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Adherence and persistence with oral adjuvant chemotherapy in older women with early-stage breast cancer in CALGB 49907: adherence companion study 60104.

https://arctichealth.org/en/permalink/ahliterature144428
Source
J Clin Oncol. 2010 May 10;28(14):2418-22
Publication Type
Article
Date
May-10-2010
Author
Ann H Partridge
Laura Archer
Alice B Kornblith
Julie Gralow
Debjani Grenier
Edith Perez
Antonio C Wolff
Xiaofei Wang
Helen Kastrissios
Donald Berry
Clifford Hudis
Eric Winer
Hyman Muss
Author Affiliation
Dana-Farber Cancer Institute, 44 Binney St, Boston, MA 02115, USA. ahpartridge@partners.org
Source
J Clin Oncol. 2010 May 10;28(14):2418-22
Date
May-10-2010
Language
English
Publication Type
Article
Keywords
Administration, Oral
Age Factors
Aged
Aged, 80 and over
Antimetabolites, Antineoplastic - administration & dosage - adverse effects
Breast Neoplasms - drug therapy - mortality - pathology - surgery
Canada
Chemotherapy, Adjuvant
Deoxycytidine - administration & dosage - adverse effects - analogs & derivatives
Drug Administration Schedule
Drug Monitoring - instrumentation
Female
Fluorouracil - administration & dosage - adverse effects - analogs & derivatives
Humans
Kaplan-Meier Estimate
Linear Models
Logistic Models
Mastectomy
Medication Adherence
Micro-Electrical-Mechanical Systems - instrumentation
Neoplasm Staging
Risk assessment
Risk factors
Time Factors
Treatment Outcome
United States
Abstract
Patient adherence is critical in evaluating the effectiveness of an oral therapy. We sought to measure adherence among women randomly assigned to capecitabine in a preplanned substudy of a multicenter clinical trial.
Cancer and Leukemia Group B study CALGB 49907 was a randomly assigned trial comparing standard chemotherapy versus oral chemotherapy with capecitabine in patients age 65 years or older with early-stage breast cancer. We used microelectronic monitoring system (MEMS) caps on participants' capecitabine bottles to record pill bottle openings. Capecitabine was given in two divided daily doses for 14 consecutive days of a 21-day cycle for six cycles. Adherence was calculated as the number of doses taken divided by doses expected, taking into account toxicity-related dosing changes. A participant was defined as adherent if 80% or more of expected doses were recorded by MEMS.
Overall, 161 patients were enrolled. Median age was 71 years (range, 65 to 89 years); 124 patients (83%) persisted with capecitabine to completion of planned protocol therapy. Adherence was 78% across all cycles, and adherence did not vary by cycle (P = .32). Twenty-five percent of participants took fewer than 80% of expected doses and were nonadherent. In a logistic regression model, participants with node-negative disease (P = .01) and mastectomy (P = .01) were more likely to be nonadherent. Adherence was not related to age, tumor stage, or hormone receptor status. Adherence was not significantly associated with relapse-free survival or grade 3 or 4 toxicity.
Most older women with early-stage breast cancer were adherent to short-term oral chemotherapy in a randomized clinical trial. Age was not associated with adherence.
Notes
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PubMed ID
20368559 View in PubMed
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Adjuvant capecitabine, docetaxel, cyclophosphamide, and epirubicin for early breast cancer: final analysis of the randomized FinXX trial.

