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4D Brachytherapy for improved clinical outcomes

Dr Robert Laing
Dr Robert Laing is a Radiation Oncologist who has worked at the St Luke’s Cancer Centre in Guildford for more than 14 years. Following completion of his training at The Royal Marsden Hospital he undertook research into stereotactic radiation techniques and so he was ideally placed to develop the procedure of prostate brachytherapy. He has been instrumental in driving award-winning research in prostate cancer and prostate brachytherapy that has helped The Prostate Brachytherapy Centre to become a centre of excellence for the treatment of this disease.
He has also published widely in the area of prostate cancer and co-supervised academic research at the University of Surrey leading to the award of two PhDs to date and is held in high regard within the field of oncology in the UK.
PAPER PUBLICATIONS
Laing, RW, Glazer MG, Barrett GS:
Breast cancer in association with in-vitro  fertilisation.  
J.Royal Soc of Med, 1989,  52, 503.
Laing RW, Child J, Brada M:
Failure of conventionally fractionated radiotherapy to decrease  the risk of haemorrhage in operable arteriovenous malformations.  
Neurosurgery 1992, 30, 6, 870-876.
Laing RW, Brada M:
Intracranial germ cell tumour in association with cryptorchidism.  
Clinical Oncology, 1992, 4, 269-270.
Laing RW, Saunders MI: 
  
A case of lung carcinoma induced by radioactive Iodine given for  disseminated thyroid carcinoma.  
Clinical  Oncology, 1992, 4, 394-395.
Laing RW, Warrington AP, Graham J, Hines F, Brada  M:  
Efficacy and toxicity of fractionated  stereotactic radiotherapy in the treatment of recurrent gliomas (phase 1/11  study).  
Radiotherapy and Oncology, 1992,  27, 22-29.
Brada M, Laing RW:   
  Radiosurgery/stereotactic external beam radiotherapy for  malignant brain tumours. 
  Chapter in:
  Molecular neuro-oncology: impact on clinical management of brain  tumours, eds 
  Weisler OD, Schlegel V, Schramm J,Springer Verlag.  1994, 91-104.
Laing RW, Warrington AP, Brada M:  
Fractionated external beam stereotactic  radiotherapy in the management of intracranial metastases.  
European Journal of Cancer, 1992, 29A,  1387-1391.
Laing RW, Nahum AE, Bentley R, Brada M:  
Stereotactic radiotherapy planning for  irregular targets: a comparison between static conformal beams and non  coplanar rotations.  
Radiotherapy and Oncology 1993, 28, 241-246.
Laing RW, Thompson V, Warrington AP, Brada M:  
Feasibility of patient immobilisation for  conventional cranial irradiation with a relocatable stereotactic frame.  
British Journal of Radiology, 1993, 66,  1020-1024.
Warrington AP, Laing RW, Brada M:  
Quality assurance in fractionated external  beam stereotactic radiotherapy.   
Radiotherapy and Oncology, 1994, 30, 239-246.
Laing RW, Hoskin P, Vaughan Hudson B, Vaughan Hudson  G, Harmer C, Bennett M, Maclennan K:  
The  significance of MALT histology in thyroid lymphoma; a review of patients from  the BNLI and Royal Marsden Hospital.   
Clinical Oncology, 1994.
Landau DB, Laing RW:   
An audit of indications and techniques for  supraclavicular fossa irradiation in early  breast cancer in the United    Kingdom.   
Clinical Oncology (R Coll Radiol) 2000, 12(13), 172-8.
Henderson A, Cahill D, Laing RW, Langley SEM:  
Iodine 125 prostate brachytherapy.  Selection strategies & outcomes from  the  first 100 consecutive patients and  selection strategies incorporating urodynamics.   
British Journal of Urology International 2002, 90, 567-572.
Langley SEM, Laing RW:   
Prostate brachytherapy has come of age;   a review of technique results.   
BJU International 2002, 89, 241-249.
Henderson A, Laing RW, Langley SEM: 
 A spanner in the works; the use of a new  temporary urethral stent to relieve bladder outflow obstruction following  prostate brachytherapy.  
Brachytherapy  2003, 1(4) 211-218.
Henderson A, Langley SEM, Laing RW: 
Is Bicalutamide equivalent to Goserelin for  prostate volume reduction prior to prostate brachytherapy?  
Clinical Oncology (R Coll Radiol), 2003 Sept;  15(6), 318-321.
Henderson A, Laing RW, Langley SEM:  
Intraoperative identification of pubic arch  interference in prostate brachytherapy, simplifying the transrectal ultrasound  technique.  
Brachytherapy June 2003,  2(4), 240-5.
Laing RW, Henderson A, Langley SEM:  
A prospective observational study of the  cytoreductive efficacy of Goserelin and Bicalutamide prior to brachytherapy.  
Brachytherapy 2003, Vol 1, page 53.
Smith IE, Hearn R, Coombes GA, Howell A, Ebbs S,  hickish TF, O’Brien M, Mansi JL, Wilson CB, Robinson AC, Murray PA, Price CGA,  Perren TJ, Laing RW, Bliss JM and other members of the TOPIC Trial Group. 
 
