A cast of shadow on adjuvant radiotherapy for prostate cancer: A critical review based on a methodological perspective.

OBJECTIVE: To perform a critical review focusing on the applicability in clinical daily practice of data from three randomized controlled trials (RCTs): SWOG 8794, EORTC 22911, and ARO/AUO 96-02. METHODS AND MATERIALS: An analytical framework, based on the identified population, interventions, comparators, and outcomes (PICO) was used to refine the search of the evidence from the three large randomized trials regarding the use of radiation therapy after prostatectomy as adjuvant therapy (ART). RESULTS: With regard to the inclusion criteria: (1) POPULATION: in the time since they were designed, in two among three trial (SWOG 8794 and EORTC 22911) patients had a detectable PSA at the time of randomization, thus representing de facto a substantial proportion of patients who eventually received salvage RT (SRT) at non-normalised PSA levels rather than ART. (2) INTERVENTIONS: although all the trials showed the benefit of postoperative ART compared to a wait-and-see approach, the dose herein employed would be now considered inadequate; (3) COMPARATORS: the comparison arm in all the 3 RCTs was an uncontrolled observation arm, where patients who subsequently developed biochemical failure were treated in various ways, with up to half of them receiving SRT at PSA well above 1ng/mL, a level that would be now deemed inappropriate; (4) OUTCOMES: only in one trial (SWOG 8794) ART was found to significantly improve overall survival compared to observation, with a ten-year overall survival rate of 74% vs. 66%, although this might be partly the result of imbalanced risk factors due to competing event risk stratification. CONCLUSIONS: ART has a high level of evidence due to three RCTs with at least 10-year follow-up recording a benefit in biochemical PFS, but its penetrance in present daily clinics should be reconsidered. While the benefit of ART or SRT is eagerly expected from ongoing randomized trials, a dynamic risk-stratified approach should drive the decisions making process.

Romanisation in Gaul: new methodological approaches for the study of Gaulish fine wares (200 B.C.-50 A.D.).

The twenty-second Theoretical Roman Archaeology Conference (TRAC) was held at the Goethe-University Frankfurt am Main in spring 2012. During the three-day conference fifty papers were delivered, discussing issues from a wide range of geographical regions of the Roman Empire, and applying various theoretical and methodological approaches. An equally wide selection of subjects was presented: sessions looked at Greek art and philhellenism in the Roman world, the validity of the concept of 'Romanisation', change and continuity in Roman religion, urban neighbourhood relations in Pompeii and Ostia, the transformation of objects in and from the Roman world, frontier markets and Roman archaeology in the Provinces. In addition, two general sessions covered single topics such as the 'transvestite of Catterick', metal recycling or Egyptian funeral practice in the Roman period. This volume contains a selection of papers from all these sessions.