Recurrence rates after treatment of breast cancer with standard radiotherapy with or without additional radiation.
Recurrence rates after treatment of breast cancer with standard radiotherapy with or without additional radiation.
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DOI：
10.1056/nejmoa010874
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发表时间：
2001-11-08
影响因子：
158.5
通讯作者：
Pierart, M
中科院分区：
文献类型：
--
作者：
Bartelink, H;Horiot, J;Pierart, M
背景：放疗可预防保乳手术后乳腺癌局部复发。我们评估了在早期乳腺癌保乳手术后接受放射治疗的患者中，肿瘤床补充剂量对局部复发率的影响。方法：I期或II期乳腺癌患者在乳房肿瘤切除和腋窝清扫后，接受50 Gy全乳2 Gy分次放射治疗，为期5周。显微镜下完全切除的患者被随机分配，要么不接受进一步的局部治疗（2657例），要么接受额外的16 Gy局部剂量，通常通过外部电子束分八次给予（2661例）。结果：在5.1年的中位随访期间，标准治疗组2657例患者中有182例局部复发，额外放疗组2661例患者中有109例局部复发。5年精算局部复发率分别为7.3%（95%置信区间，6.8%至7.6%）和4.3%（95%置信区间，3.8%至4.7%）
Background: Radiotherapy prevents local recurrence of breast cancer after breast-conserving surgery. We evaluated the effect of a supplementary dose of radiation to the tumor bed on the rates of local recurrence among patients who received radiotherapy after breast-conserving surgery for early breast cancer.Methods: After lumpectomy and axillary dissection, patients with stage I or II breast cancer received 50 Gy of radiation to the whole breast in 2-Gy fractions over a five-week period. Patients with a microscopically complete excision were randomly assigned to receive either no further local treatment (2657 patients) or an additional localized dose of 16 Gy, usually given in eight fractions by means of an external electron beam (2661 patients).Results: During a median follow-up period of 5.1 years, local recurrences were observed in 182 of the 2657 patients in the standard-treatment group and 109 of the 2661 patients in the additional-radiation group. The five-year actuarial rates of local recurrence were 7.3 percent (95 percent confidence interval, 6.8 to 7.6 percent) and 4.3 percent (95 percent confidence interval, 3.8 to 4.7 percent), respectively (P