Breast Cancer: Shorter, More Intense Radiation Therapy Better

Women in early stages of breast cancer may benefit more from shorter, yet more intensive radiation treatment, a recent study has found. The women have less toxicity and higher quality of life in comparison to those who undergo a longer course of treatment, according to researchers from The University of Texas MD Anderson Cancer Center.

In the U.S., radiation treatment for breast cancer is usually given in smaller doses over a longer period of time, in a method called conventionally fractionated whole breast irradiation (CF-WBI), rather than with higher doses over a shorter period of time, or hypofractionated whole breast irradiation (HF-WBI).

Dr. Simona Shaitelman, assistant professor of Radiation Oncology at MD Anderson Cancer Center, said:

“Patients who received the shorter course reported less difficulty in caring for their families’ needs. This is a major priority for women undergoing breast cancer radiation. Most are busy working mothers, working inside or outside the home, and are juggling a number of priorities. It’s paramount that we address this need.”

The study was an unblended, randomized trial on 287 women with stage 0 to II breast cancer where whole-breast irradiation was recommended. 76 percent of the patients were overweight or obese.

Previous studies on HF-WBI had excluded patients with a larger body mass index, despite obesity being a strong associated risk factor for the disease.

The women were randomly given either hypofractionated radiation or the more traditional method. It was found that those who underwent the shorter, higher-dose group experienced less of the typical side effects such as eczema, fatigue and breast pain than those who underwent the conventional methods. Also, those who recieved hypofractionated whole breast irradiation were able to function much more normally than the other group.

“These findings should be communicated to patients as part of shared decision making regarding election of radiotherapy regimen and are relevant to the ongoing discussion regarding the most appropriate standard of care for WBI dose fractionation,” the authors concluded in their report.

Jagsi R, Griffith KA, Boike TP, et al.
Differences in the Acute Toxic Effects of Breast Radiotherapy by Fractionation Schedule: Comparative Analysis of Physician-Assessed and Patient-Reported Outcomes in a Large Multicenter Cohort.
JAMA Oncol.  doi:10.1001/jamaoncol.2015.2590.

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