Featured Research

from universities, journals, and other organizations

Intensity modulated radiotherapy reduces side effects in patients with early breast cancer

Date:
April 21, 2013
Source:
ESTRO
Summary:
Intensity modulated radiotherapy (IMRT) gives better results than standard radiotherapy in patients with early breast cancer, according to results from a randomized trial. IMRT is an advanced, high-precision form of radiotherapy that can deliver an even dose of radiation, thus reducing the cosmetic problems that can often occur after breast radiotherapy.

Intensity modulated radiotherapy (IMRT) gives better results than standard radiotherapy in patients with early breast cancer, according to results from a randomised trial presented today (Sunday) to the 2nd Forum of the European Society for Radiotherapy and Oncology (ESTRO). IMRT is an advanced, high-precision form of radiotherapy that can deliver an even dose of radiation, thus reducing the cosmetic problems that can often occur after breast radiotherapy.

Related Articles


"We believe that this study, the largest prospective trial in the world to test breast IMRT against standard two-dimensional radiotherapy, will be practice-changing at an international level," said Dr Charlottes Coles, from Addenbrooke's Hospital Oncology Centre, Cambridge, UK. "Analysing the results five years after treatment, we saw significant benefits in patients who had received IMRT."

The researchers analysed the radiotherapy treatment plans of 1145 patients with early breast cancer who had previously had breast-conserving surgery. The plans were screened to see if they would produce an uneven radiation dose with standard two-dimensional radiotherapy (2DRT). A total of 71% of the plans fell into this category, and those patients were randomised between standard 2DRT and IMRT. The 29% of patients whose plans would not produce an uneven dose were treated with standard 2D RT, but still followed up within the trial.

One of the aims of external radiotherapy is to treat the target -- in this case the whole breast -- with an even dose distribution, i.e. within a range of 95% to 107% of the prescribed dose. Too low a dose can risk tumour recurrence, and too high a dose can cause undesirable side-effects such as skin changes.

"The problem with 2D breast radiotherapy is that the dose distribution is only recorded across the central part of the breast. Usually it meets the 95-107% constraints, but the shape of the breast changes, so if the same plan is looked at in 3D, then there may well be areas with overly high doses. By modulating the intensity of the radiation beam, IMRT can be used to correct for this and smooth out the dose," said Dr Coles.

The researchers set out to see whether the effect of using IMRT in those patients who would have received a dose greater than 107% to parts of their breast with 2DRT would translate into clinical benefit. IMRT planning uses results from scans to determine the dose intensity that will best treat the tumour, and therefore is more complex and time-consuming than 2DRT planning, so there was an important need to see a clear advantage to patients from the use of the procedure.

The only previous study looking at this was much smaller, and rather than picking out all patients with doses greater than 107% and randomising them, it only included women with larger breasts who are already known to be more likely to have regions of dose above the upper limit. "Our trial was more inclusive as all women were able to take part and we could quantify those who would receive an uneven dose," said Dr Coles.

"We saw that fewer patients in the IMRT group developed skin telangiectasia (dilated blood vessels near the surface of the skin), and the overall cosmetic effect in the breast was better," she said. Although there was no significant difference between the two groups in breast shrinkage, breast oedema, breast induration (hardening), and pigmentation changes, the benefits of using IMRT in these patients were clear.

The researchers intend to follow up their work by analysing the patients' questionnaires to see whether IMRT has an influence on quality of life. The trial has also contributed 1000 blood samples to the UK translational research study RAPPER (Radiogenomics: Assessment of Polymorphisms for Predicting the Effects of Radiotherapy), which aims to ultimately develop individualised radiotherapy plans based on the analysis of individual patients' genetics.

"Although IMRT is employed increasingly in breast cancer, its use is far from universal throughout the world. We hope that the evidence of benefit shown in our trial will encourage its greater use, resulting in improved patient access and, ultimately, improved outcomes for breast cancer patients," said Dr Coles.

