and quality of life impact of WBRT. It is, however, unclear as to the contemporary practice pattern and outco...
Article
Full-text available
Objectives Prostate cancer is the second most common cause of cancer-related death in males after lung cancer, imposing a significant burden on the healthcare system in Australia. We propose the use of autoregressive integrated moving average (ARIMA) models in conjunction with population forecasts to provide for robust annual projections of prostat...
Article
Full-text available
Introduction Stereotactic body radiotherapy (SBRT) is a non-invasive alternative to surgery for the treatment of non-metastatic prostate cancer (PC). The objectives of the Novel Integration of N ew prostate radiation schedules with adJuvant Androgen deprivation (NINJA) clinical trial are to compare two emerging SBRT regimens for efficacy with techn...
Article
6568 Background: Single fraction palliative radiotherapy (SFRT) has been shown to be equivalent to multi-fraction radiotherapy (MFRT) for bone metastases symptom management. Remuneration for radiotherapy (RT) in Australia are largely determined by fractions delivered. We aim to determine the use of SFRT for bone metastases in Australia. Methods: We...
Article
Conservative management, specifically with active surveillance (AS), has emerged as the preferred approach for low-risk prostate cancer (LRPC). We evaluated the trend for conservative management (ie, no active treatment within 12 mo of diagnosis) for LRPC in an Australian population-based cohort of men captured in the Prostate Cancer Outcomes Regis...
Article
Purpose: To evaluate the adoption of the Royal Australian and New Zealand College of Radiologists Choosing Wisely (CW) radiation oncology recommendations before and after the release of the recommendations. Methods and materials: The Victorian Radiotherapy Minimum Data Set captures details of radiation therapy delivered in the state of Victoria,...
Article
PURPOSE To detail the process for importing a defined data set into a centralized global registry via a secure file transfer platform and to understand the barriers to the establishment of a centralized global registry. RESULTS A bespoke solution was developed to allow transmission of data from international local data centers to a centralized repo...
Article
Purpose: High-dose-rate (HDR) brachytherapy boost is a treatment of intermediate- to high-risk prostate cancer, but long-term clinical outcome data are sparse. We report long-term survival and toxicity data in a cohort of patients treated in a single institution. Methods: Between 1998 and 2004, 654 patients with localized prostate cancer receive...
Article
Full-text available
Object: To determine the extent and impact of upgrading and downgrading among men who underwent radical prostatectomy (RP) according to new grade groupings and to identify predictors of upgrading from biopsy grade Group I and II, and downgrading to grade Group I, in a community setting. Methods: Study participants included 2279 men with non-meta...
Article
13 Background: The aim of this study is to evaluate the practice pattern of management of NCCN low-risk prostate cancer (LRPC) in a population-based cohort of Australian men. Methods: This is prospective cohort of men captured in Prostate Cancer Outcomes Registry Victoria (PCOR-Vic), who were diagnosed with LRPC between Aug 2008 and Dec 2016. Conse...
Article
Full-text available
Purpose: To detail the process for importing a defined data set into a centralized global registry via a secure file transfer platform and to understand the barriers to the establishment of a centralized global registry. Results: A bespoke solution was developed to allow transmission of data from international local data centers to a centralized...
Article
Rapid change, treatment responsiveness, and prognostication difficulties present challenges for palliative care integration for hematology patients. This Australian study aimed to document end-of-life hospital care for patients with non-Hodgkin lymphoma (NHL) to consider opportunities for palliative care integration. A retrospective population coho...
Article
Background: Clinical trial registries were established to improve the transparency and completeness of clinical trial reporting and a number of policies have been introduced to encourage or mandate their use. While prospective trial registration has been endorsed in Australia, there is currently no legal requirement for researchers to register or c...
Article
Introduction The aim of this study is to evaluate the use of androgen deprivation therapy (ADT) with post‐prostatectomy radiotherapy (PPRT) in a population‐based cohort of Australian men. Methods This is a prospective cohort of men with localised prostate cancer captured in the Prostate Cancer Outcomes Registry Victoria (PCOR‐Vic), who received PP...
Article
Objectives To describe health service use, symptom and survival characteristics in mPCA in order to outline usual care practices and identify future opportunities to improve the quality of care in this patient group. Patients and methods This population cohort study, conducted in Victoria, Australia, used 10 years (2000‐10) of linked hospital disc...
Article
Background To update patterns of care for men diagnosed with prostate cancer in Victoria, Australia between 2008 and 2015. Methods From August 2008 to December 2015, 14 025 men diagnosed with prostate cancer were included. These data were obtained from the Prostate Cancer Outcome Registry – Victoria (PCOR‐Vic). Frequencies were used to describe ho...
Article
To the Editor Among 1809 men with prostate cancer and a Gleason score of 9 to 10, Dr Kishan and colleagues¹ reported lower prostate cancer–specific mortality and longer time to distant metastases in men treated with external beam radiotherapy (EBRT) plus brachytherapy (BT) compared with radical prostatectomy or EBRT alone.
Article
Full-text available
Objective: To characterise the practice of active surveillance (AS) for men with low risk prostate cancer by examining the characteristics of those who commence AS, the rate of adherence to accepted AS follow-up protocols over 2 years, and factors associated with good adherence. Design, setting: Retrospective cohort study; analysis of data collect...
Article
To provide recommendations for the selection of radiobiological parameters for prostate cancer treatment planning. Recommendations were based on validation of the previously published values, parameter estimation and a consideration of their sensitivity within a tumour control probability (TCP) model using clinical outcomes data from low-dose-rate...
Article
Background and purpose: Quality indicators (QIs) have been developed for many aspects of prostate cancer care, but are under-developed with regard to radiotherapy treatment. We aimed to develop a valid, relevant and feasible set of core QIs to measure quality of radiotherapy care in men with prostate cancer. Materials and methods: We used a RAND...
Article
1 Aim This study aims to assess characteristics of patients with prostate cancer for whom clinical T stage category (cT) was not documented in the medical record and assess whether specialists had concordant conclusions regarding cT based on digital rectal examination (DRE) notes. 2 Methods Data from the Prostate Cancer Outcome Registry – Victoria...
Article
Context: Increasing emphases are being placed upon early integration of palliative care for patients with advanced cancers, yet barriers to implementation in clinical practice remain. Criteria to standardise referral have been endorsed, but their application are yet to be tested at the population level. Objectives: This study sought to: 1) estab...