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在高风险的绝经后乳腺癌患者接受辅助他莫西芬的术后放射治疗:丹麦乳腺癌合作组织DBCG 82c随机试验.

M Overgaard1, M B Jensen, J Overgaard

  • 1Department of Oncology, Aarhus University Hospital, Aarhus, Denmark. deco@onko.aau.dk

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|May 21, 1999
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概括

将放射治疗添加到塔莫西芬显著降低了高风险的绝经后乳腺癌患者的复发和改善了存活率. 这种结合方法在乳房切除术后提供了比单独使用塔莫西芬更好的结果.

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科学领域:

  • 在瘤学瘤学.
  • 辐射疗法 辐射疗法
  • 乳腺癌研究研究 乳腺癌研究

背景情况:

  • 乳腺切除术后的放射治疗改善了接受化疗的绝经前乳腺癌患者的治疗结果.
  • 乳房切除术后放射治疗对接受辅助性他莫西芬的绝经后妇女的益处尚未得到充分证实.
  • 高风险乳腺癌需要有效的治疗策略,以改善存活率.

研究的目的:

  • 为了评估在高风险的绝经后乳腺癌患者中,添加术后放射治疗与辅助性他莫西芬的疗效.
  • 为了比较单独使用他莫西芬和他莫西芬加放射治疗组之间的局部区域复发,无病生存率和整体生存率.
  • 在这个患者群体中确定局部和全身瘤控制的最佳治疗策略.

主要方法:

  • 一项随机试验,涉及1375名经更年期妇女,在乳房切除术后患有高风险乳腺癌 (II或III期).
  • 参与者单独接受辅助性他莫西芬 (30毫克每天1年) 或与胸壁和区域淋巴结的术后放射治疗.
  • 随访时间中位数为123个月,终点包括复发部位,无病生存期和整体生存期.

主要成果:

  • 在放射治疗加上他莫西芬组 (8%) 与仅服用他莫西芬组 (35%) (p<0.001) 相比,局部复发明显较低.
  • 无病生存率在放射治疗加上他莫西芬组 (36%) 和单独他莫西芬 (24%) (p<0.001) 中得到改善.
  • 放射治疗组的整体存活率也较高 (10年后为45%),而单独使用塔莫西芬则高 (36%) (p=0.03).

结论:

  • 术后放射治疗,当与辅助性他莫西芬相结合时,在高风险的绝经后乳腺癌患者中显著减少局部区域复发.
  • 这种联合治疗策略与改善无病和整体存活率有关.
  • 为了提高高风险乳腺癌患者的存活率,需要采用全面的方法,包括局部区域和全身瘤控制.