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Mason MD, Parulekar WR, Sydes MR, Brundage M, Kirkbride P, Gospodarowicz M, Cowan R, Kostashuk EC, Anderson J, Swanson G, Parmar MKB, Hayter C, Jovic G, Hiltz A, Hetherington J, Sathya J, Barber JBP, McKenzie M, El-Sharkawi S, Souhami L, Hardman PDJ, Chen BE, Warde P. Final Report of the Intergroup Randomized Study of Combined Androgen-Deprivation Therapy Plus Radiotherapy Versus Androgen-Deprivation Therapy Alone in Locally Advanced Prostate Cancer. J Clin Oncol 2015; 33:2143-50. [PMID: 25691677 PMCID: PMC4477786 DOI: 10.1200/jco.2014.57.7510] [Citation(s) in RCA: 173] [Impact Index Per Article: 19.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
Purpose We have previously reported that radiotherapy (RT) added to androgen-deprivation therapy (ADT) improves survival in men with locally advanced prostate cancer. Here, we report the prespecified final analysis of this randomized trial. Patients and Methods NCIC Clinical Trials Group PR.3/Medical Research Council PR07/Intergroup T94-0110 was a randomized controlled trial of patients with locally advanced prostate cancer. Patients with T3-4, N0/Nx, M0 prostate cancer or T1-2 disease with either prostate-specific antigen (PSA) of more than 40 μg/L or PSA of 20 to 40 μg/L plus Gleason score of 8 to 10 were randomly assigned to lifelong ADT alone or to ADT+RT. The RT dose was 64 to 69 Gy in 35 to 39 fractions to the prostate and pelvis or prostate alone. Overall survival was compared using a log-rank test stratified for prespecified variables. Results One thousand two hundred five patients were randomly assigned between 1995 and 2005, 602 to ADT alone and 603 to ADT+RT. At a median follow-up time of 8 years, 465 patients had died, including 199 patients from prostate cancer. Overall survival was significantly improved in the patients allocated to ADT+RT (hazard ratio [HR], 0.70; 95% CI, 0.57 to 0.85; P < .001). Deaths from prostate cancer were significantly reduced by the addition of RT to ADT (HR, 0.46; 95% CI, 0.34 to 0.61; P < .001). Patients on ADT+RT reported a higher frequency of adverse events related to bowel toxicity, but only two of 589 patients had grade 3 or greater diarrhea at 24 months after RT. Conclusion This analysis demonstrates that the previously reported benefit in survival is maintained at a median follow-up of 8 years and firmly establishes the role of RT in the treatment of men with locally advanced prostate cancer.
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Affiliation(s)
- Malcolm D Mason
- Malcolm D. Mason, Cardiff University School of Medicine, Velindre Hospital; James B.P. Barber, Velindre Hospital, Cardiff; Matthew R. Sydes, Mahesh K.B. Parmar, Gordana Jovic, Medical Research Council Clinical Trials Unit at University College London, London; Peter Kirkbride, The Clatterbridge Cancer Centre National Health Service Foundation Trust, Wirral; Richard Cowan, Christie Hospital, University of Manchester, Manchester; John Anderson, Sheffield Teaching Hospitals, National Health Service Foundation Trust, Sheffield; John Hetherington, Castle Hill Hospital, Hull; Salah El-Sharkawi, South West Wales Cancer Centre, Swansea; P.D. John Hardman, The James Cook University Hospital, Middlesbrough, United Kingdom; Wendy R. Parulekar, Andrea Hiltz, and Bingshu E. Chen, NCIC Clinical Trials Group, Queen's University; Michael Brundage, Cancer Centre of Southeastern Ontario, Kingston; Mary Gospodarowicz and Padraig Warde, University of Toronto, Princess Margaret Cancer Centre; Charles Hayter, University of Toronto, Carlo Fidani Peel Regional Cancer Center, Toronto, Ontario; Edmund C. Kostashuk, Fraser Valley Cancer Centre, Surrey; Michael McKenzie, Vancouver Cancer Centre, Vancouver, British Columbia; Jinka Sathya, Memorial University of Newfoundland, St Johns, Newfoundland and Labrador, Canada; Luis Souhami, McGill University, Montreal, Quebec, Canada; and Gregory Swanson, University of Texas Health Science Center, San Antonio, TX.
