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Previous Volume 336:1609-1610 May 29, 1997 Number 22 Next

	Since this article has no abstract, we have provided an extract of the first 100 words of the full text and any section headings.

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To the Editor: I am disturbed by the design of the trial reported by Hortobagyi et al. (Dec. 12 issue).¹ The standard of care for painful lytic metastases is radiation therapy or surgery, especially for lesions involving a risk of pathologic fracture.² These treatments are extremely effective if implemented in a timely manner. In large series, a rate of pain relief approaching 90 percent has been reported for radiation therapy,³ and surgery usually results in prompt relief as well.⁴ With such effective treatments readily available, it is arguably unethical to have a placebo arm in the trial; the two arms . . . [Full Text of this Article]

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