The BMJ Awards 2018: UK Research Paper of the YearBMJ 2018; 361 doi: https://doi.org/10.1136/bmj.k1873 (Published 01 May 2018) Cite this as: BMJ 2018;361:k1873
- Nigel Hawkes, freelance journalist
- London, UK
Partial-breast radiotherapy after breast conservation surgery for patients with early breast cancer (UK IMPORT LOW trial): five year results from a multicentre, randomised, controlled, phase 3, non-inferiority trial
Do women who have radiotherapy targeted at the site of the original tumour do as well as those who have whole breast radiotherapy? The IMPORT LOW trial, carried out in 30 UK centres, showed that recurrence was no more likely and side effects fewer for the targeted group, changing both opinions and clinical practice.1
Charlotte Coles, consultant clinical oncologist at Addenbrooke’s Hospital, Cambridge, says that when the trial started, whole breast irradiation was considered better. “The earlier trials had failed because radiotherapy then was not as good at targeting, and they didn’t pick the lower risk women for the trials.” For IMPORT LOW, 2000 women aged over 50 who had early stage breast cancer at low risk of coming back were randomised to radiotherapy of the whole breast at full or reduced dose or targeted radiotherapy to only part of the breast—about a third of it. They were followed up for five years.
Recurrences were very rare, and did not differ between the three groups. “In the partial therapy group there was less change in the appearance and hardness of the breast,” Coles says. “This may seem a small thing but it is important, psychologically and emotionally, to women. There’s also a chance that the partial dose will reduce second radiation-induced cancers and damage to the heart and lungs, though we’d need a bigger trial to prove it.”
The technique is simple, safe, and effective, and most radiotherapy centres can adopt it with no increase in resources, using the equipment they already have.
Abiraterone for prostate cancer not previously treated with hormone therapy
Prostate cancer is treated by cutting off the supply of testosterone that drives it. But androgen ablation, …