Postoperative Concurrent Chemoradiotherapy Versus Postoperative Radiotherapy in High-Risk Cutaneous Squamous Cell Carcinoma of the Head and Neck: The Randomized Phase III TROG 05.01 Trial

© 2018 by American Society of Clinical Oncology Purpose To report the results of the Trans Tasman Radiation Oncology Group randomized phase III trial designed to determine whether the addition of concurrent chemotherapy to postoperative radiotherapy (CRT) improved locoregional control in patients with high-risk cutaneous squamous cell carcinoma of the head and neck. Patients and Methods The primary objective was to determine whether there was a difference in freedom from locoregional relapse (FFLRR) between 60 or 66 Gy (6 to 6.5 weeks) with or without weekly carboplatin (area under the curve 2) after resection of gross disease. Secondary efficacy objectives were to compare disease-free survival and overall survival. Results Three hundred twenty-one patients were randomly assigned, with 310 patients commencing allocated treatment (radiotherapy [RT] alone, n = 157; CRT, n = 153). Two hundred thirty-eight patients (77%) had high-risk nodal disease, 59 (19%) had high-risk primary or in-transit disease, and 13 (4%) had both. Median follow-up was 60 months. Median RT dose was 60 Gy, with 84% of patients randomly assigned to CRT completing six cycles of carboplatin. The 2- and 5-year FFLRR rates were 88% (95% CI, 83% to 93%) and 83% (95% CI, 77% to 90%), respectively, for RT and 89% (95% CI, 84% to 94%) and 87% (95% CI, 81% to 93%; hazard ratio, 0.84; 95% CI, 0.46 to 1.55; P = .58), respectively, for CRT. There were no significant differences in disease-free or overall survival. Locoregional failure was the most common site of first treatment failure, with isolated distant metastases as the first site of failure seen in 7% of both arms. Treatment was well tolerated in both arms, with no observed enhancement of RT toxicity with carboplatin. Grade 3 or 4 late toxicities were infrequent. Conclusion Although surgery and postoperative RT provided excellent FFLRR, there was no observed benefit with the addition of weekly carboplatin

Caring Leadership: A Heideggerian Perspective

This paper develops the idea of caring leadership based on Heidegger’s philosophy of care. From this perspective, caring leadership is grounded in the practices of ‘leaping-in’ and ‘leaping-ahead’ as modes of intervention in the affairs of the world and the efforts of others. This involves gauging and taking responsibility for the ramifications of intervention, balancing the urge for certainty of outcome and visibility of contribution with the desire to encourage and enable others. Our analysis suggests several twists to contemporary leadership debates. We argue that the popular models of transactional and transformational leadership are to be critiqued not for their over-reliance, but rather, their under-reliance on agency. This is a different kind of agency to that of heroic or charismatic models. It involves tolerance of complexity and ambivalence; a rich sense of temporal trajectory; concern for one’s presence in the world; and crucially, the ability to resist the soothing normativity of ‘best practice’. From this position, we argue that the problem with the growing scholarly interest in an ethic of care is that it provides too tempting a recipe to follow. In a Heideggerian view, caring leadership has little to do with compassion, kindness or niceness; it involves and requires a fundamental organization and leadership of self

Influence of domiciliary humidification on symptom burden and feeding tube use up to 2 years postradiation therapy for head and neck cancer: Trans-Tasman Radiation Oncology Group (TROG) 07.03 RadioHUM randomized phase 2 trial secondary analysis

ePoster Abstract #1126A.M.J. Macann, T. Fua, C.G. Milross, S. Porceddu, M.G. Penniment, C. Wratten, H. Krawitz, M.G. Poulsen, C.I. Tang, R.P. Morton, V. Thomson, M.L. Bell, M.T. King, C.L. Fraser-Browne, and H.U.P. Hocke

The screen and the world: a phenomenological investigation into screens and our engagement in the world

In this paper, we attempt to show how phenomenology can provide an interesting and novel basis for thinking about screens in a world where screens now pervade all aspects of our daily existence. We first provide a discussion of the key phenomenological concepts. This is followed by its application to the phenomenon of a screen. In our phenomenology of the screen, we aim to give an essential account of a screen, as a screen, in its very screen-ness. We follow Heidegger’s argument that the screen will only show itself as a screen in its functioning as a screen in the world where screens are what they are. We claim, and aim to show, that our analysis provides many insights about the screen-ness of screens that we can not gain through any other method of investigation. We also show that although our method is not empirical its results have many important implications for the empirical world