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WEDNESDAY, Aug. 20, 2003 (HealthDayNews) -- A woman with breast cancer who undergoes limited-field radiation after surgery has similar survival and recurrence rates as a woman who receives whole-breast radiation, researchers report.
"For about 10 years, we have been looking at whether limited-field radiation, which limits radiation to the tumor site and a small surrounding area, is as effective as treating the whole breast in patients with early-stage breast cancer," says Dr. Frank A. Vicini, the chief of oncology at William Beaumont Hospital in Royal Oak, Mich.
Vicini notes that the current report represents five-year results of 199 women with early-stage breast cancer who were treated with limited-field radiation after breast-conserving surgery. Vicini and his colleagues compared these women with 199 similar women who were treated with whole-breast radiation therapy.
The researchers found that for women in both groups there was no difference in the median time to the recurrence of cancer or to recurrence of cancer at the same location. Vicini's team also found that there was no difference between the women in the spread of cancer beyond the breast or in survival.
Their results appear in the Aug. 20 issue of the Journal of the National Cancer Institute.
Vicini says the advantages of limited-field radiation therapy include a shorter treatment cycle -- five days compared with six weeks for whole-breast radiation -- and fewer side effects.
"These results look good," Vicini says. "But are they good enough to say that this is the standard of care?"
While randomized trials that compare both treatments are going on in Europe, Vicini would like to see a randomized study done in the United States.
The advantage of such a study is that it would identify the kind of patients most likely to benefit from limited-field radiation therapy.
The disadvantage is that it will take many years to complete. In the meantime, physicians are offering limited-field radiation therapy now, Vicini says. He cautions that limited-field radiation therapy, like many other therapies, may become the standard of care without proper study.
Vicini says he thinks limited-field radiation is appropriate therapy in a select group of patients, namely those women with an early-stage cancer that has not spread to the lymph nodes and has a clearly defined tumo .
There is a limit to the patients who will benefit from this treatment, Vicini adds. But he feels the treatment will be beneficial to most women with early-stage cancer who undergo breast-conserving surgery.
Vicini advises that women considering limited-field radiation right now should discuss it with their physician.
In an editorial in the journal accompanying the study, Dr. Paul Wallner, the chief of radiation oncology at the National Cancer Institute, and his colleagues recommend randomized trials before limited-field radiation therapy is widely used.
"But we recognize that physicians will use this therapy now and trials will take a long time," Wallner says.
"We are raising a note of caution. One of our concerns is that people will think this therapy is applicable to a different group of patients than it was tested on," he adds.
Wallner says patients may elect to have the therapy, but they need to have all the data, so they should ask their physicians.
"Physicians should be sure to tell their patients that the results are based on small studies among highly selected patients," he adds.
More information
To learn more about breast cancer treatment, visit the National Cancer Institute or the American Cancer Society.
