News Release

Radiotherapy booster cuts risk of breast cancer recurrence - findings should change practice, conference told

Peer-Reviewed Publication

ECCO-the European CanCer Organisation

A major international trial has produced the first firm evidence that giving extra radiotherapy to patients with early breast cancer substantially reduces the risk of cancer recurring in the breast. The results were so unambiguous that clinical practice should be changed immediately, particularly for younger women, said the principal co-ordinator.

The findings from the 5,569-patient multi-centre study carried out by the EORTC radiotherapy and breast cancer groups* (32 institutions from nine countries), will be presented today (Tuesday 19 September 2000) in Istanbul to delegates at the conference of the European Society for Therapeutic Radiology and Oncology.

Trial statistician Laurence Collette told delegates that the aim of the study was to see whether a booster radiation dose would reduce the risk of local recurrence of the tumour in women who had undergone breast conserving surgery.

The majority of patients (95.5%) had undergone complete removal of their tumour. All the patients had 50Gy radiation to the whole breast and were randomised to receive either a 16Gy boost localised to the tumour bed area or no further radiotherapy.

After a median follow-up of over five years, only 109 patients in the booster group had suffered a recurrence compared with 182 in the control group ­ a reduction in risk to date of nearly 50%. The largest benefit was seen in women aged under 40, where the chances of recurrence were cut by 54%. Patients will be followed up for many years to see whether booster doses will also cut mortality.

Professor Harry Bartelink, principal trial co-ordinator, said that the size of the trial meant the results were definite and unambiguous. "It demonstrates clearly that a 16Gy boost significantly improves local control. Patients who had the boost had an overall local control rate of 95%, and survival at five years was 91%. These impressive results mean that a boost should now be considered the standard treatment for early breast cancer, particularly in younger women. With this study we have set the standards for optimal techniques, dose prescribing and dose reporting."

Professor Bartelink said that the trial had also been important for health economic reasons. "It would not have been acceptable to keep giving booster doses to patients (which has a cost both financially and on the cosmetic outcome) without evidence of benefit."

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Notes for editors:

* EORTC = European Organization for Research and Treatment of Cancer.

Institutions from the following countries participated in the trial: Australia, Belgium, France, Germany, Israel, The Netherlands, Spain, Switzerland and UK.

The European Society for Therapeutic Radiology and Oncology (ESTRO) was founded in 1980 as a society of individual members working in the field of radiotherapy and oncology. It aims to improve the treatment of cancer patients by establishing the integration of radiation oncology with other methods of treatment (e.g. surgery, chemotherapy), and by establishing best practice in radiotherapy. ESTRO has nearly 5000 members throughout Europe.



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