A novel continuous infusional 5FU based  chemotherapy regimen compared with conventional chemotherapy in the  neo-adjuvant treatment of early breast cancer:   5 year results of the TOPIC trial.   
Annals of Oncology 2004 May, 15(5), 751-8.
Langley SEM, Laing RW:  
Iodine seed prostate brachytherapy:  an alternative first  line choice for early prostate cancer.  
Prostate Cancer Dis.  2004 June 8.
Henderson A, Sooriakumaran P, Laing RW, Langley  SEM: 
Brachytherapy:  the Surgeon’s perspective.  
BJU Int. 2004 May: 93(7), 1118.
Henderson A, Bott SR, Sooriakumaran P, Laing RW,  Langley SEM:  
Urinary morbidity after I125  brachytherapy of the prostate.  
BJU Int.  2004 April: 93(6), 880.
Henderson A, Laing RW, Langley SEM:  
Quality of life following treatment for early  prostate cancer:  does low dose rate  (LDR) brachytherapy offer a better outcome?   
Eur Urol.  2004 Feb, 45(2),  134-42.
Henderson A, Laing RW, Langley SEM:  
Improvement in urinary symptoms after radical  prostatectomy: a prospective evaluation of flow rates and symptom scores.  
BJU Int. 2004 Jan:  93(1), 180-1.
Khaksar SJ, Laing RW, Sooriakumaran P, Lovell D,  Langley SEM:  
PSA relapse free survival  and toxicity follow I-125 prostate brachytherapy.  
British Journal of Urology International.  2006: 98(4); 1210-1215. 
Khaksar SJ, Langley SEM, Lovell D, Laing RW:  
Interstitial low dose rate (LDR)  brachytherapy for intermediate and high risk prostate cancer.  
Clinical Oncology.  2006.   18: 513-518.
Khaksar SJ, Laing RW, Langley SEM:  
Fertility after brachytherapy.  
BJUInt 2005 Oct: 96(6), 915.
Barrett-Lee P, Bloomfield D, Dougherty L, Harries M,  Laing R, Patel H, Walker M.  
An audit to  determine the time taken to administer intravenous bisphosphonate infusions in  patients diagnosed with metastatic breast cancer to bone in a hospital  setting.  
Current Medical Research and  Opinions 2007 May: 23(7): 1575-82.
Dowsett M, Hanby A M, Laing R, Walker R.  
From the National HER2 Consultation Steering  Group.  HER2 testing in the UK: consensus  from a national consultation. 
Journal of Clinical Pathology:  June 2007; 60: 685-689. 
Helena Nam, Sara Smith, Robert Laing: 
 
A pitfall in 18 fluorodeoxyglucose-PET in a  patient with a tattoo.  
The Lancet  Oncology, Vol 8, December 2007, pp 1147-1148.
Nobes J, Laing RW, Langley SEM.  
An overview of I-125 prostate brachytherapy  for early prostate cancer.  
Urology News  2007; 12(1):7-9.
Nobes J, Laing RW, Langley SEM. 
 Letter: The value of day 1 imaging following LDR prostate brachytherapy.  
Radiother Oncol 2008; 86(2):288-9.
Voulgaris S, Nobes J, Laing RW, Langley SEM.  
State of the art: prostate LDR  brachytherapy.  
Prostate Cancer Prostatic  Dis. 2008 March 25;11(3):237-40.
Nobes J, Wells IG, Khaksar S, Money-Kyrle J, Laing RW,  Langley SEM. 
 
