Purpose This paper aims to contribute to the ethical debate over roles and responsibilities to address the injustices of climate change and its impacts. The current impasse over taking action may lie in the very different ways people view the world and their place in it. The aim is to explore some profound contradictions within differing strands of knowledge feeding into common understandings of climate justice. Design/methodology/approach A literature review of appropriate peer-reviewed and “grey” literature was conducted with a view to defining the term “climate justice”. Findings In addition to there being no single, clear definition of climate justice, a fundamental schism was found between what indigenous peoples want to see happen and what industrialised nations can do with respect to both the mitigation of, and adaptation to, climate change. Research limitations/implications One limitation to defining climate justice, and reason for publishing, is the lack of peer-reviewed work on this topic. Practical implications This paper has many practical implications, the most fundamental of which is the need to reach a consensus over rights to the Earth’s resources. If humanity, within which there are many societies, chooses to follow a truly equitable path post 2015, industrialised countries and corporations will need to move away from “endless growth economics”. The ways in which climate justice might be operationalised in future are considered, including the concept of a “climate-justice” checklist. Originality/value While the reconciliation proposed in this paper might be considered idealistic, unless it is acknowledged the Earth’s resources are limited, over-exploited and for all people to use sustainably, thus requiring a reduction in consumption by individuals relatively affluent in global terms, climate negotiators will continue talking about the same issues without achieving meaningful change.
SummarySkin cancer patients may be treated definitively using radiation therapy (RT) with electrons, kilovoltage, or megavoltage photons depending on tumor stage and invasiveness. This study modeled tumor control probability (TCP) based on the pooled clinical outcome data of RT for primary basal and cutaneous squamous cell carcinomas (BCC and cSCC, respectively). Four TCP models were developed and found to be potentially useful in developing optimal treatment schemes based on recommended ASTRO 2020 Skin Consensus Guidelines for primary, keratinocyte carcinomas (i.e. BCC and cSCC).BackgroundRadiotherapy (RT) with electrons or photon beams is an excellent primary treatment option for keratinocyte carcinoma (KC), particularly for non-surgical candidates. Our objective is to model tumor control probability (TCP) based on the pooled clinical data of primary basal and cutaneous squamous cell carcinomas (BCC and cSCC, respectively) in order to optimize treatment schemes.MethodsPublished reports citing crude estimates of tumor control for primary KCs of the head by tumor size (diameter: ≤2 cm and >2 cm) were considered in our study. A TCP model based on a sigmoidal function of biological effective dose (BED) was proposed. Three-parameter TCP models were generated for BCCs ≤2 cm, BCCs >2cm, cSCCs ≤2 cm, and cSCCs >2 cm. Equivalent fractionation schemes were estimated based on the TCP model and appropriate parameters.ResultsTCP model parameters for both BCC and cSCC for tumor sizes ≤2 cm and >2cm were obtained. For BCC, the model parameters were found to be TD50 = 56.62 ± 6.18 × 10-3 Gy, k = 0.14 ± 2.31 × 10−2 Gy−1 and L = 0.97 ± 4.99 × 10−3 and TD50 = 55.78 ± 0.19 Gy, k = 1.53 ± 0.20 Gy−1 and L = 0.94 ± 3.72 × 10−3 for tumor sizes of ≤2 cm and >2 cm, respectively. For SCC the model parameters were found to be TD50 = 56.81 ± 19.40 × 104 Gy, k = 0.13 ± 7.92 × 104 Gy−1 and L = 0.96 ± 1.31 × 10-2 and TD50 = 58.44 ± 0.30 Gy, k = 2.30 ± 0.43 Gy−1 and L = 0.91± 1.22 × 10−2 for tumors ≤2cm and >2 cm, respectively. The TCP model with the derived parameters predicts that radiation regimens with higher doses, such as increasing the number of fractions and/or dose per fraction, lead to higher TCP, especially for KCs >2 cm in size.ConclusionFour TCP models for primary KCs were developed based on pooled clinical data that may be used to further test the recommended kV and MV x-ray and electron RT regimens from the 2020 ASTRO guidelines. Increasing both number of fractions and dose per fraction may have clinically significant effects on tumor control for tumors >2 cm in size for both BCC and cSCC.
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