A boost dose of radiation does not have a significant effect on survival, but does improve local control, in patients with early breast cancer who undergo breast-conserving therapy, according to results of a large European trial. A boost dose of radiation does not have a significant effect on survival, but does improve local control, in patients with early breast cancer who undergo breast-conserving therapy, according to results of a large European trial.

In fact, lead researcher Dr. Harry Bartelink told Reuters Health, "I am surprised by the magnitude of the effect of this extra radiation dose in preventing a local recurrence in the breast, especially in young women with breast cancer."

"It is also rewarding," he added, "to see that ten years after treatment, 82 per cent of the patients are still alive."

As they report in the August 1st issue of the Journal of Clinical Oncology, Dr. Bartelink of the Netherlands Cancer Center, Amsterdam, and colleagues followed 5318 women who had been treated with microscopically complete excision followed by whole-breast irradiation of 50 Gy. They were then randomized to receive or not receive a further 16 Gy of radiation.

The subjects were followed for a median of 10.8 years. Local recurrence was the first reported treatment failure in 165 patients given a radiation boost compared to 268 patients who did not receive the boost.

The cumulative incidence of local recurrence in the boost group was 6.2 versus 10.2 per cent in the no-boost group. The hazard ratio for local recurrence was 0.59 in favor of the boost group.

The greatest reduction in the local recurrence rate (from 23.9 to 13.5 per cent) was seen in patients aged 40 years or less.

However, survival in both the boost and no-boost groups was 82 per cent at ten years.

Dr. Bartelink added that "the favorable treatment results are partly due to the strict quality control that the participating centers had to adhere to.

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