Connie,

Did they just look at all kinds of chemo lumped together when they used that as a variable? Because, as has been discussed here before, there is much better data on the added benefits of chemo for some types of chemo than others, so I wonder if that could be part of the issue. I also suspect that the effects of stage and chemo may have gotten confounded -I assume this wasn't a study where patients were randomly assigned to receive chemo or not so it seems likey that, for example, the 15% of people who were not stage III or IV probably mostly did not have chemo. So you would expect frm previous data that they as a group would do better anyway, even without chemo, which might wipe out real effects of chemo in the data for people who were at more advanced stages.

And did they use random assignment for whether the people in the research got IMRT or not? because if not, as I've seen reading about other people's experienes here, it seems that there is a tendency (among some doctors anyway) to believe that more advanced cancer is more likely to be effectively treated my non-IMRT, ie. general field, radiation. If that tendency happened for patients in this study, what it means is that there would be a greater likelihood that patients with more advanced symptoms (which are only partly measured by the TNM system as far as I can tell, there are things like whether there was perineural invasion or not that is completely outside of that system) would be more likely to be in the non-IMRT group which measn that any differences between the two groups could partly be due to that pre-existing difference.

Anyway, those are just some things that occur to me in interpreting the results. I do think it's interesting that in general the two year rate of local or regional recurrence was much less than other stats you have seen. I wodner why that is, and it certainly seems very hopeful.

Nelie