The benefit of adjuvant radiotherapy after breast conserving surgery in older patients with low risk breast cancer- a meta-analysis of randomized trials
It is currently unclear whether patients with low risk breast cancer receiving adjuvant endocrine therapy need adjuvant radiation therapy after breast conserving surgery. The data of randomized trials are available. In a database search 5 randomized trials including in total 3766 mostly elderly pati...
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| Veröffentlicht in: | Radiation oncology (London, England) England), 2017-03, Vol.12 (1), p.60-60, Article 60 |
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| creator | Matuschek, Christiane Bölke, Edwin Haussmann, Jan Mohrmann, Svjetlana Nestle-Krämling, Carolin Gerber, Peter Arne Corradini, Stefanie Orth, Klaus Kammers, Kai Budach, Wilfried |
| description | It is currently unclear whether patients with low risk breast cancer receiving adjuvant endocrine therapy need adjuvant radiation therapy after breast conserving surgery. The data of randomized trials are available.
In a database search 5 randomized trials including in total 3766 mostly elderly patients with early stage breast cancer treated either with adjuvant endocrine therapy or with endocrine therapy and additional whole breast radiation after breast conserving surgery were identified. Published hazard ratios for time to local recurrence were the basis of our meta-analysis. Meta-analysis of the effect sizes on local recurrence was performed using a random effects model based on parameter estimates of log hazard ratios in Cox models and their standard errors. Furthermore, overall survival was examined.
Adjuvant hormone therapy alone in mostly older patients with low risk breast cancer resulted in significantly shorter time to local relapse compared to radiation therapy combined with hormone therapy (Hazard Ratio: 6.8, 95% CI: 4.23-10.93, p |
| doi_str_mv | 10.1186/s13014-017-0796-x |
| format | Article |
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In a database search 5 randomized trials including in total 3766 mostly elderly patients with early stage breast cancer treated either with adjuvant endocrine therapy or with endocrine therapy and additional whole breast radiation after breast conserving surgery were identified. Published hazard ratios for time to local recurrence were the basis of our meta-analysis. Meta-analysis of the effect sizes on local recurrence was performed using a random effects model based on parameter estimates of log hazard ratios in Cox models and their standard errors. Furthermore, overall survival was examined.
Adjuvant hormone therapy alone in mostly older patients with low risk breast cancer resulted in significantly shorter time to local relapse compared to radiation therapy combined with hormone therapy (Hazard Ratio: 6.8, 95% CI: 4.23-10.93, p < 0.0001) . There was no significant difference for overall survival.
Additional radiation therapy to hormone therapy did improve local relapse in breast cancer patients but did not show significant impact on overall survival.</description><identifier>ISSN: 1748-717X</identifier><identifier>EISSN: 1748-717X</identifier><identifier>DOI: 10.1186/s13014-017-0796-x</identifier><identifier>PMID: 28335784</identifier><language>eng</language><publisher>England: BioMed Central</publisher><subject>Age ; Aged ; Aged, 80 and over ; Antineoplastic Agents, Hormonal - therapeutic use ; Breast cancer ; Breast Neoplasms - mortality ; Breast Neoplasms - radiotherapy ; Breast Neoplasms - surgery ; Cancer ; Cancer therapies ; Chemoradiotherapy - methods ; Clinical trials ; Endocrine therapy ; Estimates ; Female ; Geriatrics ; Health risks ; Humans ; Kaplan-Meier Estimate ; Mastectomy ; Mastectomy, Segmental ; Meta-analysis ; Middle Aged ; Older people ; Patients ; Radiation therapy ; Radiotherapy, Adjuvant - methods ; Randomization ; Randomized Controlled Trials as Topic ; Risk ; Studies ; Surgery ; Survival ; Tamoxifen - therapeutic use ; Vital statistics ; Womens health</subject><ispartof>Radiation oncology (London, England), 2017-03, Vol.12 (1), p.60-60, Article 60</ispartof><rights>Copyright BioMed Central 2017</rights><rights>The Author(s). 2017</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c460t-66e3739409a23a0e923fa492e255f17e7a7a7328e6d595c31911e4a1d626a693</citedby><cites>FETCH-LOGICAL-c460t-66e3739409a23a0e923fa492e255f17e7a7a7328e6d595c31911e4a1d626a693</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC5364687/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC5364687/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,864,885,27924,27925,53791,53793</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/28335784$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Matuschek, Christiane</creatorcontrib><creatorcontrib>Bölke, Edwin</creatorcontrib><creatorcontrib>Haussmann, Jan</creatorcontrib><creatorcontrib>Mohrmann, Svjetlana</creatorcontrib><creatorcontrib>Nestle-Krämling, Carolin</creatorcontrib><creatorcontrib>Gerber, Peter Arne</creatorcontrib><creatorcontrib>Corradini, Stefanie</creatorcontrib><creatorcontrib>Orth, Klaus</creatorcontrib><creatorcontrib>Kammers, Kai</creatorcontrib><creatorcontrib>Budach, Wilfried</creatorcontrib><title>The benefit of adjuvant radiotherapy after breast conserving surgery in older patients with low risk breast cancer- a meta-analysis of randomized trials</title><title>Radiation oncology (London, England)</title><addtitle>Radiat Oncol</addtitle><description>It is currently unclear whether patients with low risk breast cancer receiving adjuvant endocrine therapy need adjuvant radiation therapy after breast conserving surgery. The data of randomized trials are available.