| | - Wendy R Parulekar
- Malcolm D. Mason, Cardiff University School of Medicine, Velindre Hospital; James B.P. Barber, Velindre Hospital, Cardiff; Matthew R. Sydes, Mahesh K.B. Parmar, Gordana Jovic, Medical Research Council Clinical Trials Unit at University College London, London; Peter Kirkbride, The Clatterbridge Cancer Centre National Health Service Foundation Trust, Wirral; Richard Cowan, Christie Hospital, University of Manchester, Manchester; John Anderson, Sheffield Teaching Hospitals, National Health Service Foundation Trust, Sheffield; John Hetherington, Castle Hill Hospital, Hull; Salah El-Sharkawi, South West Wales Cancer Centre, Swansea; P.D. John Hardman, The James Cook University Hospital, Middlesbrough, United Kingdom; Wendy R. Parulekar, Andrea Hiltz, and Bingshu E. Chen, NCIC Clinical Trials Group, Queen's University; Michael Brundage, Cancer Centre of Southeastern Ontario, Kingston; Mary Gospodarowicz and Padraig Warde, University of Toronto, Princess Margaret Cancer Centre; Charles Hayter, University of Toronto, Carlo Fidani Peel Regional Cancer Center, Toronto, Ontario; Edmund C. Kostashuk, Fraser Valley Cancer Centre, Surrey; Michael McKenzie, Vancouver Cancer Centre, Vancouver, British Columbia; Jinka Sathya, Memorial University of Newfoundland, St Johns, Newfoundland and Labrador, Canada; Luis Souhami, McGill University, Montreal, Quebec, Canada; and Gregory Swanson, University of Texas Health Science Center, San Antonio, TX
| | - Matthew R Sydes
- Malcolm D. Mason, Cardiff University School of Medicine, Velindre Hospital; James B.P. Barber, Velindre Hospital, Cardiff; Matthew R. Sydes, Mahesh K.B. Parmar, Gordana Jovic, Medical Research Council Clinical Trials Unit at University College London, London; Peter Kirkbride, The Clatterbridge Cancer Centre National Health Service Foundation Trust, Wirral; Richard Cowan, Christie Hospital, University of Manchester, Manchester; John Anderson, Sheffield Teaching Hospitals, National Health Service Foundation Trust, Sheffield; John Hetherington, Castle Hill Hospital, Hull; Salah El-Sharkawi, South West Wales Cancer Centre, Swansea; P.D. John Hardman, The James Cook University Hospital, Middlesbrough, United Kingdom; Wendy R. Parulekar, Andrea Hiltz, and Bingshu E. Chen, NCIC Clinical Trials Group, Queen's University; Michael Brundage, Cancer Centre of Southeastern Ontario, Kingston; Mary Gospodarowicz and Padraig Warde, University of Toronto, Princess Margaret Cancer Centre; Charles Hayter, University of Toronto, Carlo Fidani Peel Regional Cancer Center, Toronto, Ontario; Edmund C. Kostashuk, Fraser Valley Cancer Centre, Surrey; Michael McKenzie, Vancouver Cancer Centre, Vancouver, British Columbia; Jinka Sathya, Memorial University of Newfoundland, St Johns, Newfoundland and Labrador, Canada; Luis Souhami, McGill University, Montreal, Quebec, Canada; and Gregory Swanson, University of Texas Health Science Center, San Antonio, TX
| | - Michael Brundage
- Malcolm D. Mason, Cardiff University School of Medicine, Velindre Hospital; James B.P. Barber, Velindre Hospital, Cardiff; Matthew R. Sydes, Mahesh K.B. Parmar, Gordana Jovic, Medical Research Council Clinical Trials Unit at University College London, London; Peter Kirkbride, The Clatterbridge Cancer Centre National Health Service Foundation Trust, Wirral; Richard Cowan, Christie Hospital, University of Manchester, Manchester; John Anderson, Sheffield Teaching Hospitals, National Health Service Foundation Trust, Sheffield; John Hetherington, Castle Hill Hospital, Hull; Salah El-Sharkawi, South West Wales Cancer Centre, Swansea; P.D. John Hardman, The James Cook University Hospital, Middlesbrough, United Kingdom; Wendy R. Parulekar, Andrea Hiltz, and Bingshu E. Chen, NCIC Clinical Trials Group, Queen's University; Michael Brundage, Cancer Centre of Southeastern Ontario, Kingston; Mary Gospodarowicz and Padraig Warde, University of Toronto, Princess Margaret Cancer Centre; Charles Hayter, University of Toronto, Carlo Fidani Peel Regional Cancer Center, Toronto, Ontario; Edmund C. Kostashuk, Fraser Valley Cancer Centre, Surrey; Michael McKenzie, Vancouver Cancer Centre, Vancouver, British Columbia; Jinka Sathya, Memorial University of Newfoundland, St Johns, Newfoundland and Labrador, Canada; Luis Souhami, McGill University, Montreal, Quebec, Canada; and Gregory Swanson, University of Texas Health Science Center, San Antonio, TX
| | - Peter Kirkbride
