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Titolo:
EFFECTS OF RADIOTHERAPY AND SURGERY IN EARLY BREAST-CANCER - AN OVERVIEW OF THE RANDOMIZED TRIALS
Autore:
ABE O; ABE R; ASAISHI K; ENOMOTO K; HATTORI T; IINO Y; KIKUCHI K; KOYAMA H; SAWA K; UCHINO J; YOSHIDA M; VANDEVELDE AO; VERMORKEN JB; FOROGLOU P; GIOKAS G; LISSAIOS B; HARVEY VJ; HOLDAWAY TM; KAY RG; MASON BH; FORBES JF; FOCAN C; LOBELLE JP; PEEK U; OATES GD; POWELL J; BASTERT G; RAUSCHECKER H; SAUER R; SAUERBREI W; SCHAUER A; SCHUMACHER M; GELMAN RS; HENDERSON IC; SHAPIRO CL; HANCOCK AK; JACKSON S; RAGAZ J; DELOZIER T; MACELESECH J; HAYBITTLE JL; CIRRINCIONE C; KORZUN A; WEISS RB; WOOD WC; BAUM M; HOUGHTON J; RILEY D; DENT DM; GUDGEON CA; HACKING A; HORGAN K; HUGHES L; STEWART HJ; GORDON NH; DAVIS HL; OWEN JR; MEIER P; HOWELL A; RIBEIRO GC; SWINDELL R; ALBANO J; DEOLIVEIRA CF; GERVASIO H; GORDILHO J; CARSTENSEN B; PALSHOF T; JOHANSEN H; KORZENIOWSKI S; SKOLYSZEWSKI J; ANDERSEN KW; AXELSSON CK; BLICHERTTOFT M; MOURIDSEN HT; OVERGAARD M; ROSE C; CORCORAN N; TRAMPISCH HJ; ABELOFF MD; CARBONE PC; GLICK J; GRAY R; TORMEY DC; BARTELINK H; FENTIMAN IS; PARIDAENS R; VANDRIEL OJR; SYLVESTER RJ; VANDEVELDE CJH; VANDERSCHUEREN E; VANDONGEN JA; WELVAART K; SCANLON EF; SCHURMAN S; DESCHRYVER A; YOSEF HMA; MCARDLE CS; SMITH DC; LARA PC; BOCCARDO F; IZUO M; MORISHITA Y; BENTLEY A; DORAN Z; HAYWARD JL; RUBENS RD; KAUFMANN M; JONAT W; SCHEURLEN H; VONFOURNIER D; KAUFMANN M; KLEFSTROM P; CUZICK J; MARGREITER R; CAVALLI F; COLLINS J; GELBER RD; GOLDHIRSCH A; ISLEY MR; LINDTNER J; PRICE KN; RUDENSTAM CM; BLISS JM; CHILVERS CED; COOMBES RC; MARTY M; BRUFMAN G; HAYAT H; BOROVIK R; ROBINSON E; PANNUTI F; TAKASHIMA S; YASUTOMI T; SONOO H; YAMASHITA J; OGAWA M; NOMURA Y; BONTE J; TENGRUP I; TENNVALLNITTBY L; MARTIN P; ROMAIN S; AHMANN D; SCHAID DJ; BUZDAR AU; SMITH T; HAKES T; NORTON L; WITTES R; DELAHUERTA R; SAINZ MG; BONADONNA G; DELVECCHIO M; VALAGUSSA P; VERONESI U; DUBOIS JB; BIANCO AR; LIPPMAN ME; PIERCE LJ; SIMON R; STEINBERG SM; BROWN A; FISHER B; REDMOND C; WOLMARK N; JACKSON IM; PALMER MK; INGLE JN; BENGTSSON NO; LARSSON LG; LYTHGOE JP; KISSIN M; HANNISDAL E; VARHAUG JE; BLAMEY RW; MITCHELL AK; ROBERTSON JFR; NAKAMURA Y; MATHE G; MISSET JL; CLARKE EA; MCLAUGHLIN JR; CLARK RM; LEVINE M; MORIMOTO K; GUNDERSEN S; HAUERJENSEN M; HOST H; CROSSLEY E; DURRANT K; HARRIS A; BEIGHTON A; CHADBON D; CLARKE M; COLLINS R; DAVIES C; EVANS V; GODWIN J; GREAVES E; HARWOOD C; JAMES S; MEAD G; MULDAHL A; PETO R; TOOTH A; WHEATLEY K; RAMBERT P; ASSELAIN B; SALMON RJ; VILCOQ JR; ARRIAGADA R; HILL C; LAPLANCHE A; LE MG; SPIELMANN M; COCCONI