Women with early breast cancer have fewer side effects when they’re treated with shorter courses of radiation at higher doses than with conventional radiation to the whole breast. These findings were reported in JAMA Oncology.
Treatment with shorter course of radiation at higher doses is known as hypofractionated radiation therapy. This approach allows for less overall radiation than conventionally fractionated regimens. Fractionated refers to the separation of the total radiation into separate doses. According to earlier research, this approach can be as effective in breast cancer as traditional radiation therapy while reducing overall patient exposure to radiation and requires less time.
When it comes to radiation treatment for early breast cancer, experts haven’t yet established the best dose for whole-breast radiation. Disease outcomes and side effects help guide these decisions. A recent study compared side effect and quality-of-life outcomes between breast cancer patients who had received hypofractionated radiation and patients who received conventional radiation.
A total of 287 women with early-stage breast cancer participated in the study. All had undergone breast-conserving therapy and then received either conventional radiation (149 patients) or hypofractionated radiation (138 patients). Patients joined the study between February 2011 and February 2014 and were followed for a minimum of six months after completing treatment. To allow for as fair a comparison as possible, both treatment groups were closely matched for health and quality-of-life characteristics.
Six months after treatment, patients who received hypofractionated radiation tended to have fewer side effects than those who received conventional radiation therapy. Specifically, the patients in the hypofractionated group had lower rates of skin inflammation (36% versus 69% in the conventional group); itching (54% versus 81%); breast pain (54% versus 81%); darker patches of skin, or hyperpigmentation (9% versus 20%); and fatigue (9% versus 17%). In addition, the patients in the hypofractionated group experienced less fatigue (47% versus 78%), less lack of energy (23% versus 39%), and less trouble meeting family needs (3% versus 9%).
According to these findings, six months after finishing treatment, patients with early breast cancer who are treated with hypofractionated radiation therapy have fewer serious side effects and less interruption in their daily lives than those who receive conventional radiation therapy. Combined with previous findings that hypofractionated radiation can be as effective in early breast cancer as conventional radiation, this information can help doctors and patients choose the most appropriate approach to radiation for each individual.
 Shaitelman SF, Schlembach PJ, Arzu I, et al. Acute and Short-term Toxic Effects of Conventionally Fractionated vs Hypofractionated Whole-Breast Irradiation: A Randomized Clinical Trial. JAMA Oncology [early online publication]. August 6, 2015.
 Haviland JS, Owen JR, Dewar JA, et al. The UK Standardisation of Breast Radiotherapy (START) trials of radiotherapy hypofractionation for treatment of early breast cancer: 10-year follow-up results of two randomised controlled trials. The Lancet Oncology. 2013; 14(11): 1086 – 1094.
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