The clinical importance of early stopping of randomized trials in cancer treatments

1994 ◽  
Vol 13 (13-14) ◽  
pp. 1293-1295 ◽  
Author(s):  
Robert L. Souhami
Keyword(s):  
Randomized Trials ◽  
Clinical Importance ◽  
Early Stopping ◽  
Cancer Treatments

scholarly journals Evidence of survival benefit was often ambiguous in randomized trials of cancer treatments

2020 ◽  
Vol 127 ◽  
pp. 1-8
Author(s):  
Thomas V. Perneger ◽  
Pauline Brindel ◽  
Christophe Combescure ◽  
Angèle Gayet-Ageron
Keyword(s):  
Survival Benefit ◽  
Randomized Trials ◽  
Cancer Treatments

Role of meta-analyses and of large randomized trials in the study of cancer treatments

Lung Cancer ◽  
2009 ◽  
Vol 65 (1) ◽  
pp. 9-12 ◽  
Author(s):  
Jean-Pierre Pignon ◽  
Anne Auperin ◽  
Isabelle Borget ◽  
Catherine Hill
Keyword(s):  
Randomized Trials ◽  
Cancer Treatments ◽  
Meta Analyses

scholarly journals The History of Hyperthermia Rise and Decline

2013 ◽  
Vol 2013 ◽  
pp. 1-40 ◽  
Author(s):  
Sergey Roussakow
Keyword(s):  
Randomized Trials ◽  
Experimental Treatment ◽  
Tumor Oxygenation ◽  
Outcome Analysis ◽  
Thermal Dose ◽  
Living Matter ◽  
Cancer Treatments ◽  
History Of ◽  
Electromagnetic Hyperthermia ◽  
Temperature Concept

Electromagnetic hyperthermia remains experimental treatment after 40 years of research and application in view of its “temperature concept” based on the belief that temperature is the only parameter of the efficacy. Initial “extreme hyperthermia” concept was based on the wrong premise of much higher thermal susceptibility of malignant cells and broad therapeutic range of hyperthermia, allowing to kill tumor cells by above-threshold (>43°C) temperature without damaging healthy tissues. Indeed, this therapeutic gap is minor or absent which makes the extreme hyperthermia impossible. The next concept of “thermal dose” was based on the ungrounded extrapolation of the biochemical Arrhenius relationship onto the living matter and formed the basis of “moderate hyperthermia” concept, believing that it could enhance tumor oxygenation and radio- and chemosensitivity, ignoring the special features of tumor blood flow. Both concepts have not been confirmed; “thermal dose” is currently proven to be not connected with any clinical outcome. Analysis of randomized trials with respect to biases has not confirmed hyperthermia efficacy. The growing evidence of athermal effects and their broad application has caused development of some athermal cancer treatments. Hyperthermia concept should be cardinally reevaluated now with respect to obvious bankruptcy of the temperature concept and development of the athermal concept.

End-to-end test for fractionated online adaptive MR-guided radiotherapy using a deformable anthropomorphic pelvis phantom

2021 ◽  
Author(s):  
Alina Elter ◽  
Carolin Rippke ◽  
Wibke Johnen ◽  
Philipp Mann ◽  
Emily Hellwich ◽  
...  
Keyword(s):  
Treatment Plan ◽  
Clinical Importance ◽  
Polymer Gel ◽  
Cancer Treatments ◽  
Passing Rates ◽  
End To End ◽  
Pre Treatment ◽  
Prostate Cancer Treatments ◽  
Treatment Procedures ◽  
Dose Measurements

Abstract Objective: In MR-guided radiotherapy (MRgRT) for prostate cancer treatments inter-fractional anatomy changes such as bladder and rectum fillings may be corrected by an online adaption of the treatment plan. To clinically implement such complex treatment procedures, however, specific end-to-end tests are required that are able to validate the overall accuracy of all treatment steps from pre-treatment imaging to dose delivery. Approach: In this study, an end-to-end test of a fractionated and online adapted MRgRT prostate irradiation was performed using the so-called ADAM-PETer phantom. The phantom was adapted to perform 3D polymer gel (PG) dosimetry in the prostate and rectum. Furthermore, thermoluminescence detectors (TLDs) were placed at the center and on the surface of the prostate for additional dose measurements as well as for an external dose renormalization of the PG. For the end-to-end test, a total of five online adapted irradiations were applied in sequence with different bladder and rectum fillings, respectively. Main results: A good agreement of measured and planned dose was found represented by high γ-index passing rates (3 %⁄ 3 mm criterion) of the PG evaluation of 98.9 % in the prostate and 93.7 % in the rectum. TLDs used for PG renormalization at the center of the prostate showed a deviation of -2.3 %. Significance: The presented end-to-end test, which allows for 3D dose verification in the prostate and rectum, demonstrates the feasibility and accuracy of fractionated and online-adapted prostate irradiations in presence of inter-fractional anatomy changes. Such tests are of high clinical importance for the commissioning of new image-guided treatment procedures such as online adaptive MRgRT.

