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History of the randomized evidence on early breast cancer overall survival:
Radiation vs no radiationafter mastectomy
L. Vakaet
2006
The effect of RT on the chance of locoregional recurrence after mastectomy
(node positive patients)
Lancet 2005
Materials and methods (1/2)• Only evidence from randomized clinical
trials (EBCTCG)
• All patients, in both arms, received mastectomy
• Only comparison is RT versus no RT
• First graph endpoint = locoregional recurrence
Materials and methods• All other graphs endpoint = Overall Survival • Overall survival = Death after breast cancer
relapse (breast cancer mortality) + Other deaths (non-breast cancer mortality)
• All evidence (the good and the bad), no selection of only the « good » results (cfr only 5 yrs of tamoxifen!)
• First studies started in the 1950’s! Randomization by envelope.