6 research outputs found
Radiotherapy to the prostate for men with metastatic prostate cancer in the UK and Switzerland: Long-term results from the STAMPEDE randomised controlled trial
Background
STAMPEDE has previously reported that radiotherapy (RT) to the prostate improved overall survival (OS) for patients with newly diagnosed prostate cancer with low metastatic burden, but not those with high-burden disease. In this final analysis, we report long-term findings on the primary outcome measure of OS and on the secondary outcome measures of symptomatic local events, RT toxicity events, and quality of life (QoL).
Methods and findings
Patients were randomised at secondary care sites in the United Kingdom and Switzerland between January 2013 and September 2016, with 1:1 stratified allocation: 1,029 to standard of care (SOC) and 1,032 to SOC+RT. No masking of the treatment allocation was employed. A total of 1,939 had metastatic burden classifiable, with 42% low burden and 58% high burden, balanced by treatment allocation. Intention-to-treat (ITT) analyses used Cox regression and flexible parametric models (FPMs), adjusted for stratification factors age, nodal involvement, the World Health Organization (WHO) performance status, regular aspirin or nonsteroidal anti-inflammatory drug (NSAID) use, and planned docetaxel use. QoL in the first 2 years on trial was assessed using prospectively collected patient responses to QLQ-30 questionnaire.
Patients were followed for a median of 61.3 months. Prostate RT improved OS in patients with low, but not high, metastatic burden (respectively: 202 deaths in SOC versus 156 in SOC+RT, hazard ratio (HR) = 0·64, 95% CI 0.52, 0.79, p < 0.001; 375 SOC versus 386 SOC+RT, HR = 1.11, 95% CI 0.96, 1.28, p = 0·164; interaction p < 0.001). No evidence of difference in time to symptomatic local events was found. There was no evidence of difference in Global QoL or QLQ-30 Summary Score. Long-term urinary toxicity of grade 3 or worse was reported for 10 SOC and 10 SOC+RT; long-term bowel toxicity of grade 3 or worse was reported for 15 and 11, respectively.
Conclusions
Prostate RT improves OS, without detriment in QoL, in men with low-burden, newly diagnosed, metastatic prostate cancer, indicating that it should be recommended as a SOC.
Trial registration
ClinicalTrials.gov NCT00268476, ISRCTN.com ISRCTN78818544
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Geothermal binary-cycle working-fluid properties information. Annual report
The research discussed was performed prior to December 31, 1979. The report was not released until September 30, 1981, so that pressure-enthalpy diagrams for a number of potential geothermal binary cycle working fluids could be prepared in SI units. Efforts were directed principally to working fluid thermophysical property correlation and presentation of properties information. Pressure-enthalpy diagrams are presented for propane, normal butane, isobutane, normal pentane, isopentane and propylene. Generalized correlations are presented for the thermodynamic and transport properties of hydrocarbon pure and mixture working fluids. Specific correlations are presented for the thermodynamic properties of 27 fluids and for the viscosity and thermal conductivity of hydrocarbons including isobutane and isopentane
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Development of Geothermal Binary Cycle Working Fluid Properties Information and Analysis of Cycles
The research discussed in this report was performed at the University of Oklahoma during the period January 1, 1979 through December 31, 1979. Efforts were directed principally to the following tasks: (1) comparisons of mixture and pure fluid cascade cycles, (2) development of guidelines for working fluid selection for single boiler cycles, (3) continued evaluation of mixtures as working fluids, (4) working fluid thermophysical property correlation and presentations of properties information