Hi Paul,
Very nice pick on this reference. I ran it down two levels down and pleasantly surprised full text versions were viewable.
I did get stuck on ref 8 to view the TNM guideline from AJCC cancer staging manual. I suspect it looks not-surprisingly like the one published by NCCN.
One of the serious questions I posed to the RO was the IMRT rad field map and talked me through the rationale to use the advanced contouring and targeting features but be conservative and still radiate no targeted areas at lower dosage in case small cancers exist but not picked up on PET/CT or CT. This provides support to his rational; it is just too early in the game of medical clinical testing and verification to make such "radical" deviation from standard of care protocols.
[quote]O'Sullivan et al12 appropriately highlight the limitations of their observations and recommend further validation in prospective clinical trials. Given our current knowledge, treatment of
HPV-associated, locoregionally advanced cancers with anything less than the standard full doses of radiotherapy and concurrent cisplatin should only occur in the context of a clinical trial. To modify treatment components at this juncture may jeopardize a high probability of cure. [/quote]
ABSTRACT
http://jco.ascopubs.org/content/31/5/520.full.pdf+htmlFULL REPORT
http://jco.ascopubs.org/content/31/5/543.full.pdf+htmlFYI - on another tangent. This is the first real dive for me into the subject of prognosis. I just started week 3 of concurrent CRT using standard of care protocols and able to feel just seeing some glimmer of light at the end of this journey.
I have only accepted the general statements that
HPV 16+ had better responses and outcomes but this is the first time I really looked at numbers. Pleasantly surprised that based on my staging going in and other factors (never smoke, drink) statistically I am 90+ percent of beating this first go around.
