Radiation Therapy Reduces Cancer Recurrence In Older Women
长了一些，不过藏龙卧虎，不过以后尽量少发太长的。
Main Category: Radiology / Nuclear Medicine News
Article Date: 25 Jan 2007 - 0:00 PST
Radiation therapy after lumpectomy and five years of treatment with the drug tamoxifen can dramatically reduce the risk of both cancer recurrence and new tumors in older women with early breast cancer, according to researchers from Wake Forest University School of Medicine and colleagues.
"While these treatments are standard care for younger patients, it is has been shown that older women are less likely to receive them," said lead author Ann M. Geiger, M.P.H., Ph.D., an associate professor of public health sciences at Wake Forest and formerly of Kaiser Permanente Southern California. "Our results provide strong evidence of the importance of providing high quality care to all patients, regardless of age."
The results, reported on-line today in Cancer, a journal of the American Cancer Society, will be published in the March 1 print issue of the journal.
Geiger said there is a pressing need for information about the effectiveness of breast cancer treatments in women over 65 because this is an expanding segment of the U.S. population. Women in this age group are at the highest risk for breast cancer and make up half of those diagnosed, but only recently have been included in treatment trials.
"Based on our findings, we recommend that mastectomy, or lumpectomy with radiation therapy, along with adequate duration of hormone therapy for women with hormone-responsive tumors, be considered standard therapy in women of all ages and health conditions, except for those with very limited life expectancies," said Geiger.
The study also included women undergoing chemotherapy, but the number of participants wasn't large enough to evaluate the treatment's effectiveness.
The study involved 1,837 women age 65 or older with early stage breast cancer that was confined to the breast or lymph nodes. The women underwent either mastectomy or lumpectomy, also known as breast-conserving surgery, from 1990 to 1994. Treatment was at one of six health systems (in Washington, Massachusetts, Minnesota, California, and New Mexico) that were part of the Cancer Research Network funded by the National Cancer Institute.
Participants were identified from medical records and were followed for 10 years. Researchers recorded all cancer recurrences: "local" recurrences in the same breast, "regional" recurrences in the lymph nodes, skin or chest muscle on the same side as the original diagnosis, and "distant" recurrences in the brain or other areas of the body. They also recorded cases of new breast tumors, not related to the original tumor, in the opposite breast -- known as a second primary breast cancer.
Twenty percent of women treated with mastectomy or lumpectomy experienced a recurrence or second primary breast cancer during the follow-up. Women treated with lumpectomy but no radiation therapy had a risk of local or regional recurrence that was 3.5 times higher than women radiation therapy after their surgery. The increased risk of any recurrence or second primary breast cancer was 60 percent higher.
The study also revealed that for women who took tamoxifen, but not chemotherapy, those who took the drug for less than a year had a 90 percent higher risk of a recurrence than women who took the drug for five years. Tamoxifen, a drug that blocks the effects of estrogen on the body, is often used to treat women whose tumors are sensitive to estrogen.
One-third of the study participants were 65-69 years old, half were 70-79 and 20 percent were 80 and older. About 80 percent of the women were white, 10 percent were black and 10 percent were Hispanic, Asian or Pacific Islanders.
Co-researchers were Soe Soe Thwin, M.S., Timothy L. Lash, D.Sc., and Marianne Prout, M.D., all with Boston University School of Public Health; Diana S.M. Buist, Group Health Center for Health Studies in Seattle, Wash.; Feifei Wei, Ph.D., HealthPartners Research Foundation in Minneapolis, Minn.; Terry S. Field, D.Sc., Meyers Primary Care Institute/Fallon Community Health Plan; Marianne Ulcickas Yood, Henry Ford Health System; Floyd J. Frost, Ph.D., Lovelace Health Systems, Albuquerque, N.M.; and Shelley M. Enger, Ph.D., Kaiser Permanente Southern California. Rebecca A. Silliman, M.D., Ph.D., of Boston University Medical Center was the lead investigator for the larger study of which this was one piece.
The goal of the research network is to improve the effectiveness of cancer prevention and treatment through research that identifies system, provider, treatment, and patient factors affecting outcomes.
Wake Forest University Baptist Medical Center is an academic health system comprised of North Carolina Baptist Hospital and Wake Forest University Health Sciences, which operates the university's School of Medicine. U.S. News & World Report ranks Wake Forest University School of Medicine 18th in family medicine, 20th in geriatrics, 25th in primary care and 41st in research among the nation's medical schools. It ranks 35th in research funding by the National Institutes of Health. Almost 150 members of the medical school faculty are listed in Best Doctors in America.
