Adjuvant radiotherapy and chemotherapy in node-positive premenopausal women with breast cancer
- PMID: 9309100
- DOI: 10.1056/NEJM199710023371402
Adjuvant radiotherapy and chemotherapy in node-positive premenopausal women with breast cancer
Abstract
Background: Radiotherapy after mastectomy to treat early breast cancer has been known since the 1940s to reduce rates of local relapse. However, the routine use of postoperative radiotherapy began to decline in the 1980s because it failed to improve overall survival. We prospectively tested the efficacy of combining radiotherapy with chemotherapy.
Methods: From 1978 through 1986, 318 premenopausal women with node-positive breast cancer were randomly assigned, after modified radical mastectomy, to receive chemotherapy plus radiotherapy or chemotherapy alone. Radiotherapy was given to the chest wall and locoregional lymph nodes between the fourth and fifth cycles of cyclophosphamide, methotrexate, and fluorouracil.
Results: After 15 years of follow-up, the women assigned to chemotherapy plus radiotherapy had a 33 percent reduction in the rate of recurrence (relative risk, 0.67; 95 percent confidence interval, 0.50 to 0.90) and a 29 percent reduction in mortality from breast cancer (relative risk, 0.71; 95 percent confidence interval, 0.51 to 0.99), as compared with the women treated with chemotherapy alone.
Conclusions: Radiotherapy combined with chemotherapy after modified radical mastectomy decreases rates of locoregional and systemic relapse and reduces mortality from breast cancer.
Comment in
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Stopping metastases at their source.N Engl J Med. 1997 Oct 2;337(14):996-7. doi: 10.1056/NEJM199710023371408. N Engl J Med. 1997. PMID: 9309106 No abstract available.
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Radiotherapy and chemotherapy in high-risk breast cancer.N Engl J Med. 1998 Jan 29;338(5):329-30; author reply 331-2. N Engl J Med. 1998. PMID: 9446030 No abstract available.
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Radiotherapy and chemotherapy in high-risk breast cancer.N Engl J Med. 1998 Jan 29;338(5):330-1; author reply 331-2. N Engl J Med. 1998. PMID: 9446031 No abstract available.
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Breast-conserving surgery for breast cancer.N Engl J Med. 2003 Feb 13;348(7):657-60; author reply 657-60. N Engl J Med. 2003. PMID: 12587570 No abstract available.
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