A single dose is sufficient.
New technologies can revolutionize radiotherapy in women with early breast cancer. It is now being tested at the University Hospital in Orebro.
– It’s a shame we do not use it in Sweden. It would be easier for many women, says consultant Göran Liljegren.
A new technique could shorten treatment time by up to five weeks for women with early breast cancer.
Today, beamed all over his chest 15-25 times during breast conserving surgery to prevent recurrence of the disease.
A single dose of radiation, however, could suffice – with a new method.
It is called Intraoperative radiotherapy (IORT), and are given direct access to the operation. When the tumor is removed, placed a spherical applicator in the cavity, so it radiates straight into sårhålan. Since not the entire breast is radiated so protect the heart and lungs, reducing the risk of heart attacks as side effects.
The method is applicable to women over 50 years with non-dispersed low-risk cancer and small tumor.
Not as promising as 2010
In the UK, it is now recommended by health authorities as an alternative to conventional radiotherapy for breast cancer.
In large randomized trials – TARGIT – the results are published in The Lancet in 2014 not as promising as those of 2010.
Of 3450 patients received half the new radiotherapy and half conventional radiation. The new method (IORT) offers:
• Higher risk of breast cancer recurrence – 3.3 compared with 1.3 per cent.
• Slightly higher mortality from breast cancer – 2.6 compared with 1.9 per cent.
• However, lower mortality as a whole – 3.9 compared with 5.3 per cent, mainly fewer deaths from cardiovascular disease.
In southeastern health region has an expert evaluated the method.
– We believe that the data available is so reliable that it could introduce treatment, says Elvar Theodorsson, Professor of Clinical and Experimental Medicine, Linköping University.
– We think that those women who meet the criteria should be offered it as an alternative to conventional radiation. We believe that this method would be a great advantage for them. You get everything done in one day. You will not have five weeks of radiotherapy and perhaps long distances.
“Can not say that the method is safe enough”
The experts, however, disagree. Radium home at the Karolinska University Hospital averted a purchase of the new straw pieces Athens INTRABEAM.
– It was put on hold when the latest results of the TARGIT study came because they were not quite as promising as before. The observation period is not long enough to be able to say that the method is safe enough. It has not had time to see if it is equivalent to the traditional treatment, says Irma Fredriksson, section head of breast surgery.
At the University Hospital in Orebro is however positive. There they have – instead of buying into the expensive apparatus – constructed an equivalent equipment to connect to ordinary straw Tuneable. 20 Swedish women have now been treated with the method. Four of them were, however, supplement with conventional radiotherapy afterwards.
– The farther away the patients live, the more likely they are to say yes to this. They see this as an easier method. I think it’s a shame we do not use it in the country, says consultant Göran Liljegren leading the pilot study.
Required controlled trials
He believes that the method may be a good option for them who otherwise would have chosen to remove the entire breast to avoid extensive radiation treatments.
SBU recommend an evaluation from 2012 to the treatment only takes place in the context of controlled trials.
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