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Radiotherapy treatment for breast cancer - the shorter the better
It is perfectly possible to reduce the number of sessions of radiotherapy after surgery for breast cancer from 25 to 13 without comprising the quality of the clinical results. This would also lead to a far higher level of patient comfort... and a considerable reduction in costs.
These are the conclusions of a randomised phase III study conducted in Scotland on a sample of over 4,500 breast cancer sufferers over the course of 6 years. The results are likely to lead to a return in force to what specialists call hypofractioning, in a discipline in which improved patient safety and dosage reduction are a constant objective. “It’s definite, I shall be starting as soon as I get back and this approach is going to spread very rapidly”, said one French physician in charge of radiotherapy at a hospital in the Paris area as he left the 43rd Annual Meeting of the American Society of Clinical Oncology (ASCO) in Chicago.
In this particular case there seems to be no room for doubt. Particularly in the present situation where the safety of both control software and radiotherapy equipment is subject to constant improvement. John A. Dewar and his colleagues at Dundee in Scotland evaluated different radiotherapy protocols with 2 groups of 2,236 and 2,215 women respectively who underwent surgery for invasive breast cancer. One group was treated over 25 sessions and the other in 13 sessions but the results proved comparable in every respect without any increase in the relapse rate. The aesthetic after-effects and secondary effects of radiotherapy treatment were also reduced in the women who underwent the fewer number of sessions.
This approach has had other associated effects which make it a popular choice among patients… and no doubt among funding bodies too. In particular there is the consequent reduction in costs associated with travel to the hospital, which is generally by some form of ambulance car… Similar trials at the Constantine Hospital Centre in Algeria (under Professor W. Boughrara) and at Antananarivo in Madagascar (under Professor F. Rafaramino) have also shown the advantages of this approach, highlighting the fact that these techniques make it possible to increase the number of patients treated using the same infrastructure and the same medical teams.
There can be no doubt that the French Assurance-Maladie will show just as much interest in this new approach as its counterpart on the other side of the Channel, the National Health Service.
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