LOCALLY ADVANCED BREAST-CANCER - LONG-TERM RESULTS OF A RANDOMIZED TRIAL COMPARING PRIMARY-TREATMENT WITH TAMOXIFEN OR RADIOTHERAPY IN POSTMENOPAUSAL WOMEN

We have previously reported the early results of a randomized cross-ov er study of radical radiotherapy vs tamoxifen in patients with locally advanced breast cancer, This study has now recruited 143 patients wit h a median time from randomization of almost 10 years for both groups, Seventy-three patients received 20 mg tamoxifen twice daily, and 70 h ad primary radiotherapy at a dose of 40 Gy, which is a lower dose than currently administered, The treatment groups were similar in age, siz e of tumour and oestrogen receptor status. There was no significant di fference between the two treatment groups for the combined initial res ponse and static disease rates (89% for radiotherapy and 78% for tamox ifen, P=0.15), The median duration of initial response was 12 months f or both groups, When patients crossed over to the alternative therapy on local relapse, there was no difference in response/static disease r ates (P=0.34) and duration of response (P=0.76), A non-significant pro longation of the metastatic-free interval in favour of tamoxifen (P=0. 08) was identified, although there was no difference in survival outco me (P=0.38), This study shows that in this group of patients primary t amoxifen offers a similar clinical benefit to primary radiotherapy at a dose of 40 Gy, and is therefore an acceptable alternative primary tr eatment.