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Breast cancer studies find radiation reduces deaths

radiation treatment Latest developments: October 1, 1997
Web posted at: 11:35 p.m. EDT (0335 GMT)

ATLANTA (CNN) -- For most women with breast cancer, the operating room is the first stop on the road to recovery. Chemotherapy often comes next when the tumor is large enough, or if cancer has spread to nearby lymph nodes.

But two new studies suggest that a third step may be called for: radiation therapy.

Two new studies report that when combined with conventional chemotherapy, radiation dramatically reduces the risk of death.

Breast cancer is the most common cancer in adult American women. About 182,000 American women are diagnosed with it each year, and 46,000 die from it annually.

Radiation therapy fell from favor several years ago after studies showed that although the treatment seemed to reduce the risk of having a tumor reappear, it failed to increase a woman's chance of survival.

vxtreme CNN's Dan Rutz reports.

But a Canadian study found that radiation treatments cut the death rate by 29 percent. And in a larger study conducted in Denmark, 54 percent of the women who received radiation therapy were alive after 10 years compared with 45 percent of those who did not get the treatment.

"This is a positive finding with a real impact on survival," said Dr. Samuel Hellman of the University of Chicago, in an editorial in Thursday's New England Journal of Medicine, which published the studies. "These are substantial survival advantages."

Today's radiation safer

Hellman said the findings suggest that all women who have lost a breast to cancer should receive radiation therapy. In addition, he said, perhaps all women who are receiving chemotherapy for breast cancer should also be given radiation treatments.

"We're really seeing a pendulum swing here," says Dr. William Wood, the head of Emory University's cancer center.

Wood says today's radiation equipment is safer and that, along with more potent chemotherapy, may explain why the studies found that radiation improves chances of living cancer-free from 1 out of 3 to 1 out of 2.

"I think these studies will actually have an impact on practice because most women, as in these two trials, do receive chemotherapy if they have anything other than a very small tumor," Wood said. "The addition of radiation, if they have any significant degree of nodal involvement, now appear more justified than it did previously."

The studies began in 1978 in Canada and in 1982 in Denmark. It took until now to get results because researchers wanted to determine the effects of the treatments over a long period of time.

The Danish study was the largest, involving 1,708 women who had undergone a mastectomy. Dr. Marie Overgaard, of Aarhus University Hospital in Aarhus, and her colleagues found that 48 percent of women who received radiation plus the drug combination of cyclophosphamide, methotrexate and fluorouracil (CMF) were still alive after 10 years and showed no signs of cancer.

Benefits more obvious as time passes

The researchers found that radiation was effective regardless of the size of the original tumor or how many lymph nodes showed evidence of spreading cancer cells.

The Canadian study involved 318 women who were tracked for 15 years. Joseph Ragaz of the British Columbia Cancer Agency and his colleagues, who also administered the CMF drug combination and radiation, said the benefits of radiation treatments may become more obvious as time passes and the number of breast cancer survivors lessens.

Of 28 women in the group who had a recurrence of breast cancer after 10 years, 19 received only the chemotherapy, compared with nine who had the combined treatment.

"Most of these 28 patients," the researchers said, "are expected to die of breast cancer."

Correspondent Dan Rutz and Reuters contributed to this report.

 
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