Final Report of the Intergroup Randomized Study of Combined Androgen-Deprivation Therapy Plus Radiotherapy Versus Androgen-Deprivation Therapy Alone in Locally Advanced Prostate Cancer.

Purpose: We have previously reported that radiotherapy (RT) added to androgen-deprivation therapy (ADT) improves survival in men with locally advanced prostate cancer. Here, we report the prespecified final analysis of this randomized trial.

Patients And Methods: NCIC Clinical Trials Group PR.

Combined androgen deprivation therapy and radiation therapy for locally advanced prostate cancer: a randomised, phase 3 trial.

Background: Whether the addition of radiation therapy (RT) improves overall survival in men with locally advanced prostate cancer managed with androgen deprivation therapy (ADT) is unclear. Our aim was to compare outcomes in such patients with locally advanced prostate cancer.

Methods: Patients with: locally advanced (T3 or T4) prostate cancer (n=1057); or organ-confined disease (T2) with either a prostate-specific antigen (PSA) concentration more than 40 ng/mL (n=119) or PSA concentration more than 20 ng/mL and a Gleason score of 8 or higher (n=25), were randomly assigned (done centrally with stratification and dynamic minimisation, not masked) to receive lifelong ADT and RT (65-69 Gy to the prostate and seminal vesicles, 45 Gy to the pelvic nodes).

The effectiveness of the Ivan H. Smith Memorial Studentships program on encouraging medical students to pursue a career in radiation oncology.

Background: Founded in 1963, the Ivan H. Smith Memorial Studentship (ISMS) is a summer program that familiarizes students with the work of several cancer centers and aims to attract medical students into oncology.

Methods: In this study, we attempted to evaluate the impact of the ISMS Program on career choice in radiation oncology (RO).

Reasons for poor accrual in palliative radiation therapy research studies.

Background: Patients with advanced-stage cancer commonly have multiple symptoms, poor performance status, and limited life expectancies. Despite the need for evidence-based practice and guidelines for palliative radiation therapy (RT), conducting clinical palliative research has proven to be a challenge in the past because of low accrual rates and high patient attrition. We explore the change in accrual rates, reasons for nonparticipation in palliative RT clinical research trials, and factors that contributed to the increase in accrual over a 3-year period.

Quality of life after local external beam radiation therapy for symptomatic bone metastases: a prospective evaluation.

This study was designed to prospectively evaluate quality of life in patients treated with local external beam radiation therapy for symptomatic bone metastases. Patients with symptomatic bone metastases treated with palliative radiation therapy were followed with Edmonton Symptom Assessment Scale (ESAS) at baseline and at 1, 2, 4, 8, and 12 weeks after the delivery of radiation therapy. The ESAS evaluates 10 symptoms: global pain, index pain (pain at the irradiated site), fatigue, nausea, depression, anxiety, drowsiness, appetite, sense of well-being, and shortness of breath on a categorical score of 0 to 10 (0 = absence of symptom, 10 = worst possible symptom).

Medicine's moment of misrule: the medical student show.

Medical student shows are a prominent feature of medical student life around the world. Following a traditional vaudeville format of skits and songs, the shows are notorious for their exuberance, bawdiness, and lack of political correctness. Despite their widespread prevalence and sometimes hostile reactions, there has been no previous study of these shows.

A phase II trial of palliative radiotherapy for metastatic renal cell carcinoma.

Background: Renal cell carcinoma (RCC) has previously been described as being less responsive to radiotherapy (RT) than other tumor types. The authors conducted a prospective study to assess the effect of RT on symptoms and quality of life (QOL) in patients with metastatic RCC.

Methods: Between 1996 and 2002, patients with symptomatic metastatic RCC were entered into a prospective study in two cancer centers.

Randomized trial comparing two fractionation schedules for patients with localized prostate cancer.

Purpose: The optimal radiation dose fractionation schedule for localized prostate cancer is unclear. This study was designed to compare two dose fractionation schemes (a shorter 4-week radiation schedule v a longer 6.5-week schedule).

Treatment of bone metastases with palliative radiotherapy: patients' treatment preferences.

Purpose: To determine the proportion of patients undergoing palliative radiotherapy (RT) for bone pain who would like to participate in the decision-making process, and to determine their choice of palliative RT regimen (2000 cGy in five fractions vs. 800 cGy in one fraction) for painful bone metastases.

Methods And Materials: Eligible patients were approached and all patients agreeing to participate provided written informed consent.

Accuracy of survival prediction by palliative radiation oncologists.

