Wednesday, December 10, 2014

Most breast cancer patients receiving radiotherapy longer than recommended

CANCER DIGEST – Dec. 10, 2014 – Two-thirds of women treated for early-stage breast cancer in the U.S. receive longer radiation therapy than necessary, according a new study published today in the Journal of the American Medical Association

Led by University of Pennsylvania School of Medicine's Dr. Ezekiel J. Emanuel, and Dr. Justin E. Bekelman, the researchers analyzed insurance claims data provided by Anthem, Inc., a health benefits company (formerly WellPoint, Inc.) from 14 commercial healthcare plans covering 9 million women.

Their findings showed that the vast majority of women after breast conserving surgery receive six to seven weeks of radiation therapy.  Despite multiple randomized trials and professional society guidelines showing that three weeks of hypofractionated radiation is just as clinically effective, more convenient, and less costly. Hypofractionated radiation therapy is given over a shorter period of time than standard radiation therapy. 

The researchers analysis showed that in 2013, 34.5 percent of women over 50 years old received hypofractionated radiotherapy, up from 10.6 percent in 2008. Among younger women and those with more advanced cancers, 21.1 percent of women received hypofractionated therapy in 2013, up from 8.1 percent in 2008.

In Canada, more than 70 percent of women received hypofractionated therapy vs conventional radiotherapy in 2008; that percentage is even greater in the United Kingdom, where the National Institute of Health and Clinical Excellence released guidance recommending hypofractionated radiotherapy as standard of care in 2009.

"It is clinically equivalent to longer duration radiation in curing breast cancer, has similar side effects, is more convenient for patients, and allows patients to return to work or home sooner," said lead author Bekelman.

The study was supported by Anthem, Inc., and grants from the National Cancer Institute.

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