In a database search 5 randomized trials including in total 3766 mostly elderly patients with early stage breast cancer treated either with adjuvant endocrine therapy or with endocrine therapy and additional whole breast radiation after breast conserving surgery were identified. Published hazard ratios for time to local recurrence were the basis of our meta-analysis. Meta-analysis of the effect sizes on local recurrence was performed using a random effects model based on parameter estimates of log hazard ratios in Cox models and their standard errors. Furthermore, overall survival was examined.
Adjuvant hormone therapy alone in mostly older patients with low risk breast cancer resulted in significantly shorter time to local relapse compared to radiation therapy combined with hormone therapy (Hazard Ratio: 6.8, 95% CI: 4.23-10.93, p < 0.0001) . There was no significant difference for overall survival.
Additional radiation therapy to hormone therapy did improve local relapse in breast cancer patients but did not show significant impact on overall survival.</description><subject>Age</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Antineoplastic Agents, Hormonal - therapeutic use</subject><subject>Breast cancer</subject><subject>Breast Neoplasms - mortality</subject><subject>Breast Neoplasms - radiotherapy</subject><subject>Breast Neoplasms - surgery</subject><subject>Cancer</subject><subject>Cancer therapies</subject><subject>Chemoradiotherapy - methods</subject><subject>Clinical trials</subject><subject>Endocrine therapy</subject><subject>Estimates</subject><subject>Female</subject><subject>Geriatrics</subject><subject>Health risks</subject><subject>Humans</subject><subject>Kaplan-Meier Estimate</subject><subject>Mastectomy</subject><subject>Mastectomy, Segmental</subject><subject>Meta-analysis</subject><subject>Middle Aged</subject><subject>Older people</subject><subject>Patients</subject><subject>Radiation therapy</subject><subject>Radiotherapy, Adjuvant - methods</subject><subject>Randomization</subject><subject>Randomized Controlled Trials as Topic</subject><subject>Risk</subject><subject>Studies</subject><subject>Surgery</subject><subject>Survival</subject><subject>Tamoxifen - therapeutic use</subject><subject>Vital statistics</subject><subject>Womens health</subject><issn>1748-717X</issn><issn>1748-717X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><recordid>eNqNks1uEzEUhUcIREvhAdggS2zYDPjf4w0SqviTKrHJgp11M3MncZixg-1Jmz5JH5cJKVFhhby4lvyd42PrVNVLRt8y1uh3mQnKZE2Zqamxur55VJ0zI5vaMPP98YP9WfUs5w2lUglqn1ZnvBFCmUaeV3eLNZIlBux9IbEn0G2mHYRCEnQ-ljUm2O4J9AUTWSaEXEgbQ8a082FF8pRWmPbEBxKHbka2UDyGksm1L2syxGuSfP5xUkJoMdUEyIgFaggw7LPPh3sThC6O_hY7UpKHIT-vnvTzwBf386JafPq4uPxSX337_PXyw1XdSk1LrTUKI6ykFrgAipaLHqTlyJXqmUED8xK8Qd0pq1rBLGMogXWaa9BWXFTvj7bbaTli187hEwxum_wIae8iePf3SfBrt4o7p4SWujGzwZt7gxR_TpiLG31ucRggYJyyY401wjBu-H-gDeNaSXuI9fofdBOnNP_Xb0o23CirZ4odqTbFnBP2p9yMukND3LEhbm6IOzTE3cyaVw8ffFL8qYT4BWwpujM</recordid><startdate>20170323</startdate><enddate>20170323</enddate><creator>Matuschek, Christiane</creator><creator>Bölke, Edwin</creator><creator>Haussmann, Jan</creator><creator>Mohrmann, Svjetlana</creator><creator>Nestle-Krämling, Carolin</creator><creator>Gerber, Peter Arne</creator><creator>Corradini, Stefanie</creator><creator>Orth, Klaus</creator><creator>Kammers, Kai</creator><creator>Budach, Wilfried</creator><general>BioMed Central</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QO</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8FD</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>P64</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20170323</creationdate><title>The benefit of adjuvant radiotherapy after breast conserving surgery in older patients with low risk breast cancer- a meta-analysis of randomized trials</title><author>Matuschek, Christiane ; Bölke, Edwin ; Haussmann, Jan ; Mohrmann, Svjetlana ; Nestle-Krämling, Carolin ; Gerber, Peter Arne ; Corradini, Stefanie ; Orth, Klaus ; Kammers, Kai ; Budach, Wilfried</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c460t-66e3739409a23a0e923fa492e255f17e7a7a7328e6d595c31911e4a1d626a693</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>Age</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Antineoplastic Agents, Hormonal - therapeutic use</topic><topic>Breast cancer</topic><topic>Breast Neoplasms - mortality</topic><topic>Breast Neoplasms - radiotherapy</topic><topic>Breast Neoplasms - surgery</topic><topic>Cancer</topic><topic>Cancer therapies</topic><topic>Chemoradiotherapy - methods</topic><topic>Clinical trials</topic><topic>Endocrine