Cancer
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Multicenter Study Comparative Study
Quality of integrated care for patients with nonsmall cell lung cancer: variations and determinants of care.
In the current study, the authors focused on determinants influencing the quality of care and variations in the actual quality of integrated care for patients with nonsmall cell lung cancer (NSCLC) to estimate whether there is room for improvement. ⋯ The quality of integrated care (especially patient-oriented care) for NSCLC patients needs improvement. Patient characteristics appear to influence performance more than professional or hospital characteristics.
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The authors evaluated whether the duration of androgen suppression (AS) after the completion of hormone therapy (HT) was associated with the risk of prostate cancer-specific mortality (PCSM) and all-cause mortality (ACM). ⋯ The duration of AS after 6 months of HT was associated with the risk of PCSM and ACM. This duration could be used to identify men who have prostate cancer with Gleason scores from 8 to 10 in whom 6 months of HT produces long-term testosterone suppression, which may provide the cancer-specific survival benefit observed with long-term HT.
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Mortality from childhood leukemia has declined substantially in developed countries but less markedly in the developing world. This study was designed to describe mortality trends in childhood leukemia and the impact of social inequalities on these trends in Brazil from 1980 to 2002. ⋯ A consistent decrease in mortality rates from childhood leukemia was noted in Brazil. Higher decreases in mortality were observed in more developed states, possibly reflecting better health care.
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Oncologists are often reluctant to recommend radiotherapy (RT) to palliate metastatic melanoma due to a perception that this tumor is "radioresistant." The Mayo Clinic experience was analyzed to determine the efficacy of palliative RT. ⋯ RT was found to provide effective palliation of non-CNS metastasis from malignant melanoma and should be considered for symptomatic patients. RT doses >30 Gy and a BED >39.0 Gy(10) were found to be associated with longer palliation.
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The authors prospectively evaluated the late gastrointestinal (GI) and genitourinary (GU) toxicity and prostate-specific antigen (PSA) control of magnetic resonance imaging (MRI)-guided brachytherapy used as salvage for radiation therapy (RT) failure. ⋯ The current results indicated that MRI-guided salvage brachytherapy in men who are selected based on presenting characteristics and post-failure PSA kinetics can achieve high PSA control rates, although complications requiring surgical intervention may occur in 10% to 15% of patients. Prospective randomized studies are needed to characterize the relative cancer control and toxicity after all forms of salvage local therapy.