898 / 1816
Conclusion
Results from large randomised trials demonstrate significant gain in recurrence
from loco-regional RT in pN+ breast cancer, also in overall survival. The gain is
seen also in pN1 patients treated with PMRT
The gain in recurrence from loco-regional RT is (at least) of the same magnitude as
for systemic therapy
The morbidity after RT is not higher or more serious than after systemic therapy
(lecture later on in this ESTRO course) and now virtually all departments use
CT-planning, target delineation, gating techniques, advanced RT technique with
field-in-field strategy, so morbidity is likely to be even more limited in the future
Subgroups of pN+ patients may be overtreated with loco-regional RT, but no
consensus no how to select these patients
Very promising new strategies involving gene analyses are now underway to help
optimal selection of the right therapy to the right patient
BUT, WE STILL DO NOT HAVE THE OPTIMAL SELECTION CRITERIA TO SELECT
PATIENTS WITH NODE-POSITIVE DISEASE TO LESS RADIATION THERAPY