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Main Category: 主要类别 Radiology /放射医学 Nuclear Medicine News核医学,
Article Date: 25 Jan 2007 - 0:00 PST文章发表日期：2007－1－25
Radiation therapy after lumpectomy and five years of treatment with the drug tamoxifen can dramatically reduce the risk of both cancer recurrence and new tumors in older women with early breast cancer, according to researchers from Wake Forest University School of Medicine and colleagues.
据Wake Forest大学医学院研究人员的说法，乳腺癌肿块切除术后进行放射治疗，结合他莫西芬治疗五年可以显著减少患有早期乳腺癌的老年妇女癌症再发和新肿瘤的发生
"While these treatments are standard care for younger patients, it is has been shown that older women are less likely to receive them," said lead author Ann M. Geiger, M.P.H., Ph.D., an associate professor of public health sciences at Wake Forest and formerly of Kaiser Permanente Southern California. "Our results provide strong evidence of the importance of providing high quality care to all patients, regardless of age."
Wake Forest医学院和南加州凯撒公司的公共卫生科学系得前助理教授，本文的第一作者 Ann M. Geiger, M.P.H., Ph.D.,说，虽然这些治疗方案是年轻患者的标准疗法，但老年患者却很少乐于接受，但我们的研究结果有充分的证据表明对任何患者提供高质量的关注是很有必要的这与年龄无关。
The results, reported on-line today in Cancer, a journal of the American Cancer Society, will be published in the March 1 print issue of the journal.
此研究结果今天在线发表在癌症杂志上，其书面形式将在3月1日美国癌症协会所属的期刊上发表。
Geiger said there is a pressing need for information about the effectiveness of breast cancer treatments in women over 65 because this is an expanding segment of the U.S. population. Women in this age group are at the highest risk for breast cancer and make up half of those diagnosed, but only recently have been included in treatment trials.
Geiger说作为美国人口的大部分65岁以上妇女急迫需要一种有效的乳腺癌治疗方法，因为这一年龄段的老人正在扩大。且该年龄段的妇女罹患乳腺癌的风险是整个人群中发病率最高的，占所有确诊患者术的总数一半还要多，但是只有最近才纳入治疗研究的实验当中。
"Based on our findings, we recommend that mastectomy, or lumpectomy with radiation therapy, along with adequate duration of hormo ne therapy for women with hormone-responsive tumors, be considered standard therapy in women of all ages and health conditions, except for those with very limited life expectancies," said Geiger.对于激素有效型的乳癌，基于我们的研究结果，我们推荐不论发病年龄段、健康状况如何，乳房切除或者局部病灶切除术结合放疗连同适当的持续激素治疗都应作为标准的治疗方案，但预期寿命很有限的患者除外，Geiger.如是说。
The study also included women undergoing chemotherapy, but the number of participants wasn't large enough to evaluate the treatment's effectiveness.
这研究也包括 经过化学疗法的妇女，但参与研究的患者数量较少不足以用来评价此疗法的治疗效果如何。
The study involved 1,837 women age 65 or older with early stage breast cancer that was confined to the breast or lymph nodes. The women underwent either mastectomy or lumpectomy, also known as breast-conserving surgery, from 1990 to 1994. Treatment was at one of six health systems (in Washington, Massachusetts, Minnesota, California, and New Mexico) that were part of the Cancer Research Network funded by the National Cancer Institute.
此研究涉及1837名65岁以上患有早期局限在乳房范围内或淋巴结内的女性乳癌患者，这些患者均来自美国国立癌症研究所资助的分布在华盛顿、麻萨诸塞州、明尼苏达州、加州及新墨西哥州的六所研究所收集的在1990—1994期间经历了全乳房切除或局部病灶切除术，也有进行保留乳房的乳癌手术患者，治疗在上述六个研究机构中一个展开。
Participants were identified from medical records and were followed for 10 years. Researchers recorded all cancer recurrences: "local" recurrences in the same breast, "regional" recurrences in the lymph nodes, skin or chest muscle on the same side as the original diagnosis, and "distant" recurrences in the brain or other areas of the body. They also recorded cases of new breast tumors, not related to the original tumor, in the opposite breast -- known as a second primary breast cancer.
所有的参与患者均是经医疗文件确定是乳癌患者并被随访十年。研究人员记录了所有患者的癌症复发："局灶"复发局限在同一乳房，"局部"复发则指原诊断的同一侧淋巴结、皮肤或胸部肌肉，而"远距"复发则指脑部或身体其他部位出现病灶。研究人员同时记录了与原发肿瘤不相关区域的对侧乳房的新发肿瘤，即所谓的继发的原发性肿瘤。
Twenty percent of women treated with mastectomy or lumpectomy experienced a recurrence or second primary breast cancer during the follow-up. Women treated with lumpectomy but no radiation therapy had a risk of local or regional recurrence that was 3.5 times higher than women radiation therapy after their surgery. The increased risk of any recurrence or second primary breast cancer was 60 percent higher.
