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Whole brain radiotherapy WBRT significantly improves tumor control in the brain after stereotactic radiosurgery SRS , yet because of its association with cognitive decline, its role in the treatment of patients with brain metastases remains controversial. Secondary end points included time to intracranial failure, quality of life, functional independence, long-term cognitive status, and overall survival. Median overall survival was In the absence of a difference in overall survival, these findings suggest that for patients with 1 to 3 brain metastases amenable to radiosurgery, SRS alone may be a preferred strategy. None of these prospective analyses have demonstrated a survival advantage to adjuvant WBRT, and a single RCT has reported a survival disadvantage. Exclusion criteria included pregnant or nursing women, men or women of childbearing potential unwilling to use adequate contraception, inability to complete a magnetic resonance imaging scan with contrast, prior resection of cerebral metastasis, chemotherapy within 7 days of preregistration or planned chemotherapy during the radiotherapy, prior cranial radiotherapy, leptomeningeal metastases, lesion located within 5 mm of the optic chiasm or within the brainstem, or metastases from primary germ cell tumor, small cell carcinoma, or lymphoma. Prior to patient enrollment, each participating institution provided institutional review board approval and each patient provided written informed consent. Randomized assignment to the treatment group was done electronically. Neither patients nor clinicians were blinded to treatment assignment, although the neuropsychologists grading the cognitive assessments were blinded to treatment assignment. Patients randomly assigned to receive SRS alone received 24 Gy in a single fraction if lesions were less than 2.
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Background: Whether shock wave therapy or shock wave therapy combined with plantar fascia-specific stretching is more efficient in treating chronic plantar heel pain remains unclear. The aim of the study was to test the null hypothesis of no difference of these two forms of management for patients who had unilateral plantar fasciopathy for a minimum duration of twelve months and which had failed at least three other forms of treatment. All patients completed the nine-item pain subscale of the validated Foot Function Index and a subject-relevant outcome questionnaire. Patients were evaluated at baseline, and at two, four, and twenty-four months after baseline. The primary outcome measures were a mean change in the Foot Function Index sum score at two months after baseline, a mean change in item 2 pain during the first steps of walking in the morning on this Index, and satisfaction with treatment. Results: No difference in mean age, sex, weight or duration of symptoms was found between the groups at baseline. Significant differences persisted at four months, but not at twenty-four months. Conclusions: A program of manual stretching exercises specific to the plantar fascia in combination with repetitive low-energy radial shock-wave therapy is more efficient than repetitive low-energy radial shock-wave therapy alone for the treatment of chronic symptoms of proximal plantar fasciopathy. Published by Elsevier Ltd. All rights reserved.
He also described Max's vocals as "a moment designed for glass-clinking, unified swaying and other forms of party camaraderie". The official video of the song was uploaded on Walker's YouTube channel on 27 December It is the sequel to the video of " On My Way ", Walker's single in collaboration with Sabrina Carpenter and Farruko , as the music video also includes Susanne Karin Moe portraying the female protagonist from the previous video.