Two recently published randomized trials documented the benefit of administering radiotherapy after mastectomy for breast cancer. In both these papers, the local-regional recurrence rate was reduced from 40% with surgery alone to 10% with surgery and radiation. In the March/April issue of the Cancer Journal physicians from The University of Pennsylvania report their experience with postmastectomy radiation therapy.
221 women at high risk for local-regional failure after mastectomy were selected to receive radiotherapy. High-risk features included stage T3 and T4 disease, positive lymph nodes or close margins. Thirty-nine percent of women had more than one of these high-risk features and four percent had none. Radiotherapy to the chest wall was administered in 1.8Gy or 2.0Gy daily fractions to a total dose of 45 to 50.4Gy. Regional lymph node basins were treated in the majority of women. The median follow-up was 4.3 years.
Eleven patients experienced a local-regional failure, yielding an actuarial rate of local-regional control of 89% at ten years. Much more common than local failure was distant failure. Over half of the women received adjuvant chemotherapy or hormonal therapy, but the rate of distant failure remained high: 75 patients (34%) developed distant metastases.
Women who are at high risk for local-regional failure after mastectomy benefit from adjuvant radiotherapy. The rate of local-regional failure reported in this American study corroborates the rates reported in the two recently reported randomized trials. The authors conclude that postmastectomy radiotherapy is recommended for high-risk women.
Apr 19, 2014 - Long-term survival may be increased in medium-risk prostate cancer patients who receive short-term androgen deprivation therapy before and during radiation treatment compared with men who receive radiation alone. In addition, proton beam therapy may be associated with a decreased risk of disease recurrence after 10 years and has minimal side effects after one year, according to research presented at the 51st Annual Meeting of the American Society for Radiation Oncology, held from Nov. 1 to 5 in Chicago.