The British journal of radiology
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Ureteric obstruction causing renal failure is a serious complication of advanced prostate cancer. Percutaneous nephrostomies (PCNs) are used to decompress the obstructed kidney(s). This study aims to identify whether bilateral PCN insertion confers any advantage over unilateral PCN insertion for patients with bilateral ureteric obstruction. ⋯ The mean survival time following PCN was 7.5 months for all patients. The data suggest that the nadir serum creatinine after PCN insertion was similar, independent of whether one or two nephrostomies were inserted. There was also little difference in the serum creatinine levels at the time of death, suggesting that survival after PCN insertion is based on the aggressiveness of the prostate cancer as opposed to the number of nephrostomies inserted.
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Randomized Controlled Trial Multicenter Study Comparative Study
Pre-trial quality assurance processes for an intensity-modulated radiation therapy (IMRT) trial: PARSPORT, a UK multicentre Phase III trial comparing conventional radiotherapy and parotid-sparing IMRT for locally advanced head and neck cancer.
The purpose of this study was to compare conventional radiotherapy with parotid gland-sparing intensity-modulated radiation therapy (IMRT) using the PARSPORT trial. The validity of such a trial depends on the radiotherapy planning and delivery meeting a defined standard across all centres. At the outset, many of the centres had little or no experience of delivering IMRT; therefore, quality assurance processes were devised to ensure consistency and standardisation of all processes for comparison within the trial. ⋯ Each exercise had to be accepted before patients could be recruited into the trial. 10 centres successfully completed the quality assurance exercises. A range of treatment planning systems, linear accelerators and delivery methods were used for the planning exercises, and all the plans created reached the standard required for participation in this multicentre trial. All 10 participating centres achieved implementation of a comprehensive and robust IMRT programme for treatment of head and neck cancer.