Radiotherapy in bone metastasis : the Dutch bone metastasis study Linden, Y.M. van der
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Hele tekst
(2) 2EFERENTIES 'ALASKO # 3 )NCIDENCE OF SKELETAL METASTASES * .UCL -ED 4UBIANA (ULIN - )NCIDENCE
(3) PREVALENCE AND DISTRIBUTION OF BONE METASTASES "ONE 3UPPL 3 3TOLL "! .ATURAL HISTORY
(4) PROGNOSIS AND STAGING OF BONE METASTASES 0ARBHOO 3 2AVEN 0RESS 'Y SINGLE FRACTION RADIOTHERAPY FOR THE TREATMENT OF METASTATIC SKELETAL PAIN RANDOMISED COMPARISON WITH A MULTIFRACTION SCHEDULE OVER MONTHS OF PATIENT FOLLOW UP "ONE 0AIN 4RIAL 7ORKING 0ARTY 2ADIOTHER /NCOL #OLE $ * ! RANDOMIZED TRIAL OF A SINGLE TREATMENT VERSUS CONVENTIONAL FRACTIONATION IN THE PALLIATIVE RADIOTHERAPY OF PAINFUL BONE METASTASES #LIN /NCOL 2 #OLL 2ADIOL 'AZE - .
(5) +ELLY # '
(6) +ERR ' 2
(7) #ULL !
(8) #OWIE 6 *
(9) 'REGOR !
(10) ET AL 0AIN RELIEF AND QUALITY OF LIFE FOLLOWING RADIOTHERAPY FOR BONE METASTASES A RANDOMISED TRIAL OF TWO FRACTIONATION SCHEDULES 2ADIOTHER /NCOL .IELSEN / 3
(11) "ENTZEN 3 -
(12) 3ANDBERG %
(13) 'ADEBERG # #
(14) 4IMOTHY ! 2 2ANDOMIZED TRIAL OF SINGLE DOSE VERSUS FRACTIONATED PALLIATIVE RADIOTHERAPY OF BONE METASTASES 2ADIOTHER /NCOL .IEWALD -
(15) 4KOCZ ( *
(16) !BEL 5
(17) 3CHEIB 4
(18) 7ALTER +
(19) .IEDER #
(20) ET AL 2APID COURSE RADIATION THERAPY VS MORE STANDARD TREATMENT A RANDOMIZED TRIAL FOR BONE METASTASES )NT * 2ADIAT /NCOL "IOL 0HYS 0RICE 0
(21) (OSKIN 0 *
(22) %ASTON $
(23) !USTIN $
(24) 0ALMER 3 '
(25) 9ARNOLD * 2 0ROSPECTIVE RANDOMISED TRIAL OF SINGLE AND MULTIFRACTION RADIOTHERAPY SCHEDULES IN THE TREATMENT OF PAINFUL BONY METASTASES 2ADIOTHER /NCOL 2ASMUSSON "
(26) 6EJBORG )
(27) *ENSEN ! "
(28) !NDERSSON -
(29) "ANNING ! -
(30) (OFFMANN 4
(31) ET AL )RRADIATION OF BONE METASTASES IN BREAST CANCER PATIENTS A RANDOMIZED STUDY WITH YEAR FOLLOW UP 2ADIOTHER /NCOL 2OOS $ % #ONTINUING RELUCTANCE TO USE SINGLE FRACTIONS OF RADIOTHERAPY FOR METASTATIC BONE PAIN AN AUSTRALIAN AND NEW ZEALAND PRACTICE SURVEY AND LITERATURE REVIEW 2ADIOTHER /NCOL 4ONG $
