Defining the role of post-mastectomy radiotherapy: the new evidence.
In an early meta-analysis of the post-mastectomy radiotherapy trials, the use of obsolete radiotherapy techniques resulted in increased cardiac mortality. With maturation of these data and inclusion of more recent trials, however, a survival advantage is now emerging. This, in concert with the improvement in disease-free and overall survival evident in the larger studies of post-mastectomy radiotherapy with adjuvant chemotherapy, generates a new enthusiasm in support of post-mastectomy radiotherapy. The lessons we have learned from the earlier trials emphasize the importance of precise radiation planning and delivery so that long-term morbidity can be minimized and survival improved by the reduction in breast cancer deaths.
Pierce
L J
LJ
Department of Radiation Oncology, University of Michigan Medical Center, Ann Arbor, USA.
Lichter
A S
AS
D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D001943:Breast Neoplasms / Q000188:drug therapy / Q000532:radiotherapy* / Q000601:surgery; D017024:Chemotherapy, Adjuvant; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006321:Heart / Q000528:radiation effects; D006801:Humans; D008408:Mastectomy; D010347:Patient Care Planning; D011879:Radiotherapy Dosage; D018714:Radiotherapy, Adjuvant; D016032:Randomized Controlled Trials as Topic; D015996:Survival Rate; D016896:Treatment Outcome