Early-stage breast cancer patients who receive a more intensive course of radiation to their whole breast over 3 weeks is as effective as the standard, less-intensive 5-week whole-breast radiation and offers patients more convenience at a lower cost, thereby providing a better quality of life, according to a randomized, long-term study presented September 22, 2008, in the plenary session at the 50th Annual Meeting of the American Society for Therapeutic Radiology and Oncology (ASTRO), held in Boston.
The cost of this shorter treatment, called accelerated hypofractionated whole-breast irradiation, is two-thirds of the cost of the standard whole breast radiation. It is also less expensive then other new approaches such as partial-breast irradiation.
Potential Advantages
“There has been renewed interest in hypofractioned whole-breast irradiation, due to the potential radiation advantages, patient convenience, quality of life, and lower costs. However, long-term effects were a potential concern,” Timothy Whelan, md, lead author of the study and a radiation oncologist at the Juravinski Cancer Centre at McMaster University in Hamilton, Ontario, Canada, said. “We were surprised that the risk of local recurrence and side effects for women treated with accelerated whole-breast irradiation was so low even at 12 years. Our study shows that this treatment should be offered to select women treated with early-stage breast cancer.”
Many women with early-stage breast cancer are able to undergo breast-conserving therapy to keep their breast after treatment. Typically, this means they first have surgery to remove the cancer followed by a course of radiation therapy to kill any cancer cells that may remain. The standard whole-breast radiation therapy treatment takes approximately 15 minutes every day, Monday through Friday, for 5 weeks.
Study Details
Between April 1993 and September 1996, researchers randomly assigned 1,234 women to be treated with either accelerated whole-breast irradiation or standard whole-breast irradiation. These women were followed for 12 years to determine if accelerated whole-breast irradiation was as effective as the standard treatment. At 10 years after treatment, cancer returned locally in 6.2% of patients treated with the accelerated radiation therapy, compared to 6.7% for those patients treated with standard therapy. Both groups of patients also had a good or excellent cosmetic outcome from the radiation treatments.
“This shorter treatment may not be for everyone, however. I would encourage women whose breast cancer is caught early to talk to their oncologist to see if they are a good candidate for this shorter therapy,” Dr. Whelan added.
A 70-year-old man with a history of localized prostate cancer treated with whole-pelvis radiation therapy with a boost to the prostate, in conjunction with androgen deprivation therapy 7 years prior, presented with lower back pain. A bone scan revealed an area of activity in the sacrum. What is the most likely diagnosis?
