Older patients with breast cancer may not be suitable for radiation therapy: Study | Health

According to new research, radiotherapy does not increase the chance of survival in older adults with early-stage breast cancer. The findings were published in the New England Journal of Medicine. The addition of radiation therapy along with breast-conserving surgery and hormone therapy — the current standard treatment — made no difference to mortality for patients 65 and older, the researchers said.

Radiation therapy was also found to have no effect on the risk of secondary tumors, called metastases. However, it did slightly reduce the risk of the cancer coming back, but the risk was still within the clinically acceptable range. The 10-year study, one of the first long-term clinical trials in older breast cancer patients, shows that radiation therapy can be safely ruled out as breast cancer treatment, experts say early stage over 65 years old. (Also read: World Cancer Day: 5 common reasons why women get breast cancer )

Regardless of age, the standard treatment for early-stage breast cancer is breast-conserving surgery — sometimes called lumpectomy — followed by radiation therapy and hormone therapy to reduce risk. breast recurrence. Patients 65 years of age and older account for at least 50% of patients with this condition. Although radiation therapy imposes an additional burden on older patients with side effects related to heart problems and second cancers, there are few clinical trials in this age group.

Researchers from the University of Edinburgh and Western General Hospital, Edinburgh, conducted a randomized clinical trial – called PRIME II – with 1,326 patients to investigate whether combined radiation therapy is necessary. with tumor resection and hormone therapy or not. Patients 65 years and older with breast cancer are referred to as ‘low-risk’, meaning that the tumor is no more than 3cm in size, does not involve the lymph nodes below the armpit, and is likely to respond. with hormone treatment.

All participants were assigned to breast-conserving surgery and at least 5 years of hormone therapy. Half of the group were randomized to receive additional radiation 3 to 5 weeks after surgery. Patients were evaluated at annual clinic visits and mammograms.

The team found that in patients treated without radiation, the risk of cancer recurrence in the treated breast after 10 years was 9.5%, while radiation therapy reduced the risk to zero. 9%. Despite this difference in rates, both are within the accepted recurrence range according to current clinical guidelines.

There was no difference in overall survival between both groups, and most deaths were from causes other than breast cancer. The work was supported by the Scottish Government Office of Chief Scientist and the Breast Cancer Institute NHS Foundation Trust, Western General Hospital, Edinburgh.

Professor Ian Kunkler, Professor of Clinical Oncology at the University of Edinburgh, said: “Radiotherapy can be burdensome for patients, especially the elderly. Our findings should help clinicians. ready to educate older patients about whether this particular aspect of early breast cancer treatment can be implemented.” ignored in a shared decision-making process, weighing all the risks and benefits.”

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