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.
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: Rosalinda Alvarado; Sara A Lari; Robert E Roses; Benjamin D Smith; Wei Yang; Elizabeth A Mittendorf; Banu K Arun; Anthony Lucci; Gildy V Babiera; Jamie L Wagner; Abigail S Caudle; Funda Meric-Bernstam; Rosa F Hwang; Isabelle Bedrosian; Kelly K Hunt; Henry M Kuerer Journal: Ann Surg Oncol Date: 2012-05-24 Impact factor: 5.344
Authors: R Souchon; M-L Sautter-Bihl; F Sedlmayer; W Budach; J Dunst; P Feyer; R Fietkau; W Haase; W Harms; F Wenz; R Sauer Journal: Strahlenther Onkol Date: 2014-01 Impact factor: 3.621
Authors: Rachel A Sabol; Vidal A Villela; Alexandra Denys; Benjamin T Freeman; Alifiani B Hartono; Rachel M Wise; Mark A A Harrison; Maxwell B Sandler; Fokhrul Hossain; Lucio Miele; Bruce A Bunnell Journal: Int J Mol Sci Date: 2020-04-15 Impact factor: 5.923