Inferring the Effects of Cancer Treatment: Divergent Results From Early Breast Cancer Trialists' Collaborative Group Meta-Analyses of Randomized Trials and Observational Data From SEER Registries.

Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology
Katherine E HensonS Darby

Abstract

To compare the effect of breast cancer radiotherapy as estimated from observational data with findings from randomized trials. Rate ratios were obtained for selected end points among 13,932 women randomly assigned to receive radiotherapy or not in trials contributing to recent meta-analyses by the Early Breast Cancer Trialists' Collaborative Group. Estimates of the same quantities were derived for 393,840 women registered with breast cancer in the US SEER registries between 1973 and 2008. In the randomized trials, radiotherapy after breast-conserving surgery reduced mortality from both breast cancer (rate ratio, 0.82; 95% CI, 0.75 to 0.90) and all causes (rate ratio, 0.92; 95% CI, 0.86 to 0.99). Reductions of similar magnitude were seen in the trials of radiotherapy after mastectomy in node-positive disease (rate ratios, breast cancer 0.84; 95% CI, 0.76 to 0.94; all causes, 0.89; 95% CI, 0.81 to 0.97). In the observational data, radiotherapy after breast-conserving surgery was associated with much larger mortality reductions (rate ratios, breast cancer, 0.64; 95% CI, 0.62 to 0.66; all causes, 0.63; 95% CI, 0.62 to 0.65), whereas radiotherapy after mastectomy in node-positive disease was associated with substantial increases in ...Continue Reading

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Citations

Jan 22, 2010·World Journal of Surgical Oncology·Alessandra MascaroLucio Fortunato
Jun 13, 2016·Radiotherapy and Oncology : Journal of the European Society for Therapeutic Radiology and Oncology·Tinne LaurbergJens Overgaard
Sep 20, 2016·Radiotherapy and Oncology : Journal of the European Society for Therapeutic Radiology and Oncology·Stefanie CorradiniJutta Engel
Oct 18, 2016·Journal of Obstetric, Gynecologic, and Neonatal Nursing : JOGNN·Nicole S Carlson
Mar 31, 2017·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·Kala VisvanathanGary H Lyman
Apr 5, 2017·Journal of the National Cancer Institute·Marjanka K SchmidtLaura J van 't Veer
May 7, 2021·Cancer Treatment and Research Communications·Pablo MandóMatías Chacon

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