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Study: Shorter Radiation Regimen May be Effective for Early-Stage Breast Cancer (dateline May 25, 2008)

A shorter duration of radiation therapy may be as beneficial for treating breast cancer as traditional five to six week regimens, according to a recent study. Radiation therapy is often used after breast cancer surgery (often lumpectomy) to treat early-stage breast cancer and prevent the risk of a recurrence. The research, which was conducted in the United Kingdom, found that women who received a slightly higher dose of radiation over a three week period compared to a standard dose over a five week period did not incur additional side effects and received the same protection. However, the researchers caution that additional research is needed to confirm the findings.

Radiation therapy (also called radiotherapy) uses high-energy rays to stop cancer cells from growing and dividing. Radiation is often used in conjunction with other breast cancer treatment, commonly lumpectomy, to reduce the risk that the cancer will return. Radiation therapy may occasionally be recommended for women to destroy remaining cancer cells after mastectomy or to shrink tumors in patients with advanced breast cancer.

Most women with early stage breast cancer who receive radiation therapy do so in a five to six week regimen (about 25 doses, or fractions of about 2.0 Gray (Gy) each). However, lead researcher John Yarnold of the Institute of Cancer Research and Royal Marsden Hospital, and his colleagues studied whether giving a shorter duration but higher dose of radiation provided the same benefit to early stage breast cancer patients. In a study of over 2,000 women with early breast cancer, Yarnold and his colleagues compared half the women who received standard radiation (25 treatments, five times per week over five weeks) with the other half who received a higher dose of radiation in fewer treatments (about 15 doses, or fractions of about 2.67 Gy each).

After five years, the researchers found that the women who received the shorter but higher radiation therapy had a similar rate of cancer recurrence compared to the women who received the standard radiation therapy. The researchers also noted that side effects were similar among the two groups. Common temporary side effects of radiation therapy for breast cancer include fatigue, neutropenia, (reduction in white blood cells), breast swelling or tenderness, feeling of heaviness in the breast, sunburn-like appearance of the breast skin, and loss of appetite.

Based on the study, the researchers conclude that shorter duration radiation therapy may be more convenient for the patient and as beneficial as standard duration radiation therapy. However, medical experts caution that more research is needed to confirm the study's findings. Potential harmful effects of a higher dose of radiation could include damage of normal at the site of the radiation. Another concern is whether the protection seen with the shorter regimen remains over time.

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