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Ca prsu - novinky 30-12-2001 |
Radiotherapy May Not Be Necessary After Breast-Conserving Surgery
NEW YORK (Reuters Health) Dec 27 - Women treated with tamoxifen, no therapy, or radiotherapy, after undergoing breast-conserving lumpectomy all have similar median disease-free survival rates, Japanese researchers report.
Dr. T. Tominaga, from Toyosu Hospital, and colleagues randomly assigned 112 women, who underwent lumpectomy for breast tumors 2 cm in diameter or smaller, to no therapy or to 20 mg tamoxifen for 2 years.
For women who received no treatment the median 5-year disease-free survival rate was 86.0% and for women receiving tamoxifen it was 78.5%, a nonsignificant difference (p= 0.308). The difference in overall survival at 5 years was not significantly different between the groups (92.5% no treatment versus 94.3% tamoxifen, p = 0.745), the researchers found.
When Dr. Tominaga's team retrospectively studied 70 patients who had opted for radiotherapy after lumpectomy, 5-year disease-free survival and overall survival was comparable to the tamoxifen and no treatment groups combined, according to their report in the November issue of Clinical Drug Investigations.
Median 5-year disease-free survival rates were 82.2% in the combined groups and 86.6% in the radiotherapy group (p = 0.352). There was also no difference in the median overall survival between the combined groups and the radiotherapy group (p = 0.224), they note.
"Our findings suggest that breast cancer patients may not always require radiotherapy after breast-conserving surgery, although the generally favorable prognosis of patients treated in this study and the low number of tumor recurrences did not allow the equivalence of the treatment regimens to be proved statistically," Dr. Tominaga and colleagues comment.
"However, because of this finding, and the facts that local tumor recurrences have been reported at 10 to 15 years after radiotherapy and that its late-onset adverse effects after 20 to 30 years are unclear, the development of newer treatment methods to replace radiotherapy is needed."
Clin Drug Invest 2001;21:775-782
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