- Malcolm D. Mason, Cardiff University School of Medicine, Velindre Hospital; James B.P. Barber, Velindre Hospital, Cardiff; Matthew R. Sydes, Mahesh K.B. Parmar, Gordana Jovic, Medical Research Council Clinical Trials Unit at University College London, London; Peter Kirkbride, The Clatterbridge Cancer Centre National Health Service Foundation Trust, Wirral; Richard Cowan, Christie Hospital, University of Manchester, Manchester; John Anderson, Sheffield Teaching Hospitals, National Health Service Foundation Trust, Sheffield; John Hetherington, Castle Hill Hospital, Hull; Salah El-Sharkawi, South West Wales Cancer Centre, Swansea; P.D. John Hardman, The James Cook University Hospital, Middlesbrough, United Kingdom; Wendy R. Parulekar, Andrea Hiltz, and Bingshu E. Chen, NCIC Clinical Trials Group, Queen's University; Michael Brundage, Cancer Centre of Southeastern Ontario, Kingston; Mary Gospodarowicz and Padraig Warde, University of Toronto, Princess Margaret Cancer Centre; Charles Hayter, University of Toronto, Carlo Fidani Peel Regional Cancer Center, Toronto, Ontario; Edmund C. Kostashuk, Fraser Valley Cancer Centre, Surrey; Michael McKenzie, Vancouver Cancer Centre, Vancouver, British Columbia; Jinka Sathya, Memorial University of Newfoundland, St Johns, Newfoundland and Labrador, Canada; Luis Souhami, McGill University, Montreal, Quebec, Canada; and Gregory Swanson, University of Texas Health Science Center, San Antonio, TX
| | - Mary Gospodarowicz
- Malcolm D. Mason, Cardiff University School of Medicine, Velindre Hospital; James B.P. Barber, Velindre Hospital, Cardiff; Matthew R. Sydes, Mahesh K.B. Parmar, Gordana Jovic, Medical Research Council Clinical Trials Unit at University College London, London; Peter Kirkbride, The Clatterbridge Cancer Centre National Health Service Foundation Trust, Wirral; Richard Cowan, Christie Hospital, University of Manchester, Manchester; John Anderson, Sheffield Teaching Hospitals, National Health Service Foundation Trust, Sheffield; John Hetherington, Castle Hill Hospital, Hull; Salah El-Sharkawi, South West Wales Cancer Centre, Swansea; P.D. John Hardman, The James Cook University Hospital, Middlesbrough, United Kingdom; Wendy R. Parulekar, Andrea Hiltz, and Bingshu E. Chen, NCIC Clinical Trials Group, Queen's University; Michael Brundage, Cancer Centre of Southeastern Ontario, Kingston; Mary Gospodarowicz and Padraig Warde, University of Toronto, Princess Margaret Cancer Centre; Charles Hayter, University of Toronto, Carlo Fidani Peel Regional Cancer Center, Toronto, Ontario; Edmund C. Kostashuk, Fraser Valley Cancer Centre, Surrey; Michael McKenzie, Vancouver Cancer Centre, Vancouver, British Columbia; Jinka Sathya, Memorial University of Newfoundland, St Johns, Newfoundland and Labrador, Canada; Luis Souhami, McGill University, Montreal, Quebec, Canada; and Gregory Swanson, University of Texas Health Science Center, San Antonio, TX
| | - Richard Cowan
- Malcolm D. Mason, Cardiff University School of Medicine, Velindre Hospital; James B.P. Barber, Velindre Hospital, Cardiff; Matthew R. Sydes, Mahesh K.B. Parmar, Gordana Jovic, Medical Research Council Clinical Trials Unit at University College London, London; Peter Kirkbride, The Clatterbridge Cancer Centre National Health Service Foundation Trust, Wirral; Richard Cowan, Christie Hospital, University of Manchester, Manchester; John Anderson, Sheffield Teaching Hospitals, National Health Service Foundation Trust, Sheffield; John Hetherington, Castle Hill Hospital, Hull; Salah El-Sharkawi, South West Wales Cancer Centre, Swansea; P.D. John Hardman, The James Cook University Hospital, Middlesbrough, United Kingdom; Wendy R. Parulekar, Andrea Hiltz, and Bingshu E. Chen, NCIC Clinical Trials Group, Queen's University; Michael Brundage, Cancer Centre of Southeastern Ontario, Kingston; Mary Gospodarowicz and Padraig Warde, University of Toronto, Princess Margaret Cancer Centre; Charles Hayter, University of Toronto, Carlo Fidani Peel Regional Cancer Center, Toronto, Ontario; Edmund C. Kostashuk, Fraser Valley Cancer Centre, Surrey; Michael McKenzie, Vancouver Cancer Centre, Vancouver, British Columbia; Jinka Sathya, Memorial University of Newfoundland, St Johns, Newfoundland and Labrador, Canada; Luis Souhami, McGill University, Montreal, Quebec, Canada; and Gregory Swanson, University of Texas Health Science Center, San Antonio, TX
| | - Edmund C Kostashuk
