© 2005 Oxford University Press
EDITORIAL |
More Evidence That Locoregional Radiation Therapy Improves Survival: What Should We Do?
Affiliations of authors: McMaster University and the Juravinski Cancer Centre, Hamilton, ON, Canada
Correspondence to: Timothy Whelan, BM, BCh, MSc, Juravinski Cancer Centre, 699 Concession St., Rm. 4-204, Hamilton, ON, Canada L8V 5C2 (e-mail: tim.whelan@hrcc.on.ca)
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In this issue of the Journal, Ragaz et al. (1) report the long-term results (20 years of follow-up) of a randomized trial of locoregional radiation therapy compared with no further treatment after mastectomy among axillary lymph node–positive premenopausal patients with breast cancer treated with adjuvant intravenous chemotherapy (cyclophosphamide, methotrexate, and 5-fluorouracil). In this follow-up, radiation therapy reduced isolated locoregional recurrence, distant recurrence, deaths due to breast cancer, and overall mortality. The previous report of this study (2) demonstrated similar findings, but the reduction in mortality was not statistically significant. This update is important because it demonstrates that in patients with lymph node–positive breast cancer, survival is improved with locoregional radiation therapy (relative risk [RR] = 0.73, 95% confidence interval [CI] = 0.55 to 0.98). This update also reports that the improvement in survival appears to be the
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