Cooperative clinical trials in primary breast cancer: A critical appraisal

Fisher, Bernard

doi:10.1002/1097-0142(197305)31:5<1271::aid-cncr2820310536>3.0.co;2-g

Cited by 47 publications

(9 citation statements)

References 10 publications

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“…However, it is well recognized that the radiation dose was much. lower than what is currently considered optimum for local control of breast carcinoma (FISHER 1973. PKOSNITZ & GOLDENBERG, FORREST 1977.…”

Section: Discussionmentioning

confidence: 94%

Radical Irradiation in the Primary Management of Localized Breast Carcinoma

Southard

Turalba

Mansfield

et al. 1982

Acta Radiologica: Oncology

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Section: Discussionmentioning

confidence: 94%

Radical Irradiation in the Primary Management of Localized Breast Carcinoma

Southard

Turalba

Mansfield

et al. 1982

Acta Radiologica: Oncology

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“…Published data on the use of postoperative XRT (without chemotherapy) are confusing and often contradictory. This detrin/ental effect has been seriously questioned by some (32,33), and many authors have found no such survival disadvantage (13,14,22,(34)(35)(36)(37)(38) while others haveactually found survival advantages for postoperati,~e XRT in at least some patient subsets (15,36,(39)(40)(41)(42)(43). Some workers have concluded that patients treated with postoperative radiation therapy might actually be at increased risk of distant metastatic disease (14,16,19,(22)(23)(24) with a potential for decreased overall survival (22,(25)(26)(27)(28)(29)(30)(31).…”

Section: Discussionmentioning

confidence: 99%

Postmastectomy adjuvant chemotherapy with or without radiation therapy in women with operable breast cancer and positive axillary lymph nodes: The Southeastern Cancer Study Group experience

Enrique

Moore

Vogel

et al. 1983

Breast Cancer Res Tr

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Between September 1976 and June 1982, 308 patients with operable breast cancer with 1-3 involved axillary nodes were stratified according to institution, type of mastectomy, and time from surgery to protocol entry, and then randomized to receive either six or 12 months of adjuvant chemotherapy with cyclophosphamide, methotrexate, and 5-fluorouracil (CMF). With a median time of follow-up of 33 months, relapse rates among 181 reviewed and evaluable patients are 20/85 (23.5%) for pre- and 23/96 (24%) for postmenopausal patients. Results for premenopausal women, while better than historical controls at a similar time interval, appear inferior to other published adjuvant studies (e.g., NSABP and Milan). Although total relapse rates were 23/100 (23%) for six months and 20/81 (25%) for 12 months of therapy, suggestive differences were encountered by menopausal status with early trends favoring 12 months of treatment for premenopausal patients and six months of treatment for postmenopausal patients. During this same period, 283 patients with four or more involved axillary nodes were randomized to 1-3 treatment arms: six months of CMF, six months of CMF preceded by local-regional x-ray therapy (XRT), or 12 months of CMF. The latter arm was closed in February 1980 while the two six-month chemotherapy arms remain open as of January 1983. Relapse rates for 174 reviewed and evaluable patients on the three arms include: 27/76 (36%) for six months CMF, 15/54 (28%) for XRT and CMF, and 24/44 (45%) for 12 months CMF. Local-regional relapse rates were 12/120 (10%) for the combined two non-XRT arms and 3/54 (6%) for the XRT treatment arm (p = 0.34). Thus, at this early stage of follow-up there are still no statistically significant differences between six or 12 months of adjuvant CMF therapy and neither definite beneficial nor detrimental effects of prechemotherapy adjuvant radiation therapy. Longer follow-up will be needed to provide definitive conclusions.

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“…6 In the first study, radical mastectomy with adjuvant radiation was compared with radical mastectomy alone 274 (Fig. 7); in the second study, simple mastectomy with or without adjuvant radiation was compared with radical mastectomy alone 275 ; and, in the third study, segmentectomy with or without adjuvant radiation was compared with simple mastectomy alone. 276 At about the same time, Umberto Veronesi (1925-), an Italian surgeon, initiated a controlled clinical trial of breast conservation and lumpectomy followed by breast irradiation.…”

Section: Surgical Oncologymentioning

confidence: 99%

A note from history: Landmarks in history of cancer, part 7

Hajdu

Vadmal

Tang

2015

Cancer

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In the 2 and half decades reviewed , research established that chromosomal translocation, deletion, and DNA amplification are prerequisites to cancerogenesis and that oncogenes, tumor-suppressor genes, growth factors, and cytokines play crucial roles in the pathomechanism of cancer. Human papillomavirus, human immunodeficiency virus, herpes virus, and hepatitis B virus were identified as cancer-causing viruses. Several laboratory tests were developed for the detection of primary and recurrent cancers, and cancer prevention by screening methods was popularized. Sonography, computerized tomography, magnetic resonance imaging, positron emission tomography, excision of sentinel lymph nodes, and immunohistochemical techniques became routine procedures. Clinicopathologic staging and classification of tumors were standardized. Limited surgery, adjuvant and neoadjuvant chemoradiation, and the therapeutic use of monoclonal antibodies, tumor vaccines, and targeted chemotherapy became routine practice. The decline in cancer incidence and mortality demonstrated that cancer prevention and advancement in oncology are pivotal to success in the crusade against cancer. Above all, it was clearly established that the care of patients with cancer can be accomplished best in a multidisciplinary setting involving surgical oncologists, radiologists, radiation therapists, medical oncologists, surgical pathologists, and laboratory scientists. In conclusion, the 25 years from 1970 and 1995 are the high-water mark in clinical oncology, and this is the period when oncology turned from art to science. Cancer 2015;121:2480-513.

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Cooperative clinical trials in primary breast cancer: A critical appraisal

Cited by 47 publications

References 10 publications

Radical Irradiation in the Primary Management of Localized Breast Carcinoma

Radical Irradiation in the Primary Management of Localized Breast Carcinoma

Postmastectomy adjuvant chemotherapy with or without radiation therapy in women with operable breast cancer and positive axillary lymph nodes: The Southeastern Cancer Study Group experience

A note from history: Landmarks in history of cancer, part 7

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