- Malcolm D. Mason, Cardiff University School of Medicine, Velindre Hospital; James B.P. Barber, Velindre Hospital, Cardiff; Matthew R. Sydes, Mahesh K.B. Parmar, Gordana Jovic, Medical Research Council Clinical Trials Unit at University College London, London; Peter Kirkbride, The Clatterbridge Cancer Centre National Health Service Foundation Trust, Wirral; Richard Cowan, Christie Hospital, University of Manchester, Manchester; John Anderson, Sheffield Teaching Hospitals, National Health Service Foundation Trust, Sheffield; John Hetherington, Castle Hill Hospital, Hull; Salah El-Sharkawi, South West Wales Cancer Centre, Swansea; P.D. John Hardman, The James Cook University Hospital, Middlesbrough, United Kingdom; Wendy R. Parulekar, Andrea Hiltz, and Bingshu E. Chen, NCIC Clinical Trials Group, Queen's University; Michael Brundage, Cancer Centre of Southeastern Ontario, Kingston; Mary Gospodarowicz and Padraig Warde, University of Toronto, Princess Margaret Cancer Centre; Charles Hayter, University of Toronto, Carlo Fidani Peel Regional Cancer Center, Toronto, Ontario; Edmund C. Kostashuk, Fraser Valley Cancer Centre, Surrey; Michael McKenzie, Vancouver Cancer Centre, Vancouver, British Columbia; Jinka Sathya, Memorial University of Newfoundland, St Johns, Newfoundland and Labrador, Canada; Luis Souhami, McGill University, Montreal, Quebec, Canada; and Gregory Swanson, University of Texas Health Science Center, San Antonio, TX
| | - John Anderson
- Malcolm D. Mason, Cardiff University School of Medicine, Velindre Hospital; James B.P. Barber, Velindre Hospital, Cardiff; Matthew R. Sydes, Mahesh K.B. Parmar, Gordana Jovic, Medical Research Council Clinical Trials Unit at University College London, London; Peter Kirkbride, The Clatterbridge Cancer Centre National Health Service Foundation Trust, Wirral; Richard Cowan, Christie Hospital, University of Manchester, Manchester; John Anderson, Sheffield Teaching Hospitals, National Health Service Foundation Trust, Sheffield; John Hetherington, Castle Hill Hospital, Hull; Salah El-Sharkawi, South West Wales Cancer Centre, Swansea; P.D. John Hardman, The James Cook University Hospital, Middlesbrough, United Kingdom; Wendy R. Parulekar, Andrea Hiltz, and Bingshu E. Chen, NCIC Clinical Trials Group, Queen's University; Michael Brundage, Cancer Centre of Southeastern Ontario, Kingston; Mary Gospodarowicz and Padraig Warde, University of Toronto, Princess Margaret Cancer Centre; Charles Hayter, University of Toronto, Carlo Fidani Peel Regional Cancer Center, Toronto, Ontario; Edmund C. Kostashuk, Fraser Valley Cancer Centre, Surrey; Michael McKenzie, Vancouver Cancer Centre, Vancouver, British Columbia; Jinka Sathya, Memorial University of Newfoundland, St Johns, Newfoundland and Labrador, Canada; Luis Souhami, McGill University, Montreal, Quebec, Canada; and Gregory Swanson, University of Texas Health Science Center, San Antonio, TX
| | - Gregory Swanson
- Malcolm D. Mason, Cardiff University School of Medicine, Velindre Hospital; James B.P. Barber, Velindre Hospital, Cardiff; Matthew R. Sydes, Mahesh K.B. Parmar, Gordana Jovic, Medical Research Council Clinical Trials Unit at University College London, London; Peter Kirkbride, The Clatterbridge Cancer Centre National Health Service Foundation Trust, Wirral; Richard Cowan, Christie Hospital, University of Manchester, Manchester; John Anderson, Sheffield Teaching Hospitals, National Health Service Foundation Trust, Sheffield; John Hetherington, Castle Hill Hospital, Hull; Salah El-Sharkawi, South West Wales Cancer Centre, Swansea; P.D. John Hardman, The James Cook University Hospital, Middlesbrough, United Kingdom; Wendy R. Parulekar, Andrea Hiltz, and Bingshu E. Chen, NCIC Clinical Trials Group, Queen's University; Michael Brundage, Cancer Centre of Southeastern Ontario, Kingston; Mary Gospodarowicz and Padraig Warde, University of Toronto, Princess Margaret Cancer Centre; Charles Hayter, University of Toronto, Carlo Fidani Peel Regional Cancer Center, Toronto, Ontario; Edmund C. Kostashuk, Fraser Valley Cancer Centre, Surrey; Michael McKenzie, Vancouver Cancer Centre, Vancouver, British Columbia; Jinka Sathya, Memorial University of Newfoundland, St Johns, Newfoundland and Labrador, Canada; Luis Souhami, McGill University, Montreal, Quebec, Canada; and Gregory Swanson, University of Texas Health Science Center, San Antonio, TX
| | - Mahesh K B Parmar