G; DIBLASIO B; CATALANO R; CREECH RH; BROCKSCHMIDT J; COOPER MR; ANDRYSEK O; BARKMANOVA J; TREURNIETDONKER AD; VANPUTTEN WLJ; EASTON D; POWLES TJ; GAZET JC; SEMIGLAZOV V; DESHPANDE N; DIMARTINO L; DOUGLAS P; LINDTNER A; NOTTER G; NISSENMEYER R; FORREST APM; JACK W; MCDONALD C; MOLLER TR; RYDEN S; CARSTENSEN J; HATSCHEK T; SODERBERG M; CARPENTER JT; ALBAIN K; CROWLEY J; GREEN S; OSBORNE CK; RUTQUIST LE; WALLGREN A; HOLM LE; CASTIGLIONE M; FLUCKIGER H; THURLIMANN B; BRENNER H; HERCBERGS A; YOSHIMOTO M; DEBOER G; PATERSON AHG; PRITCHARD KI; MEAKIN JW; PANZARELLA T; NAJA A; BAHI J; REID M; SPITTLER M; SENANAYAKE F; HOLMBERG L; SEVELDA P; ZIELINSKY CC; JAKESZ R; BUCHANAN RB; CROSS M; DUNN JA; GILLESPIE WM; KELLY K; MORRISON JM; LITTON A; CHLEBOWSKI RT; BEZWODA WR; CAFFIER H;
Indirizzi:
RADCLIFFE INFIRM,NUFFIELD DEPT CLIN MED,ICRF MRC CLIN TRIAL SERV UNIT,EBCTCG SECRETARIAT OXFORD OX2 6HE ENGLAND INTEGRAAL KANKERCENTRUM ZUID EINDHOVEN NETHERLANDS METAXAS MEM HOSP PIRAEUS GREECE AUCKLAND BREAST CANC STUDY GRP AUCKLAND NEW ZEALAND AKAD WISSENSCH BERLIN BERLIN GERMANY BIRMINGHAM GEN HOSP BIRMINGHAM W MIDLANDS ENGLAND BUNDESMINIST FORSCH & TECHNOL BONN GERMANY FDN BERGONIE BORDEAUX FRANCE DANA FARBER CANC INST BOSTON MA 02115 BRADFORD ROYAL INFIRM BRADFORD W YORKSHIRE ENGLAND BRITISH COLUMBIA CANC AGCY VANCOUVER BC CANADA ADDENBROOKES HOSP CAMBRIDGE ENGLAND CANC RES CAMPAIGN LONDON ENGLAND GROOTE SCHUUR HOSP CAPE TOWN SOUTH AFRICA CARDIFF SURG TRIALISTS CARDIFF S GLAM WALES CASE WESTERN RESERVE UNIV CLEVELAND OH 44106 CHELTENHAM GEN HOSP CHELTENHAM PA 00000 UNIV CHICAGO CHICAGO IL 60637 CHRISTIE HOSP & HOLT RADIUM INST MANCHESTER LANCS ENGLAND COIMBRA INST ONCOL COIMBRA PORTUGAL DANISH CANC REGISTRY COPENHAGEN DENMARK COPENHAGEN RADIUM CTR COPENHAGEN DENMARK CRACOW INST ONCOL KRAKOW POLAND DUBLIN ST LUKES HOSP DUBLIN IRELAND UNIV DUSSELDORF DUSSELDORF GERMANY EASTERN COOPERAT ONCOL GRP BOSTON MA 00000 EUROPEAN ORG RES TREATMENT CANC AMSTERDAM NETHERLANDS EVANSTON HOSP CORP EVANSTON IL 00000 GLASGOW BEATSON ONCOL CTR GLASGOW LANARK SCOTLAND GLASGOW VICTORIA INFIRM GLASGOW LANARK SCOTLAND GRANADA UNIV HOSP GRANADA SPAIN GUNMA UNIV MAEBASHI GUMMA JAPAN GUYS HOSP LONDON ENGLAND UNIV HEIDELBERG W-6900 HEIDELBERG GERMANY DEACONESS MED CTR HELSINKI FINLAND IMPERIAL CANC RES FUND LONDON ENGLAND INNSBRUCK UNIV INNSBRUCK AUSTRIA INT BREAST CANC STUDY GRP BERN SWITZERLAND CHARING CROSS HOSP,INT COLLABORAT CANC GRP LONDON ENGLAND TECHNION ISRAEL INST TECHNOL,RAMBAM MED CTR IL-32000 HAIFA ISRAEL KAWASAKI MED UNIV KAWASAKI KANAGAWA JAPAN KUMAMOTO UNIV GRP KUMAMOTO JAPAN ACAD ZIEKENHUIS ST RAFAEL