Concentrated doses of radiotherapy shown to be better in treating breast cancer

Cancer Research UK

Giving breast cancer patients fewer but larger doses of radiotherapy may be as safe and as effective at reducing the risk of cancer returning, according to Cancer Research UK trial results published in today’s (Tuesday 30 May) Lancet Oncology*.

A team of researchers at The Royal Marsden NHS Foundation Trust, the Gloucestershire Oncology Centre, The Institute of Cancer Research and the University of Wisconsin, trialled an experimental schedule of 13 larger doses that appears to offer the same protection against cancer returning in the same breast as the international standard of 25 smaller doses, without any increase in side effects.

The ten-year trial followed 1410 women who had a lumpectomy for early breast cancer followed by different radiotherapy treatments. The findings from the study could mean simpler and more effective radiotherapy treatment for breast cancer patients and create cost savings for health services in the future.

Usually, patients have radiotherapy treatment once a day, from Monday to Friday, with a rest at the weekend, meaning patients have to travel to hospital every weekday for five weeks. A reduction in the number of hospital visits could lessen anxiety for patients and save valuable time and money spent travelling to and from hospital.

The women participating in the study were randomly divided into three groups to rule out any bias. One group was given the standard treatment of 25 doses in five weeks, and the other two groups were given 13 doses in two slightly larger amounts over the same period. The researchers then monitored the women in the three groups and showed that a regimen of 13 doses can apparently offer an outcome at least as good as the standard treatment.

Lead researcher, Professor John Yarnold from The Institute of Cancer Research and The Royal Marsden NHS Foundation Trust, said: “We think it should be possible to give fewer but higher daily doses of radiotherapy to the breast to prevent cancer from returning without harming the patient’s healthy tissues.

“However, we will have to wait for the results of our further trials that have followed this study before we can confirm that the strategy is more effective than the standard treatment in the long term.”

Dr Lesley Walker, director of cancer information at Cancer Research UK, said: “This was an extremely important early trial. If these results are confirmed in the larger follow-up studies, it could mean better outcomes with less hospital visits for patients and therefore an improvement in their quality of life.”

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Notes to Editor

*Patients with early breast cancer may benefit from few, larger fractions of radiotherapy after local tumour excision: long-term results of a randomised trial (2005). Owen et al. Lancet Oncology.

Trial results

  • Group 1: 50 grays, 25 fractions, 5 weeks - 10-year risk of recurrence was 12.1 per cent.
  • Group 2: 42.9 grays, 13 fractions, 5 weeks - 10-year risk of recurrence was 9.6 per cent
  • Group 3: 39 grays, 13 fractions, 5 weeks - 10-year risk of recurrence was 14.8 per cent

Radiotherapy for breast cancer

Radiotherapy is cancer treatment using radiation. It used often to treat breast cancer. Cancer cells are more likely to be killed by radiation than normal cells because they are more likely to be growing. It is actively growing cells that are most at risk from radiation. Mostly doctors use radiotherapy as a back-up to breast surgery - after breast conserving surgery or mastectomy.

Most people begin their treatment for breast cancer with surgery. Depending on the size and position of the tumour, women may be able to have just the cancerous lump removed (lumpectomy) plus several weeks of radiotherapy to the breast. Some women may prefer to have a mastectomy with no radiotherapy.

Radiotherapy is split into a course of small treatments because it would be too harmful to the normal body tissues to have the total dose in one go. The dose is therefore split into smaller, daily doses that are given over a number of weeks. Each daily dose is known as a ‘fraction’.

For more information about radiotherapy for breast cancer, visit our patient information website Cancer Help UK.

The trial was supported by Cancer Research UK through a grant for the Clinical Trials and Statistics Unit at The Institute of Cancer Research. The trial was partly supported in its early years by a grant from Marks and Spencer plc.

The Institute of Cancer Research

The  Institute of Cancer Research is Europe’s leading cancer research centre with expert scientists working on cutting edge research. It was founded in 1909 to carry out research into the causes of cancer and to develop new strategies for its prevention, diagnosis, treatment and care.

The Institute works in a unique partnership with The Royal Marsden NHS Foundation Trust, forming the largest Comprehensive Cancer Centre in Europe. This relationship enables close daily contact with those on the frontline in the fight against cancer - the clinicians, the carers and most importantly, the patients.

The Institute is a charity that relies on voluntary income. The Institute is one of the world’s most cost-effective major cancer research organisations with over 90p in every pound directly supporting research.

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