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Lower Dose Radiation

Posted 1/13/2013

Posted in

  As you well know, radiation therapy is part of breast cancer treatment for many women. With a few exceptions, women who have a lumpectomy/wide excision have radiation as part of the local treatment package. Some women who have mastectomies also receive radiation. When I began working at BIDMC (then BIH, Beth Israel Hospital), it was one of three hospitals in the country that offered this treatment to some women with early breast cancer. We always had women staying at hotels, with friends, anywhere they could find for six to seven weeks while they had the radiation that they could not receive at home. Clearly, this was difficult and added more stress to what is already a tough situation.

  There have been a number of studies looking at the standard six/seven weeks of radiation with the question as to whether a lower dose (meaning less time) would be equally effective. This one, the UK START study, was presented last month in San Antonio and described ten year follow up of women who received a lower dose of radiation vs those who received the standard longer course. As an aside, less radiation would also be less expensive, and, if it is equally good, that is pretty important as we stuggle with rising health care costs.

  This is a brief excerpt from and then a link to read more:

A British study compared the standard radiation therapy schedule to shorter, lower­dose radiation schedules and found that the risk of early­stage breast cancer coming back (recurrence) was about the same for all the schedules. The lower­dose schedules also had fewer effects on healthy breast tissue.

The research, "The UK START (Standardisation of Breast Radiotherapy) Trials; 10­year follow­up results" was presented at the 2012 San Antonio Breast Cancer Symposium.

After surgery to remove early­stage breast cancer (either lumpectomy or a type of mastectomy), radiation therapy often is used to reduce the risk of recurrence. Radiation therapy after breast cancer surgery is usually given as one treatment per day, 5 days a week for 5 to 7 weeks. A Gray is the way radiation oncologists measure the dose of radiation therapy; if you’re on a 5­week treatment schedule, 50 Gray is the usual amount given during the 5 weeks (2 Gray at each treatment). A supplemental "boost" dose may be included at the end of the regimen that targets the area where the cancer was.

Radiation treatment schedules have been developed based on research results. But a 5­ to 7­week commitment may be difficult for some women, especially if they live far away from a treatment center.


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