When radiotherapy is given after surgery for breast cancer it involves a number of treatments over several weeks. Each treatment is known as a fraction. Over the years different cancer hospitals developed different patterns of giving radiotherapy for their breast cancer patients. Some preferred longer courses of treatment, giving 25 or 30 fractions over 5 or 6 weeks. Others preferred shorter schedules, with 15 or 20 fractions over 3 to 4 weeks. When fewer fractions are given, the dose of each fraction is higher.
Several research studies have looked at comparing these different ways of giving radiotherapy and showed that giving radiotherapy treatment over 3 weeks is just as effective at preventing breast cancer from coming back as giving the treatment over 6 weeks. The side effects are the same with the shorter course of treatment as the long course of treatment.
A very large UK study, called the START trial, is looking at the optimum dose and number of fractions to give after breast cancer surgery. But, it will be some time before the results are known. However, a recent survey has shown that many cancer specialists in Britain have already started using a 3 or 4 week course of treatment for their breast cancer patients.
Having the radiotherapy over a shorter time can be much better for patients and less disruptive to their lives. It also eases the strain on hard-pressed radiotherapy departments, many of which have waiting lists for treatment.
References
- Owen JR et al. Effect of radiotherapy fraction size on tumour control in patients with early-stage breast cancer after local tumour excision: long-term results of a randomised trial. Lancet Oncology, May 2006
- Williams MV et al. National survey of radiotherapy fractionation practice in 2003. Clinical Oncology, 2006; 18: 3-14