Toxicity of Hypofractionated Whole Breast Radiotherapy Without Boost and Timescale of Late Skin Responses in a Large Cohort of Early-Stage Breast Cancer Patients.

Autor: Fodor A; Department of Radiation Oncology, IRCCS San Raffaele Scientific Institute, Milan, Italy. Electronic address: fodor.andrei@hsr.it., Brombin C; University Center for Statistics in the Biomedical Sciences, Vita-Salute San Raffaele University, Milan, Italy; Vita-Salute San Raffaele University, Milan, Italy. Electronic address: brombin.chiara@hsr.it., Mangili P; Medical Physics, IRCCS San Raffaele Scientific Institute, Milan, Italy., Tummineri R; Department of Radiation Oncology, IRCCS San Raffaele Scientific Institute, Milan, Italy., Pasetti M; Department of Radiation Oncology, IRCCS San Raffaele Scientific Institute, Milan, Italy., Zerbetto F; Department of Radiation Oncology, IRCCS San Raffaele Scientific Institute, Milan, Italy., Longobardi B; Medical Physics, IRCCS San Raffaele Scientific Institute, Milan, Italy., Galvan AS; Department of Radiation Oncology, IRCCS San Raffaele Scientific Institute, Milan, Italy., Deantoni CL; Department of Radiation Oncology, IRCCS San Raffaele Scientific Institute, Milan, Italy., Dell'Oca I; Department of Radiation Oncology, IRCCS San Raffaele Scientific Institute, Milan, Italy., Castriconi R; Medical Physics, IRCCS San Raffaele Scientific Institute, Milan, Italy., Esposito PG; Medical Physics, IRCCS San Raffaele Scientific Institute, Milan, Italy., Deli AM; Department of Radiation Oncology, IRCCS San Raffaele Scientific Institute, Milan, Italy., Rancoita PMV; University Center for Statistics in the Biomedical Sciences, Vita-Salute San Raffaele University, Milan, Italy; Vita-Salute San Raffaele University, Milan, Italy., Fiorino C; Vita-Salute San Raffaele University, Milan, Italy; Medical Physics, IRCCS San Raffaele Scientific Institute, Milan, Italy., Vecchio AD; Medical Physics, IRCCS San Raffaele Scientific Institute, Milan, Italy., Di Serio MS; University Center for Statistics in the Biomedical Sciences, Vita-Salute San Raffaele University, Milan, Italy; Vita-Salute San Raffaele University, Milan, Italy., Di Muzio NG; Department of Radiation Oncology, IRCCS San Raffaele Scientific Institute, Milan, Italy; Vita-Salute San Raffaele University, Milan, Italy.
Jazyk: angličtina
Zdroj: Clinical breast cancer [Clin Breast Cancer] 2022 Jun; Vol. 22 (4), pp. e480-e487. Date of Electronic Publication: 2021 Dec 01.
DOI: 10.1016/j.clbc.2021.11.008
Abstrakt: Aim: To report toxicity of hypofractionated whole-breast radiotherapy in a large cohort of early-stage breast cancer (BCaients.
Materials and Methods: From 02/2009-05/2017, 1325 consecutive BCa patients were treated with 40.05 Gy/15 fractions, without boost. Median age was 62 (IQR:51.1-70.5) years. Chemotherapy was prescribed for 28% of patients, hormonal therapy for 80.3%, monoclonal antibodies for 8.2%.
Results: Median follow-up was 72.4 (IQR: 44.6-104.1) months. Acute RTOG toxicity was: 69.8% Grade (G) 1, 14.3% G2 and 1.7% G3. Late SOMA-LENT toxicities were: edema-hyperpigmentation (E-H): G1 28.67%, G2 4.41%, G3 0.15%; fibrosis-atrophy-telangiectasia-pain (F-A-T-P): G1 14.6%, G2 3.2%, G3 0.8%, G4 0.1%. Median time to first occurrence was 6 and 18 months, respectively. Aesthetic result after surgery was excellent in 28.7%, good in 41.5%, acceptable in 20.3% and poor in 9.5% of patients. Change in breast appearance after radiotherapy was mild in 6.9%, moderate in 2.3% and marked in 1.3% of patients. Concomitant chemotherapy, obesity, smoking, use of bolus and planning target volume (PTV) were associated with higher acute toxicity. Patients ≥55 years old were less likely to experience acute toxicity. PTV and acute G2 toxicity were associated with ≥G2 E-H. PTV, concomitant chemotherapy, hypertension and ≥G2 acute toxicity were associated with increased risk of F-A-T-P.
Conclusion: Hypofractionated whole-breast radiotherapy without boost demonstrated mild acute and late toxicity in a large cohort of consecutive patients. Moderate and marked changes in breast appearance were registered for 3.6% of patients and occurred between 18 to 42 months.
(Copyright © 2021 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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