51 research outputs found

    Desiring Discord: Political Conflict in Medieval Romance

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    Desiring Discord: Political Conflict in Medieval Romance contends that medieval romance frequently creates and dwells on discord and political tensions left unresolved by the narrator. Accusations of treason in particular become a critical aspect of romance adventures, where the nature of the traitor’s crime or transgression is ambiguously defined at best, but is often central to the hero’s success. The steward frequently embodies this dissent and treason, even as he is silenced and vilified by the protagonist, text, and scholarship. This project clarifies why the figure of the royal steward repeatedly stands at the center of such treason. Why, for example, does the unnamed (and loyal) steward in Amis and Amiloun become the “fals traytour” blamed for Amis’s judicial battle or Amiloun’s leprosy when it is the heroes themselves who commit crimes against the duke? Through my analyses of Amis and Amiloun, as well as King Horn, The Squyre of Low Degree, The Erle of Tolous, and Le Morte D’Arthur, I argue that the treasonous stewards open up avenues to engage in political dissent and alternative methods of political activism—where the political intrigue of the medieval court can be functional and productive of good governance rather than obstructionist. These narratives’ political multiplicity—diversifying rather than preventing treason—raises questions about the value of internal conflict and the boundaries of criminality. Tensions over how to define and set boundaries around the reach of the crown in these romances persists from 1200 to the early sixteenth century, arguing that the steward’s literary vilificafrtion exceeds any particular historical anxieties. The steward Maradose calls attention to the diverse and competive political environment in The Squire of Low Degree, where his failed support of the duke’s law results in the princess’s rejection of the court and the narrative’s turn away from the hero. The steward is both “traytour” and faithful vassal, both “trewe” and “fals,” and both lover and villain. He unveils the multiple value systems competing within the romance court. Amis and Amiloun divorces treason from its political definition by condemning the steward as traitor while the text’s characters support his integrity. Not only is the court divided, but the very means of understanding and unifying it are unstable. The traitor turned steward turned emperor in The Erle of Tolous expands an unstable court structure to treat treason as a productive and beneficial response to the emperor’s misrule. The political “ryght” championed by the treasonous Erle Barnard suggests that readers’ sympathy may extend as much to the court’s traitors as to the hero. The characters’ and narrators’ dissonant conceptions of justice suggest that effective leadership relies on a system of power rather than an individual—a system that requires and thrives off the competing voices of political and social actors. The final chapter demonstrates that Malory’s steward Kay acts as gatekeeper to Arthur’s court. Kay’s stewardship opposes sovereign desire, statutory laws, as well as common laws and highlights the inconsistency among various affinities’ interpretive approach to power. His rude and abrasive opposition to many Round Table knights emphasizes their multiple and competing identities—but in doing so he also foregrounds diversity as a unifying factor. He allows the conflict between identities and approaches to inspire negotiation and solidarity to an overarching unity.PHDEnglish Language & LiteratureUniversity of Michigan, Horace H. Rackham School of Graduate Studieshttps://deepblue.lib.umich.edu/bitstream/2027.42/149917/1/mfarrarw_1.pd

    Adding 6 months of androgen deprivation therapy to postoperative radiotherapy for prostate cancer: a comparison of short-course versus no androgen deprivation therapy in the RADICALS-HD randomised controlled trial