(32) 'ILLICK ,
(33) (ENDRICKSON & 2 4HE PALLIATION OF SYMPTOMATIC OSSEOUS METASTASES lNAL RESULTS OF THE 3TUDY BY THE 2ADIATION 4HERAPY /NCOLOGY 'ROUP #ANCER 2ATANATHARATHORN 6
(34) 0OWERS 7 %
(35) -OSS 7 4
(36) 0EREZ # ! "ONE METASTASIS REVIEW AND CRITICAL ANALYSIS OF RANDOM ALLOCATION TRIALS OF LOCAL lELD TREATMENT )NT * 2ADIAT /NCOL "IOL 0HYS "LITZER 0 ( 2EANALYSIS OF THE 24/' STUDY OF THE PALLIATION OF SYMPTOMATIC OSSEOUS METASTASIS #ANCER DE (AES
(37) (
(38) /LSCHEWSKI -
(39) &AYERS 0 ET AL -EASURING THE QUALITY OF LIFE OF CANCER PATIENTS WITH THE 2OTTERDAM 3YMPTOM #HECKLIST 23#, A MANUAL
(40) .ORTHERN #ENTRE FOR (EALTHCARE 2ESEARCH %URO1OL A NEW FACILITY FOR THE MEASUREMENT OF HEALTH RELATED QUALITY OF LIFE 4HE %URO1OL 'ROUP (EALTH 0OLICY .EDERLANDSE 6ERENIGING VAN 2ADIOTHERAPIE EN /NCOLOGIE 4WIJNSTRA 'UDDE -ASTERPLAN 2ADIOTHERAPIE (ET TEKORT OOK UW ZORG . . 3INGLE FRACTION RADIOTHERAPY IS EFlCACIOUS A FURTHE ANALYSIS OF THE $UTCH "ONE -ETASTASIS 3TUDY CONTROLLING FOR THE INmUENCE OF RETREATMENT. :WFUUF.WBOEFS-JOEFO +VEJUI+-PL &MTCFUI4UFFOMBOE )FOESJL.BSUJKO )BOTWBO)PVXFMJOHFO $PSSJF"..BSJKOFO +BO8JMMFN)-FFSGPSUIF%VUDI#POF .FUBTUBTJT4UVEZ(SPVQ *OUFSOBUJPOBM+PVSOBMPG3BEJBUJPO0ODPMPHZ#JPMPHZ1IZTJDT .
(41) )NTRODUCTION. !BSTRACT 0URPOSE 5IF%VUDI#POF.FUBTUBTJT4UVEZPOUIFFGGFDUPOQBJOGVMCPOFNFUBTUBTFTPG(Z TJOHMFGSBDUJPO 4' WT(ZJONVMUJQMFGSBDUJPOT .' TIPXFESFUSFBUNFOUBGUFS4'WT BGUFS.' 1 1VSQPTFPGUIFQSFTFOUTUVEZXBTUPFWBMVBUFGBDUPSTJOGMVFODJOHSFUSFBUNFOU BOEJUTFGGFDUPOSFTQPOTF -ETHODS -ATERIALS5IFEBUBCBTFPOBMMSBOEPNJ[FEQBUJFOUTXBTSFBOBMZ[FEXJUITFQBSBUFMZ DBMDVMBUFESFTQPOTFTUPJOJUJBMUSFBUNFOUBOESFUSFBUNFOU 2ESULTS 3FTQPOTFUPJOJUJBMUSFBUNFOUXBTBGUFS4'WTBGUFS.' 1 3FUSFBUNFOU SBJTFESFTQPOTFUPGPS4' .'SFNBJOFEVOBMUFSFE 1 5IFSFTQPOTFTUBUVTBGUFSJOJUJBM USFBUNFOUEJEOPUQSFEJDUPDDVSSFODFPGSFUSFBUNFOU4'WT.'OPOSFTQPOEFST BOE 4'WT.'QBUJFOUTXJUIQSPHSFTTJWFQBJOXFSFSFUSFBUFE-PHJTUJDSFHSFTTJPOBOBMZTFT TIPXFEUIFSBOEPNJ[BUJPOBSNBOEUIFQBJOTDPSFCFGPSFSFUSFBUNFOUUPTJHOJGJDBOUMZQSFEJDU SFUSFBUNFOU 1 