Timing of first-line cancer treatments – Early versus late – A systematic review of phase III randomized trials

2010 ◽  
Vol 36 (8) ◽  
pp. 621-628 ◽  
Author(s):  
A.R. Mhaskar ◽  
G. Quinn ◽  
S. Vadaparampil ◽  
B. Djulbegovic ◽  
C.K. Gwede ◽  
...  
Keyword(s):  
Systematic Review ◽  
Randomized Trials ◽  
Phase Iii ◽  
First Line ◽  
Cancer Treatments

Cancer cell death

2016 ◽  
pp. 42-48
Author(s):  
Amanda S. Coutts ◽  
Sandra Maniam ◽  
Nicholas B. La Thangue
Keyword(s):  
Cell Death ◽  
Cancer Cell ◽  
Control Cell ◽  
Clinical Importance ◽  
Signalling Pathways ◽  
Cancer Treatments ◽  
Cell Death Pathways ◽  
Cancer Cell Death ◽  
Cell Death Mechanisms ◽  
Apoptotic Pathways

Inducing cancer cell death is the basis of the majority of cancer treatments and understanding the mechanisms that control cell death is of prime clinical importance. As a defining feature of cancer is the ability to circumvent cell death pathways, understanding the mechanisms involved is also important in the development of novel therapeutic agents. This chapter outlines three main mechanisms involved in cancer cell death—apoptosis, necroptosis, and autophagy—to give an overview of some of the specific pathways involved. There are a plethora of genetic and epigenetic changes in tumour cells that can circumvent apoptotic pathways; as such understanding and developing therapies that can target other death-signalling pathways could have great clinical significance. Given the complexity involved in the variety of cell death mechanisms, the challenge in oncology is how to harness these different modes of cell death in order to effectively eliminate cancer cells.

Research Consumerism 101: Evaluating External Evidence of Treatment Effectiveness

2008 ◽  
Vol 17 (2) ◽  
pp. 43-49
Author(s):  
James L. Coyle
Keyword(s):  
Treatment Effectiveness ◽  
Code Of Ethics ◽  
Oropharyngeal Dysphagia ◽  
Clinical Importance ◽  
Professional Services ◽  
Adverse Outcomes ◽  
Professional Judgment ◽  
Evidence Based ◽  
Intervention Selection ◽  
Published Research

Abstract The modern clinician is a research consumer. Rehabilitation of oropharyngeal impairments, and prevention of the adverse outcomes of dysphagia, requires the clinician to select interventions for which evidence of a reasonable likelihood of a successful, important outcome exists. The purpose of this paper is to provide strategies for evaluation of published research regarding treatment of oropharyngeal dysphagia. This article utilizes tutorial and examples to inform and educate practitioners in methods of appraising published research. It provides and encourages the use of methods of efficiently evaluating the validity and clinical importance of published research. Additionally, it discusses the importance of the ethical obligation we, as practitioners, have to use evidence-based treatment selection methods and measurement of patient performance during therapy. The reader is provided with tactics for evaluating treatment studies to establish a study's validity and, thereby, objectively select interventions. The importance of avoiding subjective or unsubstantiated claims and using objective methods of generating empirical clinical evidence is emphasized. The ability to evaluate the quality of research provides clinicians with objective intervention selection as an important, essential component of evidence-based clinical practice. ASHA Code of Ethics (2003): Principle I, Rule F: “Individuals shall fully inform the persons they serve of the nature and possible effects of services rendered and products dispensed…” (p. 2) Principle I, Rule G: “Individuals shall evaluate the effectiveness of services rendered and of products dispensed and shall provide services or dispense products only when benefit can reasonably be expected.” (p. 2) Principle IV, Rule G: “Individuals shall not provide professional services without exercising independent professional judgment, regardless of referral source or prescription.” (p. 4)

Sign in / Sign up

Export Citation Format

Share Document