A Randomised Study of Whole-breast vs Tumour-bed Irradiation After Local Excision and Axillary Dissection for Early Breast Cancer

Czy napromienianie części piersi powinno się stać standardowym elementem oszczędzającego leczenia chorych na wczesnego raka piersi? Głos na nie

“…W kolejnym badaniu angielskim odsetek wznów był również wyższy po APBI z pól zewnętrznych w stosunku do konwencjonalnej teleradioterapii (12% vs 4%) [33].…”

Partial-Breast Irradiation or Whole-Breast Radiotherapy for Early Breast Cancer: a Meta-Analysis of Randomized Trials

“…However, the necessity of giving WBI to all patients after BCS has been questioned, and several centers have evaluated the feasibility and efficacy of partial-breast irradiation (PBI) [1,2,4,5,7,[9][10][11]14]. Parallel with the growing evidence obtained from phase I-II studies supporting the use of PBI for selected early stage breast cancer patients, three early phase III trials comparing different techniques of PBI to conventional WBI have been conducted in the early 1980s and 1990s [3,6,8,12]. During the 2009 ASCO (American Society of Clinical Oncology) Meeting, Valachis et al [15] presented a meta analysis of these randomized controlled PBI trials.…”

“…Its main limitation is the mixture of the results of two unsuccessful "old" British PBI trials (the Christie Hospital and Cookridge Hospital trials) using inadequate patient selection criteria with a third successful PBI trial using stringent patient selection [3,6,8,12]. Obviously, the high rates of local failure seen in the Christie and Cookridge Hospitals' studies reflect inadequate patient selection critera [3,6,12].…”

“…Obviously, the high rates of local failure seen in the Christie and Cookridge Hospitals' studies reflect inadequate patient selection critera [3,6,12]. In the Christie Hospital series, patients with tumor size up to 4 cm (76% T2) were enrolled on the study, and axillary staging was omitted (100% pNx).…”

“…There were major limitations in the RT technique used in the PBI arms of the first two studies [3,6,12]. The Christie Hospital trial was conducted > 25 years ago (between 1982 and 1987) [6,12].…”