- Malcolm D. Mason, Cardiff University School of Medicine, Velindre Hospital; James B.P. Barber, Velindre Hospital, Cardiff; Matthew R. Sydes, Mahesh K.B. Parmar, Gordana Jovic, Medical Research Council Clinical Trials Unit at University College London, London; Peter Kirkbride, The Clatterbridge Cancer Centre National Health Service Foundation Trust, Wirral; Richard Cowan, Christie Hospital, University of Manchester, Manchester; John Anderson, Sheffield Teaching Hospitals, National Health Service Foundation Trust, Sheffield; John Hetherington, Castle Hill Hospital, Hull; Salah El-Sharkawi, South West Wales Cancer Centre, Swansea; P.D. John Hardman, The James Cook University Hospital, Middlesbrough, United Kingdom; Wendy R. Parulekar, Andrea Hiltz, and Bingshu E. Chen, NCIC Clinical Trials Group, Queen's University; Michael Brundage, Cancer Centre of Southeastern Ontario, Kingston; Mary Gospodarowicz and Padraig Warde, University of Toronto, Princess Margaret Cancer Centre; Charles Hayter, University of Toronto, Carlo Fidani Peel Regional Cancer Center, Toronto, Ontario; Edmund C. Kostashuk, Fraser Valley Cancer Centre, Surrey; Michael McKenzie, Vancouver Cancer Centre, Vancouver, British Columbia; Jinka Sathya, Memorial University of Newfoundland, St Johns, Newfoundland and Labrador, Canada; Luis Souhami, McGill University, Montreal, Quebec, Canada; and Gregory Swanson, University of Texas Health Science Center, San Antonio, TX
| | - Charles Hayter
- Malcolm D. Mason, Cardiff University School of Medicine, Velindre Hospital; James B.P. Barber, Velindre Hospital, Cardiff; Matthew R. Sydes, Mahesh K.B. Parmar, Gordana Jovic, Medical Research Council Clinical Trials Unit at University College London, London; Peter Kirkbride, The Clatterbridge Cancer Centre National Health Service Foundation Trust, Wirral; Richard Cowan, Christie Hospital, University of Manchester, Manchester; John Anderson, Sheffield Teaching Hospitals, National Health Service Foundation Trust, Sheffield; John Hetherington, Castle Hill Hospital, Hull; Salah El-Sharkawi, South West Wales Cancer Centre, Swansea; P.D. John Hardman, The James Cook University Hospital, Middlesbrough, United Kingdom; Wendy R. Parulekar, Andrea Hiltz, and Bingshu E. Chen, NCIC Clinical Trials Group, Queen's University; Michael Brundage, Cancer Centre of Southeastern Ontario, Kingston; Mary Gospodarowicz and Padraig Warde, University of Toronto, Princess Margaret Cancer Centre; Charles Hayter, University of Toronto, Carlo Fidani Peel Regional Cancer Center, Toronto, Ontario; Edmund C. Kostashuk, Fraser Valley Cancer Centre, Surrey; Michael McKenzie, Vancouver Cancer Centre, Vancouver, British Columbia; Jinka Sathya, Memorial University of Newfoundland, St Johns, Newfoundland and Labrador, Canada; Luis Souhami, McGill University, Montreal, Quebec, Canada; and Gregory Swanson, University of Texas Health Science Center, San Antonio, TX
| | - Gordana Jovic
- Malcolm D. Mason, Cardiff University School of Medicine, Velindre Hospital; James B.P. Barber, Velindre Hospital, Cardiff; Matthew R. Sydes, Mahesh K.B. Parmar, Gordana Jovic, Medical Research Council Clinical Trials Unit at University College London, London; Peter Kirkbride, The Clatterbridge Cancer Centre National Health Service Foundation Trust, Wirral; Richard Cowan, Christie Hospital, University of Manchester, Manchester; John Anderson, Sheffield Teaching Hospitals, National Health Service Foundation Trust, Sheffield; John Hetherington, Castle Hill Hospital, Hull; Salah El-Sharkawi, South West Wales Cancer Centre, Swansea; P.D. John Hardman, The James Cook University Hospital, Middlesbrough, United Kingdom; Wendy R. Parulekar, Andrea Hiltz, and Bingshu E. Chen, NCIC Clinical Trials Group, Queen's University; Michael Brundage, Cancer Centre of Southeastern Ontario, Kingston; Mary Gospodarowicz and Padraig Warde, University of Toronto, Princess Margaret Cancer Centre; Charles Hayter, University of Toronto, Carlo Fidani Peel Regional Cancer Center, Toronto, Ontario; Edmund C. Kostashuk, Fraser Valley Cancer Centre, Surrey; Michael McKenzie, Vancouver Cancer Centre, Vancouver, British Columbia; Jinka Sathya, Memorial University of Newfoundland, St Johns, Newfoundland and Labrador, Canada; Luis Souhami, McGill University, Montreal, Quebec, Canada; and Gregory Swanson, University of Texas Health Science Center, San Antonio, TX
| | - Andrea Hiltz
- Malcolm D. Mason, Cardiff University School of Medicine, Velindre Hospital; James B.P. Barber, Velindre Hospital, Cardiff; Matthew R. Sydes, Mahesh K.B. Parmar, Gordana Jovic, Medical Research Council Clinical Trials Unit at University College London, London; Peter Kirkbride, The Clatterbridge Cancer Centre National Health Service Foundation Trust, Wirral; Richard Cowan, Christie Hospital, University of Manchester, Manchester; John Anderson, Sheffield Teaching Hospitals, National Health Service Foundation Trust, Sheffield; John Hetherington, Castle Hill Hospital, Hull; Salah El-Sharkawi, South West Wales Cancer Centre, Swansea; P.D. John Hardman, The James Cook University Hospital, Middlesbrough, United Kingdom; Wendy R. Parulekar, Andrea Hiltz, and Bingshu E. Chen, NCIC Clinical Trials Group, Queen's University; Michael Brundage, Cancer Centre of Southeastern Ontario, Kingston; Mary Gospodarowicz and Padraig Warde, University of Toronto, Princess Margaret Cancer Centre; Charles Hayter, University of Toronto, Carlo Fidani Peel Regional Cancer Center, Toronto, Ontario; Edmund C. Kostashuk, Fraser Valley Cancer Centre, Surrey; Michael McKenzie, Vancouver Cancer Centre, Vancouver, British Columbia; Jinka Sathya, Memorial University of Newfoundland, St Johns, Newfoundland and Labrador, Canada; Luis Souhami, McGill University, Montreal, Quebec, Canada; and Gregory Swanson, University of Texas Health Science Center, San Antonio, TX
