Primary radiation therapy for locally advanced XXXX .

@entity1 @entity0 @entity5 @entity4 @entity5300
The optimal local-regional treatment for @entity1 with @entity0 has not been determined. To evaluate the effectiveness of radiation therapy as local treatment for such @entity1 , the results of 192 @entity1 (five with bilateral disease) treated with radiation therapy without mastectomy between July 1, 1968 and December 31, 1981 were reviewed. Excisional biopsy (gross @entity5 removal) was performed in only 54 of the 197 breasts. @entity1 typically received 4500 to 5000 cGy in 5 weeks to the breast and draining lymph nodes; a local boost to areas of gross disease was delivered to 157 @entity1 . Multi-agent chemotherapy was given to 53 @entity1 . The median follow-up was 65 months. The actuarial probability of survival for the entire group was 41% at 5 years and 23% at 10 years. The probability of relapse-free survival (RFS) was 30% at 5 years and 19% at 10 years. The addition of multi-agent chemotherapy was associated with a significantly improved 5-year RFS (40% versus 26%, P = 0.02). The 5-year survival rate was 51% for @entity1 who received adjuvant multi-agent chemotherapy and 38% for @entity1 who did not (P = 0.16). The actuarial rate of @entity5 control (not censored for distant failure) for all @entity1 was 73% at 5 years and 68% at ten years, and the crude incidence of local-regional control was 78%. @entity5 control was principally influenced by radiation dose. @entity1 who received 6000 cGy or greater to the primary site had a better 5-year rate of control in the breast than did @entity1 who received less than 6000 cGy (83% versus 70%, P = 0.06). Significant complications were seen in 15 @entity1 (8%); these included moderate or severe arm @entity4 in six @entity1 and @entity5300 in four @entity1 . Cosmetic results at last evaluation were excellent or good in 56% of evaluable @entity1 , fair in 25%, and poor in 19%. It is concluded that high-dose radiation therapy without mastectomy is an effective means of controlling @entity5 in @entity1 with locally advanced @entity0 .
