Comparing Radiation Regimens in Early-Stage Breast Cancer
Posted: Monday, July 8, 2019
For patients with stage 0, I, or II breast cancer who have not undergone chemotherapy, partial-breast irradiation may represent a more convenient option, with less fatigue and slightly poorer cosmesis after 36 months, than whole-breast irradiation. For patients who underwent chemotherapy, cosmesis was equivalent at 36 months, concluded Patricia A. Ganz, MD, of the University of California, Los Angeles, Jonsson Comprehensive Cancer Center, and colleagues.
These findings from the NRG Oncology/NSABP B-39/RTOG 0413 trial, were presented at the 2019 American Society of Clinical Oncology (ASCO) Annual Meeting in Chicago (Abstract 508).
In this clinical trial (ClinicalTrials.gov identifier NCT00103181), the authors included a prospective quality-of-life subsidy with a patient-reported outcome evaluation of breast cancer treatment outcomes and fatigue using the Breast Cancer Treatment Outcomes Scale and the 36-Item Short Form Survery vitality scales. Patients with breast cancer who had received (n = 446) or not received (n = 504) chemotherapy were enrolled.
For patients who did not receive chemotherapy, partial-breast irradiation was associated with less fatigue (P = .011) yet failed to meet the criteria for cosmesis equivalence (confidence interval = 97.5%). For patients who underwent chemotherapy, partial-breast irradiation resulted in worse fatigue (P = .011) and equivalent cosmesis to whole-breast irradiation.
For both cohorts, patients who had partial-breast irradiation reported less pain at the end of treatment. Among the group who did not undergo chemotherapy, patients who had partial-breast irradiation reported more pain at 36 months, whereas there seemed to be no difference for those who were treated with chemotherapy.
“There is no denying that the 5-day treatment is less costly and disruptive to life,” commented Julia White, MD, of The Ohio State University Comprehensive Cancer Center–Arthur G. James Cancer Hospital and Richard J. Solove Research Institute, who is co-principal investigator of this trial. “A significant portion of the breast cancer patient population nationally—about 25,000 to 30,000 women—would qualify for partial-breast irradiation.”
Disclosure: The study authors’ disclosure information may be found at coi.asco.org.