| | - John Hetherington
- Malcolm D. Mason, Cardiff University School of Medicine, Velindre Hospital; James B.P. Barber, Velindre Hospital, Cardiff; Matthew R. Sydes, Mahesh K.B. Parmar, Gordana Jovic, Medical Research Council Clinical Trials Unit at University College London, London; Peter Kirkbride, The Clatterbridge Cancer Centre National Health Service Foundation Trust, Wirral; Richard Cowan, Christie Hospital, University of Manchester, Manchester; John Anderson, Sheffield Teaching Hospitals, National Health Service Foundation Trust, Sheffield; John Hetherington, Castle Hill Hospital, Hull; Salah El-Sharkawi, South West Wales Cancer Centre, Swansea; P.D. John Hardman, The James Cook University Hospital, Middlesbrough, United Kingdom; Wendy R. Parulekar, Andrea Hiltz, and Bingshu E. Chen, NCIC Clinical Trials Group, Queen's University; Michael Brundage, Cancer Centre of Southeastern Ontario, Kingston; Mary Gospodarowicz and Padraig Warde, University of Toronto, Princess Margaret Cancer Centre; Charles Hayter, University of Toronto, Carlo Fidani Peel Regional Cancer Center, Toronto, Ontario; Edmund C. Kostashuk, Fraser Valley Cancer Centre, Surrey; Michael McKenzie, Vancouver Cancer Centre, Vancouver, British Columbia; Jinka Sathya, Memorial University of Newfoundland, St Johns, Newfoundland and Labrador, Canada; Luis Souhami, McGill University, Montreal, Quebec, Canada; and Gregory Swanson, University of Texas Health Science Center, San Antonio, TX
| | - Jinka Sathya
- Malcolm D. Mason, Cardiff University School of Medicine, Velindre Hospital; James B.P. Barber, Velindre Hospital, Cardiff; Matthew R. Sydes, Mahesh K.B. Parmar, Gordana Jovic, Medical Research Council Clinical Trials Unit at University College London, London; Peter Kirkbride, The Clatterbridge Cancer Centre National Health Service Foundation Trust, Wirral; Richard Cowan, Christie Hospital, University of Manchester, Manchester; John Anderson, Sheffield Teaching Hospitals, National Health Service Foundation Trust, Sheffield; John Hetherington, Castle Hill Hospital, Hull; Salah El-Sharkawi, South West Wales Cancer Centre, Swansea; P.D. John Hardman, The James Cook University Hospital, Middlesbrough, United Kingdom; Wendy R. Parulekar, Andrea Hiltz, and Bingshu E. Chen, NCIC Clinical Trials Group, Queen's University; Michael Brundage, Cancer Centre of Southeastern Ontario, Kingston; Mary Gospodarowicz and Padraig Warde, University of Toronto, Princess Margaret Cancer Centre; Charles Hayter, University of Toronto, Carlo Fidani Peel Regional Cancer Center, Toronto, Ontario; Edmund C. Kostashuk, Fraser Valley Cancer Centre, Surrey; Michael McKenzie, Vancouver Cancer Centre, Vancouver, British Columbia; Jinka Sathya, Memorial University of Newfoundland, St Johns, Newfoundland and Labrador, Canada; Luis Souhami, McGill University, Montreal, Quebec, Canada; and Gregory Swanson, University of Texas Health Science Center, San Antonio, TX
| | - James B P Barber
- Malcolm D. Mason, Cardiff University School of Medicine, Velindre Hospital; James B.P. Barber, Velindre Hospital, Cardiff; Matthew R. Sydes, Mahesh K.B. Parmar, Gordana Jovic, Medical Research Council Clinical Trials Unit at University College London, London; Peter Kirkbride, The Clatterbridge Cancer Centre National Health Service Foundation Trust, Wirral; Richard Cowan, Christie Hospital, University of Manchester, Manchester; John Anderson, Sheffield Teaching Hospitals, National Health Service Foundation Trust, Sheffield; John Hetherington, Castle Hill Hospital, Hull; Salah El-Sharkawi, South West Wales Cancer Centre, Swansea; P.D. John Hardman, The James Cook University Hospital, Middlesbrough, United Kingdom; Wendy R. Parulekar, Andrea Hiltz, and Bingshu E. Chen, NCIC Clinical Trials Group, Queen's University; Michael Brundage, Cancer Centre of Southeastern Ontario, Kingston; Mary Gospodarowicz and Padraig Warde, University of Toronto, Princess Margaret Cancer Centre; Charles Hayter, University of Toronto, Carlo Fidani Peel Regional Cancer Center, Toronto, Ontario; Edmund C. Kostashuk, Fraser Valley Cancer Centre, Surrey; Michael McKenzie, Vancouver Cancer Centre, Vancouver, British Columbia; Jinka Sathya, Memorial University of Newfoundland, St Johns, Newfoundland and Labrador, Canada; Luis Souhami, McGill University, Montreal, Quebec, Canada; and Gregory Swanson, University of Texas Health Science Center, San Antonio, TX
