Fewer, But Higher Doses of Radiation Effective for Breast Cancer

A study in radiotherapy treatment involving nearly 4,500 women and a 10-year trial period showed less radiation delivered in fewer doses is effective in preventing the return of the breast cancer.

Women with breast cancer normally get chemotherapy first, radiotherapy next. In the current treatment scenario, women must attend hospital five days a week for five weeks. This involves spending an hour or more queuing for the radiotherapy machine, getting their correct position under it and receiving their daily dose of radiation.

The international standard radiotherapy schedule for early breast cancer, stipulates that women should receive 50 gray of radiation in 25 equal doses over five weeks. But this requires a huge investment of time and effort from the patient, although it reduces the risk of local cancer relapse by nearly 70 percent.

The study involved women with breast cancer in two trials, called Start A and B (Standardization of Breast Radiotherapy Trial). The women attended clinics three days a week over five weeks and received a total dose of between 39 and 41.6 gray, compared with the normal 50 gray.

The findings showed that “reducing the overall dose of radiation by 20 per cent and the number of sessions by 40 per cent cut side effects without increasing cancer recurrence.”

The study published online in Lancet Oncology and The Lancet could also have implications for other cancers of glandular tissue, such as prostate cancer.

Professor John Yarnold, of the department of clinical radiotherapy at the Royal Marsden Hospital, Sutton, southwest London, led the trials. According to him, "If these results are confirmed and adopted internationally then what women will notice is that hospitals start shortening their radiotherapy schedules, which will be more convenient for them.”

Dr. Jay Brooks, chairman of hematology/oncology at Ochsner Health System in Baton Rouge, LA said, "These two studies confirm work done in the U.S…. Today, there are a whole bunch of techniques to give shorter courses of radiation."

According to Dr.Brooks, "One of the biggest problems in radiation therapy is just the sheer amount of time it takes for women to receive treatment." He added, "In the U.S., traditionally, it's about six weeks of treatment. When many women live 50 miles from a radiation center, that's a 100-mile trip each day, five days a week. That's an enormous amount of time and effort to have radiation."

Experts, who said the indications were good, however warned it was too soon to change practice on the basis of two studies that had followed patients for five to six years. Professor John Yarnold said independent researches were needed to back the findings.

Source-Medindia
THK/L