随访期间，有20%的经过全乳房切除或局部病灶切除术的患者经历了肿瘤的复发或继发的原发性肿瘤的发生。局部病灶切除术后未进行放疗的妇女肿瘤的复发率较术后结合了放疗者的复发率高3.5倍。并且患者肿瘤复发风险率或继发的原发性肿瘤的发生率高于60％。
The study also revealed that for women who took tamoxifen, but not chemotherapy, those who took the drug for less than a year had a 90 percent higher risk of a recurrence than women who took the drug for five years. Tamoxifen, a drug that blocks the effects of estrogen on the body, is often used to treat women whose tumors are sensitive to estrogen.
这项研究还提示那些未采用化疗，而服用他莫西芬及服用药物少于一年的妇女相比较那些服用药物达五年的患者有高于90%的复发风险。他莫西芬是体内雌激素效应的抑制剂，常被用于治疗女性患者体内对雌激素敏感的肿瘤的治疗。
One-third of the study participants were 65-69 years old, half were 70-79 and 20 percent were 80 and older. About 80 percent of the women were white, 10 percent were black and 10 percent were Hispanic, Asian or Pacific Islanders.
该研究涉及的患者年龄1/3处于65-69岁，1/2介于70-79岁，1/5在80岁以上。80％是白人妇女，10％是黑人，另有10％是西班牙人、亚洲人、太平洋沿岸岛民。
Co-researchers were Soe Soe Thwin, M.S., Timothy L. Lash, D.Sc., and Marianne Prout, M.D., all with Boston University School of Public Health; Diana S.M. Buist, Group Health Center for Health Studies in Seattle, Wash.; Feifei Wei, Ph.D., Health Partners Research Foundation in Minneapolis, Minn.; Terry S. Field, D.Sc., Meyers Primary Care Institute/Fallon Community Health Plan; Marianne Ulcickas Yood, Henry Ford Health System; Floyd J. Frost, Ph.D., Lovelace Health Systems, Albuquerque, N.M.; and Shelley M. Enger, Ph.D., Kaiser Permanente Southern California. Rebecca A. Silliman, M.D., Ph.D., of Boston University Medical Center was the lead investigator for the larger study of which this was one piece.
合作研究者有：Soe Soe Thwin, M.S.， Timothy L. Lash, D.Sc.， 及 Marianne Prout, M.D，他们均是Boston大学的公共健康系的研究人员，Diana S.M. Buist来自华盛顿州西雅图的健康研究中心，Feifei Wei药学博士来自明尼阿波利斯的健康合作基金会。Terry S. Field, 理学博士是 Meyers初级护理协会/法伦社区健康计划的成员。Marianne Ulcickas Yood,是亨利•福特健康体系的人员，Albuquerque, N.M.; and和理学博士Shelley M. Enger,及 Kaiser Permanente南加州凯撒公司的人员。医学及理学博士Rebecca A. Silliman, 来自波士顿大学医药中心，同时他还是这一大规模临床实验研究部分项目的首席研究人员
The goal of the research network is to improve the effectiveness of cancer prevention and treatment through research that identifies system, provider, treatment, and patient factors affecting outcomes.
协作性地网络式研究的目的是通过对验证系统，资料提供，治疗方案和患者各因素对预后影响的研究来提高癌症预防和治疗的效率。
Wake Forest University Baptist Medical Center is an academic health system comprised of North Carolina Baptist Hospital and Wake Forest University Health Sciences, which operates the university's School of Medicine. U.S. News & World Report ranks Wake Forest University School of Medicine 18th in family medicine, 20th in geriatrics, 25th in primary care and 41st in research among the nation's medical schools. It ranks 35th in research funding by the National Institutes of Health. Almost 150 members of the medical school faculty are listed in Best Doctors in America.
