Preliminary analysis of a clinical trial for three-dimensional conformal radiation therapy after conservative surgery

Objective The aim of this study was to evaluate the efficacy, complications and cosmetic results of three-dimensional conformal radiation therapy for early breast cancer after conservative surgery. Methods Among 80 patients, 44 were treated by modified radical mastectomy followed by adjuvant radiotherapy (modified radical mastectomy, MMT), 36 were treated with breast conservative surgery with adjuvant irradiation [breast-conservation therapy (BCT)]. Tangential fields were used to deliver 6 MV X-ray beams to a total dose of 50 Gy. Another 16 Gy was added to the tumor bed with 6–9 MeV electron beams for BCT. Results In MMT group, the local control, metastasis-free and death were 41, 41 and 1 respectively; in BCT group, the local control, metastasis-free and death were 35, 35 and 0. The difference of the above two indicators between the two groups showeed no statistical insignificance ( P > 0. 05). In MMT group, 32 patients suffer radiation dermatitis above 2-level, 12 patients suffer radiation pneumonia, and 10 patients suffer edema of illness-side upper extremity; in BCT group, the above indicators were only 6, 2 and 1 respectively. Three months, six months and one year after radiation therapy, 90%, 92% and 95% patients were assessed as excellence in fine cosmetic state in BCT group. Conclusion The effects of three-dimensional conformal radiation therapy after conservative surgery are the same as that of modified radical mastectomy, while the former has better cosmetic results and lower radiation therapy induced complications.