| Abstract | AIM: To summarise the results of randomised trials testing the addition of radiotherapy (RT) to breast conserving surgery for ductal carcinoma in situ (DCIS); to determine whether there are subsets of women with DCIS who do not benefit from RT; and to determine what the balance may be between reduction in risk of recurrence and long-term toxicity. METHODS: We performed a systematic review to resolve these questions, using standard Cochrane methodology to identify, select and appraise relevant randomised trials. RESULTS: Four randomised controlled trials involving 3925 women were identified. All were high quality with minimal risk of bias. Analysis confirmed a statistically significant benefit from the addition of radiotherapy on all ipsilateral breast events (HR=0.49; 95% CI 0.41-0.58, p<0.00001). All subgroups analysed (margin status, age and grade) benefited from the addition of radiotherapy. Nine women require treatment with radiotherapy to prevent one ipsilateral breast recurrence (NNT=9). Deaths due to vascular disease, pulmonary toxicity and second cancers were low and not significantly higher for women who received radiotherapy. CONCLUDING STATEMENT: Radiotherapy was beneficial in all clinically relevant subgroups. Longer follow-up is required to detect any long-term toxicity from use of radiotherapy. To date, no increase in toxicity has been identified. |
| Authors | Annabel Goodwin, Sharon Parker, Davina Ghersi, Nicholas Wilcken
(Affiliation: Familial Cancer Service, Westmead Hospital, Westmead 2145, Australia.)
|
| Journal | Breast (Edinburgh, Scotland)
(Breast)
Vol. 18
Issue 3
Pg. 143-9
(Jun 2009)
ISSN: 1532-3080 [Electronic] Netherlands |
| PMID | 19447038
(Publication Type: Journal Article, Meta-Analysis, Review)
|
| Topics |
- Aged
- Breast Neoplasms
(radiotherapy, surgery)
- Carcinoma in Situ
(radiotherapy, surgery)
- Carcinoma, Ductal, Breast
(radiotherapy, surgery)
- Combined Modality Therapy
(methods)
- Female
- Humans
- Mastectomy, Segmental
- Middle Aged
- Odds Ratio
- Postoperative Care
(methods)
- Prognosis
- Radiotherapy, Adjuvant
(adverse effects, methods)
- Randomized Controlled Trials as Topic
- Treatment Outcome
- Women's Health
|