Biochemical relapse free  survival in 400 patients treated with I-125 prostate brachytherapy: the Guildford experience.   
Prostate Cancer Prostatic Dis. 2008 Apr 22;(Epub ahead of print).
Nobes J, Laing RW, Langley SEM.  
Male health and the metabolic syndrome.  
Urology News 2008;12(4):6-10.
Nobes J, Khaksar S, Hawkins M, Cunningham M, Langley SEM, Laing  RW.  
Novel prostate brachytherapy  technique: improved dosimetric and clinical outcome.  
Radiother Oncol 2008 Jul:88(1): 121-6.
Nobes J, Langley  SEM, Laing RW. 
 
Metabolic Syndrome and  Prostate Cancer:  A Review.  
Clinic Oncol (R Coll Radiol).  2008 Dec 24.   (Epub ahead of print).
Ferran Guedea,  Ferran Aguilo, Alfredo Polo, Stephen Langley, Robert Laing, Alastair Henderson,  Sirpa Aaltomaa, Vese Kataja, Juni Palmgren, Franch Bladou, Naji Salem,  Gwenaelle Gravis, Andrea Losa, Giorgio Guazzoni, Luciano Nava.  
Early biochemical outcomes following  permanent interstitial brachytherapy as monotherapy in 1050 patients with  clinical T1-T2 prostate cancer.   
Radiotherapy and Oncology 80 (2006) 57-61.
PUBLISHED ABTRACTS
Glaser MG, Cheeseman A, Laing RW, Dale R:  
Pilot study to evaluate intra-operative  implantation of radio-iodine seeds (I125) in the control of  recurrent tumours of the head and neck.   
Proceedings of 2nd International Conference on Head and Neck  Cancer, Boston, USA.  August 1988.
Laing RW, Graham J, Warrington AP, Brada M: 
 
Fractionated external beam  stereotactic radiotherapy for recurrent  gliomas and solitary metastases (Phase 1/11 study).  
British J. Neurosurg.  1991, 5, 429.
Laing RW, Childs J, Brada M:  
Is conventionally fractionated radiotherapy  useful in operable arteriorvenous malformations.  
British J. Cancer, 1991, 64-17, supplement  XV.
Laing RW, Bennett M, Vaughan Hudson G:  
Thyroid lymphoma; clinical and pathological  features of patients registered with the BNLI.   
Clinical Oncology, 1991, 3, 5 299.
Laing RW, Warrington AP, Graham J, Brada M:  
Survival and quality of life following  fractionated stereotactic radiotherapy for recurrent gliomas and solitary  metastases.  
British J. Cancer, 1992, 5,  66, supplement XVII.
Laing RW, Warrington AP, Graham J, Brada M:  
Fractionated stereotactic radiotherapy for  recurrent gliomas and intracranial metastases; efficacy and  toxicity.   
Radiotherapy and Oncology, 1992, 32, 24 (supplement).
Laing RW, Warrington AP, Graham J, Brada M:  
Fractionated external beam radiotherapy for  recurrent glioma (Phase 1/11 study).  
Int  J. Rad Onc Bio Phys, 1992, 24, supplement 1, 129.
Laing RW.   
Stereotactic radiotherapy for irregular targets, the advantage of  static conformal beams over conventional  non-coplanar arcs.  
British J of  Radiology, 1993, 66, 92-93.
Smith IE, A’Hearn RP, Howell A, Hickish T, O’Brien M,  Mansi J, Wilson C, Robinson A, Pratt W, Price C, Perren T, Laing RW:  Royal Marsden, London UK, Christie, Manchester  UK, Royal Bournemouth UK, Kent Cancer Centre UK, St. George’s London UK,  Addenbrooke’s, Cambridge UK, Southend UK, Colchester UK, British Oncology  Centre UK, Yorkshire Breast Group, Leeds UK, St. Luke’s Guildford, UK.  
Pre-operative continuous infusion EcisF  (Epirubicin, Cisplatin and infusional 5FU) vs conventional AC chemotherapy for  early breast cancer:  A phase III  multicentre randomised trial by the TOPIC Trial Group.  
Abstracted to American Society of Clinical  Oncology 2000: vol 19: 320.
Cahill D, Henderson A, Langley SEM, Laing RW: 
Prostate brachytherapy:  Patient assessment and symptomatic  response.  
  British Association of Urological  Surgeons – Dublin 2001.  
Abstracted to  British Journal of Urology International 2001; 88 (supplement 1) 49.
Henderson A, Cahill D, Langley SEM, Laing RW:  
Prostate brachytherapy:  A prospective analysis of urological  symptoms. 
 
