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Treliske leads way in new radiotherapy treatment study

Treliske leads way in new radiotherapy treatment study

Published by Sarah Yeoman at 8:58am 6th May 2020. (Updated at 9:02am 6th May 2020)

The Royal Cornwall Hospital has helped lead the the way in a new breast cancer treatment study.

300 people across the Duchy took part at Treliske as part of the nation-wide research into radiotherapy.

It found that a one-week course of treatment in fewer but larger daily doses was just as safe and effective as a standard three-week therapy for women following surgery for early stage breast cancer,

The protocol is now being eagerly sought by hospitals to help reduce demands on the NHS during the Covid-19 pandemic.

It is feared that people who are showing symptoms of cancer are avoiding seeking medical help because of coronavirus fears and not wanting to be a strain on the health service.

More about the study:

The study, involving more than 4,000 patients in total, evaluated the effectiveness of two different radiotherapy doses each delivered over five days in one week compared with standard radiotherapy currently delivered in 15 doses over three weeks.

Researchers found that delivering a shorter course to women who have undergone surgery for early stage breast cancer was as safe and effective as the current standard of three weeks.

The trial, which recruited patients from 97 NHS hospitals in the UK, shows how treatment times can be reduced for patients while saving precious healthcare resources.

doctor health

What do experts say?

“This landmark trial reveals that a one-week schedule promises to become a new international standard for women with operable breast cancer requiring radiotherapy.

"This has major benefits in terms of convenience and costs for both patients and healthcare services globally at a time when they face increasing challenges.”

Professor Murray Brunt, the study’s clinical Chief Investigator from the University Hospitals of North Midlands and University of Keele

“We’re always looking for ways to refine and enhance cancer treatment so we can make it more effective and improve the experience for patients. No one would want to come up to hospital for three weeks of radiotherapy if they can get the same benefit in just one week.

“We expect these findings will be incorporated into breast cancer treatment guidelines around the world and we’re already seeing NHS hospitals wanting to move to the 5-dose schedule because of the challenges they’re facing during the coronavirus pandemic.”

Professor Judith Bliss, Professor of Clinical Trials at The Institute of Cancer Research, London, and Director of its Clinical Trials and Statistics Unit, and joint senior author of the study

doctor

How did the study work and what did it find?

Breast cancer is the most common cancer affecting women worldwide, with many of the wealthiest countries using around 30% of their total radiotherapy services for treating breast cancer.

There are around 55,200 of new cases of breast cancer a year in the UK – around 150 a day.

In total 81% of patients diagnosed have surgery to remove the tumour as part of their primary cancer treatment, with 63% undergoing radiotherapy.

Reducing standard radiotherapy treatment for breast cancer from 3 weeks to 1 week would save the NHS over £40 million per year.

Historically women received radiotherapy in 25 daily doses (‘fractions’) over five weeks. The UK START clinical trials, co-ordinated by The Institute of Cancer Research (ICR) reduced standard treatment to 15 daily doses in three weeks over 10 years ago.

In this latest study, researchers looked to reduce the number of doses and overall time even further.

A total of 4,096 patients who underwent surgery for their breast cancer were recruited from 97 UK centres between 2011 and 2014 and randomly allocated to one of three treatment options. A third of participants received the standard schedule of 15 daily doses amounting to a total overall dose of 40 Gy (Gray, or Gy = unit of radiation dose) in three weeks. The remaining patients were split into two groups, each receiving five daily treatments in one week, with a total dose of either 26 Gy or 27 Gy.

The study collected detailed information following treatment, including assessments of side effects from patients and health professionals. At five years after radiotherapy, the risk of cancer coming back in the same breast was very low and similar between all three treatment group. Long-term side effects were similar after the 26 Gy one-week schedule compared with the standard three-week schedule.

More information on the study is available here.

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