Timothy J. Whelan, B.M http://levitraenligne.net/levitra-avis-et-commentaire.html ., B.Ch., Jean-Philippe Pignol, M.D., Tag N. Levine, M.D., Jim A. Julian, Ph.D., Robert MacKenzie, M.D., Sameer Parpia, M.Sc., Wendy Shelley, M.D., Laval Grimard, M.D., Julie Bowen, M.D., Himu Lukka, M.D., Francisco Perera, M.D., Anthony Fyles, M.D., Ken Schneider, M.D., Sunil Gulavita, M.D., and Carolyn Freeman, M.D.: Long-Term Results of Hypofractionated Radiation Therapy for Breasts Cancer In women with breast cancer who undergo breast-conserving surgery, whole-breast irradiation reduces the chance of local recurrence and will prevent the dependence on mastectomy.1-4 An revise of a meta-evaluation conducted by the Early Breast Cancers Trialists’ Collaborative Group showed that breast irradiation after breast-conserving surgery reduces mortality from breast cancer.5 However, up to 30 percent of women in THE UNITED STATES who undergo breast-conserving surgical treatment do not undergo breasts irradiation, in part because of the inconvenience of the therapy and its cost.6 In the original trials that evaluated whole-breast irradiation after breast-conserving surgery, 50.0 Gy of radiation was commonly provided in 25 fractions over a period of 5 weeks in daily fractions of 2.0 Gy.1,2 Radiobiologic models suggest that a larger daily dose given over a shorter time may be just as effective7; this regimen may also become more convenient for patients and less resource-intensive compared to the standard schedule.
Results of all three trials are consistent with respect to the primary outcome, with point estimates supporting an advantage from hypothermia: the relative risk associated with cooling was 0.82 in the CoolCap research, 0.72 in the NICHD trial , and 0.86 in the present trial. Our categorization of neurologic outcomes is in keeping with which used in the CoolCap and NICHD trials and earlier systematic reviews,12-17 facilitating the assessment of our findings with previous results. We found a substantial increase in the rate of survival without neurologic abnormality with cooling ; the NICHD and CoolCap trials, which were smaller than the present trial, demonstrated nonsignificant benefits with respect to the outcome but had comparable point estimates.