Cancer
-
The introduction of serotonin antagonists as antiemetics for prophylaxis of chemotherapy-induced nausea and vomiting represented a major step toward better patient tolerance and adherence to this type of treatment. Several published trials compared different serotonin antagonists without demonstrating clear superiority of any one of them. Because most of these trials compared ondansetron with granisetron, the authors conducted a meta-analysis to determine if the current data available show any therapeutic difference between them. ⋯ The authors conclude that both granisetron and ondansetron have similar antiemetic efficacy for prophylaxis of chemotherapy-induced nausea and vomiting. Because the number of comparative studies that addressed the delayed nausea and vomiting scenarios is low, further RCTs are still needed to confirm these results.
-
Randomized Controlled Trial Comparative Study Clinical Trial
Czech Study on Lung Cancer Screening: post-trial follow-up of lung cancer deaths up to year 15 since enrollment.
The study was launched in the mid-1970s to explore the capability of screening by chest X-ray and sputum cytology to be used as an effective component of the lung cancer control program in the Czech Republic, a Central European country with a high and increasing occurrence of lung cancer in men at that time. A complementary objective of this report is to ascertain whether the cumulative numbers of lung cancer deaths would equalize in the two randomized groups during a prolonged follow-up period. ⋯ The study gave no evidence that screening for lung cancer by chest X-ray is beneficial in terms of reducing mortality. Based on the results of this study, there is no justification to recommend semiannual screening as a component of a comprehensive lung cancer control program.
-
At the current time, there is nearly universal agreement that screening for the early detection of lung carcinoma is not justified. This is based on the fact that, to the author's knowledge, no randomized population trial (RPT) to date has demonstrated a significant reduction in lung carcinoma mortality as a result of any screening intervention. ⋯ Systematic analysis of RPTs supports two major conclusions: 1) an improvement in the cure rate rather than a reduction is cause specific mortality is the proper measure of screening effectiveness in the RPT setting and 2) CXR screening is associated with a two- to three-fold improvement in lung carcinoma cure rates. A paradigm shift is mandatory for the proper evaluation of conventional and newer screening modalities. Indeed, hundreds of thousands of lives would be saved annually on a global basis if CXR screening were offered to individuals at high risk for lung carcinoma.