A shortened course of radiotherapy for patients with early stage breast cancer may actually produce slightly better outcomes than the conventional protocol, according to the results of a randomized clinical trial.
Studies conducted in other countries such has Canada and the United Kingdom have already established the safety and efficacy of hypofractionated whole-breast irradiation (HF-WBI), but some American clinicians have expressed skepticism about whether the results found in those studies could be replicated in the United States.
-----
Related Content
Same Survival and Toxicity With APBI and WBI for Breast Cancer
USPSTF finalizes breast cancer screening recommendations
-----
To test its effectiveness in a US demographic, investigators led by Cameron W Swanick, MD, University of Texas MD Anderson Cancer Center, compared HF-WBI (at a dose of 42.56 grays in 16 fractions plus a tumor bed boost) and conventionally fractionated whole-breast irradiation (CF-WBI [at a dose of 50 grays in 25 fractions plus a tumor bed boost]) after breast-conserving surgery using patient-reported outcomes and physician-rated cosmesis.
A total of 287 patients were enrolled in the trial, 149 were randomized to receive CF-WBI and 138 were randomized to receive HF-WBI. To address some key concerns voiced by American doctors about the use of HF-WBI in the United States, the investigators also explained that all patients involved in the trial received a tumor boost, nearly half were obese, and a quarter had central axis separation greater than 25 cm. The results of the study could therefore be seen as somewhat representative of the American population. They published their results in Cancer.
At 2 years, the Functional Assessment of Cancer Therapy-Breast Trial Outcome Index revealed a statistically significant advantage in using HF-WBI over CF-WBI (mean 79.6 vs 75.9, respectively). Other patient-reported outcomes did not differ significantly between the two treatment arms, nor did physician-rated cosmetic outcomes.
Thus, the investigators concluded that treatment outcomes did not differ based on whether patients received CF-WBI or HF-WBI, which could be an important factor for physicians to consider when they are counseling patients about their treatment options.
