A LOWER total dose of radiotherapy, delivered in fewer, larger treatments has been shown to be as effective as the international standard of a higher total dose delivered over a longer time to treat women with early breast cancer according to new research published in the Lancetand Lancet Oncology.
This confirms long-held beliefs of cancer specialists in the UK who have been using shorter schedules for many years.
Colour-enhanced image of a breast cancer cell: Cancer Research UK.
Nearly 4,500 women took part in the START Trials co-ordinated by the Clinical Trials and Statistics Unit at The Institute of Cancer Research and funded by Cancer Research UK, the Medical Research Council and the Department of Health. Just under half the women received the international standard radiotherapy delivering 25 treatments, treating five times per week over five weeks. The remainder received a lower total dose given in fewer, larger treatments in either three or five weeks.
Researchers then compared the rate of cancer recurrence in the treated breast along with the effects of the treatment on surrounding healthy breast tissues.
After an average follow-up of five to six years, the rate of recurrence in the breast remained very low for patients in each of the treatment groups studied. The rate of side-effects were low overall, and no higher in women receiving the revised treatment than those receiving the international standard of 25 treatments. The results suggested that a lower total dose given in fewer larger treatments is as safe and effective in treating early stage breast cancer as the longer standard schedule.
Shorter radiotherapy treatments have been used in the UK for many years with promising results but this is the first systematic and reliable evaluation to compare the longer international treatment and the shorter revised UK treatment.
The benefits of fewer sessions of radiotherapy to patients with early breast cancer mean fewer trips to the hospital for treatment, which in turn mean less upheaval in a daily routine. Reducing the number of trips to the hospital is also financially beneficial to patients. The results also offer new insights into how breast cancer cells handle radiotherapy damage to the DNA, suggesting how treatments might be improved further.