A number of studies show that for patients with early-stage breast cancer, a shorter but stronger course of radiation therapy is as good as a longer course.
The American Society for Radiation Oncology recommended in 2011 that women who are at least 50 years old with an early stage of the disease take the shorter but stronger type of radiation therapy called hypofractionated whole breast radiation.
The three -week cycle radiation is not only as effective as the traditional therapy that lasts five to seven weeks. It also costs less. Findings of a new research, however, show that many American patients still receive radiation therapy longer than necessary.
For the new study, which was published in the Journal of the American Medical Association (JAMA) on Dec. 10, Ezekiel Emanuel, from the University of Pennsylvania Perelman School of Medicine, and colleagues analyzed the data of more than 15,000 women who received radiation therapy after undergoing breast-conserving surgery lumpectomy.
For patients who underwent lumpectomy, radiation reduces their odds of developing another cancer in the breast and increases their likelihood for survival.
The researchers found that in 2013, 34.5 percent of early stage breast cancer patients who were at least 50 years old received the shorter radiation treatment, higher than the 2008 number of 10.6 percent. Among younger women, the prevalence of the shorter-course therapy increased to 21.2 percent from 8.1 percent in 2008.
The study likewise found that the care cost was lesser in older women who received shorter treatment. Women who received the shorter therapy spent $28,747 in total medical expenses, which is significantly lower compared with the $31,641 these cost women who were given the longer course of the treatment. For the younger women, the savings was nearly 12 percent.
Benjamin Smith, from the University of Texas MD Anderson Cancer Center in Houston, said that regardless of the potential of shorter treatment in reducing costs, some physicians still stick to the older regimen because this would allow them to earn more money billing for the treatment's extended course.
Some doctors also have concerns over the safety of the new treatment's higher dose regardless that it was deemed as safe as the old treatment.
"Hypofractionated WBI after breast conserving surgery increased among women with early-stage breast cancer in 14 US commercial health care plans between 2008 and 2013," the researchers wrote. "However, only 34.5% of patients with hypofractionation-endorsed and 21.2% with hypofractionation-permitted early-stage breast cancer received hypofractionated WBI in 2013."