Postoperative therapy after cancer.

Tamoxifen and radiation therapy after surgery

Adjuvant therapy — a treatment in order to reduce the risk of recurrence after surgery. These treatments include hormone therapy, radiation therapy and chemotherapy.

Usually if a treatment plan includes chemotherapy, it is assigned immediately after surgery. This is because chemotherapy affects the entire body, to all areas of tissues and organs, which could remain cancer cells. Therefore, chemotherapy is carried out first. After chemotherapy conducted methods of local therapy.

In some cases, when the risk of recurrence and metastasis of cancer is low, chemotherapy may be administered after radiotherapy. Sometimes, when a patient has a need for this, chemotherapy may not be assigned immediately, but after a short period of time.

Appointment of hormone therapy relative to radiotherapy

The results of some previous studies suggested that tamoxifen may reduce the efficacy of radiotherapy. Other studies have shown that tamoxifen concurrently with chemotherapy reduced the effectiveness of the treatment, but other studies have found no difference.

In these two studies have examined tamoxifen with radiotherapy in different modes after surgery in order to find out whether there is a difference in the incidence of relapse and survival, as well as side effects.

Research information about when administered one or another method of treatment.

In the first study, researchers used data from an earlier study, but with a different purpose. At the same time studied data about patients who have undergone breast-conserving surgery and then adjuvant therapy:

The first group (107 patients): radiotherapy was performed immediately after the surgery. After chemotherapy, began radiation therapy, and then a course of tamoxifen.

The second group (202 patients) received chemotherapy after surgery. Then carried out a course of radiation therapy in conjunction with tamoxifen.

In both groups patients were identical parameters: age (under 65 years), menopausal status (60% of the patients were premenopausal), the size and cleanliness of the edges of the removed tumor (in half the cases the tumor was less than 2 cm).

Approximately 70% of women from the first group and 50% in the second group the tumor was hormone-dependent . This means that some patients with tumor hormone-dependent receiving hormone treatment. The study covered the period between 1989 and 1993. The researchers observed the female patients over 10 years.

At the same time they controlled: tumor recurrence, survival, overall survival, the side effects of therapy….

The second study investigated patients with stage I and II breast cancer. The researchers collected data on patients who underwent breast-conserving surgery, radiotherapy and tamoxifen. In addition, some patients received chemotherapy.

Researchers in the same manner as in the first study, the women were divided into two groups depending on the order in which they are received adjuvant therapy;

The first group (104 patients) received radiation therapy, followed by tamoxifen.

The second group (174 patients) received radiation therapy and tamoxifen at the same time.

About 80% of women in both groups was hormone-dependent cancer, and about half of the women in each group was not cancerous lymph nodes.

Patients in the first group were older (average age 59 years) patients from the second group (an average age of 51). Women in the first group of chemotherapy were performed at a higher level than women from the second group (63% and 25%, respectively). Researchers have observed of the patients for seven and a half years.

As in the first study and monitor such parameters as: tumor recurrence, survival, overall survival rates, side effects of treatment.

Results from clinical studies

In both studies, scientists have not found any difference in the monitored parameters between the patients who received radiation therapy and tamoxifen both those who received tamoxifen after radiotherapy. In both studies noted a difference between the side effects.

In that case, if you have breast cancer detected at an early stage, the physician will likely offer different methods in different adjuvant therapy after surgery sequence. These methods include radiation therapy, hormonal therapy and chemotherapy — methods to significantly reduce the risk of recurrence of cancer, but doctors are still trying to find the best combination of these methods.

Should be the first: radiation therapy or hormone therapy? Or should appoint them at the same time? In these studies, we have seen that the sequence and time of the appointment of radiotherapy and hormone treatment did not play any role. These parameters do not influence the frequency of recurrence or survival or the severity of side effects.

It is not necessary to seek early appointment of hormonal therapy. In most cases, this treatment lasts for five years, so a slight delay for a month — the other will not have much value.

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