Comparison of adjuvant postoperative radiotherapy and multiple-drug chemotherapy (CMF-VP) in operable breast cancer patients with more than four positive axillary lymph nodes.
With the advent of the adjuvant chemotherapy in 1974 for early operable breast cancer at Massachusetts General Hospital, 41 patients with greater than or equal to 4 lymph nodes positive in their axillary dissection received a two-year course of the modified Cooper regimen (S + CH) between March 1974 and June 1976. The actuarial disease-free survival was found to be comparable to CMF as reported by Bonnadonna. No consistent randomization with a control group was possible. Since postoperative radiotherapy has been proven to decrease the incidence of local recurrence but does not affect survival; it was believed that this group should serve as an adequate control. Sixty patients with greater than or equal to 4 positive axillary lymph nodes in their axillary dissection who were given postoperative radiotherapy to the chest wall and draining lymphatics (S + RT) in 1973 and 1974 at the same institution were retrospectively analyzed and compared to the above group. Relatively little significant difference in survival and disease-free survival curves was found. At 48 months, there was 72% and 58% survival for the S + RT and S + CH groups, respectively. When subgrouped according to age, those patients less than 49-years-old had a 48-month disease-free survival of 65% and 49% for S + RT and S + CH groups, respectively (P = 0.25). No significant difference was noted in the post menopausal group. In both groups, patients with greater than 50% positive axillary lymph nodes exhibited a poor prognosis.
D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000008:administration & dosage*; D001859:Bone Neoplasms / Q000556:secondary; D001943:Breast Neoplasms / Q000188:drug therapy / Q000532:radiotherapy / Q000601:surgery*; D004359:Drug Therapy, Combination; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008175:Lung Neoplasms / Q000556:secondary; D008198:Lymph Nodes / Q000473:pathology; D008408:Mastectomy; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D011379:Prognosis
D000970:Antineoplastic Agents