[Breast cancer: value of postoperative locoregional irradiation following mastectomy].
Bibliographic record
Abstract
A CRUCIAL STEP: Locoregional control is a crucial step in the achievement of cancer cure. After mastectomy, locoregional irradiation (RT) clearly reduces the incidence of chest wall and nodal relapse, especially with initial lesions measuring more than 5 cm or with nodal involvement and/or large lymphatic or vascular emboli. CLINICAL PROOF: Two recent randomized trials have confirmed the benefit of well-adapted locoregional irradiation. In the Danish trial, including premenopausal "high-risk" women treated by mastectomy and chemotherapy (CMF protocol), RT reduced locoregional relapses from 32% to 9% (p < 0.01) and increased the 10-year survival rate from 45% to 54% (p < 0.01). These results are now confirmed in postmenopausal women with an increase in the 10-year survival rate from 36% to 45% (p < 0.001). In the Canadian trial, locoregional relapses decreased from 25% to 13% and the 10-year survival rate increased from 56% to 65%. The meta-analysis published in 1995 by the EBCTCG showed only a modest benefit due to locoregional irradiation in breast cancer. However, when small trials and old trials started before 1970 were excluded because of imperfect methodologies and inadequate irradiation techniques, the benefit of "modern" radiotherapy appeared as significant in 7,840 patients selected in this way. IN CLINICAL PRACTICE: Thus, since locoregional irradiation can avoid some metastatic evolution developed only after "local" or "nodal" relapse, it must be integrated into a multidisciplinary strategy. Nevertheless, this treatment must be safe. This can be achieved with new irradiation techniques including the definition of anatomical volumes and previsional dosimetry. The most important point concerns the treatment of internal mammary nodes, especially when previous chemotherapy including anthracyclines has been performed. The use of a direct field, with at least 40% of the dose delivered by electrons in an alternating scheme is recommended to ensure very good protection of the heart and lungs.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.003 | 0.010 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.002 | 0.003 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.000 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.011 | 0.002 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".