https://arctichealth.org/en/permalink/ahliterature129460
Source
J Clin Oncol. 2012 Jan 1;30(1):11-8
Publication Type
Article
Date
Jan-1-2012
Author
Heikki Joensuu
Pirkko-Liisa Kellokumpu-Lehtinen
Riikka Huovinen
Arja Jukkola-Vuorinen
Minna Tanner
Riitta Kokko
Johan Ahlgren
Päivi Auvinen
Outi Paija
Leena Helle
Kenneth Villman
Paul Nyandoto
Greger Nilsson
Marjo Pajunen
Raija Asola
Paula Poikonen
Mika Leinonen
Vesa Kataja
Petri Bono
Henrik Lindman
Author Affiliation
Department of Oncology, Helsinki University Central Hospital, Haartmaninkatu 4, PO Box 180, FIN-00029 Helsinki, Finland. heikki.joensuu@hus.fi
Source
J Clin Oncol. 2012 Jan 1;30(1):11-8
Date
Jan-1-2012
Language
English
Publication Type
Article
Keywords
Adult
Aged
Antimetabolites, Antineoplastic - administration & dosage
Antineoplastic Combined Chemotherapy Protocols - therapeutic use
Breast Neoplasms - chemistry - drug therapy - mortality - pathology - surgery
Carcinoma, Ductal, Breast - drug therapy - pathology
Carcinoma, Lobular - drug therapy - pathology
Chemotherapy, Adjuvant
Cyclophosphamide - administration & dosage
Deoxycytidine - administration & dosage - analogs & derivatives
Disease-Free Survival
Drug Administration Schedule
Epirubicin - administration & dosage
Female
Finland
Fluorouracil - administration & dosage - analogs & derivatives
Follow-Up Studies
Humans
Lymphatic Metastasis
Mastectomy - methods
Middle Aged
Neoplasm Grading
Neoplasm Staging
Prospective Studies
Survival Analysis
Taxoids - administration & dosage
Treatment Outcome
Tumor Markers, Biological - analysis
Abstract
Capecitabine is an active agent in the treatment of breast cancer. It is not known whether integration of capecitabine into an adjuvant regimen that contains a taxane, an anthracycline, and cyclophosphamide improves outcome in early breast cancer.
Women with axillary node-positive or high-risk node-negative breast cancer were randomly assigned to receive either three cycles of docetaxel and capecitabine (TX) followed by three cycles of cyclophosphamide, epirubicin, and capecitabine (CEX; n = 753) or three cycles of docetaxel (T) followed by three cycles of cyclophosphamide, epirubicin, and fluorouracil (CEF; n = 747). The primary end point was recurrence-free survival (RFS).
During a median follow-up time of 59 months, 214 RFS events occurred (local or distant recurrences or deaths; TX/CEX, n = 96; T/CEF, n = 118). RFS was not significantly different between the groups (hazard ratio [HR], 0.79; 95% CI, 0.60 to 1.04; P = .087; 5-year RFS, 86.6% for TX/CEX v 84.1% for T/CEF). Fifty-six patients assigned to TX/CEX died during the follow-up compared with 75 of patients assigned to T/CEF (HR, 0.73; 95% CI, 0.52 to 1.04; P = .080). In exploratory analyses, TX/CEX improved breast cancer-specific survival (HR, 0.64; 95% CI, 0.44 to 0.95; P = .027) and RFS in women with triple-negative disease and in women who had more than three metastatic axillary lymph nodes at the time of diagnosis. We detected little severe late toxicity.
Integration of capecitabine into a regimen that contains docetaxel, epirubicin, and cyclophosphamide did not improve RFS significantly compared with a similar regimen without capecitabine.
Notes
Comment In: J Clin Oncol. 2012 Jan 1;30(1):1-222105825
PubMed ID
22105826 View in PubMed
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Adjuvant hypofractionated versus conventional whole breast radiation therapy for early-stage breast cancer: long-term hospital-related morbidity from cardiac causes.

https://arctichealth.org/en/permalink/ahliterature104800
Source
Int J Radiat Oncol Biol Phys. 2014 Mar 15;88(4):786-92
Publication Type
Article
Date
Mar-15-2014
Author
Elisa K Chan
Ryan Woods
Mary L McBride
Sean Virani
Alan Nichol
Caroline Speers
Elaine S Wai
Scott Tyldesley
Author Affiliation
Department of Oncology, Saint John Regional Hospital, Saint John, Canada.
Source
Int J Radiat Oncol Biol Phys. 2014 Mar 15;88(4):786-92
Date
Mar-15-2014
Language
English
Publication Type
Article
Keywords
Aged
Breast - pathology
Breast Neoplasms - pathology - radiotherapy - surgery
British Columbia
Dose Fractionation
Female
Follow-Up Studies
Heart - radiation effects
Hospitalization - statistics & numerical data
Humans
Mastectomy - utilization
Middle Aged
Neoplasm Staging
Organ Size
Organs at Risk - radiation effects
Radiation Injuries - complications
Radiotherapy, Adjuvant - adverse effects
Risk factors
Thoracic Wall
Abstract
The risk of cardiac injury with hypofractionated whole-breast/chest wall radiation therapy (HF-WBI) compared with conventional whole-breast/chest wall radiation therapy (CF-WBI) in women with left-sided breast cancer remains a concern. The purpose of this study was to determine if there is an increase in hospital-related morbidity from cardiac causes with HF-WBI relative to CF-WBI.