| | - Michael McKenzie
- Malcolm D. Mason, Cardiff University School of Medicine, Velindre Hospital; James B.P. Barber, Velindre Hospital, Cardiff; Matthew R. Sydes, Mahesh K.B. Parmar, Gordana Jovic, Medical Research Council Clinical Trials Unit at University College London, London; Peter Kirkbride, The Clatterbridge Cancer Centre National Health Service Foundation Trust, Wirral; Richard Cowan, Christie Hospital, University of Manchester, Manchester; John Anderson, Sheffield Teaching Hospitals, National Health Service Foundation Trust, Sheffield; John Hetherington, Castle Hill Hospital, Hull; Salah El-Sharkawi, South West Wales Cancer Centre, Swansea; P.D. John Hardman, The James Cook University Hospital, Middlesbrough, United Kingdom; Wendy R. Parulekar, Andrea Hiltz, and Bingshu E. Chen, NCIC Clinical Trials Group, Queen's University; Michael Brundage, Cancer Centre of Southeastern Ontario, Kingston; Mary Gospodarowicz and Padraig Warde, University of Toronto, Princess Margaret Cancer Centre; Charles Hayter, University of Toronto, Carlo Fidani Peel Regional Cancer Center, Toronto, Ontario; Edmund C. Kostashuk, Fraser Valley Cancer Centre, Surrey; Michael McKenzie, Vancouver Cancer Centre, Vancouver, British Columbia; Jinka Sathya, Memorial University of Newfoundland, St Johns, Newfoundland and Labrador, Canada; Luis Souhami, McGill University, Montreal, Quebec, Canada; and Gregory Swanson, University of Texas Health Science Center, San Antonio, TX
| | - Salah El-Sharkawi
- Malcolm D. Mason, Cardiff University School of Medicine, Velindre Hospital; James B.P. Barber, Velindre Hospital, Cardiff; Matthew R. Sydes, Mahesh K.B. Parmar, Gordana Jovic, Medical Research Council Clinical Trials Unit at University College London, London; Peter Kirkbride, The Clatterbridge Cancer Centre National Health Service Foundation Trust, Wirral; Richard Cowan, Christie Hospital, University of Manchester, Manchester; John Anderson, Sheffield Teaching Hospitals, National Health Service Foundation Trust, Sheffield; John Hetherington, Castle Hill Hospital, Hull; Salah El-Sharkawi, South West Wales Cancer Centre, Swansea; P.D. John Hardman, The James Cook University Hospital, Middlesbrough, United Kingdom; Wendy R. Parulekar, Andrea Hiltz, and Bingshu E. Chen, NCIC Clinical Trials Group, Queen's University; Michael Brundage, Cancer Centre of Southeastern Ontario, Kingston; Mary Gospodarowicz and Padraig Warde, University of Toronto, Princess Margaret Cancer Centre; Charles Hayter, University of Toronto, Carlo Fidani Peel Regional Cancer Center, Toronto, Ontario; Edmund C. Kostashuk, Fraser Valley Cancer Centre, Surrey; Michael McKenzie, Vancouver Cancer Centre, Vancouver, British Columbia; Jinka Sathya, Memorial University of Newfoundland, St Johns, Newfoundland and Labrador, Canada; Luis Souhami, McGill University, Montreal, Quebec, Canada; and Gregory Swanson, University of Texas Health Science Center, San Antonio, TX
| | - Luis Souhami
- Malcolm D. Mason, Cardiff University School of Medicine, Velindre Hospital; James B.P. Barber, Velindre Hospital, Cardiff; Matthew R. Sydes, Mahesh K.B. Parmar, Gordana Jovic, Medical Research Council Clinical Trials Unit at University College London, London; Peter Kirkbride, The Clatterbridge Cancer Centre National Health Service Foundation Trust, Wirral; Richard Cowan, Christie Hospital, University of Manchester, Manchester; John Anderson, Sheffield Teaching Hospitals, National Health Service Foundation Trust, Sheffield; John Hetherington, Castle Hill Hospital, Hull; Salah El-Sharkawi, South West Wales Cancer Centre, Swansea; P.D. John Hardman, The James Cook University Hospital, Middlesbrough, United Kingdom; Wendy R. Parulekar, Andrea Hiltz, and Bingshu E. Chen, NCIC Clinical Trials Group, Queen's University; Michael Brundage, Cancer Centre of Southeastern Ontario, Kingston; Mary Gospodarowicz and Padraig Warde, University of Toronto, Princess Margaret Cancer Centre; Charles Hayter, University of Toronto, Carlo Fidani Peel Regional Cancer Center, Toronto, Ontario; Edmund C. Kostashuk, Fraser Valley Cancer Centre, Surrey; Michael McKenzie, Vancouver Cancer Centre, Vancouver, British Columbia; Jinka Sathya, Memorial University of Newfoundland, St Johns, Newfoundland and Labrador, Canada; Luis Souhami, McGill University, Montreal, Quebec, Canada; and Gregory Swanson, University of Texas Health Science Center, San Antonio, TX