British Cancer Research Meeting  – Leeds 2001.  
Abstracted to the British  Journal Cancer 200; 85 (supplement 1); 16.
Henderson A, Cahill D, Laing RW, Langley SEM:  
Prostate brachytherapy, lessons from our  first 100 patients.  
European Association  of Urologists, Annual Meeting, Birmingham 2002.   
Abstracted to European Urology 2002 1 (supplement 1), pp 46.
Henderson A, Laing RW, Langley SEM:  
Toxicity following Iodine 125  prostate brachytherapy; prospective prediction of symptoms using  urodynamics. 
 
European Society for  Therapeutic Radiology and Oncology, Altalya,   Turkey.  May 2002.   
Abstracted to Radiotherapy & Oncology 2002; 63 (supplement 1); 48.
Henderson A, Laing RW, Langley SEM: 
 
Iodine 125 prostate brachytherapy;  selection strategies and early outcome.   
British Association of Urological Surgeons – Glasgow 2002.  
Abstracted to British Journal of UrologyInternational 2002, 90 (supplement 1),  20 (p 118).
Henderson A, Laing RW, Langley SEM:  
Cytoreduction for brachytherapy.  Not all antiandrogens are equal. 
 
British Association of Urological Surgeons –  Glasgow 2002.  
Abstracted to British  Journal of Urology International 2002, 90 (supplement 1) 68, (p147).
Henderson A, Langley SEM, Laing RW:  
Iodine 125 prostate  brachytherapy.  Early outcome, toxicity  and patient selection – a prospective study.   
British Association of Surgical Oncology/ British Oncology Association,  Cambridge 2002.  
Abstracted to Clinical  Oncology 2002, 14 (4), 518 (p47).
Henderson A, Langley SEM, Laing RW: 
 
Iodine 125 prostate brachytherapy  – Early outcome, toxicity and patient selection – a prospective study. 
 