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    Background Previous evidence indicates that adjuvant, short-course androgen deprivation therapy (ADT) improves metastasis-free survival when given with primary radiotherapy for intermediate-risk and high-risk localised prostate cancer. However, the value of ADT with postoperative radiotherapy after radical prostatectomy is unclear. Methods RADICALS-HD was an international randomised controlled trial to test the efficacy of ADT used in combination with postoperative radiotherapy for prostate cancer. Key eligibility criteria were indication for radiotherapy after radical prostatectomy for prostate cancer, prostate-specific antigen less than 5 ng/mL, absence of metastatic disease, and written consent. Participants were randomly assigned (1:1) to radiotherapy alone (no ADT) or radiotherapy with 6 months of ADT (short-course ADT), using monthly subcutaneous gonadotropin-releasing hormone analogue injections, daily oral bicalutamide monotherapy 150 mg, or monthly subcutaneous degarelix. Randomisation was done centrally through minimisation with a random element, stratified by Gleason score, positive margins, radiotherapy timing, planned radiotherapy schedule, and planned type of ADT, in a computerised system. The allocated treatment was not masked. The primary outcome measure was metastasis-free survival, defined as distant metastasis arising from prostate cancer or death from any cause. Standard survival analysis methods were used, accounting for randomisation stratification factors. The trial had 80% power with two-sided α of 5% to detect an absolute increase in 10-year metastasis-free survival from 80% to 86% (hazard ratio [HR] 0·67). Analyses followed the intention-to-treat principle. The trial is registered with the ISRCTN registry, ISRCTN40814031, and ClinicalTrials.gov, NCT00541047. Findings Between Nov 22, 2007, and June 29, 2015, 1480 patients (median age 66 years [IQR 61–69]) were randomly assigned to receive no ADT (n=737) or short-course ADT (n=743) in addition to postoperative radiotherapy at 121 centres in Canada, Denmark, Ireland, and the UK. With a median follow-up of 9·0 years (IQR 7·1–10·1), metastasis-free survival events were reported for 268 participants (142 in the no ADT group and 126 in the short-course ADT group; HR 0·886 [95% CI 0·688–1·140], p=0·35). 10-year metastasis-free survival was 79·2% (95% CI 75·4–82·5) in the no ADT group and 80·4% (76·6–83·6) in the short-course ADT group. Toxicity of grade 3 or higher was reported for 121 (17%) of 737 participants in the no ADT group and 100 (14%) of 743 in the short-course ADT group (p=0·15), with no treatment-related deaths. Interpretation Metastatic disease is uncommon following postoperative bed radiotherapy after radical prostatectomy. Adding 6 months of ADT to this radiotherapy did not improve metastasis-free survival compared with no ADT. These findings do not support the use of short-course ADT with postoperative radiotherapy in this patient population

    Duration of androgen deprivation therapy with postoperative radiotherapy for prostate cancer: a comparison of long-course versus short-course androgen deprivation therapy in the RADICALS-HD randomised trial

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    Background Previous evidence supports androgen deprivation therapy (ADT) with primary radiotherapy as initial treatment for intermediate-risk and high-risk localised prostate cancer. However, the use and optimal duration of ADT with postoperative radiotherapy after radical prostatectomy remains uncertain. Methods RADICALS-HD was a randomised controlled trial of ADT duration within the RADICALS protocol. Here, we report on the comparison of short-course versus long-course ADT. Key eligibility criteria were indication for radiotherapy after previous radical prostatectomy for prostate cancer, prostate-specific antigen less than 5 ng/mL, absence of metastatic disease, and written consent. Participants were randomly assigned (1:1) to add 6 months of ADT (short-course ADT) or 24 months of ADT (long-course ADT) to radiotherapy, using subcutaneous gonadotrophin-releasing hormone analogue (monthly in the short-course ADT group and 3-monthly in the long-course ADT group), daily oral bicalutamide monotherapy 150 mg, or monthly subcutaneous degarelix. Randomisation was done centrally through minimisation with a random element, stratified by Gleason score, positive margins, radiotherapy timing, planned radiotherapy schedule, and planned type of ADT, in a computerised system. The allocated treatment was not masked. The primary outcome measure was metastasis-free survival, defined as metastasis arising from prostate cancer or death from any cause. The comparison had more than 80% power with two-sided α of 5% to detect an absolute increase in 10-year metastasis-free survival from 75% to 81% (hazard ratio [HR] 0·72). Standard time-to-event analyses were used. Analyses followed intention-to-treat principle. The trial is registered with the ISRCTN registry, ISRCTN40814031, and ClinicalTrials.gov , NCT00541047 . Findings Between Jan 30, 2008, and July 7, 2015, 1523 patients (median age 65 years, IQR 60–69) were randomly assigned to receive short-course ADT (n=761) or long-course ADT (n=762) in addition to postoperative radiotherapy at 138 centres in Canada, Denmark, Ireland, and the UK. With a median follow-up of 8·9 years (7·0–10·0), 313 metastasis-free survival events were reported overall (174 in the short-course ADT group and 139 in the long-course ADT group; HR 0·773 [95% CI 0·612–0·975]; p=0·029). 10-year metastasis-free survival was 71·9% (95% CI 67·6–75·7) in the short-course ADT group and 78·1% (74·2–81·5) in the long-course ADT group. Toxicity of grade 3 or higher was reported for 105 (14%) of 753 participants in the short-course ADT group and 142 (19%) of 757 participants in the long-course ADT group (p=0·025), with no treatment-related deaths. Interpretation Compared with adding 6 months of ADT, adding 24 months of ADT improved metastasis-free survival in people receiving postoperative radiotherapy. For individuals who can accept the additional duration of adverse effects, long-course ADT should be offered with postoperative radiotherapy. Funding Cancer Research UK, UK Research and Innovation (formerly Medical Research Council), and Canadian Cancer Society
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