publication date: Mar. 16, 2018

Clinical Roundup

ASTRO issues updated clinical guideline for whole breast radiation therapy

The American Society for Radiation Oncology issued a clinical guideline for the use of whole breast radiation therapy for breast cancer that expands the population of patients recommended to receive accelerated treatment known as hypofractionated therapy.

With hypofractionated WBI, patients receive larger doses of radiation across fewer treatment sessions—typically completing treatment in three to four weeks, compared with five to seven weeks for conventional treatment.

Reflecting current evidence from clinical trials and large cohort studies, the new guideline recommends hypofractionated WBI for breast cancer patients regardless of age, tumor stage and whether they have received chemotherapy. It replaces the existing ASTRO WBI guideline published in 2011.

“Previously, accelerated treatment was recommended only for certain patients, including older patients and those with less advanced disease, but recent long-term results from several large trials strongly support the safety and efficacy of accelerated treatment for most breast cancer patients,” said Benjamin Smith, co-chair of the guideline task force and an associate professor of radiation oncology at the University of Texas MD Anderson Cancer Center in Houston. “Conventional therapy does not provide an incremental benefit in either tumor control or side effects compared to hypofractionated WBI.”

Despite the data supporting accelerated treatment, large numbers of eligible breast cancer patients are not receiving shorter courses of radiation therapy. A 2013 JAMA study found an adoption rate of approximately 30 percent, and a 2017 analysis for Kaiser Health News indicated that fewer than half of patients over age 50 with early-stage disease receive the accelerated treatment.

The guideline provides clinical guidance for dosing, planning and delivering WBI with or without an additional “boost” of radiation … Continue reading ASTRO issues updated clinical guideline for whole breast radiation therapy

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