A lower total dose of radiotherapy, delivered in fewer, larger treatments, is as safe and effective at treating early breast cancer as the international standard dose, according to a major study.
The results of the Cancer Research UK START trial, which involved nearly 4,500 British women, were presented at the recent San Antonio Breast Cancer Symposium.
The ten-year follow up results supported the initial five year results which showed that it was just as effective and safe to give women a lower total dose of radiotherapy in fewer, larger treatments than the 25-dose international standard.
The new treatment routine also resulted in less damage to normal breast tissue, involved fewer trips to hospital, and offered cost savings for the health service.
Following the release of the five year results in 2008, the UK adopted a shorter radiation course of 15 treatments, but many other countries, including New Zealand, still use the traditional 25-dose treatment regime.
The latest 10-year follow-up results show that around six per cent of women experience a relapse of cancer within the same breast, regardless of whether or not they have a shorter course of radiotherapy after surgery.
Chief investigator Professor John Yarnold, Professor of Clinical Oncology at The Institute of Cancer Research (ICR) and honorary consultant at The Royal Marsden NHS Foundation Trust, says, “We have shown conclusively that less can be more in breast cancer radiotherapy. Three weeks of radiotherapy is as good as five weeks – as well as being more convenient and less tiring for patients and cheaper for the health service. The risk of breast cancer recurring continues beyond five years, and side-effects of radiotherapy can often develop many years after treatment, so these long-term results provide a very important reassurance that the shorter treatment course is definitely the best option for patients.”
BCAC chair, Libby Burgess, says New Zealand radiation therapists need to take note of this latest research.
“These results clearly show that this shorter treatment programme is as effective as the traditional longer programme, so we look forward to its early adoption in New Zealand.”
Libby says many people who live outside the main centres in New Zealand need to travel for radiation treatment and the current regime can mean that people are traveling quite some distance every day for up to six weeks.
“A shorter radiation programme will be less stressful and tiring for patients. It will take less of a toll on them and mean they are able to be closer to their families, friends and support networks which all contribute to good health and recovery.”
The same team involved in the START research is now setting out to investigate whether even fewer doses of radiation therapy could be just as effective, as part of a new Phase III randomised controlled trial of 4,000 women called FAST-FORWARD. The trial will compare the new standard 15-dose course of radiation therapy treatment, delivered over three weeks, with an even shorter five-dose course, delivered over one week.
