Increasing radiation dose shortens treatment time for women who choose breast sparing treatment

at in addition to safely increasing the dose to the whole breast during the four-week period, it is possible to deliver the "boost" concurrently, eliminating the extra two weeks.

"When delivering high doses of radiation, we have to consider the level of side effects and the cosmetic result," explained Freedman. "In this phase II study, women reported acceptable side effects, and the cosmetic result was similar to the longer six-week treatment course."

The study included 75 women treated with 2.25 Gy for 20 days (versus 2 Gy per day with conventional therapy) and a 2.8 Gy boost concurrently (versus sequentially delivering the boost after whole breast irradiation). The primary endpoint was acute skin toxicity.

"Acute toxicity on this clinical trial is not only acceptable but also compares favorably with the results seen for conventional standard fractionated radiation therapy," Freedman said.

At the end of treatment, none of the women had grade 3 or 4 skin toxicity or dermatitis (skin inflammation). Twelve percent had grade 0, 65 percent had grade 1, and 23 percent had grade 2 dermatitis. All toxicity had resolved within six weeks after treatment.

"Cosmetic results for this treatment were also acceptable," noted Freedman. "There was no difference between the cosmetic appearance before and six weeks after treatment."

Monica Morrow, M.D., chairman of surgery at Fox Chase and a co-author of the study. is an expert in patient-decision making. "Many women with breast cancer are working, have families, volunteer or have other commitments," she pointed out. "When they consider whether to have a lumpectomy or mastectomy, the time-commitment of treatment and recovery carries significant weight.

"Women may prefer a lumpectomy but often choose a mastectomy to avoid the time needed for the radiation. We believe this research is a big step in reducing the barriers for choosing breast conserving surgery." Freedman concluded by cal

Contact: Karen Mallet
Fox Chase Cancer Center

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