3FUSFBUNFOUGPSOPOSFTQPOEFSTXBTTVDDFTTGVMJO4'WT.' QBUJFOUT 1 3FUSFBUNFOUGPSQSPHSFTTJPOXBTTVDDFTTGVMJO4'WT.'QBUJFOUT 1 #ONCLUSIONS 8JUIPSXJUIPVUUIFFGGFDUPGSFUSFBUNFOU TJOHMFBOENVMUJQMFGSBDUJPOSBEJPUIFSBQZ QSPWJEFEFRVBMQBMMJBUJPOGPSQBJOGVMCPOFNFUBTUBTFT*SSFTQFDUJWFPGSFTQPOTFUPJOJUJBM USFBUNFOU QIZTJDJBOTXFSFNPSFXJMMJOHUPSFUSFBUBGUFS4'0WFSBMM SFUSFBUNFOUXBTFGGFDUJWFJO PGSFUSFBUFEQBUJFOUT. 3BEJPUIFSBQZJTBXFMMBDDFQUFEBOEFGGFDUJWFMPDBMUSFBUNFOUNPEBMJUZGPS QBUJFOUTXJUIQBJOGVMCPOFNFUBTUBTFT7BSJPVTSFUSPTQFDUJWFBOEQSPTQFDUJWFMZ SBOEPNJ[FETUVEJFTIBWFGPDVTFEPOUIFFGGFDUPGEJGGFSFOUEPTFTDIFEVMFT TUVEZ JOHCPUITJOHMFGSBDUJPO 4' BOENVMUJQMFGSBDUJPO .' SFHJNFOT 5IFNBKPS JUZPGUIFTFTUVEJFTDPODMVEFEUIBU4'SBEJPUIFSBQZXBTFRVBMMZFGGFDUJWFUP.'T GPSNPTUQBUJFOUT"MUIPVHIPOFSFWJFXDPODMVEFEUIFPQQPTJUF TZTUFNBUJD SFWJFXTBOEBSFDFOUMZQVCMJTIFENFUBBOBMZTJTBMTPDPODMVEFEUIBUOPTJHOJ¾ DBOUEJGGFSFODFTJOQBJOSFMJFGDPVMECFEFUFDUFECFUXFFOTJOHMFBOENVMUJQMF GSBDUJPOSFHJNFOT )PXFWFS UIFBVUIPSTPGUIFNFUBBOBMZTJTDPNNFOUFE UIBUBEEJUJPOBMEBUBXFSFSFRVJSFEUPFWBMVBUFUIFSPMFPGSFUSFBUNFOUEVSJOH GPMMPXVQ CFDBVTFUIFSBOEPNJ[FEUSJBMTVTFEWBSJPVTEF¾OJUJPOTXJUISFHBSE UPUIFDBMDVMBUJPOPGSFTQPOTFBOEUIFNFBOTCZXIJDIBQPTTJCMFSFUSFBUNFOU EVSJOHGPMMPXVQXBTSFQPSUFE*OUIJTSFTQFDU JOBMSFBEZBOJOUFSOBUJPOBM DPOTFOTVTBHSFFNFOUXBTQVCMJTIFEPOFOEQPJOUEF¾OJUJPOTGPSGVUVSFDMJOJDBM USJBMTJOPSEFSUPBDIJFWFNPSFVOJGPSNJUZJOCPOFNFUBTUBTFTSFTFBSDI *OUIFMBSHFTUTUVEZUPEBUF UIF%VUDI#POF.FUBTUBTJT4UVEZ %#.4 POUIF FGGFDUPG(Z4'WT(ZJOGSBDUJPOT SFTQPOTFTXFSFDBMDVMBUFEJODMVEJOH UIFFGGFDUPGBQPTTJCMFSFUSFBUNFOUEVSJOHGPMMPXVQ 3FUSFBUNFOUXBTHJWFO BUUIFEJTDSFUJPOPGUIFUSFBUJOHQIZTJDJBO8JUIJOUIF¾STUZFBSBGUFS SBOEPNJ[BUJPO TJHOJ¾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¾OJUJPOT *OBEEJUJPO UIFSFTQPOTFTUBUVTPGSF USFBUFEQBUJFOUTCFGPSFSFUSFBUNFOUXBTMBCFMFEUPJEFOUJGZGBDUPSTJO¿VFODJOH SFUSFBUNFOU-BTUMZ UIFFG¾DBDZPGSFUSFBUNFOUXBTTUVEJFE. -ATERIAL AND -ETHODS 0ATIENT SELECTION AND FOLLOW UP #FUXFFO.BSDIBOE4FQUFNCFS %VUDIQBUJFOUTXJUIQBJOGVM CPOFNFUBTUBTFTXFSFSBOEPNJ[FECFUXFFOBTJOHMFGSBDUJPOPG(Z O .
