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Titolo:
A RANDOMIZED TRIAL OF LONG-TERM ADJUVANT TAMOXIFEN PLUS POSTOPERATIVERADIATION-THERAPY VERSUS RADIATION-THERAPY ALONE FOR PATIENTS WITH EARLY-STAGE BREAST-CARCINOMA TREATED WITH BREAST-CONSERVING SURGERY
Autore:
DALBERG K; JOHANSSON H; JOHANSSON U; RUTQVIST LE;
Indirizzi:
KAROLINSKA HOSP,DEPT SURG S-10401 STOCKHOLM SWEDEN KAROLINSKA HOSP,CTR ONCOL S-10401 STOCKHOLM SWEDEN
Titolo Testata:
Cancer
fascicolo: 11, volume: 82, anno: 1998,
pagine: 2204 - 2211
SICI:
0008-543X(1998)82:11<2204:ARTOLA>2.0.ZU;2-2
Fonte:
ISI
Lingua:
ENG
Soggetto:
REQUIRING PROLONGED OBSERVATION; COMPARING TOTAL MASTECTOMY; CANCER PATIENTS; CLINICAL-TRIAL; POLYACRYLAMIDE-GEL; RECEPTOR; RADIOTHERAPY; LUMPECTOMY; IRRADIATION; TUMORS;
Keywords:
BREAST CARCINOMA; BREAST-CONSERVING SURGERY; TAMOXIFEN; LOCAL FAILURE;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Science Citation Index Expanded
Citazioni:
34
Recensione:
Indirizzi per estratti:
Citazione:
K. Dalberg et al., "A RANDOMIZED TRIAL OF LONG-TERM ADJUVANT TAMOXIFEN PLUS POSTOPERATIVERADIATION-THERAPY VERSUS RADIATION-THERAPY ALONE FOR PATIENTS WITH EARLY-STAGE BREAST-CARCINOMA TREATED WITH BREAST-CONSERVING SURGERY", Cancer, 82(11), 1998, pp. 2204-2211

Abstract

BACKGROUND. The use of adjuvant tamoxifen to treat postmenopausal breast carcinoma patients as an adjunct to primary surgery is well established. The current study reports the long term results for a low risk stratum in a randomized trial of adjuvant tamoxifen. The main focus ofthis analysis was to determine whether tamoxifen would result in a reduced local failure rate for lymph node negative, postmenopausal patients treated with breast-conserving surgery and postoperative radiotherapy. METHODS. The study population included 432 lymph node negative, postmenopausal patients with invasive breast carcinoma (classified as T1-T2) who underwent breast-conserving surgery followed by radiotherapyin Stockholm during the period 1976-1990. The patients constituted a separate stratum of the Stockholm Adjuvant Tamoxifen Trial, which included a total of 2729 patients. Of 432 patients, 213 received 40 mg of tamoxifen daily for either 2 or 5 years. The median follow-up time was8 years (range, 5-19 years). RESULTS. At 10 years, the overall survival was 90% for the tamoxifen group and 88% for the control group. The event free survival at 10 years was 80% for the tamoxifen group and 70% for the control group (P = 0.03). Tamoxifen reduced the overall rateof ipsilateral (hazard ratio = 0.4, 95% confidence interval [CI] = 0.2-0.9, P = 0.02) and contralateral breast tumor recurrences (hazard ratio = 0.4, 95% CI = 0.1-1.1, P = 0.06). Trends toward a reduced numberof distant metastases (hazard ratio = 0.6, 95% CI = 0.3-1.2, P = 0.1)and deaths due to breast carcinoma (hazard ratio = 0.5, 95% CI = 0.2-1.2, P = 0.1) also were observed. CONCLUSIONS. The addition of tamoxifen to radiotherapy for postmenopausal, lymph node negative breast carcinoma patients treated with breast-conserving surgery resulted in a reduced rate of ipsilateral and contralateral breast tumor recurrences. The avoidance of salvage mastectomies, reexcisions, and new contralateral malignancies justifies the use of tamoxifen even in the treatment of patients with a 10-year survival rate of 90%. [See editorial on pages 2090-2, this issue.] (C) 1998 American Cancer Society.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 05/04/20 alle ore 09:31:01