Post-mastectomy megavoltage radiotherapy: the Oslo and Stockholm trials.
The ability of adjuvant radiotherapy to prevent distant metastasis and to prolong survival in patients with early breast cancer is much debated. The paper presents a joint analysis of long-term results (13-16 years' follow-up) from the Oslo and Stockholm randomised trials of post-operative megavoltage radiotherapy versus surgery alone. Among node-positive patients there was a significant 37% relative reduction of distant metastases with radiation (P less than 0.01) and an overall survival difference in favor of the irradiated patients which corresponded with a 22% relative reduction of deaths of borderline significance (P less than 0.06). No significant benefit with radiation in terms of distant metastasis-free survival or overall survival was observed among node-negative patients. The results show that effective local treatment can prevent distant dissemination in some patients and contradict the contention that node-positive breast cancer invariably is a systemic disease already at primary diagnosis.
Auquier
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A
Department of Biostatistics and Epidemiology, Institut Gustave-Roussy, Villejuif, France.
Rutqvist
L E
LE
Høst
H
H
Rotstein
S
S
Arriagada
R
R
D000328:Adult; D000368:Aged; D001365:Axilla; D001943:Breast Neoplasms / Q000401:mortality / Q000532:radiotherapy* / Q000601:surgery*; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D015182:Lymphatic Irradiation; D015409:Mastectomy, Radical; D015201:Meta-Analysis as Topic; D008875:Middle Aged; D009362:Neoplasm Metastasis; D011882:Radiotherapy, High-Energy; D013997:Time Factors