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Stronger Doses Less Often May Be OK, Study Suggests
Reviewed By Louise Chang, MD
March 18, 2008 — A shorter, stronger schedule of breast cancer radiation treatment may be comparable to standard treatment, two new studies show.
But the researchers aren't ready to cut down breast cancer radiation recommendations just yet. First, they want to check for long-term side effects.
The new studies, called the START (Standardization of Breast Radiotherapy) trials, included more than 4,400 U.K. women with breast cancer.
The women had already gotten breast cancer surgery. They all got radiation to help prevent breast cancer recurrence.
Some of the women got a standard, five-week course of radiation therapy. Others followed one of three other radiation plans which used stronger doses less often for three or five weeks.
The women were followed for up to eight years. During that time, they got annual checkups to screen for recurrence and radiation-related changes in normal breast tissue.
Breast Cancer Radiation: How Strong, How Long?
The odds of relapse and breast changes (such as breast appearance) were equally low with both radiation schedules.
Longer studies lasting 15-20 years are needed to track the long-term safety of stronger, shorter radiation doses, note the researchers. They included clinical oncology professor John Yarnold, MD, of the Royal Marsden Hospital in Sutton, England.
An editorial published with the studies agrees that more research is needed.
"We realize that [stronger, shorter radiation] is convenient for patients, because it reduces the number of visits to radiotherapy departments and waiting lists in several cancer centers," the editorial states.
"Nevertheless, we have to wait for data on longer follow-up before final conclusions can be drawn from the START trials."
Professor Harry Bartelink, MD, PhD, chairman of the Netherlands Cancer Institute's radiotherapy division, wrote the editorial.
SOURCES: START Trialists' Group, The Lancet, March 19, 2008; advance online edition. Bartelink, H. The Lancet, March 19, 2008; advance online edition.
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