European Society of Therapeutic Radiation and  Oncology, Prague 2002.  
Abstracted to  Radiotherapy & Oncolgoy 2002, 64 (supplement 1), 972 (286).
Henderson A, Laing RW, Langley SEM:  
  A prospective study of urinary symptoms  following Iodine 125 seed brachytherapy; is urodynamics the  essential test to determine risk of  post  operative catheter use?   
  European  Association of Urologists, Annual Meeting, Madrid 2003.  
  Abstracted to European Urology 2003, 2 (1),  pp 134 (abstract 526)  
Winner best poster on non surgical treatment of  prostate cancer.
Henderson A, Langley SEM, Laing RW:  
A prospective study of PSA free survival  following Iodine 125 seed prostate brachytherapy – The first  reported UK  data.  
Abstracted to British Journal of  Urology International 2003.  91  (supplement 2), 102 (page 146).
Laing RW, Henderson A, Langley SEM:  
A prospective observational study of the  cytoreduction efficacy of Gosereline and Bicalutamide prior to  brachytherapy.  
Abstracted to Prostate  Cancer and Prostate Disease 2003.   Innovators in Urology.
Khaksar SJ, Henderson A, Sooriakumaran P, Laing RW,  Langley SEM:  
Biochemical outcome  following interstitial low dose rate (LDR) prostate brachytherapy in  intermediate and high risk patients.  
ECCO 13 Paris 2005.
Henderson A, Khaksar SJ, Sooriakumaran P, Langley  SEM, Laing RW:  
Quality of Life following  prostate brachytherapy – HRQol returns to baseline within nine months.  
American Society of  Therapeutic & Radiation Oncology, Denver  2005.  
Abstracted  International Journal of Radiation Oncology  Biology & Physics 2005: 63 (supplement 1), S333-334.
Khaksar SJ, Sooriakumaran P, Henderson A, Langley SEM,  Laing RW:  
  Can US prostate brachytherapy  results be reproduced in Europe?  
  American Society of Therapeutic &  Radiation Oncology, Denver 2005.   
Abstracted to International   Journal of Radiation Oncology Biology & Physics 2005:  63 (supplement 1), S328.
  Henderson A, Khaksar S, Sooriakumaran P, Langley  SEM, Laing RW:  
Quality of life and  erectile dysfunction up to 24 months after prostate brachytherapy – A  longitudinal prospective study.  
British  Association of Urological Surgeons Glasgow 2005.  
Abstracted to British Journal of Urology  International 2005:  95 (S5), 91 p125.
Sooriakumaran P, Khaksar S, Henderson A, Laing RW,  Langley SEM:  
Can Europe reproduce  the  brachytherapy results of the USA?  
European Association of Urology (EAU)  Istanbul 2005.  
Abstracted to European  Urology 2005:  4 (3), 44 (168).
Sooriakumaran P, Henderson A, Khaksar SJ, Laing RW,  Langley SEM:  
Effects of brachytherapy on  erectile dysfunction – prospective UK data.  
European Association of Urology (EAU)  Instabul 2005.  
Abstracted to European Urology 2005:  4 (3), 82 (318).
Khaksar SJ, Sooriakumaran P, Henderson A, Langley SEM,  Laing RW:  
PSA relapse free survival  following prostate brachytherapy in intermediate and high risk disease.  
European Society of Therapeutic Radiation and  Oncology, Budapest 2005.  
Abstracted to  Radiotherapy and Oncology 2005:  Vol 75  (supplement 1) S85.
Khaksar SJ, Sooriakumaran P, Henderson A, Langley SEM,  Laing RW:  
PSA bounce following prostate  brachytherapy.  Can you predict it?  
European Society of Therapeutic Radiation and  Oncology.  Budapest 2005.  
Abstracted to Radiotherapy and Oncology  2005:  Vol 75 (supplement 1) S86.
Khaksar SJ, Sooriakumaran P, Henderson A, Langley SEM,  Laing RW:  
PSA relapse free survival  following I-125 LDR prostate brachytherapy.   
UK and Ireland  Prostate Brachytherapy Meeting.  March  2005.
Khaksar SJ, Sooriakumaran P, Henderson A, Langley SEM,  Laing RW:  
Prostate brachytherapy in  intermediate and high risk disease – early results.  
UK  and Ireland  Prostate Brachytherapy Meeting.  March  2005.
Khaksar SJ, Sooriakumaran P, Henderson A, Langley SEM,  Laing RW:  
PSA bounce following  brachytherapy:  What does it mean and why  does it happen. 
UK and Ireland  Prostate Brachytherapy Meeting.  March  2005.  
Khaksar SJ, Henderson A, Sooriakumaran P, Laing RW,  Langley SEM: 
 
Are US prostate  brachytherapy results reproducible in the UK?   
British Association of Urological Surgeons 2006.
Henderson A, Sooriakumaran P, Khaksar SJ, Eden C,  Wright M, Laing RW, Langley SEM:  
Health  related quality of life after state of the art radical treatment for prostate  cancer:  brachytherapy and laparoscopic  radical prostatectomy; outcome data with 18 months follow up.  
British Prostate Group Meeting 2006.
Bott S. R J, Henderson A, Halls J. E, Montgomery B,  Laing R, Langley S:  
Extensive  transperineal template biopsies of prostate:   Modified technique and results.   
Urology 68 (5) 2006, 1037-1041.
Nobes J, Sooriakumaran P, Khaksar S, Money-Kyrle J,  Laing RW, Langley SEM. 
Updated 5 year biochemical relapse free survival  following prostate brachytherapy. 
  
