A SHORTER course of postmastectomy radiation therapy combined with breast reconstruction has been proven to be both safe and effective, according to a study presented on 30th September 2024, at the American Society for Radiation Oncology (ASTRO) annual meeting in Washington, DC, USA.
The research was led by Matthew Poppe, University of Utah, Salt Lake City, USA, and found that an abbreviated radiation therapy schedule did not increase complications for women undergoing breast reconstruction following mastectomy. “The results of this trial show we can safely reduce treatment time for these patients to three weeks, without compromising their reconstruction,” Poppe commented when presenting the research.
Traditionally, radiation therapy for breast cancer takes five to six weeks, but emerging studies suggest shorter treatment courses can be equally effective in treating cancer while improving patients’ quality of life. However, some concerns regarding higher radiation doses have previously limited the adoption of abbreviated courses. In order to investigate this further, Poppe and colleagues designed the RT Charm trial, enrolling 898 women from 209 cancer centres across the USA and Canada. The study included women with invasive breast cancer who underwent mastectomy and reconstruction. Participants were divided into two groups: one received the standard five-week radiation regimen, while the other underwent a shorter, three-week course.
Among the 650 women who completed breast reconstruction, 59% had implants, and 41% underwent autologous reconstruction, using their own tissue, with or without implants. After two years, 14% of women who received the shorter radiation treatment experienced complications, compared to 12% in the standard treatment group. The side effects were found to be mild across both groups.
The study also revealed fewer complications with autologous reconstruction (8.7%) compared to implant-based reconstruction (15.5%). Additionally, within three years of treatment, cancer recurrence occurred in 1.5% of women in the shorter radiation group, versus 2.3% in the standard group.
The team highlighted that shorter radiation courses could reduce treatment time and costs, benefiting women who travel long distances for care. They expressed hope that these findings will encourage more cancer centres to adopt abbreviated radiation schedules for postmastectomy patients.
Victoria Antoniou, EMJ
Reference
Poppe MM et al. A randomized trial of hypofractionated post-mastectomy radiation therapy (PMRT) in women with breast reconstruction (RT CHARM, Alliance A221505). Int J Rad Oncol Bio Phys. 2024;120(2 Suppl 11).
