Chemo plus radiation improve breast cancer outcome
NEW YORK (Reuters Health) - Following surgery, treatment with chemotherapy and radiation at the same time, rather than at different times, seems to improve the odds that a breast cancer won't return, according to a report in the International Journal of Radiation Oncology Biology Physics.
Dr. Bruce Haffty, of the Robert Wood Johnson Medical School-UMDNJ in New Brunswick, New Jersey, and colleagues studied 535 women with breast cancer who underwent lumpectomy, plus radiation and chemotherapy at a major medical center. Chemotherapy and radiation were administered concurrently or in aious sequences.
The overall survival rate at 10 years was 78 percent, and 75 percent of the women had no evidence of cancer in distant organs.
Despite experiencing more side effects, 92 percent of patients who received concurrent radiation and chemotherapy showed no signs that their cancer had returned. When radiation and chemotherapy were given at different times, the percentage was significantly lower, 83 percent.
The researchers note that although there have been concerns about more side effects with simultaneous treatment, the approach had acceptable cosmetic results, severity of side effects, and long-term complication rates.
Still, because outcomes are generally good with sequential therapy, the researchers do not currently recommend the use of concomitant therapy outside of clinical studies.
"The challenge over the next few years," Haffty points out, "is to identify those patients who would best benefit from this strategy." This, he concluded, can best be accomplished by forward-looking) clinical trials.
SOURCE: International Journal of Radiation Oncology Biology Physics, December 1, 2006.
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Chemo plus radiation improve breast cancer outcome
The results of this study could be of importance to you if you are going to receive both radiation and chemotherapy around the time of surgery for early, invasive breast cancer.
Early breast cancer is considered invasive when the cancer has grown beyond the milk ducts or lobules of the breast where it first started. Non-invasive breast cancer is usually called "in-situ" cancer—ductal or lobular carcinoma-in-situ (DCIS, LCIS). In addition to surgery, most women with early, invasive breast cancer will also receive radiation therapy and often some form of chemotherapy. The radiation therapy may be followed by chemotherapy, or chemotherapy may be given first—sometimes even before surgery. Chemotherapy and radiation therapy are used in this way to lower the risk of the cancer ever coming back after surgery (recurrence).
The research reported here tried to answer the question of whether giving the radiation and chemotherapy at the same time (simultaneous therapy) would be better than giving them at different times (sequential therapy).
The researchers found that ten years later, women who received radiation and chemotherapy at the same time were less likely to have their breast cancer come back. 92% of women who received radiation and chemotherapy at the same time remained breast cancer free ten years later. Only 83% of women who received the two forms of treatment at different times remained free of breast cancer. That lowered risk of breast cancer recurrence came at some price, in the form of more side effects during treatment.
Most cancer specialists today give radiation and chemotherapy in sequence. That will probably remain the "standard" until more information about simultaneous therapy is available. If you have recently been diagnosed with early, invasive breast cancer and your doctors are considering both radiation and chemotherapy around the time of your surgery you can talk to them about the timing of those treatments and the results of the research reported here.