LOUVAIN BELGIUM LUND UNIV S-22100 LUND SWEDEN APM,CANCEROL BIOL LAB MARSEILLE FRANCE MAYO CLIN ROCHESTER MN 55905 MD ANDERSON CANC CTR HOUSTON TX 77030 MEM SLOAN KETTERING CANC CTR NEW YORK NY 10021 NATL MED CTR MEXICO CITY DF MEXICO IST NAZL STUDIO & CURA TUMORI I-20133 MILAN ITALY MONTPELLIER CTR PAUL LAMARQUE MONTPELLIER FRANCE UNIV NAPLES I-80138 NAPLES ITALY NCI BETHESDA MD 20892 NATL SURG ADJUVANT BREAST & BOWEL PROJECT PITTSBURGH PA 00000 NORTHWICK PK HOSP & CLIN RES CTR HARROW MIDDX ENGLAND CITY HOSP NOTTINGHAM NOTTINGHAM ENGLAND OITA PREFECTURAL HOSP OITA JAPAN ONTARIO CANC TREATMENT & RES FDN TORONTO ON CANADA ONTARIO CLIN ONCOL GRP HAMILTON ON CANADA OSAKA CITY MED SCH OSAKA JAPAN OSLO RADIUM HOSP OSLO NORWAY OXFORD CHURCHILL HOSP OXFORD ENGLAND IMPERIAL CANC RES FUND,MRC,CLIN TRIAL SERV UNIT LONDON ENGLAND CTR RENE HUGUENIN ST CLOUD FRANCE INST CURIE F-75231 PARIS FRANCE INST GUSTAVE ROUSSY F-94805 VILLEJUIF FRANCE PARMA HOSP PARMA ITALY FOX CHASE CANC CTR PHILADELPHIA PA 19111 PIEDMONT ONCOL ASSOC WINSTON SALEM NC 00000 CHARLES UNIV PRAGUE CZECH REPUBLIC ROTTERDAM RADIO THERAPEUT INST ROTTERDAM NETHERLANDS ROYAL MARSDEN HOSP,INST CANC RES LONDON ENGLAND ST GEORGE HOSP LONDON ENGLAND ONCOL HOSP A BUSINICO SARDINIA ITALY SASKATCHEWAN CANC FDN SASKATOON SK CANADA SCOTTISH CANC TRIALS OFF EDINBURGH MIDLOTHIAN SCOTLAND SW ONCOL GRP SEATTLE WA 00000 STOCKHOLM BREAST CANC STUDY GRP STOCKHOLM SWEDEN KAROLINSKA HOSP STOCKHOLM SWEDEN TEL AVIV UNIV IL-69978 TEL AVIV ISRAEL CANC INST HOSP TOKYO JAPAN TORONTO EDMONTON BREAST CANC STUDY GRP TORONTO ON CANADA TOULOUSE CTR CLAUDIUS REGAUD TOULOUSE FRANCE INST SALAH AZAIZ TUNIS TUNISIA UPPSALA OREBRO CANC STUDY GRP UPPSALA SWEDEN UNIV HOSP VIENNA VIENNA AUSTRIA UNIV WITWATERSRAND JOHANNESBURG 2050 SOUTH AFRICA
Titolo Testata:
The New England journal of medicine
fascicolo: 22, volume: 333, anno: 1995,
pagine: 1444 - 1455
SICI:
0028-4793(1995)333:22<1444:EORASI>2.0.ZU;2-Q
Fonte:
ISI
Lingua:
ENG
Soggetto:
REQUIRING PROLONGED OBSERVATION; POSTOPERATIVE RADIOTHERAPY; RECURRENCE; PATIENT; DESIGN;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Science Citation Index Expanded
Citazioni:
14
Recensione:
Indirizzi per estratti:
Citazione:
O. Abe et al., "EFFECTS OF RADIOTHERAPY AND SURGERY IN EARLY BREAST-CANCER - AN OVERVIEW OF THE RANDOMIZED TRIALS", The New England journal of medicine, 333(22), 1995, pp. 1444-1455

Abstract

