title: Timing of radiotherapy in breast-conserving therapy: a large prospective cohort study of node-negative breast cancer patients without adjuvant systemic therapy.
abstract: BACKGROUND
  To investigate the issue of timing of radiation therapy (RT) after lumpectomy in relation to recurrences and outcome.
  
  
  METHODS
  Analysis was done on 1107 breast-conserving therapies (BCT) with 1070 women, all without lymph node metastasis and without any adjuvant systemic therapy. Timing was defined as time from lumpectomy till RT. Patients were categorised into tertiles: <45 days, 45-56 days, and 57-112 days.
  
  
  RESULTS
  Local control did not show a difference between the tertiles. The distant metastasis-free survival as well as the disease-specific survival showed a decreased outcome starting the RT to early after the lumpectomy.
  
  
  CONCLUSIONS
  The results of this cohort study further refines the hypothesis that timing of RT in BCT might have an impact on outcome. It suggests that a randomised trial in timing of RT in BCT seems necessary to give a definite answer.
authors: Department of Radiation Oncology, Medisch Spectrum Twente, Enschede, The Netherlands. j.jobsen@mst.nl
authors: J J
authors: JJ
authors: Jobsen
authors: J
authors: J
authors: van der Palen
authors: M
authors: M
authors: Baum
authors: M
authors: M
authors: Brinkhuis
authors: H
authors: H
authors: Struikmans
mesh_terms: D000328:Adult; D001943:Breast Neoplasms / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery; D015331:Cohort Studies; D003131:Combined Modality Therapy; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D008207:Lymphatic Metastasis; D015412:Mastectomy, Segmental; D008875:Middle Aged; D011446:Prospective Studies; D018714:Radiotherapy, Adjuvant / Q000379:methods; D013997:Time Factors
references: Int J Radiat Oncol Biol Phys. 2003 Nov 1;57(3):724-31
references: 14529777
references: J Natl Cancer Inst. 1990 Jan 3;82(1):4-6
references: 1688381
references: Eur J Cancer. 2005 Mar;41(4):508-15
references: 15737554
references: Crit Rev Oncol Hematol. 2009 Aug;71(2):102-16
references: 18922700
references: Cancer Res. 2001 Mar 1;61(5):2207-11
references: 11280788
references: Int J Radiat Oncol Biol Phys. 1998 Mar 1;40(4):869-74
references: 9531372
references: Clin Exp Metastasis. 1991 Mar-Apr;9(2):77-104
references: 2032423
references: Int J Radiat Oncol Biol Phys. 2000 Jan 15;46(2):363-72
references: 10661343
references: Radiother Oncol. 2008 Apr;87(1):3-16
references: 18160158
references: Breast Cancer Res Treat. 2004 Nov;88(2):187-96
references: 15564801
references: Cancer Res. 2000 Apr 15;60(8):2128-31
references: 10786673
references: J Clin Oncol. 2003 Feb 1;21(3):555-63
references: 12560449
references: Breast Cancer Res Treat. 2006 Oct;99(3):289-94
references: 16596325