Overview of Adjuvant Radiotherapy for Breast Cancer

Abstract

Two papers by Cuzick et al. (1987 a, b) have recently been published in which mortality results from all available mature randomized trials of adjuvant radiotherapy are updated and analyzed collectively. Briefly, these overviews, which were based on individual patient data for over 10000 patients with more than 6000 deaths, showed conclusively that radiotherapy had no appreciable affect on mortality in the first 5–10 years of follow-up, but they suggested rather strongly (P< 0.001) that at least some forms of radiotherapy had a deleterious effect on long-term survival as measured by subsequent survival in those patients who survived at least 10 years. This result was based primarily on the earliest generation of trials in which radiotherapy was a randomized option after all patients had received a radical mastectomy, but it was also supported by the King’s/CRC trial of simple mastectomy with or without radiotherapy. Overall, the death rate after 10 years among 10-year survivors was estimated to be 35% higher (95% CI, 15%–58%) in those who had been randomized to receive radiotherapy.