Background. Randomized trials of radiotherapy and surgery for early breast cancer may have been too small to detect differences in long-term survival and recurrence reliably. We therefore performed a systematic overview (meta-analysis) of the results of such trials. Methods. Information was sought on each subject from investigators who conducted trials that began before 1985 and that compared local therapies for early breast cancer. Data on mortality were available from 36 trials comparing radiotherapy plus surgery with the same type of surgery alone, 10 comparing more-extensive surgery with less-extensive surgery, and 18comparing more-extensive surgery with less-extensive surgery plus radiotherapy. Information on mortality was available for 28,405 women (97.4 percent of the 29,175 women in the trials). Results. The addition of radiotherapy to surgery resulted in a rate of local recurrence that was three times lower than the rate with surgery alone, but there was no significant difference in 10-year survival; among a total of 17,273women enrolled in such trials, mortality was 40.3 percent with radiotherapy and 41.4 percent without radiotherapy (P=0.3). Radiotherapy wasassociated with a reduced risk of death due to breast cancer (odds ratio, 0.94; 95 percent confidence interval, 0.88 to 1.00; P=0.03), which indicates that, after 10 years, there would be about 0 to 5 fewer deaths due to breast cancer per 100 women. However, there was an increased risk of death from other causes (odds ratio, 1.24; 95 percent confidence interval, 1.09 to 1.42; P=0.002). This, together with the age-specific death rates, implies, after 10 years, a few extra deaths not due to breast cancer per 100 older women or per 1000 younger women, During the first decade or two after diagnosis, the excess in the rate of such deaths that was associated with radiotherapy was much greater among women who were over 60 years of age at randomization (15.3 percent vs. 11.1 percent [339 vs. 249 deaths]) than among those under 50 (2.5 percent vs. 2.0 percent [62 vs. 49 deaths]). Breast-conserving surgeryinvolved some risk of recurrence in the remaining tissue, but no significant differences in overall survival at 10 years were found in the studies of mastectomy versus breast-conserving surgery plus radiotherapy (4891 women), more-extensive surgery versus less-extensive surgery (4818 women), or axillary clearance versus radiotherapy as adjuncts tomastectomy (4370 women). Conclusions. Some of the local therapies forbreast cancer had substantially different effects on the rates of local recurrence - such as the reduced recurrence with the addition of radiotherapy to surgery - but there were no definite differences in overall survival at 10 years.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 12/07/20 alle ore 06:20:04