Results of a recently published clinical study suggest that early-stage breast cancer patients treated with a shorter course of whole breast radiation with higher radiation doses per fraction experience equivalent cosmetic, functional, and pain outcomes as those receiving the standard longer, lower-dose treatment. 1
Treatment with shorter course of radiation at higher doses is known as hypofractionated whole breast radiation therapy (HF-WBI). This approach allows for less overall radiation than conventionally fractionated regimens. Fractionated refers to the separation of the total radiation into separate doses. According to earlier research, this approach can be as effective in breast cancer as traditional radiation therapy while reducing overall patient exposure to radiation and requires less time.2
Clinical trials from Canada and the United Kingdom have established HF-WBI as a safe and effective treatment for nearly all patients with early-stage breast cancer.2 However, the adoption of HF-WBI has been slower in the U.S. Doctors estimate that only one-third of patients for whom HF-WBI is currently recommended by the American Society of Radiation Oncology (ASTRO) actually receive the shorter course of therapy.
A recent study compared side effect and quality-of-life outcomes between breast cancer patients who had received HF-WBI and patients who received conventional radiation. In this trial, 287 women with stage 0-II breast cancer treated with breast conserving surgery were treated with either conventional low dose radiation or HF-WBI, and directly compared. All women also received a “boost dose,” an additional treatment targeting the cancer with a higher dose.
There were no significant differences between the treatments; both patient groups reported similar improvements in breast pain and functional assessments over time, and no meaningful difference in survival has been found, to date.
The results of this and previous studies2 further support the use of HF-WBI as a legitimate radiation therapy option for early-stage breast cancer patients. A shorter duration of therapy is more convenient and leads to fewer disruptions in daily life.
- MD Anderson. (2016.) Shorter radiation course recommended for early-stage breast cancer patients. [Press release.] Can be accessed at: https://www.mdanderson.org/newsroom/2016/06/shorter-radiation-co.html
- Haviland JS, Owen JR, Dewar JA, et al. The UK Standardisation of Breast Radiotherapy (START) trials of radiotherapy hypofractionation for treatment of early breast cancer: 10-year follow-up results of two randomised controlled trials. The Lancet Oncology. 2013; 14(11): 1086 – 1094.