Management of high-risk node-positive breast cancer by standard-dose chemotherapy and loco-regional radiotherapy

One-hundred, thirty-six women, aged up to 76 years, with high-risk breast c ancer were treated with postoperative radiotherapy and 9 cycles of adjuvant chemotherapy in standard doses. Treatment-related toxicity was mild. At a median follow-up of 7.3 years, 39.6% are disease-free. At 5 and 10 years ov erall survival was 55% and 34% respectively; disease-free survival was 39% and 33% respectively. Eighteen patients (13.2%) developed loco-regional rec urrence, which was uncontrolled in four. When compared to series treated wi th adjuvant chemotherapy, but without radiotherapy, there are apparent surv ival gains of 10-15% at 5 and 10 years. These results in both pre- and post -menopausal patients compare favourably with results of high-dose chemother apy and stem-cell rescue in much more highly selected patients. (C) 1999 Ha rcourt Publishers Ltd.