Adjuvant radiotherapy and chemotherapy in node-positive premenopausal women with breast cancer
Adjuvant radiotherapy and chemotherapy in node-positive premenopausal women with breast cancer
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DOI：
10.1056/nejm199710023371402
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发表时间：
1997-10-02
影响因子：
158.5
通讯作者：
Olivotto, IA
中科院分区：
文献类型：
--
作者：
Ragaz, J;Jackson, SM;Olivotto, IA
背景自20世纪40年代以来，乳腺切除术后放射治疗治疗早期乳腺癌已被认为可以降低局部复发率。然而，术后放疗的常规使用在20世纪80年代开始下降，因为它未能提高总生存率。方法对1978 ~ 1986年318例绝经前淋巴结阳性乳腺癌患者行改良根治术后，随机分为化疗加放疗组和单纯化疗组。在第四和第五个周期之间，对胸壁和局部淋巴结进行了环磷酰胺、甲氨蝶呤和氟尿嘧啶的放射治疗。结果经过15年的随访，接受化疗加放疗的妇女的复发率降低了33（相对危险度，0.67; 95%可信区间，0.50 ~ 0.90）和乳腺癌死亡率降低29%（相对危险度，0.71; 95%置信区间，0.51至0.99），结论乳腺癌改良根治术后放疗联合化疗可降低局部和全身复发率，并可降低术后死亡率。乳腺癌(C)1997年，马萨诸塞州医学会。
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. (C) 1997, Massachusetts Medical Society.