S. Jack Wei, MD
Abramson Cancer Center of the University of Pennsylvania
Last Modified: October 22, 2003
Moderator: Theodore L. Phillips, MD., University of California, San Francisco
Edward C. Halperin, MD, Duke University
There is a difference between research and therapy.
As a field, we have used research and randomized trials selectively if they show a benefit for radiation, but have dismissed its necessity when we do not have the data.
There have been a number of cases where early results from non-randomized data compared to historic controls appeared to show a benefit, but did not show a benefit after randomized testing. Examples include bone marrow transplant for breast cancer, beta-carotene for decreasing cancer incidence, hyperfractionated radiation for pediatric brain stem tumors, etc.
Non-randomized data compared to historic controls is not equal to randomized data.
The increased treatment time and monitor units due to IMRT result in higher leakage and scatter as is evidenced by the increased rate of second neoplasms with IMRT (1% vs. 1.75% at 10 years).
We must not confuse differential dose distributions with differential outcomes.
Oct 24, 2013 - Use of integrated intensity-modulated radiation therapy (IMRT) has increased more among urologists who have acquired ownership of IMRT services versus urologists who do not own such services, according to research published in the Oct. 24 issue of the New England Journal of Medicine.