(42) 4!",% ).#,53)/. !.$ %8#,53)/. #2)4%2)! /& 4(% $54#( "/.% -%4!34!3)3 345$9 2ANDOMIZATION CRITERIA )NCLUSION. %XCLUSION. )NFORMED CONSENT -ETASTASES OF SOLID TUMORS 0AIN SCORE MINIMUM ON POINTSCALE NO PAIN TO WORST IMAGINABLE PAIN -ETASTASES TREATABLE IN ONE RADIOTHERAPY TARGET VOLUME .O PREVIOUS RADIOTHERAPY TO SAME METASTASES. .O INFORMED CONSENT 0ATHOLOGICAL FRACTURE OR IMPENDING FRACTURE NEEDING SURGICAL l XATION 3PINAL CORD COMPRESSION -ETASTASES OF RENAL CELL CARCINOMA OR MELANOMA. -ETASTASES IN CERVICAL SPINEo . -ETASTASES OF RENAL CELL CARCINOMA OR MELANOMA WERE EXCLUDED BECAUSE OF EXPECTED DIFFERENT BIOLOGICAL BEHAVIOR o -ETASTASES IN THE CERVICAL SPINE WERE EXCLUDED BECAUSE IT WAS BELIEVED THAT LARGE FRACTIONS MIGHT LEAD TO A RADIATION INDUCED MYELOPATHY. &)'52% 4IME SCALES FOR ANALYSIS OF RESPONSE TO INITIAL TREATMENT AND RETREATMENT IN PATIENTS WITH PAINFUL BONE METASTASES TREATED WITHIN THE $UTCH "ONE -ETASTASIS 3TUDY 0!). 3#/2% . 2%30/.3%. !. 02/'2%33)/.. $ 2. %.$ /& &/,,/7 50. 0!). 3#/2% . 2%30/.3%. ". 02/'2%33)/.. $ 2. 2%42%!4-%.4. 0!). 3#/2% . %.$ /& &/,,/7 50. 2%30/.3%. 02/'2%33)/.. #. $ 2. 2%42%!4-%.4. %.$ /& &/,,/7 50. &IGURE LEGENDS 4IME SCALE ! REFERS TO PATIENTS WHO WERE NOT RETREATED DURING FOLLOW UP 4IME SCALES " AND # REFER TO PATIENTS WHO WERE RETREATED DURING FOLLOW UP &OR " EFFECT OF INITIAL TREATMENT
(43) CHANGE IN PAIN SCORE COMPARED TO RANDOMIZATION PAIN SCORE
(44) FOR # EFFECT OF RETREATMENT CHANGE IN PAIN SCORE COMPARED TO PAIN SCORE WEEK PRIOR TO RETREATMENT 2 2ANDOMIZATION 0AIN SCORE RANDOMIZATION PAIN SCORE 0AIN SCORE PAIN SCORE WEEK PRIOR TO RETREATMENT s 2ESPONSE STATUS OF THE PATIENT AFTER INITIAL TREATMENT NON RESPONDER
(45) RESPONDER
(46) OR RESPONDER WITH SUBSEQUENT PROGRESSION $ $URATION OF REMISSION &OR TIME SCALE " TIME PERIOD AFTER RETREATMENT UNTIL END OF FOLLOW UP &OR TIME SCALE # TIME PERIOD FROM RANDOMIZATION UNTIL RETREATMENT. . BOEGSBDUJPOTPG(Z O 4FWFOUFFOPVUPG%VUDISBEJPUIFSBQZ JOTUJUVUFTQBSUJDJQBUFEJOUIFUSJBM1BUJFOUTIBEBNJOJNBMQBJOTDPSFPGPOBO QPJOUTDBMFGSPN OPQBJO UP XPSTUJNBHJOBCMFQBJO 5IFSBOEP NJ[BUJPODSJUFSJBBSFMJTUFEJOUBCMF"USBOEPNJ[BUJPOBOEEVSJOHGPMMPXVQ QBUJFOUT¾MMFEPVUXFFLMZRVFTUJPOOBJSFTCZNBJMBOEDPOUJOVFEXJUINPOUI MZRVFTUJPOOBJSFTUPBNBYJNVNPGZFBSTPSVOUJMEFBUI5IFQBUJFOUT SFQPSUFEUIFNBYJNVNQBJOUIFZFYQFSJFODFEBUUIFUSFBUNFOUTJUFEVSJOHUIF QSFDFEJOHXFFLVTJOHUIFQPJOUTDBMF$PODPNJUBOUVTFPGBOBMHFTJDTXBT