- Researchers conducted studies using new approaches to radiation therapy for patients with cancer.
- One study examined FLASH radiation—radiation delivered using ultra-high dose rates—in patients with bone cancer, and another study focused on patients with breast cancer.
- The therapies appeared effective and reduced treatment duration for breast cancer patients by a few weeks.
- Both studies yielded promising results for new approaches to radiation therapy in cancer treatments.
A study presented at the American Society for Radiation Oncology (ASTRO) Annual Meeting showed that it may be possible to cut radiation treatment length in half for some breast cancer patients.
As a result of using fewer, but higher, doses of radiation following surgery, while concurrently delivering a radiation boost to the surgical site, scientists managed to reduce the average treatment length from 4–6 weeks to 3 weeks.
Another study showed the feasibility of FLASH radiation treatment, whereby radiation is delivered using ultra-high dose rates.
How prevalent is breast cancer?
Breast cancer develops as a result of genetic mutations or damage to DNA, and instead of the body attacking the mutation, the breast cells multiply. According to the Centers for Disease Control and Prevention (CDC), breast cancer typically starts in the milk ducts or glands.
The CDC also notes that “Breast cancer can spread outside the breast through blood vessels and lymph vessels. When breast cancer spreads to other parts of the body, it is said to have metastasized.”
According to the CDC, 1 in 8 women will develop breast cancer throughout their lives. Statistics from the American Cancer Society (ACS) state that 1 in 39 women with breast cancer will die from the disease.
There are many ways to describe breast cancer, including whether the cancer has spread or not. In situ breast cancer refers to pre-cancer that has not spread, unlike invasive breast cancer which the ACS describes as cancer that has spread from its initial site into the surrounding breast tissue.
Some symptoms of breast cancer include:
- a lump in the armpit or breast
- nipple discharge (not including breast milk)
- breast pain
- swelling in the breast
Early detection of breast cancer is key to getting it treated successfully, which is why self-exams are important.
Treating breast cancer
Depending on when breast cancer is detected and which type it is, there are different treatments available, including surgery, chemotherapy, and radiation therapy.
People with breast cancer are often treated using multiple approaches, with doctors from different specialties working together to provide optimum care.
Doctors may prescribe systemic treatment for breast cancer, and according to the ACS, these treatments are able to reach cancer cells almost anywhere in the body. Systemic treatments include chemotherapy, hormonal therapy, targeted drug therapy, and immunotherapy.
Radiation is another breast cancer treatment. This treatment uses high-energy particles to target cancer cells and is often used following tumor removal to lower the risk of cancer coming back.
Both systemic and radiation treatments can cause side effects such as hair loss and fatigue.
Reducing the length of radiation treatment
A study led by Dr. Frank A. Vicini, a radiation oncologist at MHP Radiation Oncology Institute in Michigan, examined different approaches to radiation therapy in breast cancer patients who recently had lumpectomies.
The researchers placed participants in one of two groups. They gave one group conventional radiation therapy with a subsequent radiation boost, lasting 4 to 6 weeks in total. The second group was given fewer, but higher, doses of radiation, while concurrently receiving a radiation boost; this treatment lasted for 3 weeks.
The findings were promising; not only was the shortened approach just as effective as the conventional treatment with a sequential radiation boost, but it also did not cause more side effects or cosmetic damage compared to the longer course of treatment.
“Adding a radiation boost reduces the likelihood of tumor recurrence in the breast by 20 to 30%, but delivering that boost after hypofractionated radiation therapy adds another week to treatment. This can be challenging for patients who need to take time off work or travel long distances for treatment,” says Dr. Vicini.
First-in-human trial for FLASH radiation
Another study presented at ASTRO investigated using FLASH radiation—whereby ultra-high dose rates are used to deliver radiation—in patients with “painful extremity bone metastases.”
The researchers tested FLASH radiation on a small group and found that the majority of their participants saw a reduction in pain. The researchers think this treatment may be useful in tumors that are harder to treat.
“Our study shows FLASH radiotherapy with protons is a practical modality to reduce pain,” said Dr. Emily C. Daugherty, lead study author and an assistant professor of clinical radiation oncology at the University of Cincinnati Cancer Center.
“It deserves further exploration because of its potential to decrease the side effects associated with conventional radiation treatments,” she added.
What experts think about new approaches to radiation
Dr. Dorraya El-Ashry, chief scientific officer at the Breast Cancer Research Foundation, spoke with MNT about the breast cancer study.
“This study reveals a promising avenue to reduce the burden of treatment on patients by improving quality of life while achieving the same outcomes,” commented Dr. El-Ashry.
“Radiation therapy can cause side effects like serious skin irritations and even impact reconstruction options, but this study reveals an approach to explore how to reduce these consequences through a potentially shorter time frame of treatment.”
— Dr. Dorraya El-Ashry
Dr. El-Ashry stressed that further studies are needed and said she looks forward to the phase III trials.
“We are constantly striving to help patients live fuller lives without sacrificing the quality of care,” she said.
Dr. Mona Karim, vice chair of radiation oncology at Morristown Medical Center, located in Morristown, New Jersey, believes FLASH radiation has a lot of potential if research continues.
“FLASH radiation means giving radiation very quickly, at an ultra-high dose rate, up to 400 times faster than we normally do,” Dr. Karim explained in an interview with Medical News Today.
“Now that the first human feasibility trial has been performed, the gates are open to new studies of using ultra-high dose rates to treat cancers in different parts of the body,” she said.
“FLASH radiation is in its infancy and its progress will rely on physicians and physicists working together to make it a safe and effective treatment.”
— Dr. Mona Karim
Dr. Karim also noted that current radiation machines will require updates to provide FLASH radiation.
“The complicating factor is that standard radiation machines need unique modifications to make the ultra-high dose rates of FLASH radiation possible and that dose calculation (called dosimetry) and checking the delivered dose is very challenging because most radiation detectors are not adequate for such ultra-high dose rate beams,” she concluded.
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