Accelerated Intensive Radiation Therapy Effective in Node-Negative Breast Cancer: Presented at ASTRO

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Title: Accelerated Intensive Radiation Therapy Effective in Node-Negative Breast Cancer: Presented at ASTRO
URL: http://www.pslgroup.com/dg/22D522.htm
Doctor's Guide
September 23, 2008

By Martha Kerr

BOSTON -- September 22, 2008 -- A 3-week regimen of dose-intensive radiation therapy has comparable efficacy and limited long-term morbidity compared with a standard 5-week course in women with early-stage, node-negative breast cancer, researchers reported here at the American Society for Therapeutic Radiation and Oncology (ASTRO) 50th Annual Meeting.

In addition, hypofractionated whole-breast irradiation is "...two-thirds of the cost of the standard whole-breast radiation," said lead author Timothy Whelan, MD, Juravinski Cancer Centre, McMaster University, Hamilton, Ontario.

Long-term morbidity with hypofractionated, whole-breast irradiation is a concern because of the high dose of radiation delivered in a short period of time.

The study involved 1,234 women with invasive breast cancer with pathologically clear margins and negative axillary nodes following lumpectomy. They were randomised to accelerated, hypofractionated, whole-breast irradiation consisting of 42.5 Gr in 16 fractions over 22 days or to standard therapy, with 50 Gray in 25 fractions over 35 days.

After 10 years of follow-up, the risk of local recurrence was "very low," said Dr. Whelan, at 6.2% with accelerated radiation therapy and not significantly different from standard radiation, which had a local recurrence rate of 6.7%.

Incidence of moderate to severe late radiation morbidity to the skin was 6% with hypofractionated and 3% with standard radiation.

The rate of morbidity to subcutaneous tissue was 8% with the 3-week, hypofractionated course and 4% with the standard 5-week course.

Good to excellent cosmetic outcome was achieved by 70% of women treated with hypofractionated and 71% treated with standard radiation therapy.

"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."

"We know that in North America, about 20% to 30% of women don't receive whole-breast irradiation, in part because of the inconvenience of extended therapy for 5 to 6 weeks and in part because of the cost," Dr. Whelan commented.

"Our study shows that this treatment should be offered to select women treated with early-stage breast cancer," he concluded.

[Presentation title: Long-Term Results of a Randomized Trial of Accelerated Hypofractionated Whole Breast Irradiation Following Breast Conserving Surgery in Women With Node-negative Breast Cancer.]

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