A lower total dose of radiotherapy, delivered in fewer, larger treatments, is as safe and effective at treating early breast cancer as the international standard dose, according to the 10-year follow-up results of a major Cancer Research U.K. trial.

Nearly 4,500 women across the U.K. have taken part in the START trials, which were coordinated by the Clinical Trials and Statistics Unit at The Institute of Cancer Research, London, and funded by Cancer Research U.K., the Medical Research Council, and the Department of Health.

The initial five-year results showed it was just as effective and safe to give women a lower total dose of radiotherapy in fewer, larger treatments than the 25-dose international standard. The new treatment routine also offered important benefits for women, including fewer trips to the hospital, as well as cost savings for the health service.

As a result, the shorter treatment course of 15 treatments was adopted in the U.K. in 2008, but the longer course is still used in many other countries.

This latest 10-year follow-up, funded by Cancer Research U.K., confirms these benefits and shows that very few women (around six percent) experience a relapse of cancer within the same breast, regardless of whether or not they have a shorter course of radiotherapy after surgery.

Chief investigator Professor John Yarnold, professor of clinical oncology at The Institute of Cancer Research (ICR) and honorary consultant at The Royal Marsden NHS Foundation Trust, says, “We have shown conclusively that less can be more in breast cancer radiotherapy. Three weeks of radiotherapy is as good as five weeks – as well as being more convenient and less tiring for patients and cheaper for the health service.

“The risk of breast cancer recurring continues beyond five years, and side-effects of radiotherapy can often develop many years after treatment, so these long-term results provide a very important reassurance that the shorter treatment course is definitely the best option for patients. Some doctors may have been hesitant to change their practice on the basis of five-year results, but these long-term findings should convert those skeptics.”

The same team is now setting out to investigate whether even fewer doses of radiotherapy could be just as effective, as part of a new Phase III randomized controlled trial of 4,000 women called FAST-FORWARD. The trial will compare the new standard 15-dose course of radiotherapy treatment, delivered over three weeks, with an even shorter five-dose course, delivered over one week.

Release Date: December 5, 2012
Source: Cancer Research U.K.