Effects of the treatment were assessed by analyses of maximum response, according to either the criteria of the World Health Organization (WHO) (30) or the Response Evaluation Criteria in Solid Tumors (RECIST) version 1.0 (31) since its announcement in 2004. Responses in bone metastases were evaluated using the methods reported by MD Anderson Cancer Center (32,33), with CR as clear evidence of complete bone recalcification with attainment of near-normal bone architecture or normalization of scan, and partial response as radio- logical evidence of sclerosis in lytic lesions or marked improvement of bone scan. In recent years, MRI was performed when available, and the imaging information was taken into account in evaluation of bone metastases. Responses in pleural fluids were determined as: CR for radiological demonstration of complete disappearance of pleural fluid, and PR for 50% or more decrease. For study inclusion, pathological diagnosis of the primary lesions had to be obtained, whereas tissue or cellular pathology of the metastatic lesions was preferred but not mandatory. In patients who performed surgical resection, a complete histopathological response will be defined as the absence of vital tumour cells. Detection of tumour necrosis or scar formation within the tumour tissue will be regarded as a partial pathohistological response.