OPUFE EJWJEFEJOUPQIBTF OPOPQPJEBOBMHFTJDTQBSBDFUBNPMBOEOPOTUFSPJE BOUJJO¿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¾STUZFBSBGUFSSBOEPNJ[BUJPO1BUJFOUT XFSFDMVTUFSFEBDDPSEJOHUPUIFJSQSJNBSZUVNPSJOUPGPVSHSPVQTCSFBTUDBO DFS QSPTUBUFDBODFS MVOHDBODFSBOEPUIFSQSJNBSZUVNPST 2ESPONSE DEFINITIONS 3FTQPOTFUPUSFBUNFOUXBTDBMDVMBUFEUBLJOHJOUPBDDPVOUDIBOHFTJOUIFBE NJOJTUSBUJPOPGPQPJET"DIBOHFGSPNQIBTFPSUPQIBTFPSXBTOPUFE BTBOBOBMHFTJDJODSFBTF*GUIFQBUJFOUTUPQQFEVTJOHQIBTFPSBOBMHFTJDT UIJTXBTOPUFEBTBOBOBMHFTJDEFDSFBTF1BSUJBMSFTQPOTF 13 XBTEF¾OFEBT BEFDSFBTFJOUIFJOJUJBMQBJOTDPSFCZBUMFBTUUXPQPJOUTPOUIFQPJOUQBJO TDBMF XJUIPVUBOBMHFTJDJODSFBTF PS BOBMHFTJDEFDSFBTFXJUIPVUBOJODSFBTF JOQBJO$PNQMFUFSFTQPOTF $3 XBTEF¾OFEBTBEFDSFBTFJOUIFJOJUJBMQBJO TDPSFUP[FSPPOUIFQBJOTDBMF XJUIPVUDPODPNJUBOUBOBMHFTJDJODSFBTF8IFO QBJOTDPSFTSFNBJOFEVOBMUFSFEPSXIFOUIFZJODSFBTFEUIFQBUJFOUXBT DPOTJEFSFEUPCFBOPOSFTQPOEFS /3 1SPHSFTTJPOBGUFSSFTQPOTFXBTEF¾OFEBT B BOJODSFBTFJOQBJOXJUISFUVSO UPUIFJOJUJBMQBJOTDPSFPSIJHIFS XJUIPVUBOBMHFTJDJODSFBTF PS C BOBMHFTJD JODSFBTFJSSFTQFDUJWFPGUIFQBJOTDPSF 2ESPONSE CALCULATIONS 3FTQPOTFUPUSFBUNFOUXBTDBMDVMBUFEFYDMVEJOHBOEJODMVEJOHUIFFGGFDUPGB QPTTJCMFSFUSFBUNFOUEVSJOHGPMMPXVQ'JHVSFTIPXTEJGGFSFOUUJNFTDBMFT JOPSEFSUPJOUFSQSFUUIFQPTTJCMFFWFOUTEVSJOHGPMMPXVQ.
(47) ,% 2%42%!4%$ 0!4)%.43 ). 4(% $54#( "/.% -%4!34!3)3 345$9 !##/2$).' 4/ 4(% 02)-!29 45-/2 !.$ 4(% 2%30/.3% 34!453 !&4%2 ).)4)!, 42%!4-%.4. AST TATE G ER. .ON RESPONDER . . 0AIN. 4IME o. 2ESPONDER . . 0AIN 4IME o. 0ROGRESSION . . 0AIN 4IME p. . . . NUMBER OF PATIENTS
(48) PATIENTS WERE LABELED INTO NON RESPONDERS OR RESPONDERS )N ADDITION
(49) RESPONDERS WITH PROGRESSIVE PAIN ARE LISTED RATELY IN THE THIRD COLUMN -EAN PAIN SCORE THE WEEK PRIOR TO RETREATMENT -EAN TIME TO RETREATMENT FROM RANDOMIZATION IN WEEKS -EAN TIME TO RETREATMENT FROM DATE OF PROGRESSION IN WEEKS. ,% 2%42%!4-%.4 0%2#%.4!'%3 !##/2$).' 4/ 4(% 0!4)%.4 #(!2!#4%2)34)#3 !4 4)-% /& 2!.$/-):!4)/. ).4/ 4(% $54#( "/.% -%4!34!3)3 345$9. ALE E. 4OTAL . . .OT RETREATED . . 2ETREATED . . 56. 0 VALUE . . . . (2 #). -6. 0 VALUE. . . N RANGE. . . . N SCOREo N RANGE. . . . p N RANGE. . . . . . . . ER. . . . . MBER OF METASTASES TIPLE TARY. . . . N MEDICATION E SE SE . . . . . . . . . . . . . . . . MARY TUMOR AST TATE G ER. ALIZATION E IS UR MERUS. . . . . . . TEMIC THERAPY. DOMIZATION ARM 'Y 'Y. NUMBERS OF PATIENTS
