Tubiana M, Arriagada R, Sarrazin D
Int J Radiat Oncol Biol Phys. 1986 Apr;12(4):477-85. doi: 10.1016/0360-3016(86)90055-6.
For several types of cancers, post-operative radiation therapy is able to reduce the incidence of local recurrences, but has only a relatively small beneficial effect on total survival. Conversely to what has been claimed, this discrepancy is not due to a detrimental effect of radiotherapy. The data do not substantiate the hypothesis that irradiation through an impact on the immune system enhances growth of neoplastic foci outside of the irradiated volume. Several sets of data show that uncontrolled primary tumors or lymph node metastases can be important foci for distant spread. However the analysis of the data shows that post-operative radiotherapy can prevent metastatic spread only in a small subset of patients, those without distant metastases at the initial treatment and in whom local recurrences can be a nidus for distant dissemination before being detected and treated. The results of the clinical trials carried out on patients with breast cancers show that this situation is frequently observed in patients with tumors located in the inner quadrants of the breast who are those in whom the involvement of the internal mammary chain is relatively frequent.
对于几种类型的癌症，术后放射治疗能够降低局部复发的发生率，但对总生存率的有益影响相对较小。与所声称的相反，这种差异并非由于放射治疗的有害作用。数据并未证实通过影响免疫系统的照射会增强照射体积外肿瘤灶生长的假说。几组数据表明，未控制的原发性肿瘤或淋巴结转移可能是远处转移的重要病灶。然而，数据分析表明，术后放射治疗仅能在一小部分患者中预防转移扩散，这些患者在初始治疗时没有远处转移，且局部复发在被检测和治疗之前可能是远处播散的病灶。对乳腺癌患者进行的临床试验结果表明，这种情况在位于乳腺内象限的肿瘤患者中经常观察到，这些患者中内乳链受累相对频繁。
