November 6, 2009 — A shorter, cheaper and more convenient three-week course of radiation appears to work just as well as the traditional six-week schedule for some women with early-stage breast cancer, a new study suggests.
"We cut the duration of radiation treatment in half," says study researcher Manjeet Chadha, MD, a radiation oncologist at the Beth Israel Medical Center in New York. The approach is part of "the effort to personalize care and tailor it to specific patients in specific situations."
The findings were presented at the annual meeting of the American Society for Radiation Oncology (ASTRO).
European and Canadian studies have already shown that a short course of radiation is just as effective as the conventional longer course, Chadha says.
"But in the U.S., there are limited data on this topic," she says. And many Americans doctors are reluctant to embrace a new treatment unless it's been proven to work here, says Harvard Medical School's Anthony Zietman, MD, incoming president of ASTRO.
Additionally, the radiation therapy technique used in the current study is different than what's usually done, according to Chadha. Typically, doctors irradiate the entire affected breast for four or five weeks. Then, they give a radiation boost, a little each day, to the part of the breast from which the tumor was removed.
With the new technique -- called accelerated hypofractionated whole breast irradiation -- "we simultaneously give the boost at the same time the whole breast is treated," Chadha says.
Also, a personalized plan is developed using each patient's CT scan images. The idea is to help ensure that radiation is blasted at the tumor site and not at surrounding healthy tissue. At the meeting, Chadha reported on the first 121 women enrolled in the ongoing trial. All had breast-conserving surgery for early-stage breast cancer, followed by the accelerated radiation treatment.
So far, the women have been followed for a median of two and a half years. None has suffered a recurrence of cancer in the same breast.
None of the women experienced serious side effects, just the skin irritation and redness that is typical of any radiation treatment, Chadha says.
The cosmetic results are "excellent," she says.
The study did not include a group of women who got the traditional longer course of radiation for comparison. But the results obtained with the short course are what would be expected with the longer course, Chadha says.
"Though encouraging, it is early," says Chadha, who plans to continue following the women.
If further study in larger numbers of women "proves this shorter schedule is effective and safe, we have an opportunity to improve the quality of life of patients," she says.
Zietman tells WebMD that together with the Canadian and European studies, "the data all suggest a shorter course of radiation is safe and effective."
Zietman says doctors should be offering the short course of treatment to women -- particularly if, for reasons of travel or cost, they have trouble getting in for six or eight weeks of treatment.
"There are a host of advantages, including less time away from work and family," he says.
51st Annual Meeting of the American Society for Radiation Oncology, Chicago, Nov. 1-5, 2009.
Manjeet Chadha, MD, radiation oncologist, Beth Israel Medical Center, New York.
Anthony Zietman, MD, incoming president, ASTRO; Harvard Medical School.