The benefit of adjuvant radiotherapy after breast conserving surgery in older patients with low risk breast cancer- a meta-analysis of randomized trials
نویسندگان
چکیده
PURPOSE/OBJECTIVE(S) It is currently unclear whether patients with low risk breast cancer receiving adjuvant endocrine therapy need adjuvant radiation therapy after breast conserving surgery. The data of randomized trials are available. MATERIALS/METHODS In a database search 5 randomized trials including in total 3766 mostly elderly patients with early stage breast cancer treated either with adjuvant endocrine therapy or with endocrine therapy and additional whole breast radiation after breast conserving surgery were identified. Published hazard ratios for time to local recurrence were the basis of our meta-analysis. Meta-analysis of the effect sizes on local recurrence was performed using a random effects model based on parameter estimates of log hazard ratios in Cox models and their standard errors. Furthermore, overall survival was examined. RESULTS Adjuvant hormone therapy alone in mostly older patients with low risk breast cancer resulted in significantly shorter time to local relapse compared to radiation therapy combined with hormone therapy (Hazard Ratio: 6.8, 95% CI: 4.23-10.93, p < 0.0001) . There was no significant difference for overall survival. CONCLUSION Additional radiation therapy to hormone therapy did improve local relapse in breast cancer patients but did not show significant impact on overall survival.
منابع مشابه
Hypofractionated Radiotherapy as Adjuvant Treatment in Early Breast Cancer. A Review and Meta-Analysis of Randomized Controlled Trials.
BACKGROUND Adjuvant radiotherapy after breast-conserving surgery is indicated in the vast majority of breast cancer patients. Conventionally fractionated radiotherapy with 50 Gy in 25 fractions was considered standard of care for several decades. The recently publishes long-term results of randomized trials that have tested different moderately hypofractionated radiotherapy schedules that may c...
متن کاملPostoperative radiotherapy for breast cancer: growing evidence for an impact on survival.
Postoperative radiotherapy for breast cancer is known to substantially reduce the risk of locoregional recurrence, both when given after mastectomy and after breast-conserving surgery. Recent reports [cited below] suggest that radiotherapy following mastectomy may also have a beneficial impact on survival, and the article by Vinh-Hung et al. (1), published in this issue of the Journal, further ...
متن کاملCompare the organs at risk in breast-conserving three- dimensional conformal radiotherapy (3D-CRT) based on patient's breast size
Introduction: Breast cancer is the most common cancer among women. Radiotherapy plays an important role in the treatment of breast cancer and essential part of the standard treatment after breast-conserving surgery, routinely done to eliminate the microscopic residual cancer. The heart and lungs are one of the most important organs at risk of breast cancer radiotherapy that th...
متن کاملCompare the organs at risk in breast-conserving three- dimensional conformal radiotherapy (3D-CRT) based on patient\'s breast size
Introduction: Breast cancer is the most common cancer among women. Radiotherapy plays an important role in the treatment of breast cancer and essential part of the standard treatment after breast-conserving surgery, routinely done to eliminate the microscopic residual cancer. The heart and lungs are one of the most important organs at risk of breast cancer radiotherapy that th...
متن کاملBreast-conserving surgery with or without radiotherapy in women with ductal carcinoma in situ: a meta-analysis of randomized trials
BACKGROUND To investigate whether Radiation therapy (RT) should follow breast conserving surgery in women with ductal carcinoma in situ from breast cancer (DCIS) with objective of decreased mortality, invasive or non invasive recurrence, distant metastases and contralateral breast cancer rates. We have done a meta-analysis of these results to give a more balanced view of the total evidence and ...
متن کامل