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Brief Radiotherapy for Early Breast Cancer Considered Top Option

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radiation therapy early breast cancer

Data gathered and examined from a 10 year study verify that administering radiotherapy to women with early breast cancer in a lower overall dose via fewer, higher doses is considerably safe and effective compared to the present standard of a higher overall dose.

The discoveries come from the UK Standardisation of Breast Radiotherapy (START) trials, the results of which have gone on to be recently published in the journal, The Lancet Oncology.

Over the course of the study, 4,451 women from 35 radiotherapy centers in the UK were examined between 1999 and 2002 for two different components or subsets of the trial.

Each subset group compared various doses with the international standard, which is a total dose of 50 Gy, the unit of absorbed radiation, administered in 25 small doses of 2 Gy over 5 weeks.

The two subsets were:

1-    START A (5 weeks): compared the international standard with 41.6 Gy of 3.2 Gy and 39 Gy of 3.0 Gy given in 13 treatments over 5 weeks.

2-    START B (3 weeks): compared the international standard with 40 Gy delivered in 15 doses of 2.67 Gy over 3 weeks.

Following 10 years, the tumor control rates of the women in START A were comparable to both START B and the international standard. Very few women in START B suffered a setback of their cancer, and they exhibited identical damage to surrounding healthy breast tissue.

Likewise in START B, the number of women who experienced recurring cancer was comparable following 10 years. Yet, women in this subset group demonstrated considerably less harm to the healthy breast tissue.

"These 10-year results reassure us that 3 weeks of radiotherapy is as good as the 5 weeks still used in many countries, with less damage to nearby healthy tissue, as well as being more convenient for women (shorter waiting lists and fewer hospital visits) and cheaper for health services,” said study leader and professor from The Institute of Cancer Research, London, John Yarnold.

In addition, the researchers also note that these results were mostly alike "irrespective of age, tumor grade, stage, chemotherapy use, or use of tumor bed boost."

“The upshot is that, contrary to conventional thinking, cancer cells are just as sensitive to the size of daily radiotherapy dose as the normal tissues responsible for late onset side effects. This means that continuing to use the standard lower doses spares the cancer as much as the healthy tissue," effectively offering no benefit to the patients,” added Yarnold.

"Our results support the continued use of 40 Gy in 15 fractions, which has already been adopted as the standard of care by most UK centers,” he concluded.


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