Fewer dose hope for breast cancer

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Fewer but larger doses of radiotherapy may be a safe and effective way to treat breast cancer, research suggests.

A team of UK and US researchers found giving 13 larger doses was as effective at preventing cancer from returning as the standard regime of 25 small doses.

The preliminary findings could lead to simpler and more effective radiotherapy treatment - and save the NHS money. 

Details of the 10-year trial, funded by Cancer Research UK and involving 1,410 women, are reported in Lancet Oncology.

The research was a collaboration between the Royal Marsden NHS Foundation Trust, the Gloucestershire Oncology Centre, The Institute of Cancer Research and the University of Wisconsin.

The trial followed 1,410 women who had a lumpectomy following treatment for early breast cancer followed by different radiotherapy treatments.

Daily treatment

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.

One group was given the standard treatment of 25 doses of radiation totalling 50 grays (measurement of radiation) in five weeks.

The other two groups were given 13 doses in the same period. One received a total of 39 grays, and the other 42.9 grays.

Among the women in the first group, the 10-year risk of breast cancer returning was 12.1%.

Among the group who received 39 grays it was 14.8%, but among those who got the slightly higher dose of 42.9 grays it was 9.6%.

Lead researcher Professor John Yarnold 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.”

‘Important findings’

Cancer Research UK’s director of cancer information, Dr Lesley Walker, 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.”

Maria Leadbeater, a specialist nurse for Breast Cancer Care, said patients often found daily trips for therapy exhausting.

“Fewer, more targeted doses could really help ease this and reduce the often prohibitive costs patients incur of having to travel miles to the nearest specialist centre for treatment,” she said.

Emma Taggart, of the charity Breakthrough Breast Cancer, said: “Anything that can improve a patient’s experience of breast cancer treatment and is as effective as the current standard, with no increase in side effects, is to be welcomed.”

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