Radiotherapy and tamoxifen after mastectomy in postmenopausal women – 20 year follow-up of the South Sweden Breast Cancer group randomised trial SSBCG II:I

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• 作者：Fredrika Kill ; er ; Harald Anderson ; Stefan Rydé ; n ; Torgil Mö ; ller ; Knut Aspegren ; Jeanette Ceberg ; Christina Danewid ; Per Malmströ ; m
• 关键词：Breast cancer ; Mastectomy ; Radiotherapy ; Local recurrence ; Mortality ; Long-term ; Tamoxifen
• 刊名：European Journal of Cancer
• 出版年：2007
• 出版时间：September 2007
• 年：2007
• 卷：43
• 期：14
• 页码：2100-2108
• 全文大小：439 K

文摘

To evaluate long-term effects of radiotherapy and tamoxifen after mastectomy on recurrence and survival in stage II breast cancer.

Methods

A randomised phase III study with three treatment alternatives. (1) Radiotherapy 50 Gy/25 fractions to chest wall and regional lymph nodes (RT). (2) Radiotherapy and tamoxifen 30 mg/day for one year (RT + tam) and 3. Tamoxifen (tam).

Results

724 postmenopausal women were included between 1978 and 1985 and the trial was close to population based. Follow-up for survival was 23 years. Locoregional recurrences were reduced from 18.5 % in the tam arm to 5.3 % in the RT + tam arm. Overall mortality at 20 years was 71 % in the RT arm, 68 % in the RT + tam arm and 62 % in the tam arm. The difference between RT + tam and tam was not significant except in the receptor positive subgroup in favour of non-irradiated patients (p = 0.047). The cumulative incidence of systemic disease at 20 years was lower in the RT + Tam arm than in the RT arm, 40 % versus 50 % (p = 0.047).

Conclusion

Postmastectomy radiotherapy significantly reduced loco-regional recurrences, but overall survival was not improved. At 20 years, a lower mortality was recorded for non-irradiated patients treated with tam.