(Ivanhoe Newswire) -- Breast cancer patients who received a lower overall
dose of radiation therapy in fewer, higher doses (hypofractionated) didn't
report an increase in adverse symptoms or worsened body image in a new study.
These results add to the evidence that shorter hypofractionated radiotherapy
schedules do not cause more side effects in the breast, are equally effective at
reducing the risk of further cancer in the breast and thus provide better
quality of life for patients.
Penelope Hopwood and colleagues from The Institute of Cancer Research, UK and
the Royal Marsden NHS Foundation Trust, UK examined the patients' experience of
adverse breast, arm, and shoulder symptoms and functional outcomes and body
image after different radiotherapy regimens for up to five years after
treatment.
A total of 2,208 women given radiotherapy after primary surgery for early-stage
breast cancer, recruited from START (Standardization of Breast Radiotherapy
Trials), completed quality-of-life questionnaires and self-assessments of body
image and radiotherapy effects on healthy tissues at regular intervals for five
years after treatment.
The most frequently reported adverse effects were breast hardness and change in
breast appearance. In addition, up to a third of patients experienced arm and
shoulder pain, while the five-year rate of moderate or marked shoulder stiffness
was about 20 percent.
Adverse change in skin appearance after radiotherapy was the only symptom to
differ significantly between the radiotherapy schedules, but the overall pattern
for all adverse effects was similar, with lower or similar rates for the
schedules with a higher daily dose compared with the international standard
treatment.
The team found that 40 percent of women reported moderate or striking concerns
up to five years following treatment, such as feeling physically less attractive
and being dissatisfied with their bodies.
The authors were quoted as saying, "Considerable morbidity still arises due to
effects on normal [healthy] tissues of treatment for early breast cancer, and
patients' self-assessments are important to ascertain the extent and duration of
these effects."
They added, "These ratings by patients … strengthen evidence in favor of
hypofractionated regimens, [with the potential for] reduced adverse normal
breast tissue effects reported … [and] have important implications for
radiotherapy practice."
SOURCE: Online, Lancet Oncology, February 7, 2010
