Post-mastectomy radiation therapy can be safely shortened prior to breast reconstruction
Breast cancer patients who have undergone mastectomy surgery could shorten their radiation therapy treatments by weeks without facing a greater risk of recurrence, according to new research presented this week at American Society for Radiation Oncology (ASTRO) Annual Meeting.
The data was derived from the third phase of the RT CHARM trial, which evaluated the impact of shortening radiation therapy treatments in women who opt for breast reconstruction post-mastectomy. The results suggest that treatment regimens can be nearly cut in half without increasing the risk of recurrence or complications further down the road.
“Over the past 10 years, we’ve tried to move all patients who need breast radiation to a shorter, more convenient schedule,” said Matthew M. Poppe, MD, the principal investigator of the trial and a professor of radiation oncology at the University of Utah in Salt Lake City. “But patients after mastectomy who were planning breast reconstruction were the one group where we didn’t have sufficient data to support shorter courses. Now, the results of this trial show we can safely reduce treatment time for these patients to three weeks, without compromising their reconstruction.”
The majority of patients who undergo mastectomy also opt for reconstructive surgery once their treatments are completed. Many of these patients also require radiation therapy to the chest wall and regional lymph nodes to reduce their risk of recurrence, but in the past, there were concerns about how the treatment could hinder the healing process, especially for those who sought additional reconstructive surgery.
Results from the RT CHARM trial are questioning that notion. The trial included nearly 900 patients with unilateral invasive breast cancer, each of whom had undergone mastectomy and were planning to complete reconstructive surgery after treatment.
The patients were divided into two groups—one that was given a standard course of treatment, consisting of 25 fractions administered over a period of five weeks, and one that was given a shorter course of 16 fractions across three weeks. The team analyzed outcomes and complication rates based on which course of treatment the patients received and the type of reconstruction they underwent—either implants only or autologous reconstruction that used their own tissue, with or without the addition of implants.
After two years, the complication rates were similar between both cohorts, at 14% in the group who received the shorter course and 12% who underwent the standard regimen. This was much less than the team expected, as the group anticipated rates to range between 25% and 35%.
Overall, complication rates were lower in the autologous group, as were recurrence rates.
The group noted that their findings can save patients both time and money and could expand access to those who previously might have been hesitant or unable to set aside six or more weeks for treatment.
ASTRO 2024 is set to conclude on Wednesday, Oct. 2.
In addition to her background in journalism, Hannah also has patient-facing experience in clinical settings, having spent more than 12 years working as a registered rad tech. She began covering the medical imaging industry for Innovate Healthcare in 2021.