Between 1990 and 1998, 5334 women = 80 years of age with early-stage breast cancer were treated with postoperative radiation therapy to the breast or chest wall alone. A population-based database recorded baseline patient, tumor, and treatment factors. Hospital administrative records identified baseline cardiac risk factors and other comorbidities. Factors between radiation therapy groups were balanced using a propensity-score model. The first event of a hospital admission for cardiac causes after radiation therapy was determined from hospitalization records. Ten- and 15-year cumulative hospital-related cardiac morbidity after radiation therapy was estimated for left- and right-sided cases using a competing risk approach.
The median follow-up was 13.2 years. For left-sided cases, 485 women were treated with CF-WBI, and 2221 women were treated with HF-WBI. Mastectomy was more common in the HF-WBI group, whereas boost was more common in the CF-WBI group. The CF-WBI group had a higher prevalence of diabetes. The 15-year cumulative hospital-related morbidity from cardiac causes (95% confidence interval) was not different between the 2 radiation therapy regimens after propensity-score adjustment: 21% (19-22) with HF-WBI and 21% (17-25) with CF-WBI (P=.93). For right-sided cases, the 15-year cumulative hospital-related morbidity from cardiac causes was also similar between the radiation therapy groups (P=.76).
There is no difference in morbidity leading to hospitalization from cardiac causes among women with left-sided early-stage breast cancer treated with HF-WBI or CF-WBI at 15-year follow-up.
PubMed ID
24606848 View in PubMed
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Adjuvant radiotherapy for breast cancer significantly improves overall survival: the missing link.

https://arctichealth.org/en/permalink/ahliterature20379
Source
Radiother Oncol. 2000 Jun;55(3):263-72
Publication Type
Article
Date
Jun-2000
Author
J. Van de Steene
G. Soete
G. Storme
Author Affiliation
Department of Radiotherapy, Oncology Centre AZ-VUB, Academic Hospital, Free University Brussels, Laarbeeklaan 101, Jette-Brussels, Belgium.
Source
Radiother Oncol. 2000 Jun;55(3):263-72
Date
Jun-2000
Language
English
Publication Type
Article
Keywords
Breast Neoplasms - mortality - radiotherapy - surgery
Comparative Study
Denmark - epidemiology
Female
Humans
Mastectomy
Prospective Studies
Radiotherapy, Adjuvant - standards
Randomized Controlled Trials
Survival Rate - trends
Treatment Outcome
Abstract
BACKGROUND AND PURPOSE: The influence of surgical adjuvant radiotherapy on overall survival of patients with operable breast cancer is still a controversial subject. The negative result of the EBCTCG meta-analysis (Early breast cancer trialists', collaborative group. Effects of radiotherapy and surgery in early breast cancer. An overview of the randomised trials. N. Engl. J. Med. 1995;333:1444-1455) of clinical randomized trials on adjuvant radiotherapy in breast cancer is in strong contrast with the Danish 82B, 82C and British Columbia trials (Overgaard M, Hanse PS, Overgaar J, et al. Postoperative radiotherapy in high-risk premenopausal women with breast cancer who receive adjuvant chemotherapy. Danish Breast Cancer Cooperative Group 82b Trial. N. Engl. J. Med. 1997;337:949-955; Overgaard M, Jensen MB, Overgaard J, et al. Postoperative radiotherapy in high-risk postmenopausal breast-cancer patients given adjuvant tamoxifen: Danish Breast Cancer Cooperative Group DBCG 82c randomized trial. Lancet 1999;353:1641-1648; Ragaz J, Jackson S, Le N, et al. Adjuvant radiotherapy and chemotherapy in node-positive premenopausal women with breast cancer. N. Engl. J. Med. 1997;337:956-962) showing an impressive survival benefit. This paper tries to fill in the gap between the conflicting results. MATERIALS AND METHODS: The 36 trials of the EBCTCG (Early breast cancer trialists', collaborative group, 1995) were prospectively screened for a number of objective parameters that are usually not analyzed in review papers. The odds of death data (and its variance) were borrowed from the original meta-analysis (Early breast cancer trialists', collaborative group, 1995) to check whether the objective features were significant predictors for overall survival benefit. RESULTS: A significant survival benefit for the radiotherapy arm was found for recent trials (2P
PubMed ID
10869741 View in PubMed
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Adjuvant radiotherapy for early breast cancer: patterns of practice in Ontario.

