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Howard W. Bruckner, MD
Mount Sinai Medical Center New York

JAMA. 1989;261(7):987.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

To the Editor.—

The meta-analysis of Buyse et al¹ and the accompanying editorial² identify a double standard that discriminates against patients with colorectal cancer. The same order of success that created enthusiasm for the adjuvant therapy of breast cancer has failed to create a similar response for analogous patients with colorectal cancer.

The medical community's history of inappropriate responses to promising colorectal cancer trials should cause serious concern. Good controlled trials describing improved survival, based on variants of the now-respectable metaanalysis for adjuvant trials³ and the dose intensity concept for advanced disease, which doubles the frequency of objective tumor regression,⁴ were incorrectly attacked as invalid and trivial. Controlled trials that found that chemotherapy enhanced radiotherapy were largely ignored for years.⁵ Combined modality therapy regimens for rectal cancer are still too often disregarded in preference to radiotherapy that has failed consistently in controlled trials and now . . . [Full Text PDF of this Article]

Footnotes
Edited by Drummond Rennie, MD, Deputy Editor (West); Sharon Iverson, Assistant Editor.

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