A breast cancer treatment that unleashes less radiation and requires only a few days of treatment has cleared a major hurdle.
Researchers at the annual meeting of the American Society for Therapeutic Radiology and Oncology (ASTRO) on Tuesday announced the results of a five-year randomized trial of the treatment known as accelerated partial breast irradiation (APBI) in patients with early stage breast cancer.
The researchers said the trials showed APBI brachytherapy has equivalent overall survival and local cancer control rates compared to the more common whole breast irradiation (WBI) treatment.
The results were published today in the Lancet.
APBI is a more targeted treatment requiring less radiation, and it is completed in five days compared to six weeks for WBI.
“This is a true paradigm shift in medicine,” said Dr. Robert Kuske, a pioneer in APBI treatment. “It’s like a sigh of relief.”
Right now, WBI accounts for 85 percent of early stage breast cancer treatment, with the remainder being APBI. Both APBI and WBI are used after lumpectomies.
Kuske, an oncologist at Arizona Breast Cancer Specialists, said he hopes APBI will quickly jump to 25 percent of treatment and continue upward from there.
He expects that patients who want shorter treatment time and less radiation will power the increase.
“One thing that’s going to drive all this is women,” he said.
The Differences in the Treatments
Kuske began experimenting with APBI in 1991. It caught on in some academic medical institutions during that decade.
The treatments started to become more widespread in 2002 when the Food and Drug Administration approved some of the products needed for APBI.
Kuske said WBI basically blasts the entire breast with radiation from the outside in. The radiation can reach part of the lungs as well as the coronary artery.
There are three methods of APBI. Each involves slipping a catheter-like tube inside the lumpectomy cavity and releasing targeted radiation from the inside out.
In the five-year trial, researchers studied 1,184 early stage breast cancer patients at 16 hospitals and medical centers in Europe. Some of the women received WBI treatment while others were treated with APBI.
After five years, only 14 patients experienced a recurrence, with no significant difference in outcomes between women who received one technology as opposed to the other.
The researchers concluded the APBI treatment was just as effective as WBI, while having fewer side effects and a shorter treatment time than WBI.
More Studies Coming Up
Kuske said a similar study is underway in North America that he hopes will back up the European research.
In addition, his medical facility in Arizona is starting a clinical trial to shorten APBI treatments to less than two days.
Kuske hopes the study results will encourage more academic institutions to train medical students on how to administer APBI. Right now, he said, the profession is suffering from a lack of training.
In addition, he’s optimistic that the research will lead to treatment advancements that exceed APBI.
“Technology always raises up to meet science,” he said.