Overview of Adjuvant Radiotherapy for Breast Cancer

Abstract

Two papers (Cuzick et al. (1987 a, 1987 b)) have recently been published, in which mortality results from all available mature randomized trials of adjuvant radiotherapy were updated and analyzed collectively. These overviews were based on individual patient data for over 10000 patients, of whom more than 6000 had died. Brief details of the individual trials are shown in Table 1. As shown in Figs. 1 and 2, no effect of radiotherapy could be found in the first 10 years of follow-up in the two types of pure radiotherapy trials — radical mastectomy with or without radiotherapy and simple mastectomy with or without radiotherapy. There was no indication of heterogeneity between different trials. In trials of simple mastectomy with radiotherapy vs. radical mastectomy without radiotherapy, a slightly worse prognosis (P=0.05) was observed in the irradiated patients (Fig. 3). This was due to poor survival in one trial (Southeast Scotland) in the first 5 years of follow-up and appears to be a chance finding.