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Accelerated whole-breast radiation may be a treatment alternative.

An intense three-week course of radiation treatment is as effective as the standard five-week whole-breast radiation treatment for women with early-stage breast cancer, according to a new study. The radiation, given as fewer but larger daily doses (hypofractionated radiotherapy), prevented breast cancer recurrence at the same rate as radiation given over the standard schedule with similar cosmetic results and no increase in toxicity.

The trial followed 1,234 women who had node-negative breast cancer with tumors smaller than 5 cm and negative margins after breast-conserving surgery. The women were randomly assigned to receive either the standard 50 Gy in 25 fractions over five weeks or 42.5 Gy in 16 fractions over three weeks. After a median of 12 years following treatment, the local invasive disease recurrence rates were similar, 6.7% for women in the standard group and 6.2% for women in the hypofractionated radiation group, with approximately 70% of patients having good to excellent cosmetic results. For patients with high-grade tumors (19% of all patients), the accelerated treatment was less effective than the standard treatment, with a local recurrence rate of 15.6% and 4.7%, respectively.

Whole-breast radiation after lumpectomy in early-stage cancer has been shown to significantly reduce breast cancer mortality compared to surgery alone. However, 30% of American women who have breast-conserving surgery do not have radiation treatment after surgery. If a shorter course of treatment is less costly and more convenient for patients, more eligible women may choose to undergo lumpectomy and radiation in place of mastectomy.

Whelan, T.J., Pignol, J.P., Levine, M.N., Julian, J.A., Mackenzie, R., Parpia, S., ... Freeman, C. (2010). Long-term results of hypofractionated radiation therapy for breast cancer. New England Journal of Medicine, 362, 513-520. doi: 10.1056/NEJMoa0906260

[By Deborah McBride, RN, MSN, CPON[R], Contributing Editor]
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Title Annotation:JUSTIN
Author:McBride, Deborah
Publication:ONS Connect
Article Type:Brief article
Geographic Code:1USA
Date:Apr 1, 2010
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