Breast Cancer and COVID-19: Alternative Radiation Therapies
Posted: Wednesday, June 3, 2020
Amid the COVID-19 pandemic, efforts have been made to reduce patient and staff exposure to the virus by implementing alternative hypofractionation and accelerated partial-breast irradiation regimens for patients with breast cancer. “A 5-fraction regimen of accelerated partial breast irradiation for these eligible patients with breast cancer could reduce the number of daily treatment visits by approximately 500 and 900 for 16- and 25-fraction regimens, respectively,” advised Lisa Barbera, MD, MPA, of Tom Baker Cancer Center, Alberta, Canada, and colleagues in a Letter to the Editor in Advances in Radiation Oncology.
Hypofractionation irradiation for breast cancer had been reduced from a standard 5-week fractionation of 50 Gy in 25 fractions to 42.5 Gy in 16 fractions or 40 Gy in 15 fractions, resulting in increased efficacy and low overall toxicity. These alternative hypofractionation regimens have demonstrated similar local control and cosmetic outcomes for patients following breast conservation therapy. In addition, the UK FAST FORWARD study is currently examining the therapeutic benefit of a 1 week 5-fraction treatment regimen; however, the outcome has yet to be determined.
There is mounting evidence supporting accelerated partial-breast irradiation as a treatment option for early-stage breast cancer. Results from two, phase III randomized trials—RAPID and NSABP B39/Radiation Therapy Oncology Group 0413—have demonstrated no significant differences in an accelerated partial-breast irradiation regimen when compared with whole-breast irradiation. Currently, many treatment centers have begun utilizing the 27 Gy 5-fraction therapy option, as it has the potential to reduce visits by 10, 11, or 20 treatments for patients with breast cancer.
“For our patient population, approximately 40% of patients with breast cancer are suitable candidates for accelerated partial-breast irradiation,” stated Dr. Barbera and colleagues.
Disclosure: For full disclosures of the authors, visit advancesradonc.org.