(50) PERCENTAGES ADD UP HORIZONTALLY 56 UNIVARIATE ANALYSIS
(51) (2 HAZARD RATIO CALCULATED WITH #OX PROPORTIONAL HAZARDS MODEL
(52) #) CONl DENCE INTERVALS
(53) -6 MULTIVARIATE ANALYSIS. 0AIN SCORE AT RANDOMIZATION +ARNOFSKY 0ERFORMANCE 3CORE PHYSICAL SCORE
(54) RANGING FROM NORMAL SITUATION
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(59) -& X 'Y
(60) . NUMBER OF PATIENTS "ETWEEN BRACKETS NUMBER OF RESPONDERSTOTAL NUMBER OF RETREATED PATIENTS $UE TO MISSING DATA
(61) RESPONSE TO RETREATMENT WAS CALCULATED IN PATIENTS. 56 UNIVARIATE ANALYSIS
(62) (2 HAZARD RATIO CALCULATED WITH #OX PROPORTIONAL HAZARDS MODEL
(63) #) CONl DENCE INTERVALS o 2ESPONSE TO RETREATMENT CHANGES IN PAIN SCORE AFTER RETREATMENT COMPARED TO PAIN SCORE THE WEEK PRIOR TO RETREATMENT p -EAN TIME TO RESPONSE AFTER RETREATMENT IN WEEKS
(64) MEAN DURATION OF REMISSION FOR RESPONDERS IN WEEKS e 2ESPONSE TO RETREATMENT ACCORDING TO THE RETREATMENT RADIOTHERAPY DOSE SCHEDULE \\ 2ESPONSE TO RETREATMENT ACCORDING TO THE RESPONSE STATUS PRIOR TO RETREATMENT 2ESPONDER ALL RESPONDERS TO INITIAL TREATMENT 0ROGRESSION PATIENTS WHO EXPERIENCED PROGRESSIVE PAIN PRIOR TO RETREATMENT 0ERCENTAGES ADD UP EXCEEDING . 4!",% 2%30/.3% 4/ 2%42%!4-%.4 !##/2$).' 4/ 4(% 2%30/.3% 34!453 !&4%2 ).)4)!, 42%!4-%.4 !.$ 4(% 2%42%!4-%.4 $/3% 3#(%$5,% ST TREATMENT 2ESPONSE STATUS ND TREATMENT 2ESPONSE ND. 4IME o ND 2EMISSION 3& . 2ESPONSE TO RETREATMENT 5BCMF MJT UTUIFFGGFDUPGSFUSFBUNFOUPOUIFQBJOFYQFSJFODFEUIFXFFL CFGPSFSFUSFBUNFOU TFFUJNFTDBMF$ 'JHVSF *OUPUBM PGSFUSFBUFE QBUJFOUTSFTQPOEFEUPSFUSFBUNFOUPGSFUSFBUFE4'QBUJFOUTSFTQPOEFE DPNQBSFEXJUIPG.'QBUJFOUT 1 )3 . "GUFSSFUSFBU NFOU UJNFUPSFTQPOTFXBTOPUEJGGFSFOUGPSJOJUJBM4'BOE.'QBUJFOUT CVU UIFNFBOEVSBUJPOPGSFNJTTJPOXBTTVCTUBOUJBMMZMPOHFSJOJOJUJBM4' QBUJFOUT XFFLTWTPOMZXFFLTJOJOJUJBM.'QBUJFOUT'PS4'QBUJFOUT SFTQPOTFUPSFUSFBUNFOUXBTJSSFTQFDUJWFPGUIFJOJUJBMSFTQPOTF BOEPGJOJUJBMOPOSFTQPOEFST SFTQPOEFST BOEQSPHSFTTJWFQBUJFOUT SFTQFDUJWFMZ SFTQPOEFEUPSFUSFBUNFOU"MUIPVHINPSFJOJUJBM4'UIBO.' OPOSFTQPOEJOHQBUJFOUTSFTQPOEFEUPSFUSFBUNFOU EVFUPTNBMMOVNCFST UIJTEJGGFSFODFSFBDIFEOPTJHOJ¾DBODF WT SFTQFDUJWFMZ 1 )3 . . 3& . . .ON RESPONDER 2ESPONDERp . -& . 3& -& . 3& -& . . . . . . . . 0ROGRESSION . 3& -& . . . . .ON RESPONDER . 3& -& . . . . 2ESPONDERp . 3& -& . . . . 0ROGRESSION . 3& -& . . . . 3& X 'Y
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