The use of paclitaxel and RT in the primary treatment of breast cancer should be undertaken with caution. Clinical trials with the use of combination CT, including paclitaxel plus RT, whether concurrent or sequential, must evaluate carefully the incidence of radiation pneumonitis.

ObjectiveThe authors investigated the combined experience of a single institution in treating bile duct carcinoma during the modern era. Summary Background DataBile duct carcinomas are notoriously difficult to cure, with locoregional recurrence the rule, even after radical resection. Adjuvant efforts have included various radiation modalities, with limited success. Recently, charged-particle radiotherapy has also been used in these patients. MethodsThe authors performed a retrospective chart analysis of 129 patients with bile duct adenocarcinomas treated between 1977 and 1987 through the University of California at San Francisco, including 22 patients treated at Lawrence Berkeley Laboratory with the charged particles helium and neon. The minimum follow-up was 5 years. Survival, outcome, and complication results were analyzed. ResultsSixty-two patients were treated with surgery alone (S), 45 patients received conventional adjuvant x-ray radiotherapy (S + X), and 22 were treated with charged particles (S + CP). The median survival times were 6.5, 1 1, and 14 months, respectively, for the entire group, and 16, 16, and 23 months in patients treated with curative intent.There was a survival difference in patients undergoing total resection compared with debulking (p = 0.05) and minor resections (p = 0.0001). Patients with microscopic residual disease had increased median survival times when they were treated with adjuvant irradiation, most markedly after CP (p = 0.0005) but also with conventional X (p = 0.0109). Patients with gross residual disease had a less marked but still statistically significant extended survival (p = 0.05 for S + X and p = 0.0423 for S + CP) after irradiation. Conclusions

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Purpose: Women physicians do not advance in academic promotion or leadership at the same rate as their male counterparts. One factor contributing to academic promotion and advancement is the experience of serving in elected leadership positions. Although >400 women are running for political office in 2018, fewer than a handful are physicians and there has never been a woman physician elected to the Congress. Yet, little is known about women physicians who run for elected positions within their institutions, medical/professional societies, or government. This study sought to examine how women physicians experience elections using a cross-sectional survey of women physicians to gain insight into patterns of reported experiences and perceived barriers to elected leadership positions. Methods: A cross-sectional survey study of 1221 women physicians. Results: 43.8% (N=535) of women physicians ran for an elected office from high school through medical school graduation, in contrast to only 16.7% (N=204) after graduating from medical school. Only 8.5% of women physicians surveyed reported a boss or supervisor encouraged them to run for an elected position. Conclusion: Women physicians are less likely to run for elected positions and for those with previous election experience, the most common barriers cited were lack of institutional time and support, experience, and mentorship.