Shorter Radiation Course Recommended for Breast Cancer Treatment

A new study suggests that early-stage breast cancer (BC) patients who receive shorter radiation therapy (RT) treatments with higher doses per fraction show cosmetic, functional, and pain outcomes similar to those receiving a conventional longer, lower-dose per fraction courses of treatment.

Researchers at the University of Texas MD Anderson Cancer Center (Houston, USA) conducted a study involving 287 women with stage 0 to stage II BC, who were randomized to receive conventionally fractionated whole-breast irradiation (CF-WBI, 149 patients) or hypo-fractionated whole-breast irradiation (HF-WBI, 138 patients) following breast-conserving surgery between 2011 and 2014. Longitudinal patient-reported outcomes and physician-rated cosmesis were assessed at 0.5, 1, 2, and 3 years after RT.

The results showed that patient-reported functional status and breast pain improved significantly following both radiation schedules, and there were no significant differences in physician-reported cosmetic evaluations at any time point. In a previously published study, the authors showed that patients receiving HF-WBI experienced less acute toxicity and post-radiation fatigue compared to those treated with CF-WBI. The study was published on June 15, 2016, in Cancer.

“This trial is particularly important, because there is still some hesitation among clinicians in the U.S. about adopting the hypofractionated schedule,” said lead author Cameron Swanick, MD. “Because American patients tend to have a higher prevalence of obesity, and because prior trials excluded certain patients with high body mass index, there has been this concern that the shorter radiation treatment course may not be as safe for American patients.”

“The results of this and previous studies further support the use of HF-WBI as the preferred radiation therapy for early-stage breast cancer patients; at MD Anderson these shorter courses have become the standard of care,” said study co-author Benjamin Smith, MD, an associate professor of radiation oncology. “This was the first investigator-initiated randomized trial conducted in the network. It was a success because of the support of our partners and illustrated the potential, promise and power of our network to help achieve our mission.”

Related Links:
University of Texas MD Anderson Cancer Center