A 1-week course of postsurgery radiotherapy demonstrated comparable safety and efficacy to the traditional 3-week regimen in patients with early-stage breast cancer, according to new findings presented by Brunt et al at the European Society for Radiotherapy and Oncology (ESTRO) 2025 Annual Meeting (Abstract E25-5025). The findings could further reduce the burden of treatment and expand access to radiotherapy in this patient population.
Previous 5-year results from the phase III FAST-Forward trial have already led to a shift in clinical practice.
Study Methods and Results
In the phase III FAST-Forward trial, published in Radiotherapy and Oncology, researchers randomly assigned about 4,000 patients with early-stage breast cancer to receive either the standard 3-week radiotherapy course of 40 Gy administered in 15 treatments, or a shorter, 1-week course of 27 Gy or 26 Gy administered in 5 treatments.
After a follow-up of 10 years, the researchers discovered that the 1-week radiotherapy course provided a similar level of cancer control compared with the 3-week course—without causing additional long-term adverse effects.
The researchers emphasized that a shorter treatment course could offer benefits such as more convenience for patients, fewer hospital visits, less pressure on radiotherapy services, greater treatment accessibility, and similar safety and efficacy compared with the longer treatment regimen.
“This 10-year analysis provides definitive long-term evidence that 1-week radiotherapy to the breast is a safe, effective, and more practical option for [patients with] breast cancer,” said lead study author Murray Brunt, MBBS, FRCR, FRCP, Professor at the University of Keele.
The results of the trial marked a milestone in breast cancer treatment and could reinforce the growing shift toward more efficient radiotherapy approaches.
Concluding Remarks
“The FAST-Forward trial revolutionized cancer treatment by reducing the standard radiotherapy from 3 weeks to just 1 week, without compromising effectiveness. This approach has significantly improved patient experience and health-care practices, both during and after the COVID-19 pandemic, by minimizing hospital visits,” detailed senior study author Judith Bliss, MSC, Professor of Clinical Trials at The Institute of Cancer Research in London. “The streamlined schedule has made radiotherapy more accessible to more women, particularly those who are less able to attend hospital and those from lower-income countries,” she highlighted.
“Radiotherapy is a cornerstone of modern cancer treatment, and studies like FAST-Forward demonstrate how we can optimize its delivery to benefit more patients,” underscored Matthias Guckenberger, MD, Full Professor and Chair of the Department of Radiation Oncology at the University Hospital Zurich and the University of Zurich as well as President of ESTRO. “By reducing treatment time without compromising effectiveness, we are not only improving patient experience but also making better use of radiotherapy resources and health-care systems worldwide. These findings reinforce the critical role of radiotherapy in the fight against cancer,” he concluded.
Disclosure: The research in this study was sponsored by The Institute of Cancer Research and funded by a grant from the UK National Institute of Health Research. For full disclosures of the study authors, visit estro.org.
