Locoregional PMRT is recommended for women with 4 or more positive axillary lymph nodes .
The role of PMRT in women with 1 to 3 positive axillary lymph nodes is unclear .
Locoregional PMRT is generally not recommended for women who have tumours that are less than 5 cm in diameter and who have negative axillary nodes .
OBJECTIVE To provide information and recommendations to assist women with breast cancer and their physicians in making decisions regarding the use of locoregional post-mastectomy radiotherapy ( PMRT ) .
OUTCOMES Locoregional control , disease-free survival , overall survival and treatment-related toxicities .
To reduce the risk of lymphedema , radiation of the entire axilla should not be used routinely after complete axillary dissection of level I and II lymph nodes .
The use of modern techniques in radiotherapy planning is recommended to minimize excessive normal tissue exposure , particularly to the cardiac and pulmonary structures .
Common short-term side effects of PMRT , including fatigue and skin erythema , are generally tolerable and not dose-limiting .
Severe long-term side effects , including lymphedema , cardiac and pulmonary toxicities , brachial plexopathy , rib fractures and secondary neoplasms , are relatively rare .
Adjuvant postoperative radiotherapy, chemotherapy, and immunotherapy in stage III breast cancer. II. 5‐year results and influence of levamisole
One hundred twenty pathologically confirmed operable Stage III breast cancer patients were r and omized to receive either postoperative radiotherapy or chemotherapy , or a combination of these , with or without levamisole immunotherapy . Radiotherapy was given to regional lymph nodes and chest wall . Chemotherapy consisted of six cycles of vincristine , doxorubicin , and cyclophosphamide . Radiotherapy provided local and chemotherapy systemic control over the tumor , but the best patient‐saving results were achieved with a combination of radiotherapy and chemotherapy . This clinical trial was commenced in 1976 , and the first 60 of 120 patients also received oral levamisole , 150 mg/day , on 2 consecutive days weekly as immunotherapy .  All patients were followed for at least 5 years . At this stage levamisole seems to increase disease‐free and overall survival in all three treatment arms ( radiotherapy , chemotherapy , combined treatment ) . Significance is reached in disease‐free survival ( P = 0.035 ) and overall survival , adjusted for all other treatment modalities ( P = 0.019 )
Locoregional PMRT is recommended for women with 4 or more positive axillary lymph nodes .
The role of PMRT in women with 1 to 3 positive axillary lymph nodes is unclear .
Locoregional PMRT is generally not recommended for women who have tumours that are less than 5 cm in diameter and who have negative axillary nodes .
OBJECTIVE To provide information and recommendations to assist women with breast cancer and their physicians in making decisions regarding the use of locoregional post-mastectomy radiotherapy ( PMRT ) .
OUTCOMES Locoregional control , disease-free survival , overall survival and treatment-related toxicities .
To reduce the risk of lymphedema , radiation of the entire axilla should not be used routinely after complete axillary dissection of level I and II lymph nodes .
The use of modern techniques in radiotherapy planning is recommended to minimize excessive normal tissue exposure , particularly to the cardiac and pulmonary structures .
Common short-term side effects of PMRT , including fatigue and skin erythema , are generally tolerable and not dose-limiting .
Severe long-term side effects , including lymphedema , cardiac and pulmonary toxicities , brachial plexopathy , rib fractures and secondary neoplasms , are relatively rare .