Radiation therapy does not improve survival rates in older patients with early-stage breast cancer, a new study suggests. new research published in the magazine in New England Journal of Medicine.
According to the researchers, radiation therapy added to breast-conserving surgery and hormone therapy, the current standard treatment, it made no difference to mortality rates in patients 65 years and older.
Radiation therapy also did not affect the risk of secondary tumors, known as metastases. However, did slightly reduce the risk of cancer recurrencebut the risk is still within the clinically acceptable range.
According to experts, this 10-year study, one of the first long-term clinical trials in elderly breast cancer patients, indicates that radiotherapy can be safely excluded when treating people over 65 years of age with early stage breast cancer.
Regardless of age, the Standard treatment for early breast cancer is breast-conserving surgery.sometimes called a lumpectomy, followed by radiation therapy and hormone treatment to reduce the risk of recurrence in the breast.
Less than half of those affected
Patients 65 years of age or older represent at least 50% of those affected. Although radiation therapy places an additional burden on older patients, with side effects related to heart problems and second cancers, there have been very few clinical trials in this age group.
Researchers from the University of Edinburgh and the Western General Hospital in Edinburgh (United Kingdom) conducted a randomized clinical trial, called PRIME II, with 1,326 patients to investigate whether radiotherapy is necessary in combination with lumpectomy and hormone therapy.
The patients were 65 years or older and suffered from the so-called “low-risk” breast cancer, that is, a tumor no larger than 3 cmwhich did not affect the axillary lymph nodes and which probably responded to hormonal treatment.
All participants were prescribed breast-conserving surgery. and at least five years of hormone therapy. Half the group was randomly selected to also receive radiation therapy for three to five weeks postoperatively. Patients were evaluated at annual clinic visits and by breast scans.
The research team found that in patients treated without radiation therapy the risk of cancer recurrence in the treated breast after 10 years was 9.5%, while the administration of radiation therapy reduced the risk to 0.9%. Despite this difference in rates, both are within the raccepted range of recurrence according to current clinical guidelines. There were no differences in overall survival between the two groups. and most deaths were due to causes other than breast cancer.
Professor Ian Kunkler, Professor of Clinical Oncology at the University of Edinburgh, explains that “Radiation therapy can place a heavy burden on patients, especially older ones. Our findings will help clinicians guide older patients on whether this particular aspect of early breast cancer treatment can be omitted from a shared decision-making process, weighing all risks and benefits,” he says. .
