Clinical oncology : a journal of the Royal College of Radiologists
-
Clin Oncol (R Coll Radiol) · Jul 2020
Randomized Controlled Trial Comparative StudyWhole Brain Radiotherapy Versus Stereotactic Radiosurgery in Poor-Prognosis Patients with One to 10 Brain Metastases: A Randomised Feasibility Study.
A significant proportion of patients with brain metastases have a poor prognosis, with a life expectancy of 3-6 months. To determine the optimal radiotherapeutic strategy for brain metastases in this population, we conducted a randomised feasibility study of whole brain radiotherapy (WBRT) versus stereotactic radiosurgery (SRS). ⋯ A randomised trial evaluating WBRT versus SRS in patients with one to 10 metastases and a poor prognosis is feasible. A slower than expected accrual rate and difficulties with accurate prognostication were identified as issues in this feasibility study. A larger phase III randomised trial is planned to determine the optimal treatment in this patient population.
-
Clin Oncol (R Coll Radiol) · Mar 2013
Randomized Controlled TrialNeoadjuvant androgen deprivation therapy for prostate volume reduction, lower urinary tract symptom relief and quality of life improvement in men with intermediate- to high-risk prostate cancer: a randomised non-inferiority trial of degarelix versus goserelin plus bicalutamide.
The treatment of intermediate- to high-risk prostate cancer with radical radiotherapy is usually in combination with neoadjuvant androgen deprivation therapy. The aim of the present trial was to investigate whether degarelix achieves comparable efficacy with that of goserelin plus bicalutamide as neoadjuvant therapy before radiotherapy. ⋯ The efficacy of degarelix in terms of prostate shrinkage is non-inferior to that of goserelin plus bicalutamide. The added benefits of degarelix in terms of more pronounced lower urinary tract symptom relief in symptomatic patients could be the reflection of differences in the direct effects on extra-pituitary receptors in the lower urinary tract [Clinicaltrials.gov ID: NCT00833248].
-
Clin Oncol (R Coll Radiol) · Mar 2013
Randomized Controlled Trial Multicenter StudyModern hypofractionation schedules for tangential whole breast irradiation decrease the fraction size-corrected dose to the heart.
Hypofractionation of postoperative radiotherapy for breast cancer has been evaluated in a number of large randomised clinical trials, but concerns remain over the late cardiac toxicity. In this study, we examined the predictions of the linear quadratic model on the estimated fraction size-corrected dose to the heart for four evidence-based hypofractionation regimens. ⋯ For standard tangential field whole breast irradiation, most of the examined hypofractionation schedules are estimated to spare the heart when compared with normofractionation. The dose to the heart, adjusted for fraction size using the linear quadratic model, will generally be lower after hypofractionated compared with normofractionated schedules, even for very low values of α/β.
-
Clin Oncol (R Coll Radiol) · Mar 2013
Randomized Controlled Trial Multicenter StudyInterim data from the Medical Research Council QUARTZ Trial: does whole brain radiotherapy affect the survival and quality of life of patients with brain metastases from non-small cell lung cancer?
Over 30% of patients with non-small cell lung cancer (NSCLC) develop brain metastases. If inoperable, optimal supportive care (OSC), including steroids, and whole brain radiotherapy (WBRT) are generally considered to be standard care, although there is no randomised evidence demonstrating that the addition of WBRT to OSC improves survival or quality of life. ⋯ These interim data indicate no early evidence of detriment to quality of life, overall survival or QALYs for patients allocated to OSC alone. They provide key information for discussing the trial with patients and strengthen the argument for continuing QUARTZ to definitively answer this important clinical question.
-
Clin Oncol (R Coll Radiol) · Apr 2008
Randomized Controlled TrialConcomitant boost radiotherapy compared with conventional radiotherapy in squamous cell carcinoma of the head and neck--a phase III trial from a single institution in India.
To test the efficacy of an accelerated fractionation schedule (concomitant boost) against standard conventional fractionation in squamous cell carcinomas of the head and neck region in our patient population. ⋯ Concomitant boost is a therapeutically superior and logistically feasible accelerated radiotherapy regimen in advanced head and neck cancers, especially in the setting of a developing country.