Wake Forest大学的教会医学中心是美国北卡罗来纳州教会和Wake Forest大学医院的健康学术研究中心，该中心管理着Wake Forest大学的医学院。美国《信息和世界报道》的家庭医学栏目的评比中，Wake Forest大学的药学排第18名，老年病第20，初级保健第25名，医学科研水平则在全国医学院校中排名第41。国家健康学会按研究经费将其排名第35。这家医学院的150名教职员工在美国《好医生》杂志的评选中榜上有名。
据Wake Forest大学医学院研究人员的说法，乳腺癌肿块切除术后进行放射治疗，结合他莫西芬治疗五年可以显著减少患有早期乳腺癌的老年妇女癌症再发和新肿瘤的发生
Wake Forest医学院和南加州凯撒公司的公共卫生科学系得前助理教授，本文的第一作者 Ann M. Geiger, M.P.H., Ph.D.,说，虽然这些治疗方案是年轻患者的标准疗法，但老年患者却很少乐于接受，但我们的研究结果有充分的证据表明对任何患者提供高质量的关注是很有必要的这与年龄无关。此研究结果今天在线发表在癌症杂志上，其书面形式将在3月1日美国癌症协会所属的期刊上发表。Geiger说作为美国人口的大部分65岁以上妇女急迫需要一种有效的乳腺癌治疗方法，因为这一年龄段的老人正在扩大。且该年龄段的妇女罹患乳腺癌的风险是整个人群中发病率最高的，占所有确诊患者术的总数一半还要多，但是只有最近才纳入治疗研究的实验当中。对于激素有效型的乳癌，基于我们的研究结果，我们推荐不论发病年龄段、健康状况如何，乳房切除或者局部病灶切除术结合放疗连同适当的持续激素治疗都应作为标准的治疗方案，但预期寿命很有限的患者除外，Geiger.如是说。这研究也包括 经过化学疗法的妇女，但参与研究的患者数量较少不足以用来评价此疗法的治疗效果如何。此研究涉及1837名65岁以上患有早期局限在乳房范围内或淋巴结内的女性乳癌患者，这些患者均来自美国国立癌症研究所资助的分布在华盛顿、麻萨诸塞州、明尼苏达州、加州及新墨西哥州的六所研究所收集的在1990—1994期间经历了全乳房切除或局部病灶切除术，也有进行保留乳房的乳癌手术患者，治疗在上述六个研究机构中一个展开。
所有的参与患者均是经医疗文件确定是乳癌患者并被随访十年。研究人员记录了所有患者的癌症复发："局灶"复发局限在同一乳房，"局部"复发则指原诊断的同一侧淋巴结、皮肤或胸部肌肉，而"远距"复发则指脑部或身体其他部位出现病灶。研究人员同时记录了与原发肿瘤不相关区域的对侧乳房的新发肿瘤，即所谓的继发的原发性肿瘤。随访期间，有20%的经过全乳房切除或局部病灶切除术的患者经历了肿瘤的复发或继发的原发性肿瘤的发生。局部病灶切除术后未进行放疗的妇女肿瘤的复发率较术后结合了放疗者的复发率高3.5倍。并且患者肿瘤复发风险率或继发的原发性肿瘤的发生率高于60％。
这项研究还提示那些未采用化疗，而服用他莫西芬及服用药物少于一年的妇女相比较那些服用药物达五年的患者有高于90%的复发风险。他莫西芬是体内雌激素效应的抑制剂，常被用于治疗女性患者体内对雌激素敏感的肿瘤的治疗。该研究涉及的患者年龄1/3处于65-69岁，1/2介于70-79岁，1/5在80岁以上。80％是白人妇女，10％是黑人，另有10％是西班牙人、亚洲人、太平洋沿岸岛民。合作研究者有：Soe Soe Thwin, M.S.， Timothy L. Lash, D.Sc.， 及 Marianne Prout, M.D，他们均是Boston大学的公共健康系的研究人员，Diana S.M. Buist来自华盛顿州西雅图的健康研究中心，Feifei Wei药学博士来自明尼阿波利斯的健康合作基金会。Terry S. Field, 理学博士是 Meyers初级护理协会/法伦社区健康计划的成员。Marianne Ulcickas Yood,是亨利•福特健康体系的人员，Albuquerque, N.M.; and和理学博士Shelley M. Enger,及 Kaiser Permanente南加州凯撒公司的人员。医学及理学博士Rebecca A. Silliman, 来自波士顿大学医药中心，同时他还是这一大规模临床实验研究部分项目的首席研究人员。协作性地网络式研究的目的是通过对验证系统，资料提供，治疗方案和患者各因素对预后影响的研究来提高癌症预防和治疗的效率。
Wake Forest大学的教会医学中心是美国北卡罗来纳州教会和Wake Forest大学医院的健康学术研究中心，该中心管理着Wake Forest大学的医学院。美国《信息和世界报道》的家庭医学栏目的评比中，Wake Forest大学的药学排第18名，老年病第20，初级保健第25名，医学科研水平则在全国医学院校中排名第41。国家健康学会按研究经费将其排名第35。这家医学院的150名教职员工在美国《好医生》杂志的评选中榜上有名。
