What is your preferred comprehensive nodal irradiation approach in non-metastatic breast cancer patients with underlying respiratory diseases or poor baseline respiratory function in light of the findings from the RadComp Trial?
This question is part of our collaboration with ASTRO 2025 to highlight impactful trial data from this year's meeting. This question is inspired by the Plenary Session Presentation "Phase III Randomized Trial of Proton vs. Photon Therapy for Patients with Non-Metastatic Breast Cancer Receiving Comprehensive Nodal Radiation: A Radiotherapy Comparative Effectiveness (RadComp) Consortium Trial: Health-Related Quality Of Life Outcomes" by Dr. Shannon MacDonald.
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Radiation Oncology · Southwest Florida Proton Center
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The RadComp trial PRO-CTCAE item for no shortness of breath versus any shortness of breath significantly favored protons as reported in the abstract. However, after correction for multiplicity, this became non-significant, meaning there was no difference. While multiplicity analyses ensure that fals...
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Radiation Oncology · Varian Medical Systems/Allegheny health network
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I would also add that for someone with such poor lung function, the absolute benefit of treatment has to be weighed against the risk of non-cancer morbidity and mortality.
Also threshold to reduce the volume of treatment, like prophylactic IMN, should be low to meet tighter lung constraints.
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