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Breast Cancer Radiation Therapy: Comparison of Different Protocols

Posted Feb 09 2010 6:54am
In one of my 2009 blogsI discussed two clinical trials whose results suggested that breast cancer radiation therapy given in fewerthough higherdoses might be beneficial.  Howeverone of those studies included only 75 patients and the other included only 105 patients.  I indicated that while the results of these studies were promisinga larger study would be needed to confirm these results.  The results of such a study have recently been made available.

In this new breast cancer radiation therapy studyinvestigators recruited women who were taking part in the Standardisation of Breast Radiotherapy Trials (START).  These trials consisted of the following radiation therapy protocols
  • 50 Gy in 25 fractions over 5 weeks (2 Gy per fraction; the global standard)
  • 41.6 Gy in 13 fractions over 5 weeks (3.2 Gy per fraction)
  • 40 Gy in 15 fractions over 3 weeks  (2.7 Gy per fraction)
  • 39 Gy in 13 fractions over 5 weeks (3 Gy per fraction)
The breast cancer patients in these trials were asked to complete quality of life questionnaires over a 5-year follow up period.  Side effects and image concerns were recorded and compared between the different radiation therapy procedures.  Some of the results showed that
  • About 40% of the women reported breast changes due to radiation therapy
  • About 33% of the breast cancer patients reported arm and shoulder pain
  • Compared to the 50 Gy protocolthe 40 Gy and 39 Gy radiation therapy procedures resulted in fewer adverse side effects.
  • Patients receiving the 39 Gy protocol had about a 37% lower chance of seeing undesireable skin changes compared to the 50 Gy protocolwhile patients receiving the 40 Gy protocol had about a 24% lower chance of seeing these unwanted changes.
The START trials are apparently the largest trials to test the safety and effectiveness of radiation therapy given in fewer fractions at higher doses (hypofractionation).  According to a press releasethese trials have shown that this type of radiation therapy procedure is just as effective as the current global standard protocol. The fact that hypofractionated radiation therapy remains effective and results in fewer side effects is great news.  By reducing these side effectsbreast cancer survivors are able to experience a better quality of life than they might have otherwise.  As long as breast cancer remains an unwanted fact of lifeimproving outcomes and quality of life will continue to be a critical medical goal.

By eating properly and living a healthy lifestyleyou can reduce your risk of getting breast cancer.  To learn more about the kind of changes you can makeread my book Fight Now: Eat & Live Proactively Against Breast Cancer at
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