Guidelines for Complications of Cancer Treatment Vol VIII Part B

For women diagnosed during 1993-2001 and irradiated thecardiac mortality ratio was 0.96 (0.82-1.12), with none yetfollowed for 10 years. Among women irradiated for breastcancer who subsequently developed an ipsilateral orcontralateral lung cancer, the lung cancer mortality ratio(ipsilateral versus contralateral) for women diagnosed during1973-82 and irradiated was 1.17 (0.62-2.19), 2.00 (1.00-4.00),and 2.71 (1.65-4.48), respectively, less than 10 years, 10-14years, and 15 or more years afterwards (trend: 2p=0.04). Forwomen irradiated after 1982 there is, as yet, little informationon lung cancer risks more than 10 years afterwards.INTERPRETATION: US breast cancer radiotherapy regimensof the 1970s and early 1980s appreciably increased mortalityfrom heart disease and lung cancer 10-20 years afterwardswith, as yet, little direct evidence on the hazards after morethan 20 years. Since the early 1980s, improvements inradiotherapy planning should have reduced such risks, but thelong-term hazards in the general populations of variouscountries still need to be monitored directly.Lancet. 2005 Dec 17;366(9503):2087-106.Effects of radiotherapy and of differences in the extent ofsurgery for early breast cancer on local recurrence and 15-year survival: an overview of the randomised trials.Clarke M, Collins R, Darby S, Davies C, Elphinstone P,Evans E, Godwin J, Gray R, Hicks C, James S, MacKinnonE, McGale P, McHugh T, Peto R, Taylor C, Wang Y; EarlyBreast Cancer Trialists’ Collaborative Group (EBCTCG).Clinical Trial Service Unit, Oxford, UK.BACKGROUND: In early breast cancer, variations in localtreatment that substantially affect the risk of locoregionalrecurrence could also affect long-term breast cancer mortality.To examine this relationship, collaborative meta-analyses were312