A systematic overview of radiation therapy effects in XXXX .

@entity1 @entity135 @entity706 @entity146 @entity5 @entity3521 @entity348 @entity1893 @entity1499 @entity2359
A systematic review of radiation therapy trials in several @entity5 types was performed by The Swedish Council of Technology Assessment in Health Care (SBU). The procedures for evaluation of the scientific literature are described separately (Acta Oncol 2003; 42: 357-365). This synthesis of the literature on radiation therapy for @entity1893 ( @entity1893 ) is based on data from seven randomized trials. Moreover, data from 17 prospective studies, 22 retrospective studies and 27 other articles were used. In total, 73 scientific articles are included, involving 13,305 @entity1 . The results were compared with those of a similar overview from 1996 including 14,137 @entity1 . The conclusions reached can be summarized as follows: @entity706 . Data indicate that one-third to one-half of @entity1 with @entity706 in stage I are cured by radiotherapy (follow-up more than 15 years). Addition of chemotherapy to radiotherapy does not indicate any improvement in overall outcome. Optimal radiation dose is not defined and extended field is not superior to involved field. @entity146 . Data indicate that half of the @entity1 in stage I are cured by radiotherapy alone. Although randomized and non-randomized studies favour combined modality treatment with chemotherapy followed by radiotherapy instead of radiotherapy or chemotherapy alone in localized disease, no firm conclusions can be drawn. Conflicting data have been published on the value of radiotherapy towards bulky disease and no firm conclusions can be drawn. Optimal dose for radiation alone or after chemotherapy has not been established. @entity348 ( @entity348 ). The value of @entity348 for treatment of @entity1893 has not been proven. There is no proof that fractionated @entity348 in conjunction with high-dose chemotherapy is superior to chemotherapy regimens alone. Primary @entity706 . Data show that radiotherapy induces a response of short duration and is associated with major @entity2359 , especially in elderly @entity1 . High-dose methotrexate therapy seems to lead to longer survival than radiotherapy alone. No randomized trials have been performed. There is fairly good support for primary chemotherapy including high-dose @entity1499 followed by radiotherapy in @entity1 below 60 years. To minimize the risk of @entity2359 of combined modality treatment it has been proposed to use chemotherapy alone and delay radiotherapy for relapse, especially in @entity1 above 60 years, or use it in chemotherapy-resistant disease. Optimal chemotherapy regimen is not defined and the role of radiotherapy remains to be determined. @entity135 . There is some support for combined modality treatment with chemotherapy and radiotherapy for @entity146 in @entity3521 with limited disease. There are sparse data supporting radiotherapy alone in localized @entity706 in salivary glands. Radioimmunotherapy (RIT). Radioimmunotherapy is a new treatment modality with systemic radiation for @entity1 with @entity1893 , where conventional external beam radiotherapy plays only a minor role. Several phase I and II studies with RIT have documented promising results. A variety of monoclonal antibodies, radionuclides and study designs with both myeloablative and non-myeloablative approach have resulted in high response rates in @entity1 with recurrent or refractory @entity1893 . One randomized clinical trial is published, showing superior therapy results with radiolabelled antibody compared with the corresponding unlabelled antibody.
