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Hi-dose re-irradiation helps breast cancer patients who have limited options

Oct 16, 2015

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Sunnybrook-led report published in Oncotarget

High-dose re-irradiation or second radiation therapy can help control cancer, and with moderate side effects in patients with locally recurrent refractory breast cancer, suggests a new Sunnybrook-led report published in the journal, Oncotarget.

Locally recurrent refractory breast cancer is disease that has returned after chemotherapy, surgical treatment and radiation therapy. The recurrence is confined to the breast or immediate surrounding area and is refractory or resistant to chemotherapy.

“Many patients, unfortunately, have limited options for treatment. They often go untreated and experience symptoms from local recurrence that significantly impact quality of life,” says Dr. Gregory Czarnota, radiation oncologist, Temerty Breast Cancer Centre, Sunnybrook’s Odette Cancer Centre.

Uncontrolled locally recurrent breast cancer can cause many significant problems that include ulcerations, bleeding, arm edema or excess watery fluid in the tissues, pain and brachial-plexus palsy or loss of movement or weakness of the arm.

The researchers observed and treated 47 women at an average age of 60 years, and followed them for overall survival (OS) for a median of 17.4 months. Overall survival was 73 percent at one year, and 67 at 2 years. Loco-regional cancer control was 63 percent at 1 year, and 50 percent at 2 years.

For most patients, the common side effect was acute radiation dermatitis at Grade 1 – 2, which ”is equivalent to slight redness of the skin,” says Dr. Czarnota.

In 2014, an estimated 24,400 Canadian women were diagnosed with breast cancer. Rates of breast cancer local recurrence after treatment are approximately 10 to 20% at 10 and 15 years respectively.

Gregory Czarnota

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Hi-dose re-irradiation helps breast cancer patients who have limited options

October 16, 2015 (Toronto, ON) – High-dose re-irradiation or second radiation therapy can help control cancer, and with moderate side effects in patients with locally recurrent refractory breast cancer, suggests a new Sunnybrook-led reportpublished in the journal, Oncotarget.

Locally recurrent refractory breast cancer is disease that has returned after chemotherapy, surgical treatment and radiation therapy. The recurrence is confined to the breast or immediate surrounding area and is refractory or resistant to chemotherapy.

"Traditionally, doctors hesitate to give patients second radiation treatment due to concerns about adverse side effects. Our report shows encouraging evidence for the feasibility of aggressive re-irradiation therapy for these patients, with acceptable side effects, and good local control and survival,” says Dr. Gregory Czarnota, radiation oncologist, Temerty Breast Cancer Centre, Sunnybrook’s Odette Cancer Centre

“Many patients, unfortunately, have limited options for treatment. They often go untreated and experience symptoms from local recurrence that significantly impact quality of life.”

Uncontrolled locally recurrent breast cancer can cause many significant problems that include ulcerations, bleeding, arm edema or excess watery fluid in the tissues, pain and brachial-plexus palsy or loss of movement or weakness of the arm.

The researchers observed and treated 47 women at an average age of 60 years, and followed them for overall survival (OS) for a median of 17.4 months. Overall survival was 73 percent at one year, and 67 at 2 years. Loco-regional cancer control was 63 percent at 1 year, and 50 percent at 2 years.

For most patients, the common side effect was acute radiation dermatitis at Grade 1- 2, which ”is equivalent to slight redness of the skin,” says Dr. Czarnota, who is also an assistant professor in the Departments of Radiation Oncology and Medical Biophysics at the University of Toronto, and a senior scientist in the Odette Cancer Research Program at Sunnybrook Research Institute.

“It is our hope this report will help form the basis for administering re-irradiation for breast cancer local recurrence,” says Dr. Czarnota.

In 2014, an estimated 24,400 Canadian women were diagnosed with breast cancer. Rates of breast cancer local recurrence after treatment are approximately 10 to 20% at 10 and 15 years respectively.

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