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Call me a true believer/stubborn/dogmatic or whatever, but this will not change my practice. The problem with population based studies of this is that you have so many patients that you can generate low magnitude but statistically significant endpoints. Maybe the increase in left-sided mortality was driven by coronary atherosclerosis s/p XRT? Why is there no benefit in terms of DM? I would expect this with occult LN mets.
I need a Phase III randomized trial.
Death by ischemic heart disease was the same in left and right treated patients.
Distant metastasis was less common in patients treated with IMRT by 2.5% and showed a trend to significance (p=0.07)