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Health Sciences profile

Associate Professor Patries Herst

PositionAssociate Professor
DepartmentDepartment of Radiation Therapy (UOW)
QualificationsMSc (Nijmegen) MPhil (Waik) PhD(Otago)
Research summaryCancer Treatment

Research

Patries leads a clinical cancer research platform consisting of a series of randomized controlled trials (5 completed RCTs and two RCTs in development) that investigate the management of acute radiation-induced side effects. Data collection is done primarily by qualified RTs as part of the BRT(Hons) in collaboration with radiation oncologists, charge RTs, staff RTs, oncology nurses and medical physicists. This research platform gives RTs the opportunity to take part in clinical research relevant to their profession, it has also put NZ at the forefront of world class research in radiation toxicities. The clinical trials have been funded by grants from UORG, FRST, Regional Divisions of the Cancer Society, Health Otago Charitable Trust and the Breast Cancer Foundation. Various companies have supplied free product.

Soft silicone dressings for skin reactions
Radiation-induced skin reactions are an unavoidable side effect of external beam radiation therapy, particularly in areas prone to friction and excess moisture such as the axilla, head and neck region, perineum and skin folds. Clinical studies investigating interventions for preventing or managing these reactions have largely focussed on formulations with moisturizing, anti-inflammatory, anti-microbial and wound healing properties. However, none of these interventions has emerged as a consistent candidate for best practice. We have conducted three RCTs in the last 5 years that have shown that preventing friction of radiation-damaged skin caused by items of clothing or other body parts is very successful in decreasing the severity of these skin reactions. Soft silicone dressings were shown to reduce skin reaction severity by 30-40% (Diggelmann et al, 2010; Paterson et al, 2012). The most recent trial reported that if a thin transparent silicone film is used from the very start of radiation treatment, this prevents severe skin reactions from developing altogether (Herst et al, 2014).

Honey for oral mucositis
Oral mucositis is an unavoidable side effect of radiation therapy to the head and neck. This painful condition adversely affects patients’ ability to speak and eat, often resulting in weight loss, and decreased quality of life. In extreme cases, treatment must be delayed to allow for healing; this may compromise local tumour control and thus patient survival. There is currently no gold standard for the prevention or treatment of oral mucositis. In contrast to previous honey trials in Malaysia, Egypt, Iran and India, diluted manuka honey did not decrease the extent and onset of radiation-induced oral mucositis (Parsons et al, 2012).

Cranberries for cystitis
Radiation induced cystitis is a sterile form of cystitis and is often experienced by men who receive radiation therapy for prostate cancer. A pilot study in Dunedin hospital showed that cranberry capsules were superior to placebo capsules in decreasing the incidence of cystitis as well as the pain associated with cystitis (manuscript in preparation)

Publications

Herst, P. M., Bennett, N. C., Sutherland, A. E., Peszynski, R. I., Paterson, D. B., & Jasperse, M. L. (2014). Prophylactic use of Mepitel Film prevents radiation-induced moist desquamation in an intra-patient randomised controlled clinical trial of 78 breast cancer patients. Radiotherapy & Oncology, 110(1), 137-143. doi: 10.1016/j.radonc.2014.01.005

Grasso, C., Fabre, M.-S., Collis, S. V., Castro, M. L., Field, C. S., Schleich, N., McConnell, M. J., & Herst, P. M. (2014). Pharmacological doses of daily ascorbate protect tumors from radiation damage after a single dose of radiation in an intracranial mouse glioma model. Frontiers in Oncology, 4, 356. doi: 10.3389/fonc.2014.00356

Castro, M. L., McConnell, M. J., & Herst, P. M. (2014). Radio-sensitisation by pharmacological ascorbate in glioblastoma multiforme cells, human glial cells, and HUVECs depends on their antioxidant and DNA repair capabilities and is not cancer specific. Free Radical Biology & Medicine, 74, 200-209. doi: 10.1016/j.freeradbiomed.2014.06.022

Herst, P. M., Broadley, K. W. R., Harper, J. L., & McConnell, M. J. (2012). Pharmacological concentrations of ascorbate radiosensitize glioblastoma multiforme primary cells by increasing oxidative DNA damage and inhibiting G2/M arrest. Free Radical Biology & Medicine, 52(8), 1486-1493. doi: 10.1016/j.freeradbiomed.2012.01.021

Journal - Research Article

Herst, P. M., Bennett, N. C., Sutherland, A. E., Peszynski, R. I., Paterson, D. B., & Jasperse, M. L. (2014). Prophylactic use of Mepitel Film prevents radiation-induced moist desquamation in an intra-patient randomised controlled clinical trial of 78 breast cancer patients. Radiotherapy & Oncology, 110(1), 137-143. doi: 10.1016/j.radonc.2014.01.005

Grasso, C., Fabre, M.-S., Collis, S. V., Castro, M. L., Field, C. S., Schleich, N., McConnell, M. J., & Herst, P. M. (2014). Pharmacological doses of daily ascorbate protect tumors from radiation damage after a single dose of radiation in an intracranial mouse glioma model. Frontiers in Oncology, 4, 356. doi: 10.3389/fonc.2014.00356

Castro, M. L., McConnell, M. J., & Herst, P. M. (2014). Radio-sensitisation by pharmacological ascorbate in glioblastoma multiforme cells, human glial cells, and HUVECs depends on their antioxidant and DNA repair capabilities and is not cancer specific. Free Radical Biology & Medicine, 74, 200-209. doi: 10.1016/j.freeradbiomed.2014.06.022

Herst, P. M., Broadley, K. W. R., Harper, J. L., & McConnell, M. J. (2012). Pharmacological concentrations of ascorbate radiosensitize glioblastoma multiforme primary cells by increasing oxidative DNA damage and inhibiting G2/M arrest. Free Radical Biology & Medicine, 52(8), 1486-1493. doi: 10.1016/j.freeradbiomed.2012.01.021

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