https://arctichealth.org/en/permalink/ahliterature219973
Source
CMAJ. 1993 Nov 1;149(9):1273-7
Publication Type
Article
Date
Nov-1-1993
Author
T. Whelan
D. Marcellus
R. Clark
M. Levine
Author Affiliation
Ontario Cancer Foundation (Hamilton Regional Cancer Centre, Hamilton, Ont.
Source
CMAJ. 1993 Nov 1;149(9):1273-7
Date
Nov-1-1993
Language
English
Publication Type
Article
Keywords
Breast Neoplasms - radiotherapy - surgery
Combined Modality Therapy
Female
Humans
Mastectomy, Segmental
Ontario
Physician's Practice Patterns
Radiation Dosage
Retrospective Studies
Abstract
To determine the number of different radiation schedules used in Ontario to treat women with node-negative breast cancer after lumpectomy and axillary dissection.
Retrospective survey.
Princess Margaret Hospital, Toronto, and regional centres of the Ontario Cancer Treatment and Research Foundation (in Hamilton, London, Ottawa, Windsor and Thunder Bay).
A total of 551 of 1624 consecutive patients with node-negative breast cancer having undergone lumpectomy and axillary dissection who were eligible but did not participate in the Ontario Clinical Oncology Group randomized clinical trial and who received adjuvant breast irradiation between April 1984 and February 1989.
Schedules of radiotherapy received.
Forty-eight different radiotherapy schedules were identified. Total doses ranged from 4000 to 6600 cGy and the number of fractions from 15 to 30. Several different schedules were preferred: 322 patients (58.5%) received 4000 cGy in 15 or 16 fractions to the whole breast over 3 weeks plus a local boost of 1250 cGy to the primary site in 5 fractions over 1 week; 66 patients (12.0%) received 4000 cGy in 15 or 16 fractions over 3 weeks to the whole breast plus a local boost of 1000 cGy to the primary site in 4 or 5 fractions over 1 week; and 63 patients (11.5%) received 5000 cGy in 25 fractions to the whole breast in 5 weeks, without a boost.
The practice of adjuvant radiotherapy for early breast cancer in Ontario varies. The optimal radiation regimen for patients after lumpectomy should be determined through randomized clinical trials.
Notes
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PubMed ID
8221482 View in PubMed
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Adjuvant radiotherapy of women with breast cancer - information, support and side-effects.

