analysis of the interspecific difference in egg hatchability and larval survival showed that these differences are due largely to cytoplasmic effects and to autosomal genes, with sex chromosomes playing little or no role.

ObjectiveTo evaluate whether a history of smoking or smoking during therapy after external beam radiotherapy (EBRT) for clinically localised prostate cancer is associated with increased treatment-related toxicity or disease progression. Patients and MethodsOf 2358 patients receiving EBRT for prostate cancer between 1988 and 2005, 2156 had chart-recorded smoking histories. Patients were classified as 'never smokers' , 'current smokers' , 'former smokers' , and 'current smoking unknown' . Variables considered included quantity of tobacco use in pack-years, duration of smoking, and, for former smokers, how long before initiation of RT the patient quit smoking, when available. The median EBRT dose was 8100 Gy and the median follow-up was 95 months. Toxicity was graded according to the National Cancer Institute's Common Terminology Criteria for Adverse Events. ResultsCurrent smoking significantly increased the risks of both prostate-specific antigen relapse [hazard ratio (HR) 1.4, P = 0.02] and distant metastases (HR 2.37, P < 0.001), as well as prostate cancer-specific death (HR 2.25, P < 0.001). Multivariate analysis showed that smoking was also associated with increased risk of EBRT-related genitourinary toxicities (current smoker, HR 1.8, P = 0.02; former smoker, HR 1.45, P = 0.01). Smoking did not increase gastrointestinal toxicity. ConclusionsCurrent smokers with prostate cancer are at increased risk of biochemical recurrence, distant metastasis, and prostate cancer-related mortality after definitive RT to the prostate. Current and former smokers, regardless of duration and quantity of exposure, are at an increased risk of long-term genitourinary toxicity after EBRT. Oncologists should encourage patients to participate in smoking-cessation programmes before therapy to potentially lower their risk of relapsing disease and post-treatment toxicities.

BackgroundUnresectable pancreatic cancer (UPC) has low survival. With improving staging techniques and systemic therapy, local control in patients without metastatic disease may have increasing importance. We investigated whether the radiation dose used in chemoradiation (CRT) as definitive treatment for UPC and the CA 19–9 response to therapy have an impact on overall survival (OS).MethodsFrom 1997–2009 46 patients were treated with CRT for non-metastatic UPC. Median prescribed RT dose was 54 Gy (range 50.4-59.4 Gy). All patients received concurrent chemotherapy (41: 5-fluorouracil, 5: other) and 24 received adjuvant chemotherapy.Results41 patients were inoperable due to T4 disease and 5 patients with T3 disease were medically inoperable. Five patients did not complete CRT due to progressive disease or treatment-related toxicity (median RT dose 43.2 Gy). Overall, 42 patients were dead of disease at the time of last follow-up. The median and 12 month OS were 8.8 months and 35%, respectively. By univariate analysis, minimum CA 19–9 post-CRT <90 U/mL was favorably associated with OS (12.3 versus 8.8 months, p = 0.012). Radiotherapy dose ≥54 Gy trended towards improved OS (11.3 versus 6.8 months, p = 0.089). By multivariable analysis, a delivered RT dose of ≥54 Gy (HR 0.47, p = 0.028) and minimum CA 19–9 post-CRT of <90 U/mL (HR 0.35, p = 0.008) were associated with OS.ConclusionsCRT as definitive treatment for UPC had low survival. However, our retrospective data suggest that patients treated to ≥54 Gy or observed to have a minimum post-CRT CA 19–9 <90 U/mL had improved likelihood of long-term survival.

Hospitalists, rather than oncologists, are increasingly providing inpatient medical care to hospitalized patients with cancer, yet the opinions of oncologists regarding this model of care delivery are unknown. A survey was conducted assessing these opinions and experiences with inpatient cancer care delivery at a tertiary cancer center. Only 30% of oncologists agreed that caring for hospitalized patients with cancer was an efficient use of their time, and most believed a hospitalist service allowed them to pursue other interests. Most had a positive experience with hospitalists, agreeing that hospitalists can diagnose and manage toxicities of cancer therapy, exhibit professionalism, and communicate with them and their patients appropriately. Hematologic malignancy specialists were more likely to value inpatient service time and had less confidence in the ability of hospitalists. Overall, the hospitalist model was generally accepted by oncologists and will continue to be an important part of oncologic care delivery.

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