[Is there an indication for additional local irradiation in conserving treatment of breast cancer patients aged 60 and over?].
Recent results from the European Organisation for Research and Treatment of Cancer (EORTC) trial of additional irradiation in patients with breast cancer, show that after breast-conserving surgery and radiotherapy (50 Gy) of the whole breast, an additional dose of 16 Gy on the tumour bed significantly reduces the local recurrence rate from 7.3% to 4.3%. A relative reduction was seen in all age groups but was most significant in patients aged 40 years and below (19.5% versus 10.2%). In women aged 60 years and over, the local recurrence rate after radiotherapy of 50 Gy (without the additional radiation dose) is already very low (4.0%). Therefore it is questionable whether an additional dose of 16 Gy (reducing the recurrence rate to 2.5%) is still justified as a standard treatment in this age group.
Noordijk
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EM
Leids Universitair Medisch Centrum, afd. Klinische Oncologie, Postbus 9600, 2300 RC Leiden. e.m.noordijk@lumc.nl
Creutzberg
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CL
D000328:Adult; D000367:Age Factors; D001943:Breast Neoplasms / Q000532:radiotherapy* / Q000601:surgery; D004307:Dose-Response Relationship, Radiation; D005260:Female; D006801:Humans; D015412:Mastectomy, Segmental; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000517:prevention & control*; D018714:Radiotherapy, Adjuvant; D016019:Survival Analysis