Are We Missing Acute Toxicities Associated With Hypofractionated Breast Irradiation? A Report From a Large Multicenter Cohort Study.

Autor:	Beydoun H; Department of Radiation Oncology, Barbara Ann Karmanos Cancer Institute, Wayne State University School of Medicine, Detroit, Michigan. Electronic address: hbeydoun1@mercy.com., Griffith KA; Department of Biostatistics, University of Michigan, Ann Arbor, Michigan., Jagsi R; Department of Radiation Oncology, University of Michigan, Ann Arbor, Michigan., Burmeister JW; Department of Radiation Oncology, Barbara Ann Karmanos Cancer Institute, Wayne State University School of Medicine, Detroit, Michigan., Moran JM; Department of Radiation Oncology, University of Michigan, Ann Arbor, Michigan., Vicini FA; Department of Radiation Oncology, Corewell Health South, St Joseph, Michigan., Hayman JA; Department of Radiation Oncology, University of Michigan, Ann Arbor, Michigan., Paximadis P; Department of Radiation Oncology, Corewell Health South, St Joseph, Michigan., Boike TP; GenesisCare, Farmington Hills, Michigan., Walker EM; Henry Ford Health System, Detroit, Michigan., Pierce LJ; Department of Radiation Oncology, University of Michigan, Ann Arbor, Michigan., Dominello MM; Department of Radiation Oncology, Barbara Ann Karmanos Cancer Institute, Wayne State University School of Medicine, Detroit, Michigan.
Jazyk:	angličtina
Zdroj:	International journal of radiation oncology, biology, physics [Int J Radiat Oncol Biol Phys] 2024 Jul 15; Vol. 119 (4), pp. 1092-1098. Date of Electronic Publication: 2024 Feb 15.
DOI:	10.1016/j.ijrobp.2024.01.225
Abstrakt:	Purpose: The efficacy and long-term safety of hypofractionated whole breast irradiation (HF-WBI) have been established through multiple randomized trials, yet data about acute toxicities remain more limited. Since 2013, our group has prospectively collected acute toxicity data from weekly treatment evaluations and additional assessment after completion. In 2016, we intentionally shifted the posttreatment assessment follow-up visit from 1 month to 2 weeks to evaluate for missed acute toxicity occurring in that immediate posttreatment window. Here, we report whether 2-week follow-up has resulted in increased detection of acute toxicities compared with 4-week follow-up. Methods and Materials: We prospectively compared acute toxicity for patients treated with HF-WBI between January 1, 2013, and August 31, 2015 (4 week follow-up cohort) to patients treated between January 1, 2016, and August 31, 2018 (2 week follow-up cohort). Analyses included a multivariable model that adjusted for other factors known to correlate with toxicity. We prospectively defined acute toxicity as maximum breast pain (moderate or severe rating) and/or occurrence of moist desquamation reported 7 days before the completion of radiation therapy (RT) until 42 days after completion. Results: A total of 2689 patients who received postlumpectomy radiation and boost were analyzed; 1862 patients in the 2-week follow-up cohort and 827 in the 4-week follow-up cohort. All acute toxicity measures assessed were statistically similar between follow-up cohorts when compared in an unadjusted fashion. Overall acute composite toxicity was 26.4% and 27.7% for patients in the 4-week follow-up and 2-week follow-up cohorts, respectively. Overall acute composite toxicity remained similar between follow-up cohorts in a multivariable, adjusted model and was significantly related to patient's age, body mass index, smoking status, and treatment technique (intensity-modulated RT vs 3-dimensional conformal radiation therapy) but not follow-up cohort. Conclusions: An earlier posttreatment follow-up for HF-WBI patients did not reveal a significant increased incidence of acute toxicities at 2 weeks compared with 4 weeks. This study provides physicians and patients with additional data on the safety and tolerability of HF-WBI for early stage breast cancer. (Copyright © 2024 Elsevier Inc. All rights reserved.)
Databáze:	MEDLINE
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