Differentiated approach to the use of adjuvant radiation therapy for patients with operable breast cancer
The authors discuss the problem of choice of optimal radiation treatment volume of breast cancer with account of meaningful morphological factors. Patients (196) with operable breast cancer T 1-3N 0-3M 0 were given complex treatment: chemotherapy, radical treatment with neo- and adjuvant chemotherapy, radical mastectomy and postoperative external beam radiation therapy for different radiation treatment volumes. Using single-factor statistical analysis we estimated retrospectively 5-year disease-free survival rates in relation to a radiation treatment volume and major morphological prognostic factors of the disease. Prognostic models describing probability of local recurrences of breast cancer were developed for individualization of radiation therapy tactics. Taking into account risk factors for local tumor progression allows a physician to individualize indications for radiation therapy, thereby reducing unjustified radiation dose without deterioration of delayed treatment outcomes.