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乳腺癌标准-徐兵河
Update in Adjuvant Therapy for Early Stage Breast Cancer Binghe Xu, MD Cancer Hospital Institute, Chinese Academy of Medical Sciences CALGB 9343 Comparison of Lumpectomy Plus Tamoxifen With and Without Irradiation in Women 70 or Older with Clinical Stage I, ER+ Breast Carcinoma Kevin S. Hughes, Lauren A. Schnaper, Constance Cirrincione, Donald Berry, Beryl McCormick, Hyman B. Muss, Clifford Hudis, Eric Winer, Barbara L. Smith Cancer and Leukemia Group B Radiation Therapy Oncology Group Eastern Cooperative Oncology Group CALGB 9343 ELIGIBILITY Age 3 70 Clinically Node Negative Lumpectomy, Negative Margin Tumor size ￡ 2 cm ER Positive or Indeterminate Radiation Tamoxifen Tamoxifen R A N D O M I Z E Objections to this study Patients randomized to receive no radiation would be inappropriately under-treated Patients randomized to receive radiation therapy would be inappropriately over-treated CALGB 9343 Opened July 15, 1994 Closed February 26, 1999 647 patients Eligible 631 Ineligible 5 Canceled/Never treated 11 Median follow-up 12 years Patient characteristics RT+Tam Tam Total treated 317 319 Age 75 176 (56%) 172 (54%) ER Positive 308 (97%) 310 (97%) Size 2cm 295 (93%) 296 (93%) No Ax dissection 200 (63%) 203 (64%) IBTR (Ipsilateral Breast Tumor Recurrence) TamRT Tam (N=317) (N=319) Events 6 (2%) 27 (9%) p=0.0001 21 women Ultimate mastectomy TamRT Tam (N=317) (N=319) Events 4 (2%) 10 (4%) p=0.1779 Axillary recurrence TamRT Tam 317 319 No ax dissection 200 203 Ax Recurrence 0 6 (3%) * * * outline T-CEF vs TX-CEF in TNBC ABCSG 8 ABCSG 12 CALGB 9343 Abstract #531 Abstract #534 * * * * * * * * * *
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