President of ESTRO, Professor Vincenzo Valentini, a radiation oncologist at the Policlinico Universitario A. Gemelli, Rome, Italy, said: "This study not only shows a better outcome for the women treated with IMRT, but has an additional value in defining the selection criteria for providing treatment to those patients who will benefit from new frontline technologies. In the study design, the patients who could be treated satisfactorily by standard technology were not referred for IMRT, avoiding the use of a complex technique where it was not necessary. At a time when resources are limited, individualised medicine can help us offer new technology only to those patients who will have a tangible benefit from it."


Story Source:

The above story is based on materials provided by ESTRO. Note: Materials may be edited for content and length.


Cite This Page:

ESTRO. "Intensity modulated radiotherapy reduces side effects in patients with early breast cancer." ScienceDaily. ScienceDaily, 21 April 2013. <www.sciencedaily.com/releases/2013/04/130421074507.htm>.
ESTRO. (2013, April 21). Intensity modulated radiotherapy reduces side effects in patients with early breast cancer. ScienceDaily. Retrieved December 20, 2014 from www.sciencedaily.com/releases/2013/04/130421074507.htm
ESTRO. "Intensity modulated radiotherapy reduces side effects in patients with early breast cancer." ScienceDaily. www.sciencedaily.com/releases/2013/04/130421074507.htm (accessed December 20, 2014).

Share This


More From ScienceDaily



More Health & Medicine News

Saturday, December 20, 2014

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

The Best Tips to Curb Holiday Carbs

The Best Tips to Curb Holiday Carbs

Buzz60 (Dec. 19, 2014) It's hard to resist those delicious but fattening carbs we all crave during the winter months, but there are some ways to stay satisfied without consuming the extra calories. Vanessa Freeman (@VanessaFreeTV) has the details. Video provided by Buzz60
Powered by NewsLook.com
Sierra Leone Bikers Spread the Message to Fight Ebola

Sierra Leone Bikers Spread the Message to Fight Ebola

AFP (Dec. 19, 2014) More than 100 motorcyclists hit the road to spread awareness messages about Ebola. Nearly 7,000 people have now died from the virus, almost all of them in west Africa, according to the World Health Organization. Video provided by AFP
Powered by NewsLook.com
Researchers Test Colombian Village With High Alzheimer's Rates

Researchers Test Colombian Village With High Alzheimer's Rates

AFP (Dec. 19, 2014) In Yarumal, a village in N. Colombia, Alzheimer's has ravaged a disproportionately large number of families. A genetic "curse" that may pave the way for research on how to treat the disease that claims a new victim every four seconds. Duration: 02:42 Video provided by AFP
Powered by NewsLook.com
Double-Amputee Becomes First To Move Two Prosthetic Arms With His Mind

Double-Amputee Becomes First To Move Two Prosthetic Arms With His Mind

Buzz60 (Dec. 19, 2014) A double-amputee makes history by becoming the first person to wear and operate two prosthetic arms using only his mind. Jen Markham has the story. Video provided by Buzz60
Powered by NewsLook.com

Search ScienceDaily

Number of stories in archives: 140,361

Find with keyword(s):
Enter a keyword or phrase to search ScienceDaily for related topics and research stories.

Save/Print:
Share:

Breaking News:

Strange & Offbeat Stories


Health & Medicine

Mind & Brain

Living & Well

In Other News

... from NewsDaily.com

Science News

Health News

Environment News

Technology News



Save/Print:
Share:

Free Subscriptions


Get the latest science news with ScienceDaily's free email newsletters, updated daily and weekly. Or view hourly updated newsfeeds in your RSS reader:

Get Social & Mobile


Keep up to date with the latest news from ScienceDaily via social networks and mobile apps:

Have Feedback?


Tell us what you think of ScienceDaily -- we welcome both positive and negative comments. Have any problems using the site? Questions?
Mobile: iPhone Android Web
Follow: Facebook Twitter Google+
Subscribe: RSS Feeds Email Newsletters
Latest Headlines Health & Medicine Mind & Brain Space & Time Matter & Energy Computers & Math Plants & Animals Earth & Climate Fossils & Ruins