Paris (AFP)

Radiotherapy treatment reduced to 5 days instead of several weeks generally: recent studies have paved the way for a marked improvement in the management of breast cancer for some women.

In her misfortune, Danielle (first name changed) considers having been "very lucky".

Last June, as part of a preventive screening visit, he was detected "a small tumor in the breast, 7 mm", which turned out to be cancerous after a biopsy.

From there, the meetings are linked very quickly: it is operated in July at the Gustave Roussy Institute, in the Parisian suburbs.

She sees the surgeon again in August and the radiologist in early September.

The same evening of this appointment begins his radiotherapy.

It is then specified to her that she will then have only four sessions, spread over the week.

“I thought the treatment would last at least a month, when I was told that, I was super happy!” Says Danielle.

"A week of treatment, you can easily see the end of it, it takes away the fatigue of going back and forth and above all, I didn't have time to feel really sick".

She has in fact benefited from a new "compact" course of radiotherapy, which consists in reducing the number of sessions after an operation, while maintaining the same effectiveness.

For the moment, this new course of care is not intended for all women.

Thus, at Gustave Roussy, it is offered only to patients over 60 years of age with localized cancer without lymph node involvement, which represents more than 50% of all breast cancers in France.

This new treatment began in February in the Ile-de-France hospital after the publication of two English studies, in 2020, which demonstrated the equivalence, measured in terms of relapse, of the reduction in the number of post-operative radiotherapy sessions. compared to a standard scheme.

- "Psychological gain" -

A study published in the Journal of clinical oncology thus compared the results of radiotherapy treatment administered in different ways to women with cancer with a good prognosis over ten years.

Doses divided into 25 sessions over 5 weeks for some, and one session per week over five weeks for others.

Conclusion: no difference in terms of efficacy or side effects.

Operation on the cancerous tissue of a patient during an intraoperative radiotherapy procedure on November 2, 2017, in the operating room of the cancer center of the Paoli-Calmettes Institute in Marseille ANNE-CHRISTINE POUJOULAT AFP / Archives

A second study, published in The Lancet Oncology, then compared what had become the standard in the meantime, radiotherapy in 15 sessions over 3 weeks, with a new regimen comprising only 5 sessions over 5 days.

No difference either.

Based on these studies, in the midst of the Covid-19 epidemic, European radiology experts met to promote this accelerated treatment.

"In a period of Covid, it seemed particularly relevant to bring women to the hospital as short as possible", explains Dr Sofia Rivera, head of the radiotherapy department at Gustave Roussy.

"We save time for patients, for them it is both physical and psychological," she says.

"If you have a shorter treatment, but just as effective and not more toxic, it is necessarily better," says Thomas Bachelot, president of the "breast group" of Unicancer, a network of 18 centers for the fight against cancer.

A downside: radiotherapy remains for the moment remunerated on a fee-for-service basis.

"It pushes to offer a lot of sessions, especially in the private sector," says Thomas Bachelot.

Today, it is more profitable for a hospital to administer 25 sessions to a woman rather than five.

"We are now fighting to try to obtain a package pricing," warns Sofia Rivera.

© 2021 AFP