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Medline ® Abstract for Reference 29

of 'Adjuvant radiation therapy for women with newly diagnosed, non-metastatic breast cancer'

A randomised study of whole-breast vs tumour-bed irradiation after local excision and axillary dissection for early breast cancer.
Dodwell DJ, Dyker K, Brown J, Hawkins K, Cohen D, Stead M, Ash D
Clin Oncol (R Coll Radiol). 2005;17(8):618.
AIMS: Whole-breast radiotherapy (WBRT) after conservative surgery for early breast cancer is a routine standard of care. Despite this, a number of uncertainties in management still exist. Over recent years, a number of new technologies have allowed the development of partial-breast irradiation, with the intention of improving the risk-benefit relationship of routine breast radiotherapy. We report the results of a trial comparing partial- with WBRT, with prolonged follow-up.
MATERIALS AND METHODS: Between 1986 and 1990, 174 women were randomised to receive conventional whole-breast radiotherapy (WBRT) (40 Gy in 15 fractions), with a tumour-bed boost or partial-breast irradiation by a variety of techniques. Recruitment was problematic, and the trial closed prematurely well before meeting its recruitment target.
RESULTS: A trend was observed towards higher local recurrence and a higher locoregional recurrence rate after irradiation of the tumour bed alone. Distant recurrence and survival were the same.
CONCLUSIONS: Conclusions are limited in view of the failure to complete accrual of the target of 400 participants, and in the context of the techniques of partial-breast radiotherapy used during this study, which would not compare with those in current use. Tumour-bed irradiation alone cannot currently be recommended as routine treatment outside the context of clinical trial.
Cookridge Hospital, Leeds, UK. david.dodwell@leedsth.nhs.uk