Clinical oncology : a journal of the Royal College of Radiologists
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Clin Oncol (R Coll Radiol) · Apr 2009
Accelerated radical radiotherapy for non-small cell lung cancer using two common regimens: a single-centre retrospective study of outcome.
A variety of radical radiotherapy regimens are in use for non-small cell lung cancer. Continuous hyperfractionated accelerated radiotherapy (CHART: 54 Gy in 36 fractions over 12 days) and accelerated hypofractionated radiotherapy using 55 Gy in 20 fractions over 4 weeks are standard fractionations in our centre. The primary aim of this retrospective study was to evaluate survival outcome seen in routine clinical practice. ⋯ This single-centre study reflects the outcome of unselected consecutively treated non-small cell lung cancer patients. Adjusting for stage, there was no significant difference in survival seen according to regimen. Encouragingly, CHART outcome shows reproducibility with the original CHART paper. Our hypofractionated outcome is similar to that previously reported, but despite this being the UK's most common regimen, 55 Gy in 20 daily fractions remains unvalidated by phase III trial data.
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Clin Oncol (R Coll Radiol) · Apr 2009
Oncological emergency admissions to the Norfolk and Norwich University Hospital: an audit of current arrangements and patient satisfaction.
To assess current emergency admission pathways for patients with cancer, reasons for admission, subsequent management and patient perceptions of and satisfaction with the care they received. ⋯ The cancer burden is increasing, with more patients with cancer being admitted as emergencies. Patients seem to favour continuity of care and admission to an oncology ward directly. Further research needs to be carried out in this area as to how best care may be achieved, taking into account local resources and the changes in practice that have come from continuing treatment much longer into the course of the disease. The organisation of healthcare services has to take account of patient preference to balance efficiency and patient satisfaction. Training in palliative oncology may need to be extended to other groups than oncologists.
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Clin Oncol (R Coll Radiol) · Mar 2009
Cancer in the elderly: a societal perspective from the United States.
Cancer is the second leading cause of death in the USA and will probably surpass heart disease, the current leader, over the next few years. As in other affluent nations, cancer in the USA is a disease of ageing, with a median age at diagnosis of 67 years. Moreover, men and women in average health who reach age 65 years will probably live an average of 20 more years and it is estimated that by 2025 20% of Americans will be 65 years and older compared with 12% of the present population. ⋯ Financial constraints have limited trial opportunities for elders and hopefully will improve in the future. A major challenge for those in North America will be to provide the health care for elders with cancer and other diseases in the coming years. To meet this challenge we must expand and train the number of health care providers at all levels.
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Clin Oncol (R Coll Radiol) · Feb 2009
Comparative StudyDoes magnetic resonance imaging of the spine have a role in the staging of prostate cancer?
Magnetic resonance imaging (MRI) is an effective method for evaluating the spine in patients with a high risk of metastatic disease. The aim of this study was to compare MRI spine with radionuclide bone scan in detecting spinal metastases for staging prostate cancer patients. ⋯ MRI spine has comparable specificity and slightly better sensitivity than bone scan to detect spinal metastasis from prostate cancer.