Post-mastectomy megavoltage radiotherapy: the Oslo and Stockholm trials

• Published in: European journal of cancer (1990) Vol. 28; no. 2-3; p. 433
• Main Authors: Auquier, A, Rutqvist, L E, Høst, H, Rotstein, S, Arriagada, R
• Format: Journal Article
• Language: English
• Published: England 1992
• Subjects: Adult; Aged; Axilla; Breast Neoplasms - mortality; Breast Neoplasms - radiotherapy; Breast Neoplasms - surgery; Combined Modality Therapy; Female; Humans; Lymphatic Irradiation; Mastectomy, Radical; Meta-Analysis as Topic; Middle Aged; Neoplasm Metastasis; Radiotherapy, High-Energy; Time Factors
• ISSN: 0959-8049
• DOI: 10.1016/S0959-8049(05)80070-X

The ability of adjuvant radiotherapy to prevent distant metastasis and to prolong survival in patients with early breast cancer is much debated. The paper presents a joint analysis of long-term results (13-16 years' follow-up) from the Oslo and Stockholm randomised trials of post-operative megavoltage radiotherapy versus surgery alone. Among node-positive patients there was a significant 37% relative reduction of distant metastases with radiation (P less than 0.01) and an overall survival difference in favor of the irradiated patients which corresponded with a 22% relative reduction of deaths of borderline significance (P less than 0.06). No significant benefit with radiation in terms of distant metastasis-free survival or overall survival was observed among node-negative patients. The results show that effective local treatment can prevent distant dissemination in some patients and contradict the contention that node-positive breast cancer invariably is a systemic disease already at primary diagnosis.