The lancet oncology
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The lancet oncology · Jul 2006
Role of radiotherapy in cancer control in low-income and middle-income countries.
More than half the cases of cancer in the world arise in people in low-income and middle-income countries. This proportion will rise to 70% by 2020. These are regions where the annual gross national income per person is less than 9386 US dollars. ⋯ Eastern Europe and Latin America showed similar shortages. Strategies for developing services need planning at a national level and substantial investment for staff training and equipment. Safe and effective development of services would benefit from: links with established facilities in other countries, particularly those within the same region; access to information, such as free online journal access; and better education of all medical staff about the roles and benefits of radiotherapy.
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The lancet oncology · Jul 2006
Should patients be able to choose physician-assisted suicide at the end of their lives? For the proposal.
On May 12, 2006, members of the UK House of Lords voted against a proposed Assisted Dying for the Terminal Ill Bill. This Bill was put forward to "enable an adult who has capacity and who is suffering as a result of a terminal illness to receive medical assistance to die at his own considered and persistent request". Under this Bill, it would be lawful for a physician, or a member of the health-care team working in conjunction with a physician, to assist a qualifying patient to die by prescribing drugs. In this Debate, Margaret Branthwaite, a retired barrister and former consultant medical practitioner, presents the case for physician-assisted suicide, whereas David Jeffrey, former chair of the ethics committee of the Association for Palliative Medicine of Great Britain and Ireland, presents the case against.
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The lancet oncology · Jul 2006
Analysis of RNA-binding protein IMP3 to predict metastasis and prognosis of renal-cell carcinoma: a retrospective study.
Distant metastasis is the main cause of death from renal-cell carcinoma, and the metastatic potential of tumours is often unpredictable. We aimed to investigate whether IMP3, an oncofetal RNA-binding protein, can be used as a biomarker to predict metastasis and prognosis of renal-cell carcinoma. ⋯ IMP3 is an independent prognostic marker that can be used at initial diagnosis of renal-cell carcinoma to identify patients who have a high potential to develop metastasis and who might benefit from early systemic treatment.
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The lancet oncology · Jul 2006
ReviewReassessment of the role of induction chemotherapy for head and neck cancer.
Head and neck cancers are a complex group of diseases defined by variations in histological features, anatomical location, and cause. Once the realm of surgeons and radiation oncologists, the treatment of locally advanced disease now involves medical oncologists. Major developments include primary chemoradiotherapy for unresectable disease and organ preservation, the addition of chemotherapy to adjuvant radiotherapy, improvement in surgical and radiation techniques, and biological therapies. ⋯ Given this shift in site of recurrence, therapeutic strategies to suppress distant metastases may be the next goal for further improvement of survival. One approach that merits reassessment is the use of induction chemotherapy in the setting of locally advanced disease--both resectable and unresectable. In this review we summarise data for the use of induction chemotherapy to define better which patients will likely benefit from this approach now and which questions are important in the design of future clinical trials.