Shorter Breast Cancer Therapy Works As Well As Standard Therapy

By Alice Carver
14:30, September 24th 2008
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Shorter Breast Cancer Therapy Works As Well As Standard Therapy

Women with early-stage breast cancer could benefit from a shorter, more intense radiation therapy, a team of Canadian researchers found in an analysis which was presented Monday at a conference in Boston. The treatment takes only one to three weeks compared to five to seven weeks for standard therapy.

Canadian researchers tested the shorter-course technique in 1,200 women who were randomly assigned to either accelerated radiation treatment or standard therapy between 1993 and 1996. Half of the women had 25 treatments in 35 days (five treatments a week for a period of five weeks) and the other half received the alternative treatment which included 16 treatments in 22 days. The alternative technique, called accelerated hypofractionated whole breast irradiation, requires three weeks of daily, 15-minute visits and costs two-thirds as much.

The participants were followed for a period of 12 years. At the end of the study, researchers found no significant differences between the groups. Researchers found a recurrence rate of 6.2 percent in patients treated with accelerated radiation therapy compared to a recurrence rate of 6.7 percent in patients receiving standard therapy. Both groups had a “good or excellent cosmetic outcome,” meaning the breast wasn’t highly affected by the radiation.

“We were surprised that the risk of local recurrence and side effects for women treated with accelerated whole breast irradiation was so low even at 12 years,” said Dr. Timothy Whelan of McMaster University in Hamilton, Ontario. Dr. Whelan estimated that 60 to 70 percent of women with early-stage breast cancers in Canada were already receiving this type of therapy.

“There has been renewed interest in hypofractionated whole breast irradiation due to the potential radiation advantages, patient convenience, quality of life and lower costs,” Dr. Tim Whelan of McMaster University in Toronto, who led the study, said in a statement.

“However, I would encourage women whose breast cancer is caught early to talk to their oncologist to see if they are a good candidate for this shorter therapy,” Dr. Whelan said.

In a second study presented at the meeting of the American Society for Therapeutic Radiology and Oncology, Dr. Peter Beitsch and colleagues at Medical City Dallas Hospital in Texas followed patients who have had partial breast radiation. The treatment, called accelerated partial breast irradiation (APBI), focuses radiation at the site of the removed tumor using a special single balloon catheter that delivers the radiation through tiny radioactive seeds. The procedure worked as well as standard radiation among 400 women followed for four years. The recurrence rate was similar to that seen in standard whole-breast radiation.

Dr. Beitsch said the procedure may even increase the rate of breast conservation. He said that some women choose masectomy because they live too far from a radiation center and cannot afford the time of so many weeks of living or travelling to the center.

“These are preliminary results, but they suggest that outcomes for carefully selected patients are as good as those with full breast radiation,” Beitsch said.

The FDA approved the accelerated partial breast irradiation (APBI) in 2002. But the procedure is not widely used for the treatment of breast cancer. The practice is more common in Canada and Europe.

Breast cancer is the leading cause of cancer death among women worldwide, according to the American Cancer Society. About 180,000 women a year develop breast cancer in the United States and most need radiation treatment.



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