| | - P D John Hardman
- Malcolm D. Mason, Cardiff University School of Medicine, Velindre Hospital; James B.P. Barber, Velindre Hospital, Cardiff; Matthew R. Sydes, Mahesh K.B. Parmar, Gordana Jovic, Medical Research Council Clinical Trials Unit at University College London, London; Peter Kirkbride, The Clatterbridge Cancer Centre National Health Service Foundation Trust, Wirral; Richard Cowan, Christie Hospital, University of Manchester, Manchester; John Anderson, Sheffield Teaching Hospitals, National Health Service Foundation Trust, Sheffield; John Hetherington, Castle Hill Hospital, Hull; Salah El-Sharkawi, South West Wales Cancer Centre, Swansea; P.D. John Hardman, The James Cook University Hospital, Middlesbrough, United Kingdom; Wendy R. Parulekar, Andrea Hiltz, and Bingshu E. Chen, NCIC Clinical Trials Group, Queen's University; Michael Brundage, Cancer Centre of Southeastern Ontario, Kingston; Mary Gospodarowicz and Padraig Warde, University of Toronto, Princess Margaret Cancer Centre; Charles Hayter, University of Toronto, Carlo Fidani Peel Regional Cancer Center, Toronto, Ontario; Edmund C. Kostashuk, Fraser Valley Cancer Centre, Surrey; Michael McKenzie, Vancouver Cancer Centre, Vancouver, British Columbia; Jinka Sathya, Memorial University of Newfoundland, St Johns, Newfoundland and Labrador, Canada; Luis Souhami, McGill University, Montreal, Quebec, Canada; and Gregory Swanson, University of Texas Health Science Center, San Antonio, TX
| | - Bingshu E Chen
- Malcolm D. Mason, Cardiff University School of Medicine, Velindre Hospital; James B.P. Barber, Velindre Hospital, Cardiff; Matthew R. Sydes, Mahesh K.B. Parmar, Gordana Jovic, Medical Research Council Clinical Trials Unit at University College London, London; Peter Kirkbride, The Clatterbridge Cancer Centre National Health Service Foundation Trust, Wirral; Richard Cowan, Christie Hospital, University of Manchester, Manchester; John Anderson, Sheffield Teaching Hospitals, National Health Service Foundation Trust, Sheffield; John Hetherington, Castle Hill Hospital, Hull; Salah El-Sharkawi, South West Wales Cancer Centre, Swansea; P.D. John Hardman, The James Cook University Hospital, Middlesbrough, United Kingdom; Wendy R. Parulekar, Andrea Hiltz, and Bingshu E. Chen, NCIC Clinical Trials Group, Queen's University; Michael Brundage, Cancer Centre of Southeastern Ontario, Kingston; Mary Gospodarowicz and Padraig Warde, University of Toronto, Princess Margaret Cancer Centre; Charles Hayter, University of Toronto, Carlo Fidani Peel Regional Cancer Center, Toronto, Ontario; Edmund C. Kostashuk, Fraser Valley Cancer Centre, Surrey; Michael McKenzie, Vancouver Cancer Centre, Vancouver, British Columbia; Jinka Sathya, Memorial University of Newfoundland, St Johns, Newfoundland and Labrador, Canada; Luis Souhami, McGill University, Montreal, Quebec, Canada; and Gregory Swanson, University of Texas Health Science Center, San Antonio, TX
| | - Padraig Warde
- Malcolm D. Mason, Cardiff University School of Medicine, Velindre Hospital; James B.P. Barber, Velindre Hospital, Cardiff; Matthew R. Sydes, Mahesh K.B. Parmar, Gordana Jovic, Medical Research Council Clinical Trials Unit at University College London, London; Peter Kirkbride, The Clatterbridge Cancer Centre National Health Service Foundation Trust, Wirral; Richard Cowan, Christie Hospital, University of Manchester, Manchester; John Anderson, Sheffield Teaching Hospitals, National Health Service Foundation Trust, Sheffield; John Hetherington, Castle Hill Hospital, Hull; Salah El-Sharkawi, South West Wales Cancer Centre, Swansea; P.D. John Hardman, The James Cook University Hospital, Middlesbrough, United Kingdom; Wendy R. Parulekar, Andrea Hiltz, and Bingshu E. Chen, NCIC Clinical Trials Group, Queen's University; Michael Brundage, Cancer Centre of Southeastern Ontario, Kingston; Mary Gospodarowicz and Padraig Warde, University of Toronto, Princess Margaret Cancer Centre; Charles Hayter, University of Toronto, Carlo Fidani Peel Regional Cancer Center, Toronto, Ontario; Edmund C. Kostashuk, Fraser Valley Cancer Centre, Surrey; Michael McKenzie, Vancouver Cancer Centre, Vancouver, British Columbia; Jinka Sathya, Memorial University of Newfoundland, St Johns, Newfoundland and Labrador, Canada; Luis Souhami, McGill University, Montreal, Quebec, Canada; and Gregory Swanson, University of Texas Health Science Center, San Antonio, TX
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