https://arctichealth.org/en/permalink/ahliterature98769
Source
Eur J Oncol Nurs. 2010 Apr;14(2):147-53
Publication Type
Article
Date
Apr-2010
Author
K. Sjövall
G. Strömbeck
A. Löfgren
P-O Bendahl
B. Gunnars
Author Affiliation
Department of Oncology, Lund University Hospital, S-221 85 Lund, Sweden. katarina.o.sjovall@skane.se
Source
Eur J Oncol Nurs. 2010 Apr;14(2):147-53
Date
Apr-2010
Language
English
Publication Type
Article
Keywords
Adult
Aged
Analysis of Variance
Area Under Curve
Breast Neoplasms - drug therapy - psychology - radiotherapy - surgery
Fatigue - etiology
Female
Humans
Linear Models
Mastectomy - adverse effects - methods
Middle Aged
Pain Measurement
Prospective Studies
Questionnaires
Radiotherapy, Adjuvant - adverse effects
Skin Diseases - etiology
Sleep Disorders - etiology
Social Support
Sweden
Translations
Abstract
The aim of this study was to 1) examine the occurrence and burden of side effects over time in the period after post surgical adjuvant radiotherapy in women with breast cancer and 2) explore the women's experiences of given information and need of support to handle side effects. MATERIAL AND METHOD: 171 women with breast cancer receiving post-surgical adjuvant radiotherapy completed a questionnaire on radiotherapy-related side effects (Treatment Toxicity Assessment Tool OTTAT) at four times between the start of radiotherapy and six months after completion. Comparisons were made between women with breast conservative surgery (group A) and women with modified mastectomy (group B), and for having chemotherapy or not (C+ and C-). Questions regarding the experience of delivered information and support were added. RESULTS: Fatigue was the single most prevalent side effect and, together with skin reactions and pain, it also had the highest mean score over the study period and the largest score increase during treatment. The largest increase during the six months was seen for skin reaction, pain, and dyspnoea. The average score for skin reaction was significantly higher in group B than in group A. A majority of the women experienced the given information and support as satisfying and a need for follow-up of the side-effects was expressed. CONCLUSION: Nursing for women with breast cancer receiving adjuvant radiotherapy should focus on preventing and treating side effects, and also include the period post treatment. There is a need for developing evidence based guidelines including guidelines for follow-up.
PubMed ID
19896896 View in PubMed
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Adjuvant tamoxifen in postmenopausal high-risk breast cancer patients: present status of Danish Breast Cancer Cooperative Group trials.

https://arctichealth.org/en/permalink/ahliterature26492
Source
NCI Monogr. 1986;(1):115-8
Publication Type
Article
Date
1986
Author
H T Mouridsen
A P Andersen
H. Brincker
P. Dombernowsky
C. Rose
K W Andersen
Source
NCI Monogr. 1986;(1):115-8
Date
1986
Language
English
Publication Type
Article
Keywords
Aged
Axilla
Breast Neoplasms - drug therapy - mortality - radiotherapy
Clinical Trials
Denmark
Female
Humans
Lymph Nodes - pathology
Mastectomy
Menopause
Middle Aged
Receptors, Estrogen - drug effects - physiology
Retrospective Studies
Risk
Tamoxifen - therapeutic use
Abstract
The aim of the present study was to analyze the efficacy of adjuvant tamoxifen (TAM) in postmenopausal patients with high-risk breast cancer. The primary surgical treatment was total mastectomy with axillary sampling. There were 1,650 eligible patients; 829 were randomized to receive postoperative radiotherapy (RT) and 821, to receive RT + TAM (10 mg three times daily for 1 yr). The 2 groups were identical with respect to age, tumor size, number of positive lymph nodes, degree of anaplasia, and estrogen and progesterone receptor content. Overall recurrence-free survival at 6 years was 39% in the RT group, compared to 48% in the RT + TAM group (P = 0.0008), but there was no significant difference in survival (P = 0.14). From retrospective analyses of recurrence-free survival according to prognostic variables, it appears that 4 subgroups of patients benefited from adjuvant TAM: those less than 69 years of age, those with 4 or more positive nodes, those with grade I-II tumors, and those with high estrogen receptor values (greater than 100 fmol/mg cytosol protein).
PubMed ID
3534583 View in PubMed
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Aesthetic result after breast-conserving therapy is associated with quality of life several years after treatment. Swedish women evaluated with BCCT.core and BREAST-Q™.

https://arctichealth.org/en/permalink/ahliterature289249
Source
Breast Cancer Res Treat. 2017 Aug; 164(3):679-687
Publication Type
Journal Article
Date
Aug-2017
Author
Cecilia Dahlbäck
Jenny Heiman Ullmark
Martin Rehn
Anita Ringberg
Jonas Manjer
Author Affiliation
Department of Surgery, Skåne University Hospital, Malmö, Sweden. cecilia.dahlback@med.lu.se.