British Prostate Group Spring Meeting, Newcastle.   March 2007.
Nobes J, Khaksar S, Ismail A, Hawkins M, Langley SEM, Laing  RW.  
Penile bulb dosimety – Impact of  prostate brachytherapy implant technique.   
Clinical Oncology 2006; Vol 19 (suppl 1), p7, abstract 10. 
UK  Radiation Oncology Conference, Edinburgh.  March 2007.
Nobes J, Khaksar S, Ismail A, Hawkins M, Laing RW,  Langley SEM.  
  The importance of prostate  brachytherapy implant technique on penile bulb dosimetry. 
 
European Urology Supplements 2007; Vol 6(2),  p226, abstract 814.  
Annual EAU Congress Berlin, March 2007.
Nobes, J, Thomas C, Ismail A, Langley SEM, Laing  RW.  
Post implant dosimetry – Impact of  local planning technique modifications.  
UK & Ireland Prostate Brachytherapy Group  Meeting, York.  April 2007.
Nobes J, Khaksar S, Ismail A, Langley SEM, Laing RW. 
 
Effect of a novel prostate implant technique  on post implant dosimetry and potency.  
UK & Ireland Prostate Brachytheapy Group  Meeting, York.  April 2007.
Nobes J, Wells I, Khaksar S, Money-Kyrle J, Laing RW,  Langley SEM.  
PSA relapse free survival  following prostate brachytherapy – Updated 5 year results.  
UK  & Ireland Prostate Brachytherapy Group Meeting, York.   April 2007.
Nobes J, Thomas C, Ismail A, Langley SEM, Laing RW.  
Prostate brachytherapy dosimetry following  technique modification. 
Royal College  of Radiologist Annual Scientific  Meeting – Oncology Registrar;s Forum, London.  September 2007.
Nobes J, Khaksar S, Laing RW, Langley SEM.  
Hybrid I-125 prostate brachytherapy technique  optimises dosimetry and delivers improved potency at 2 years.  
European Urology Supplements 2008; Vol 7(3),  p118, abstract 189. 
Annual EAU Congress, Milan.  March 2008.
Nobes J, Cunningham M, Voulgaris S, Khaksar S, Laing  RW, Langley SEM.  
The value of real time  intra operative planning versus pre-planned prostate brachytherapy.  
European Urology Supplements 2008; Vol 7(3),  p235, abstract 659.  
Annual EAU Congress,  Milan.  March 2008.
Nobes J, Wells I, Voulgaris S, Khaksar S, Laing RW,  Langley SEM.  
Low dose rate prostate  brachytherapy: 7 year PSA relapse free survival in 500 patients.  
UK  & Ireland Prostate Brachytherapy Group Meeting, Cheltenham.  April 2008.
Nobes J, Wells IG, Voulgaris S, Khaksar S, Langley SEM, Laing  RW.  
Prostate brachytherapy:  7 year biochemical relapse free survival  results from 500 patients.  
BJU Internal  2008:  Vol 101 (suppl 5), p5, abstract  047. 
 
British Association of Urological  Surgeons Annual Meeting, Manchester.  June 2008.
Voulgaris S, Khaksar S, Nobes J, McGrogan A, Laing RW,  Langley SEM.  
Bladder beck resection  prior to I125 LDR brachytherapy improves post implant urinary  toxicity.  A matched pair analysis.  
World Brachytherapy Congress, Boston.  May 2008.
Nobes J, Khaksar S, Langley SEM, Laing RW.  
Single centre experience of 1500 patients  treated with I125 prostate brachytherapy.  
British Uro-Oncology Group, Windsor.  September 2008.
Nobes J, Khaksar S, Laing RW, Langley SEM.
 
I-125  prostate brachytherapy – A single centre experience of 1500 patients.  
South Thames Urology Trainees Meeting, London.  November 2008
BOOKS
Khaksar SJ, Langley SEM, Laing RW: 
A patients guide to external beam  radiotherapy for prostate cancer.   
ISBN:  1 898763 194 Eurocommunica  Limited.
Khaksar SJ, Langley SEM, Laing RW,  Shah J:   
Prostate brachytherapy in clinical practice.   
Springer.   Commissioned and in progress.
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