Postmastectomy radiotherapy: Clinical practice guidelines of the American Society of Clinical Oncology Journal Article


Authors: Recht, A.; Edge, S. B.; Solin, L. J.; Robinson, D. S.; Estabrook, A.; Fine, R. E.; Fleming, G. F.; Formenti, S.; Hudis, C.; Kirshner, J. J.; Krause, D. A.; Kuske, R. R.; Langer, A. S.; Sledge, G. W.; Whelan, T. J.; Pfister, D. G.
Article Title: Postmastectomy radiotherapy: Clinical practice guidelines of the American Society of Clinical Oncology
Abstract: Objective: To determine indications for the use of postmastectomy radiotherapy (PMRT) for patients with invasive breast cancer with involved axillary lymph nodes or locally advanced disease who receive systemic therapy. These guidelines are Intended for use in the care of patients outside of clinical trials. Potential Intervention: The benefits and risks of PMRT in such patients, as well as subgroups of these patients, were considered. The details of the PMRT technique were also evaluated. Outcomes: The outcomes considered included freedom from local-regional recurrence, survival (disease-free and overall), and long-term toxicity. Evidence: An expert multidisciplinary panel reviewed pertinent information from the published literature through July 2000; certain investigators were contacted for more recent and, in some cases, unpublished information. A computerized search was performed of MEDLINE data; directed searches based on the bibliographies of primary articles were also performed. Values: Levels of evidence and guideline grades were assigned by the Panel using standard criteria. A "recommendation" was made when level I or II evidence was available and there was consensus as to its meaning. A "suggestion" was made based on level III, IV, or V evidence and there was consensus as to its meaning. Areas of clinical importance were pointed out where guidelines could not be formulated due to insufficient evidence or lack of consensus. Recommendations: The recommendations, suggestions, and expert opinions of the Panel are described in this article. Validation: Seven outside reviewers, the American Society of Clinical Oncology (ASCO) Health Services Research Committee members, and the ASCO Board of Directors reviewed this document. J Clin Oncol 19:1539-1569. (C) 2001 by American Society of Clinical Oncology.
Keywords: surgical; diseases; breast-cancer patients; internal mammary nodes; adjuvant breast; axillary lymph-nodes; comparing radical-mastectomy; postoperative radiation-therapy; local-regional recurrence; ataxia-telangiectasia heterozygotes; previously; irradiated patients; collagen vascular
Journal Title: Journal of Clinical Oncology
Volume: 19
Issue: 5
ISSN: 0732-183X
Publisher: American Society of Clinical Oncology  
Date Published: 2001-03-01
Start Page: 1539
End Page: 1569
Language: English
ACCESSION: WOS:000167326700037
PROVIDER: wos
PUBMED: 11230499
Notes: Review -- Source: Wos