- The researchers say that three weeks of radiation treatment is as effective as six weeks for people with early-stage breast cancer.
- Experts say the reduced treatment regimen is more convenient and provides a better quality of life for most patients.
- Researchers have begun looking for even shorter treatments for some people with breast cancer.
A shorter course of higher-intensity radiation treatment is just as effective at treating early-stage breast cancer as a longer regimen of lower-dose radiation, a new study finds.
The findings could lead to patients only needing three weeks of radiation therapy after a lumpectomy, as opposed to the current treatment standard of four to six weeks.
The researchers said previous studies have shown that three weeks of radiation is as safe and effective as longer treatment regimens among patients at low risk of tumor recurrence.
The new study, which has yet to be published in a peer-reviewed journal, concluded that the same is true for patients who qualify for breast-conserving therapy but face an increased risk of tumor recurrence due to slightly smaller tumor size. larger or other factors.
Dr. Frank Vicini, lead study author and radiation oncologist as well as national director of breast care research and services at GenesisCare, said most of the patients he sees in his practice fall into the latter group.
“Three weeks of radiation after lumpectomy is just as effective for patients who are at higher risk of recurrence as it is for patients at lower risk,” said Vicini, who presented his findings at the recent annual meeting of the American Society of Radiation Oncology. (STAR). , in a press release. “This approach cuts treatment time in half for these patients.”
The researchers reported that delivering a high dose of radiation to the surgical site during the three weeks of whole-breast irradiation therapy had similar results to waiting until after whole-breast treatment to target the surgical site.
“Adding a radiation boost reduces the chance of tumor recurrence in the breast by 20 to 30 percent, but adding that boost after hypofractionated radiation therapy adds another week to the treatment,” Vinci said. “This can be challenging for patients who need to take time off work or travel long distances for treatment.”
Dr. Rachel Jimenez, assistant professor of radiation oncology at Harvard Medical School and chair of quality and safety in the Department of Radiation Oncology at Massachusetts General Hospital, told Healthline, “I hope that the results of this study will be adopted. by many of us who treat breast cancer patients, as a shorter treatment schedule has a positive impact on equity in cancer care delivery and patient quality of life.”
“This study reveals a promising pathway to reduce the treatment burden on patients by improving quality of life and achieving the same outcomes,” Dorraya El-Ashry, Ph.D., chief scientific officer of the Cancer Research Foundation, told Healthline. Mother. “While we need further validation to impact clinical care, we are constantly striving to help patients live fuller lives without sacrificing quality of care.”
The researchers compared a group of patients who received conventional total breast radiation given for four to five weeks, followed by a boost of radiation to the lumpectomy site given for six to seven days with a group who received hypofractionated breast radiation given for three weeks. with the surgical site brace delivered at the same time during those three weeks.
Among the concurrent treatment group, the 5-year tumor recurrence rate was less than 2 percent and the 7-year recurrence rate was less than 3 percent, compared with approximately 2 percent in both intervals between the conventional treatment group.
There were also no significant differences in cosmetic appearance or side effects.
“While there have been, and continue to be, clinical trials that focus on improving the efficacy of breast radiation therapy, this is a large-scale trial that enrolled a sizeable portion of ‘high-risk’ patients, including those with Parkinson’s disease. high grade and/or estrogen receptor negative biology,” Jimenez said. “It showed, even among a higher-risk cohort, excellent cancer control rates with this compressed treatment schedule.”
Vinci noted that administering a simultaneous dose of radiation requires a high level of sophistication among treatment providers.
“I expect that clinicians looking to adopt this approach will need to consider the technical nuances that come with this integrated treatment technique, but this should not represent a significant barrier to adoption,” Jimenez said.
Future studies will examine whether the shorter course of treatment is also safe and effective for patients whose cancer has spread to lymph nodes.
The researchers also want to see if an even shorter cause of treatment might work. UK researchers, for example, are testing a week-long course of radiation for lower-risk patients.
“I used to treat patients with much longer courses of radiation, daily for 6 to 7 weeks,” said Dr. Robert Wollman, a radiation oncologist and medical director of the Vasek Polak Department of Radiation Oncology at the Vasek Polak Health Center. Providence Saint John in California. “For the past 10 years, most patients receive four weeks (20 treatments daily) in my practice. And some patients can even get five treatments (just one week).”
“This study provides a kind of ‘middle ground’ for patients with higher-risk characteristics that can now be finished in as little as three weeks or 15 treatments,” Wollman told Healthline. “It’s great to know that we can get the same result by killing the cancer and saving patients a lot of time without any risk of more side effects.”
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