# Radiation Oncology/Randomized

* Front Page: Radiation Oncology | RTOG Trials | Randomized Trials

## Meta-analysis and Systemic Review

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## Randomized Evidence

(In the process of being crosslinked)
* Anal canal
* Benign Diseases
* Bladder
* Brain Metastases
* Breast
* Cervix
* Cholangiocarcinoma
* Colon
* Endometrial
* Epilepsy
* Esophagus
* Gastric
* Gliomas
* Head & Neck
* Hodgkin's Disease
* Heel Spurs
* Kaposi's Sarcoma
* Lung, NSCLC
* Lung, SCLC
* Lymphoma, Non-Hodgkin's
* Medulloblastoma
* Mesothelioma
* Melanoma, Cutaneous
* Melanoma, Ocular
* Pancreas
* Prostate
* Rectum
* Sarcoma
* Skin Non-melanoma
* Spinal Cord Compression
* Superior Vena Cava Syndrome
* Testis, NSGCT
* Thymoma
* Vascular Brachytherapy
* Wilms' Tumor (Nephroblastoma)
* Hyperthermia
* Supportive Care
* RT Technology
* Proton Therapy

## Literature Review

* Kentucky; 2009 PMID 19111269 -- "Randomized prospective trials of innovative radiotherapy technology are necessary." (Halperin EC, J Am Coll Radiol. 2009 Jan;6(1):33-7.)
** "It is possible to identify innovations that should be required to meet the standard of proof of a benefit in a randomized prospective clinical trial before being introduced into widespread clinical practice."
* NCI Canada; 2008 (1975–2004) PMID 18955452 -- "Evolution of the Randomized Controlled Trial in Oncology Over Three Decades." (Booth CM, J Clin Oncol. 2008 Oct 27. [Epub ahead of print])
** 321 reports evaluating RCT in systemic therapy for breast, CRC, and NSCLC reviewed.
** Outcome: Number and size of RCT increased substantially. For profit sponsorship increased substantially (4% to 57%, SS). Effect size remained stable, but authors have become more likely to strongly endorse experimental arm (SS). Endorsement of experimental arm strongly associated with industry sponsorship
* Wisconsin; 2008 PMID 18237799 -- "Randomized controlled trials in health technology assessment: Overkill or overdue?" (Bentzen SM, Radiother Oncol. 2008 Jan 29 [Epub ahead of print])
* Oxford; 2007 PMID 17303884 -- "When are randomised trials unnecessary? Picking signal from noise." (Glasziou P, BMJ. 2007 Feb 17;334(7589):349-51.)
* RTOG; 2005 (1968–2002) PMID 15728168 -- "Evaluation of new treatments in radiation oncology: are they better than standard treatments?" (Soares HP, JAMA. 2005 Feb 23;293(8):970-8.)
** Review of all completed Phase III RTOG trials. 57 trials, 12734 patients
** Outcome: survival OR for intervention arm over standard arm 1.01 (NS). Only 10% significantly better, 88% inconclusive
** Toxicity: treatment-related mortality intervention arm worse OR 1.76 over standard arm (SS)
** Conclusion: Results of individual trials cannot be predicted in advance
* COG; 2005 (1955–1997) PMID 16299015 -- "Are experimental treatments for cancer in children superior to established treatments? Observational study of randomised controlled trials by the Children's Oncology Group." (Kumar A, BMJ. 2005 Dec 3;331(7528):1295. Epub 2005 Nov 18.)
** Review of completed Phase III trials. 126 trials, 36567 patients
** Outcome: survival OR 0.96 (NS)
** Conclusion: New treatments in childhood cancer are as likely to be inferior as they are to be superior to standard treatments