Adding radiation therapy to chemotherapy improves survival in patients with high-risk breast cancer
For patients with high-risk breast cancer treated with radical mastectomy and adjuvant chemotherapy, the addition of radiation therapy leads to better survival outcomes with few long-term toxic effects, according to a 20-year follow-up of a randomized trial, which appears in the January 19 issue of the Journal of the National Cancer Institute.
The British Columbia randomized radiation therapy trial was designed to determine the effect on survival of the addition of locoregional radiation therapy (radiation to the lymph nodes and chest wall) to a course of chemotherapy after radical mastectomy in premenopausal women with lymph node–positive breast cancer. Between 1979 and 1986, 318 patients were randomly assigned to receive no radiation therapy or to receive radiation. A 15-year follow-up found that radiation therapy was associated with improved breast cancer survival but not with overall survival.
In this 20-year follow-up of the British Columbia trial, Joseph Ragaz, M.D., of McGill University Health Center in Montreal, and colleagues found that the chemotherapy and radiation regimen, compared with chemotherapy alone, was associated with improvement in all end points analyzed. This included a 32% reduction in breast cancer mortality and a 27% reduction in overall mortality compared with chemotherapy alone. In addition, long-term toxic effects, including cardiac deaths, were acceptable for both groups of patients. "Our results, and those from other groups, confirm that in situations where residual disease remains, adjuvant chemotherapy alone in high-risk breast cancer patients is suboptimal and that the addition of locoregional radiation therapy is important to achieve the highest cure rate," the authors write.
In an editorial, Timothy Whelan, B.M., B.Ch., and Mark Levine, M.D., of the Juravinski Cancer Centre in Hamilton, Ontario, discuss the use of locoregional radiation therapy in breast cancer patients and note that fewer clinicians accept its use in moderate-risk patients. "Because uncertainties continue about the effectiveness of locoregional radiation therapy after mastectomy in moderate-risk patients, we strongly urge that a randomized controlled trial be mounted to resolve these uncertainties," they write.
Sarah L. Zielinski | EurekAlert!
The most recent press releases about innovation >>>
Die letzten 5 Focus-News des innovations-reports im Überblick:
Among the general public, solar thermal energy is currently associated with dark blue, rectangular collectors on building roofs. Technologies are needed for aesthetically high quality architecture which offer the architect more room for manoeuvre when it comes to low- and plus-energy buildings. With the “ArKol” project, researchers at Fraunhofer ISE together with partners are currently developing two façade collectors for solar thermal energy generation, which permit a high degree of design flexibility: a strip collector for opaque façade sections and a solar thermal blind for transparent sections. The current state of the two developments will be presented at the BAU 2017 trade fair.
As part of the “ArKol – development of architecturally highly integrated façade collectors with heat pipes” project, Fraunhofer ISE together with its partners...
At TU Wien, an alternative for resource intensive formwork for the construction of concrete domes was developed. It is now used in a test dome for the Austrian Federal Railways Infrastructure (ÖBB Infrastruktur).
Concrete shells are efficient structures, but not very resource efficient. The formwork for the construction of concrete domes alone requires a high amount of...
Many pathogens use certain sugar compounds from their host to help conceal themselves against the immune system. Scientists at the University of Bonn have now, in cooperation with researchers at the University of York in the United Kingdom, analyzed the dynamics of a bacterial molecule that is involved in this process. They demonstrate that the protein grabs onto the sugar molecule with a Pac Man-like chewing motion and holds it until it can be used. Their results could help design therapeutics that could make the protein poorer at grabbing and holding and hence compromise the pathogen in the host. The study has now been published in “Biophysical Journal”.
The cells of the mouth, nose and intestinal mucosa produce large quantities of a chemical called sialic acid. Many bacteria possess a special transport system...
UMD, NOAA collaboration demonstrates suitability of in-orbit datasets for weather satellite calibration
"Traffic and weather, together on the hour!" blasts your local radio station, while your smartphone knows the weather halfway across the world. A network of...
Fiber-reinforced plastics (FRP) are frequently used in the aeronautic and automobile industry. However, the repair of workpieces made of these composite materials is often less profitable than exchanging the part. In order to increase the lifetime of FRP parts and to make them more eco-efficient, the Laser Zentrum Hannover e.V. (LZH) and the Apodius GmbH want to combine a new measuring device for fiber layer orientation with an innovative laser-based repair process.
Defects in FRP pieces may be production or operation-related. Whether or not repair is cost-effective depends on the geometry of the defective area, the tools...