A new study found that women who underwent shorter course of radiation therapy during the early stage of breast cancer exhibited better quality of life and lesser toxic levels compared to those who were subjected to longer periods of treatment. According to the researchers of the new study, their findings should be imparted to women so as to enhance their power to make disease treatment decisions together with their doctors.
In radiation therapy for breast cancer, fractionation is often utilized. Fractionation refers to the division of radiation doses in smaller amounts but administered for more days to lessen the extremely harsh effects on the cells. Hypofractionated radiation therapy, on the other hand, pertains to the administration of the correct radiation dose over a shorter span of time and in fairly higher amount at once.
In the past, experts have found that hypofractionated whole-breast radiotherapy is safe and effective even in the long term; however, its short-term toxic effects are not well compared to standard fractionation. With this, the study authors, from the University of Texas MD Anderson Cancer Center, aimed to assess the toxic effects and prognoses of women, who underwent different fractionation types.
In collaboration with the Michigan Radiation Oncology Quality Consortium (MROQC), the researchers studied data, which was prospectively collated. The researcher adjusted the participants' social, demographic, clinical and therapy data. They then compared the toxic effects experienced by those who underwent hypofractionation (HF) and conventional fractionation (CF) during the course of treatment (through 7 days after treatment) and during the follow-up period (posttreatment days 8-210). All in all, the researchers were able to come up with 2,309 subjects, who had an extensive toxicity assessment by their physician within one week post radiotherapy and a weekly evaluation during the course of the therapy.
The findings of the study, published in the JAMA Oncology, showed that 578 patients fell under the HF classification. The other group of patients, who are receiving CF, was found to have notable and more elevated maximum physician-assessed skin reactions such as dermatitis and moist desquamation, higher self-reported pain, fatigue and swelling. During follow-up, no other significant differences were noted.
"This study fills in a missing piece in the literature," says Benjamin Smith, the study's corresponding author. Shorter course of therapy is no longer just a second choice, rather it has become the preferred first therapy that physicians may discuss with patients who need to undergo whole-breast radiation therapy.
With this, the authors concluded that hypofractionation has been proven not only to be a more convenient option than CF, but also to be a radiation therapy choice that can cause lesser discomfort to patients.
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