Radiation for early breast cancer: 3 weeks may be as good as 5 to 7
Reported November 04, 2009
CHICAGO (Reuters Health) – Cutting the duration of radiation treatment in half may be just as effective as delivering it over the conventional 5 to 7 weeks in appropriately selected women with early breast cancer, researchers reported at the 51st Annual Meeting of the American Society for Radiation Oncology (ASTRO 2009).
The shortened, more intensive treatment, called accelerated hypofractionated whole breast irradiation, involves delivering radiation to the entire breast and then giving a boost to the surgical bed in the same session.
Specifically, 40.5 Gy is delivered to the whole breast in 2.7 Gy fractions, and the lumpectomy site receives a concomitant boost of 45 Gy in 3 Gy fractions over 15 fractions.
Dr. Manjeet Chadha of Beth Israel Medical Center, New York City, and colleagues tested this approach in 112 women with Stage Tis, T1N0, or T2N0 breast cancer. All were evaluated weekly during treatment and then every 6 months afterward.
With a median follow-up approaching two-and-a-half years (range, 6 to 57 months), no local recurrence has been observed in any patient so far and no acute severe (grade 3 or 4) toxicities have been observed, Dr. Chadha reported.
Earlier, in a prepared statement, she noted that studies in Europe and Canada have used accelerated schedules for breast irradiation with good results on longer follow-up.
“The side effects patients may experience during treatment include skin irritation, redness of the skin, mild swelling of the breast, pain in the breast, and fatigue,” Dr. Chadha told Reuters Health. “I compared the side effects in the first 50 women who were treated on the short schedule with those in a similar group of women treated on the conventional schedule and the comparison shows us that the short schedule is not associated with any higher incidence of acute toxicity.”
She added that she was “optimistic” about the results.
“You have to follow these women for a long time, because breast cancer is a disease with a long natural history. So I am encouraged, albeit cognizant that this is an early observation period. Right now, I can say it may be a reasonable alternative for appropriately selected patients, but we will need a head-to-head comparison of short versus conventional therapy in a phase 3 randomized trial in which many more patients (are) enrolled to give us a definitive answer.”
Source : Reuters Limited