The lancet oncology
-
The lancet oncology · Apr 2014
Randomized Controlled Trial Multicenter Study Comparative StudyEscalated-dose versus control-dose conformal radiotherapy for prostate cancer: long-term results from the MRC RT01 randomised controlled trial.
The aim of this trial was to compare dose-escalated conformal radiotherapy with control-dose conformal radiotherapy in patients with localised prostate cancer. Preliminary findings reported after 5 years of follow-up showed that escalated-dose conformal radiotherapy improved biochemical progression-free survival. Based on the sample size calculation, we planned to analyse overall survival when 190 deaths occurred; this target has now been reached, after a median 10 years of follow-up. ⋯ UK Medical Research Council.
-
The lancet oncology · Apr 2014
Randomized Controlled Trial Multicenter Study Comparative StudyEffects of adjuvant exemestane versus anastrozole on bone mineral density for women with early breast cancer (MA.27B): a companion analysis of a randomised controlled trial.
Treatment of breast cancer with aromatase inhibitors is associated with damage to bones. NCIC CTG MA.27 was an open-label, phase 3, randomised controlled trial in which women with breast cancer were assigned to one of two adjuvant oral aromatase inhibitors-exemestane or anastrozole. We postulated that exemestane-a mildly androgenic steroid-might have a less detrimental effect on bone than non-steroidal anastrozole. In this companion study to MA.27, we compared changes in bone mineral density (BMD) in the lumbar spine and total hip between patients treated with exemestane and patients treated with anastrozole. ⋯ Canadian Cancer Society Research Institute, Pfizer, Canadian Institutes of Health Research.
-
The lancet oncology · Apr 2014
Randomized Controlled Trial Comparative Study4 Gy versus 24 Gy radiotherapy for patients with indolent lymphoma (FORT): a randomised phase 3 non-inferiority trial.
Follicular lymphoma has been shown to be highly radiosensitive with responses to doses as low as 4 Gy in two fractions. This trial was designed to explore the dose response for follicular lymphoma comparing 4 Gy in two fractions with 24 Gy in 12 fractions ⋯ Cancer Research UK.
-
Extranodal lymphomas constitute a heterogeneous group of malignancies, accounting for roughly 60% of all non-Hodgkin lymphomas. The extranodal organ where lymphomas arise is an important determining factor of biological, molecular, and aetio-pathogenic features, and of presentation, dissemination pattern, and outcome. An increased risk of CNS involvement, an uncommon but lethal event, has been suggested in some extranodal lymphomas, but the absolute risk is still debatable for most of these malignancies. ⋯ The identification of extranodal lymphomas at increased risk of CNS dissemination is an important unmet clinical need; affected patients could benefit from early CNS assessment by neuroimaging and cerebrospinal fluid analysis and adequate CNS prophylaxis, avoiding unnecessary prophylaxis and related toxicity in low-risk patients. This Review discusses relevant confounding factors and identifies high-risk extranodal lymphomas analysing histopathological category, involved organ, and other specific risk factors, which could be helpful for result interpretation and patient stratification in future clinical trials. Finally, a recommendation is provided for CNS-directed management of high-risk extranodal lymphoma patients in daily practice.