Relation between time-dose and local control of operable breast cancer treated by tumorectomy and radiotherapy or by radical radiotherapy alone
✍ Scribed by J. P. Bataini; C. Picco; M. Martin; R. Calle
- Publisher
- John Wiley and Sons
- Year
- 1978
- Tongue
- English
- Weight
- 477 KB
- Volume
- 42
- Category
- Article
- ISSN
- 0008-543X
No coin nor oath required. For personal study only.
✦ Synopsis
67 patients with tumors 3 cm or less and with negative axilla, who had lumpectomy and radiotherapy, and 122 patients with larger tumors or clinically positive axilla, who had radical radiotherapy without prior lumpectomy, were evaluated at five years to determine the optimum dose for local control. 7000 rad in seven to eight weeks controlled 85% of lumpectomy cases, whereas 8000 rad in 8% weeks were required to control two-thirds of cases treated by radical irradiation alone. Subclinical (NO, Nla) and clinical disease (Nlb) in the axilla was controlled, in a very high percentage, when 6000 and 7000 rad were delivered, respectively. Dose response curves were obtained for clinical disease in the breast and axilla. No such response was elicited for subclinical disease. Undifferentiated cancers had higher recurrence rates than well differentiated tumors. Radiation fibrosis in lumpectomy cases was insignificant, whereas 10% of radically irradiated patients had fibrosis of the breast.
Cancer 42:2059-2065, 1978.
ADIOTHERAPY PLAYS AN IMPORTANT ROLE R in the management of operable breast cancer at the Fondation Curie in Paris. The policy of treatment is to perform lumpectomy, followed by radiotherapy, for patients who have breast tumors 3 cm or less and with clinically negative axilla. Patients with clinically positive axilla and/or tumors larger than 3 cm, and in whom lumpectomy may cause deformity of the breast, are treated primarily by radical radiotherapy without prior lumpectomy. Secondary surgery which, in the majority of cases, consists of mastectomy is performed for persistent or recurrent cancers. The policy of treatment has been outlined in the previous paper.4 With increasing interest in the preservation of the breast by limited surgery (lumpectomy) followed by irradiation, it is necessary to deter-