therapy</topic><topic>Estimates</topic><topic>Female</topic><topic>Geriatrics</topic><topic>Health risks</topic><topic>Humans</topic><topic>Kaplan-Meier Estimate</topic><topic>Mastectomy</topic><topic>Mastectomy, Segmental</topic><topic>Meta-analysis</topic><topic>Middle Aged</topic><topic>Older people</topic><topic>Patients</topic><topic>Radiation therapy</topic><topic>Radiotherapy, Adjuvant - methods</topic><topic>Randomization</topic><topic>Randomized Controlled Trials as Topic</topic><topic>Risk</topic><topic>Studies</topic><topic>Surgery</topic><topic>Survival</topic><topic>Tamoxifen - therapeutic use</topic><topic>Vital statistics</topic><topic>Womens health</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Matuschek, Christiane</creatorcontrib><creatorcontrib>Bölke, Edwin</creatorcontrib><creatorcontrib>Haussmann, Jan</creatorcontrib><creatorcontrib>Mohrmann, Svjetlana</creatorcontrib><creatorcontrib>Nestle-Krämling, Carolin</creatorcontrib><creatorcontrib>Gerber, Peter Arne</creatorcontrib><creatorcontrib>Corradini, Stefanie</creatorcontrib><creatorcontrib>Orth, Klaus</creatorcontrib><creatorcontrib>Kammers, Kai</creatorcontrib><creatorcontrib>Budach, Wilfried</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Biotechnology Research Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Technology Research Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>Access via ProQuest (Open Access)</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Radiation oncology (London, England)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Matuschek, Christiane</au><au>Bölke, Edwin</au><au>Haussmann, Jan</au><au>Mohrmann, Svjetlana</au><au>Nestle-Krämling, Carolin</au><au>Gerber, Peter Arne</au><au>Corradini, Stefanie</au><au>Orth, Klaus</au><au>Kammers, Kai</au><au>Budach, Wilfried</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The benefit of adjuvant radiotherapy after breast conserving surgery in older patients with low risk breast cancer- a meta-analysis of randomized trials</atitle><jtitle>Radiation oncology (London, England)</jtitle><addtitle>Radiat Oncol</addtitle><date>2017-03-23</date><risdate>2017</risdate><volume>12</volume><issue>1</issue><spage>60</spage><epage>60</epage><pages>60-60</pages><artnum>60</artnum><issn>1748-717X</issn><eissn>1748-717X</eissn><abstract>It is currently unclear whether patients with low risk breast cancer receiving adjuvant endocrine therapy need adjuvant radiation therapy after breast conserving surgery. The data of randomized trials are available.
In a database search 5 randomized trials including in total 3766 mostly elderly patients with early stage breast cancer treated either with adjuvant endocrine therapy or with endocrine therapy and additional whole breast radiation after breast conserving surgery were identified. Published hazard ratios for time to local recurrence were the basis of our meta-analysis. Meta-analysis of the effect sizes on local recurrence was performed using a random effects model based on parameter estimates of log hazard ratios in Cox models and their standard errors. Furthermore, overall survival was examined.
Adjuvant hormone therapy alone in mostly older patients with low risk breast cancer resulted in significantly shorter time to local relapse compared to radiation therapy combined with hormone therapy (Hazard Ratio: 6.8, 95% CI: 4.23-10.93, p < 0.0001) . There was no significant difference for overall survival.
Additional radiation therapy to hormone therapy did improve local relapse in breast cancer patients but did not show significant impact on overall survival.</abstract><cop>England</cop><pub>BioMed Central</pub><pmid>28335784</pmid><doi>10.1186/s13014-017-0796-x</doi><tpages>1</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Age Aged Aged, 80 and over Antineoplastic Agents, Hormonal - therapeutic use Breast cancer Breast Neoplasms - mortality Breast Neoplasms - radiotherapy Breast Neoplasms - surgery Cancer Cancer therapies Chemoradiotherapy - methods Clinical trials Endocrine therapy Estimates Female Geriatrics Health risks Humans Kaplan-Meier Estimate Mastectomy Mastectomy, Segmental Meta-analysis Middle Aged Older people Patients Radiation therapy Radiotherapy, Adjuvant - methods Randomization Randomized Controlled Trials as Topic Risk Studies Surgery Survival Tamoxifen - therapeutic use Vital statistics Womens health |
| title | The benefit of adjuvant radiotherapy after breast conserving surgery in older patients with low risk breast cancer- a meta-analysis of randomized trials |
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