文档介绍：The New England Journal of Medicine
RECURRENCE RATES AFTER TREATMENT OF BREAST CANCER
WITH STANDARD RADIOTHERAPY WITH OR WITHOUT
ADDITIONAL RADIATION
HARRY BARTELINK, ., ., JEAN-CLAUDE HORIOT, ., ., PHILIP POORTMANS, .,
HENK STRUIKMANS, ., ., WALTER VAN DEN BOGAERT, ., ., ISABELLE BARILLOT, .,
ALAIN FOURQUET, ., JACQUES BORGER, ., ., JOS JAGER, ., ., WILLEM HOOGENRAAD, .,
LAURENCE COLLETTE, ., AND MARIANNE PIERART, ., FOR THE ANIZATION FOR RESEARCH
AND TREATMENT OF CANCER RADIOTHERAPY AND BREAST CANCER GROUPS
ABSTRACT EVERAL randomized clinical trials1-5 and a
Background Radiotherapy prevents local recur- meta-analysis6 have shown similar survival rates
rence of breast cancer after breast-conserving surgery. after breast-conserving therapy and after mas-
We evaluated the effect of a supplementary dose of tectomy in patients with early breast cancer.
radiation to the tumor bed on the rates of local recur- SThe B-06 trial of the National Surgical Adjuvant Breast
rence among patients who received radiotherapy af- and Bowel Project and other trials demonstrated that
ter breast-conserving surgery for early breast cancer. after plete excision, irradiation of
Methods After lumpectomy and axillary dissection, the whole breast with a dose of 50 Gy reduced the rate
patients with stage I or II breast cancer received 50 Gy of recurrence in the ipsilateral breast from 35 percent
of radiation to the whole breast in 2-Gy fractions over 4,7-10
a five-week period. Patients with a microscopically to 10 percent. However, little is known about
complete excision were randomly assigned to receive the effect of irradiation of the breast at doses higher
either no further local treatment (2657 patients) or an than 50 Gy.
additional localized dose of 16 Gy, usually given in In the absence of data from randomized trials, there
eight fractions by means of an external electron beam is no uniformi