Purpose: To examine the accuracy of survival prediction by palliative radiation oncologists.

Methods And Materials: After consultation of cancer patients with metastatic disease for referral of palliative radiotherapy, radiation oncologists estimated the survival of the patients. These were compared with the actual dates of death obtained from the Cancer Death Registry.

The role of knowledge translation for cancer control in Canada.

The definition and scope of cancer control has been evolving since its inception. The most recent model of cancer control in Canada has acknowledged the importance of knowledge translation to ensure that research results are implemented in practice and will be used to inform policy. However, without effort, the process of translation does not happen on a consistent basis.

Better knowledge translation for effective cancer control: a priority for action.

Increasing cancer rates are a world wide problem. Efforts towards controlling cancer are most effectively implemented through national cancer control programs. The literature has emphasized prevention and screening as main starting points; by applying what we know a substantial amount of cancer could be prevented.

Priapism as a possible acute side effect of radical radiotherapy for prostate cancer.

We report a case of a 73 year-old male diagnosed with T1 N0 M0 prostate cancer, Gleason score 7, undergoing a course of radical radiotherapy using 7600 cGY delivered in 38 fractions. Several hours after receiving his 27th fraction, he reported experiencing a painful penile erection lasting more than 6 hours. A history and several investigations were conducted to determine the etiology of this adverse event.

Communication with referring physicians in a palliative radiotherapy clinic.

Goals: The rapid response radiotherapy program (RRRP) at Toronto-Sunnybrook Regional Cancer Center (TSRCC) provides quick access to palliative radiotherapy for patients with a life expectancy of less than 12 months. Patients then return to their referring physician for continued oncologic management. After the initial RRRP consultation, we fax an interim consultation report to the referring physician.

Computed tomography (CT) evaluation of breast cancer patients with osteolytic bone metastases undergoing palliative radiotherapy--a feasibility study.

Twenty-five patients with osteolytic metastases had computed tomography (CT) scans before and 3 months after palliative radiotherapy. The median % density change following single 8Gy, 20Gy/5#, 30Gy/10# were: 128 (range 98-255), 141 (79-342), and 145 (65-235), respectively. It is feasible to evaluate remineralization of osteolytic lesions with palliative radiotherapy.

Tarnished adornment: The troubled history of Québec's institut du radium.

In 1922 the Québec government appropriated $100,000 for the purchase of radium to found an Institut du Radium at the University of Montreal. Opened largely through the initiative and drive of Dr. Joseph-Ernest Gendreau, the institut was the first organization devoted to radium therapy and cancer treatment in Canada.

Multidisciplinary radiation oncology palliative care rounds as a continuing educational activity implementing the rapid response radiotherapy program at the toronto sunnybrook regional cancer centre.

Background: This paper describes the development of the Rapid Response Radiotherapy Program and evaluates the continuing medical education (CME) series, in the form of multidisciplinary monthly Radiation Oncology Palliative Care Rounds at the Toronto Sunnybrook Regional Cancer Centre.

Methods: Palliative care rounds were initiated by the multidisciplinary committee in September, 1998. From January, 2000, to June, 2002, attendees used a standard 5- point Likert rating scale to conduct formal evaluations.

Seeds of discord: the politics of radon therapy in Canada in the 1930s.

In the early twentieth century, the therapeutic use of radon gas became an accepted medical practice. "Radium emanation" plants were established in many parts of North America to supply radon seeds to physicians. In Canada, these plants were usually established as part of state-supported cancer programs, creating concern among the medical profession, which had hitherto directed cancer treatment.

What do patients living with advanced cancer and their carers want to know? - a needs assessment.

Our primary objective was to determine the content and format that is most suitable for educational events targeting patients and carers who are living with advanced cancer. Secondary objectives included examining the differences in information needs between patients and their carers, and providing an estimate of the rate of participation in educational events targeting such patients and carers. Out-patients receiving palliative radiotherapy at Toronto Sunnybrook Regional Cancer Center and their carers were invited to complete the Advanced Cancer Information Needs Survey.

Fractionated stereotactic radiotherapy for the treatment of vestibular schwannomas: combined experience of the Toronto-Sunnybrook Regional Cancer Centre and the Princess Margaret Hospital.

Purpose: To evaluate the efficacy and toxicity of fractionated stereotactic radiotherapy (FSRT) for vestibular schwannomas in patients treated at two university-affiliated hospitals.

Methods And Materials: Thirty-nine patients were treated between April 1996 and September 2000. The median age was 56 years (range: 29-80), and median maximal tumor diameter was 20 mm (range: 9-40).