Radiotherapy Advance: New Trial Cuts Breast Cancer Treatment Time by a Week

The University of Cambridge and The Institute of Cancer Research in London have led a trial that has good news for some early breast cancer patients.

The IMPORT HIGH trial, published in The Lancet, shows that giving an extra dose of radiotherapy at the same time as the regular treatment can shorten the overall treatment time by at least one week.

Funded by Cancer Research UK and the National Institute of Health Research and Care Research (NIHR), the trial found that this method, known as simultaneous integrated boost (SIB), works as well as the current radiotherapy techniques in lowering the chance of cancer coming back in the breast.

The results showed that five years after treatment, the cancer had not returned in most patients. Also, patients who received the lower dose of SIB had side effects similar to those who received the standard treatment.

At present, women with a high risk of cancer coming back receive an extra radiotherapy dose after the whole breast has been treated. This approach is effective but takes longer and requires more hospital visits. SIB can cut the treatment time to just three weeks.

However, it’s essential to note that the boost treatment can lead to long-term side effects, including changes in the breast, which can affect self-esteem.

In this trial, 2,617 patients participated. They were divided into three groups. The first group received the standard treatment, while the second and third groups received different doses of SIB.

Professor Charlotte Coles, from Cambridge University and chief investigator for the trial, said, “Some women have to live with permanent breast changes after radiotherapy which may affect their well-being. With SIB, we can deliver high-quality effective radiotherapy whilst minimizing toxicity from it.”

She added, “This is a careful step towards even shorter courses of radiotherapy that include more complex techniques. By delivering more targeted boost radiotherapy over shorter time periods, women can get on with their lives more quickly.”

Another trial, the FAST Forward trial, showed that whole breast radiotherapy could be given in one week. Researchers are now looking to see if SIB can also be done in one week.

Professor Judith Bliss, from The Institute of Cancer Research, London, said, “For some patients who have a higher risk of seeing their cancer return in the treated breast, delivering an extra, targeted boost of radiotherapy to breast tissue close to the original tumor site is an effective way to lower that risk and help keep cancer from returning to the breast.”

She also said, “IMPORT HIGH has uncovered how we can streamline our delivery of these radiotherapy boosts – giving them simultaneously with whole breast radiotherapy – without impacting the effectiveness of treatment, or causing patients additional side effects. We hope this trial will change clinical practice – allowing women to benefit from sophisticated radiotherapy delivery with shorter treatment times and fewer hospital visits.”

The team believes that SIB could lower the costs for patients and reduce the time taken for treatment and recovery. It can be adopted quickly by healthcare systems since it uses standard radiotherapy equipment.

Michelle Mitchell, Chief Executive of Cancer Research UK, said, “At a time when health services across the UK are facing chronic staff shortages in cancer services, we need to look at new ways to get more patients treated as quickly as possible. In addition to training up more staff, more precise forms of radiotherapy can help to reduce the number of people who are waiting too long to begin vital treatment.”

She concluded, “Trials like IMPORT HIGH are leading the way in delivering smarter radiotherapy with existing technology. We hope that treatment centers across the UK and globally will rapidly adopt this approach to beat breast cancer sooner and give patients more precious time with their loved ones.”

Coles, CE et al. Dose-escalated simultaneous integrated boost radiotherapy in early breast cancer (IMPORT HIGH): a multicentre, phase

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