Evaluation of radiotherapy in high-risk breast cancer patients: report from the Danish Breast Cancer Cooperative Group (DBCG 82) Trial.
The role of postmastectomy irradiation together with systemic treatment was evaluated in high-risk patients included in the Danish Breast Cancer Cooperative Group (DBCG) protocol 82. As of June 1989, a total of 1473 pre- and menopausal patients were randomized to postmastectomy irradiation + CMF versus CMF alone (protocol 82-b). A total of 1202 postmenopausal patients were randomized to postmastectomy irradiation + Tamoxifen versus Tamoxifen alone (protocol 82-c). At 5 years the actuarial loco-regional recurrence rate was significantly lower in the irradiated patients (82-b: 9% vs 28%, 82-c: 6% vs 36%). Further, disease-free survival was significantly improved in both pre- and postmenopausal irradiated patients compared with those who had only systemic treatment (82-b: 54% vs 47%, 82-c: 52% vs 38%). At present, overall survival is significantly different in 82-b patients (68% vs 63%) but not in post-menopausal 82-c patients (62% vs 61%). Thus, adjuvant systemic treatment alone (chemotherapy or tamoxifen) did not prevent loco-regional recurrences in high-risk patients after mastectomy and axillary lymph node sampling. However, a longer observation time is necessary to evaluate the consequence of primary optimal loco-regional tumor control in high-risk breast cancer patients with respect to overall survival.
Overgaard
M
M
Department of Oncology, Radiumstationen, Aarhus, Denmark.
Christensen
J J
JJ
Johansen
H
H
Nybo-Rasmussen
A
A
Rose
C
C
van der Kooy
P
P
Panduro
J
J
Laursen
F
F
Kjaer
M
M
Sørensen
N E
NE
D000971:Antineoplastic Combined Chemotherapy Protocols; D001943:Breast Neoplasms / Q000453:epidemiology / Q000532:radiotherapy*; D003131:Combined Modality Therapy; D003520:Cyclophosphamide / Q000008:administration & dosage; D003718:Denmark / Q000453:epidemiology; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage; D006801:Humans; D015413:Mastectomy, Simple; D008727:Methotrexate / Q000008:administration & dosage; D012306:Risk; D016019:Survival Analysis; D013629:Tamoxifen / Q000008:administration & dosage
D013629:Tamoxifen; D003520:Cyclophosphamide; D005472:Fluorouracil; D008727:Methotrexate