Experts Aim for Shorter Radiation Treatment for Breast Cancer

Visitors at the annual congress of the European Society of Medical Oncology (Esmo), on September 15, 2024 in Barcelona (Spain)

Manaure QUINTERO

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Hopes for shorter radiotherapy treatment for women suffering from breast cancer are gaining ground among experts, according to a study presented at the world’s leading oncology congress.

Three weeks of radiation instead of five: that is the treatment period announced at the annual congress of Esmo, the European Society of Medical Oncology, which is being held this year in Barcelona until Tuesday.

The phase 3 clinical study (to test whether a new treatment is better than a traditional one) evaluated 1,265 patients for five years and compared the effects of a standard five-week radiotherapy with a new regimen, called “hypofractionated”, that is, reduced to three weeks.

All of these women suffered from breast cancer with lymph node involvement, meaning that the tumor was no longer localized but had spread to the lymph nodes.

Some patients in the study received slightly higher doses at each session, but a reduced schedule of appointments overall.

“From previous studies, it was known that shorter radiotherapy sessions were just as effective for localised tumours, but for women with lymph node involvement, there was nothing to show that the number of sessions could be shortened,” Sofia Rivera, a radiotherapy oncologist and head of service at the French Gustave-Roussy Institute, who presented the study, told AFP.

In order to reduce the sessions to three weeks, the irradiation dose was increased slightly in each session.

A study presented at the ESMO congress paves the way for a reduction in the time frame for treating breast cancer with radiotherapy

ANNE-CHRISTINE POUJOULAT

“When treating the breast, but also the lymph nodes, much larger volumes are addressed, including healthy tissue such as the lung, heart or esophagus,” says Sofia Rivera. Therefore, with a higher dose, there was a fear of an increase in treatment-related side effects.

The results of the study dispelled this fear.

“We have an overall survival rate, a rate of survival without relapse and without metastasis that is even better” with this “hypofractionated” therapy, says the oncologist.

In light of these data, it is very likely that shortened radiotherapy will soon be proposed for women with lymph node-positive breast cancer, which represents 30% of breast cancers.

“This will mean less burdensome treatments; we are clearly heading towards a reduction in the therapeutic load,” Sofia Rivera enthuses.

Reducing the number of sessions will limit the number of trips patients have to make to and from their treatment center.

“It is an improvement in the quality of life,” says the oncologist. In addition, there will be a reduction in waiting lists, with more rotation in the use of radiotherapy machines.

Charlotte Coles, an oncologist and professor at Cambridge University, praised the “really important” study on Sunday, which should help alleviate “the burden on patients” and “reduce costs for health systems.”

This study is part of a series of investigations that go in the same direction.

A meta-analysis published last week in the British Medical Journal (BMJ), which pooled trials involving more than 20,000 patients, concluded that administering higher doses per fraction of radiotherapy over a shorter period significantly reduced the risk of side effects and improved quality of life.

For breast cancer, studies first showed that three weeks of radiotherapy (15 sessions) gave results as good as five weeks (25 sessions). Other studies later showed that five sessions were as effective as 25 or 15.

The next step will be to test five sessions in one week for breast cancers with lymph node involvement. Studies are underway, but it will take at least five years to obtain the first results.