Chemo-Radiation Combo Cuts Breast Cancer Recurrence

Giving breast-cancer patients chemotherapy and radiation at the same time reduced the risk of tumors recurring by 35 percent, according to a U.K. study that may change the way doctors treat patients.

The trial, which involved almost 2,300 women with early-stage breast cancer, was the largest to investigate the approach, in which radiation is administered between or during cycles of drug treatment, the researchers said Sunday at a cancer meeting in Stockholm. Of the women who received the two treatments in this way, 41 saw their cancer return, compared with 63 of those who completed chemotherapy and then underwent radiation treatment, the researchers said.

The findings conflict with previous trials that failed to find a benefit and may change the way the tumor-fighting techniques are used, said Indrajit Fernando, the lead researcher and an oncologist who teaches at the University of Birmingham in England. Giving chemotherapy and radiation alternately or at the same time may allow women to return to work sooner, yielding economic benefits, Fernando said.

“Patients liked the fact that when they finished their latest chemotherapy, they’d finished all their treatment,” Fernando said at a press conference in Stockholm. “They didn’t have to wait another four weeks to start radiotherapy.”

Women participating in the study had had surgery to remove breast tumors. They then received either chemotherapy followed by radiation, or the experimental approach, known as synchronous chemoradiation. After five years, 5.1 percent of the women who had sequential courses of treatment had breast cancer return, compared with 2.8 percent of those who received synchronous chemoradiation, the study found.

Drop in Deaths
Because breast cancer is common, even a small reduction in recurrences can result in a drop in deaths from the disease, Fernando said. One death from breast cancer can be avoided for every four recurrences prevented, he said.

“These are treatments that are not going to increase the cost, so in terms of health benefit, it’s phenomenal,” Fernando said.

More than 500 women in the study contributed to a quality-of-life analysis, which found no differences between the two approaches to treatment, the researchers said. Patients receiving synchronous therapy had worse skin reactions, though only 4 percent of them had side effects that would curb their quality of life, the study found.

Researchers will need to follow up with patients to gauge potential side effects that may occur years after treatment, said Michael Baumann, president of the Brussels-based European Cancer Organization, which along with other oncology groups is holding its annual meeting in Stockholm.

The findings will be shared with the U.K. National Institute for Health and Clinical Excellence, which advises the country’s state-run medical system on which treatments represent value for money, Fernando said.