Source
Breast Cancer Res Treat. 2017 Aug; 164(3):679-687
Date
Aug-2017
Language
English
Publication Type
Journal Article
Keywords
Aged
Breast Neoplasms - psychology - surgery
Female
Humans
Mastectomy, Segmental - methods
Middle Aged
Patient satisfaction
Quality of Life - psychology
Retrospective Studies
Surveys and Questionnaires
Sweden
Treatment Outcome
Abstract
A gold standard for evaluation of aesthetic outcome after breast-conserving therapy (BCT) is still lacking. The BCCT.core software has been developed to assess aesthetic result in a standardised way. We aimed to study how the result of BCCT.core after BCT is associated with quality of life, measured with the BREAST-Q™, a validated questionnaire.
Women eligible for BCT were consecutively recruited between February 1st 2008 and January 31st 2012 (n = 653). Photographs of 310 women, taken one year after BCT, were evaluated using the BCCT.core software. The postoperative BCT module of the BREAST-Q™ questionnaire was administered by mail and 348 questionnaires were returned (median 5.5 years after BCT). In all, 216 women had both BCCT.core results and completed BREAST-Q™ questionnaires available.
The results from the BCCT.core evaluation were: excellent n = 49 (15.8%); good n = 178 (57.4%); fair n = 73 (23.5%); poor n = 10 (3.2%). The median BREAST-Q™ score for satisfaction with breasts was 66 [interquartile range (IQR) 57-80] and for psychosocial well-being 82 (IQR 61-100). Poor/fair results on BCCT.core were associated with Q-scores below median for both satisfaction with breasts [odds ratio (OR) 3.4 (confidence interval (CI) 1.7-6.8)] as well as for psychosocial well-being [OR 2.2 (CI 1.1-4.2)].
A statistically significant association between BCCT.core results one year after BCT and quality of life ratings using BREAST-Q™ several years later is shown in this study. This implies that the BCCT.core may be valuable in BCT follow-up and used as a standardised instrument in the evaluation of aesthetic results.
Notes
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PubMed ID
28536951 View in PubMed
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Age-related variations in the use of axillary dissection: a survival analysis of 8038 women with T1-ST2 breast cancer.

https://arctichealth.org/en/permalink/ahliterature188206
Source
Int J Radiat Oncol Biol Phys. 2002 Nov 1;54(3):794-803
Publication Type
Article
Date
Nov-1-2002
Author
Pauline T Truong
Vanessa Bernstein
Elaine Wai
Boon Chua
Caroline Speers
Ivo A Olivotto
Author Affiliation
Radiation Therapy Program, British Columbia Cancer Agency, Vancouver Island Cancer Centre, University of British Columbia, Victoria, British Columbia, Canada. ptruong@bccancer.bc.ca
Source
Int J Radiat Oncol Biol Phys. 2002 Nov 1;54(3):794-803
Date
Nov-1-2002
Language
English
Publication Type
Article
Keywords
Age Factors
Aged
Aged, 80 and over
Axilla
Breast Neoplasms - mortality - pathology - surgery - therapy
British Columbia - epidemiology
Carcinoma, Lobular - mortality - pathology - surgery - therapy
Cohort Studies
Databases, Factual
Female
Humans
Lymph Node Excision - mortality - utilization
Mastectomy, Segmental - utilization
Middle Aged
Multivariate Analysis
Proportional Hazards Models
Radiotherapy, Adjuvant - utilization
Survival Analysis
Abstract
The use of axillary dissection (AD) in women with invasive breast cancer is increasingly questioned. This study analyzes the survival in women with T1-2 breast cancer according to age and AD use.
Data from the Breast Cancer Outcomes Unit Database were analyzed for 8038 women aged 50-89 years referred to the British Columbia Cancer Agency between 1989 and 1998 with invasive T1-2,M0 breast cancer. Tumor and treatment characteristics were compared between women treated with and without AD (AD+ vs. AD-) according to three age groups: 50-64, 65-74 and 75+ years. Regional relapse and actuarial 5-year overall and breast cancer-specific survival were compared between AD+ and AD- women. Multivariate analysis of age, tumor and treatment factors, and adjusted hazard ratios with AD omission were performed.
AD was omitted more frequently with advancing age (4% vs. 8% vs. 22% in women aged 50-64, 65-74, and 75+ years, respectively, p
Notes
Comment In: Int J Radiat Oncol Biol Phys. 2002 Nov 1;54(3):637-912377311
PubMed ID
12377331 View in PubMed
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436 records – page 1 of 44.