1932-1933 / 1983
Evidence in Palliative RT
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Good data for bone mets
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Still slow to change practice
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Reasonable data for other sites
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Although lung data was pre-chemotherapy era
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It is possible to run RCTs in palliative RT….. But not easy
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“Toxicity” of single fraction
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Reimbursement
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Slow progress (1971 – 2016)