SHortening Adjuvant PHoton IRradiation for Breast Cancer: The SAPHIRe Trial

Women found to have breast cancer in their lymph nodes are often advised to receive radiation therapy to the lymph nodes to decrease the chance of cancer recurrence and improve survival.  Because of the length of treatment (at least five weeks) and the side effects of treatment (tiredness, arm swelling, and skin and tissue changes), some women who may benefit from radiation therapy do not receive it.  

An innovative shorter-duration radiation treatment regimen that delivers larger daily doses of radiation to the lymph nodes (called hypofractionation) may allow women to get the radiation they need while reducing the duration and toxicity of treatment.  The SAPHIRe trial (Shortening Adjuvant PHoton IRradiation) is a randomized, clinical trial of shorter-duration (three-week) versus standard-duration (five-week) radiation therapy in 842 patents receiving radiation therapy to the lymph nodes for invasive breast cancer conducted at academic and community practices across the United States.  The women who choose to take part in this trial will be assigned to one of these two treatments and will complete questionnaires about their side effects, physical function, quality of life, and financial well-being. They will also be evaluated for treatment complications, development of arm swelling (lymphedema), and cancer status. The trial is designed to demonstrate shorter-duration radiation to the lymph nodes provides similar cancer control while reducing the side effects and burden of treatment.

The development of a less toxic, less costly, more convenient, shorter-duration regimen is expected to reduce the burden of treatment and increase the utilization of curative radiation.