Abstract

Welcome once again to Practical Radiation Oncology (PRO). This note begins the second issue; an issue that is significant for a number of “firsts.” In this issue you will find the first ASTRO evidence-based clinical guideline to be published in PRO.1.Rodrigues G Videtic GMM Sur R et al.Palliative thoracic radiotherapy in lung cancer: an American Society for Radiation Oncology evidence-based clinical practice guideline.Practical Radiat Oncol. 2011; 1: 60-71Abstract Full Text Full Text PDF PubMed Scopus (135) Google Scholar This guideline focuses on a clinical scenario that is very common in most radiation oncology practices; the palliative treatment of advanced lung cancer. Other ASTRO guidelines have been published in our sister journal International Journal of Radiation Oncology · Biology · Physics; going forward I expect most ASTRO guidelines to be published in PRO. The current guideline provides a succinct review of the evidence and straightforward recommendations that should be relevant to your practice. You will also find 2 more “firsts” in this issue: our first letter to the editor and our first correction. I highlight these, perhaps mundane, elements of the peer review process because I want the readership to know that I view these as integral to the process of scholarship that motivates scientific publication. This issue includes a variety of papers. One in particular that I highly recommend is the manuscript by Bekelman et al on comparative effectiveness.2.Bekelman JE Shah A Hahn SM Implications of comparative effectiveness research for radiation oncology.Practical Radiat Oncol. 2011; 1: 72-80Abstract Full Text Full Text PDF PubMed Scopus (22) Google Scholar These authors have provided a concise, approachable review of this complicated subject. You will also find 2 commentaries that accompany the paper. The first is from Dr Michael Steinberg, our president-elect. As usual, Dr Steinberg provokes us to think about the assumptions underlying the existing hierarchy of evidence.3.Steinberg M The overthrow of the (evidence) hierarchy.Practical Radiat Oncol. 2011; 1: 81-82Abstract Full Text Full Text PDF PubMed Scopus (5) Google Scholar The second commentary is from Dr Lee Newcomer, a board-certified medical oncologist who now spends his time with UnitedHealthcare. I was delighted when he agreed to provide a perspective from “outside” the discipline.4.Newcomer LN Finding the answers we need: comparative effectiveness.Practical Radiat Oncol. 2011; 1: 83-84Abstract Full Text Full Text PDF PubMed Scopus (2) Google Scholar From the beginning of this new journal, the Editorial Board has asked for your input and many of you have provided constructive comments. Please feel free to contact me through the PRO e-mail address ( [email protected] ) or in person. As I wrote in the first issue, I am committed to providing readers with content that is relevant to their everyday practice and your feedback is critical to ensuring that this occurs. Additionally, I again invite photographers, historians, and other collectors to submit relevant images to display on the cover of PRO. Implications of comparative effectiveness research for radiation oncologyPractical Radiation OncologyVol. 1Issue 2PreviewThe essence of comparative effectiveness research (CER) is to understand what health interventions work, for which patients, and under what conditions. The objective of this article is to introduce the relative strengths and weaknesses of several forms of evidence to illustrate the potential for CER evidence generation within radiation oncology. Full-Text PDF Finding the answers we need: comparative effectivenessPractical Radiation OncologyVol. 1Issue 2PreviewI am always surprised by resistance to comparative effectiveness (CE) research. Simply asking the question, “What is the most effective therapy for a patient with this particular problem?” is the essence of the work. What clinician or patient wouldn't want to know the answer? Full-Text PDF The overthrow of the (evidence) hierarchyPractical Radiation OncologyVol. 1Issue 2PreviewComparative effectiveness research (CER) has many definitions and is often misunderstood or understood only at its simplest; comparing treatment A to treatment B. Bekelman et al, in their article “Implications of Comparative Effectiveness Research for Radiation Oncology,” present a sophisticated methods commentary that not only introduces clinicians to the concept of CER, but also clarifies our understanding of what constitutes useful evidence required to demonstrate the value of our treatments in this time of rising health care costs and declining resources. Full-Text PDF Palliative thoracic radiotherapy in lung cancer: An American Society for Radiation Oncology evidence-based clinical practice guidelinePractical Radiation OncologyVol. 1Issue 2PreviewTo provide guidance to physicians and patients with regard to the use of external beam radiotherapy, endobronchial brachytherapy, and concurrent chemotherapy in the setting of palliative thoracic treatment for lung cancer, based on available evidence complemented by expert opinion. Full-Text PDF Open Access

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