(This commentary was not written by CRD, but by the authors of the DH Register.)
1) The paper shows a significant improvement in life-expectancy(median 4.1 months). However, given that radiation and chemotherapy are harmful, what is the life expectancy without either treatment? 2) The costing is crude. 3) Additional costs in the intervention group of treating a higher incidence of severe infections are not included. 4) It is possible that part of the benefit in the intervention group came from delaying radiation therapy for 50 days.