Short-term dermal toxicity of breast cancer patients treated with hypofractionated radiotherapy
DOI:
https://doi.org/10.51481/amc.v55i4.813Keywords:
Breast cancer, hypofractionation, radiotherapyAbstract
Background: To report the feasibility and results of skin toxicity in a cohort of breast cancer patients treated with hypofractionated external-beam radiotherapy and multidisciplinary management.Methods: We did a retrospective analysis using SPSS v18 software of 299 patients (6 M and 293 F), treated between March 2009 and December 2011 in the Southeast Cancer Institute, Murcia, Spain. The median age was 54 years (range, 31-89); 145 (48.49%) patients with right breast cancer and 154 (51.50%) with left breast cancer. Based on the 7th ed AJCC, pathologic staging was: 118 (39.5%) T1 patients, 114 (38.1%) T2, 43 (14.1%) T3, 11 (3.8%) T4, 5 (1.7%) Tis, 4 (1.3%) Tx; 137 patients (45.8%) were N0, 94 (31.5%) N1, 45 (15%) N2, 20 (6.70%) N3 and 3 (1.00%) Nx. All patients received hypofractionated three-dimensional radiotherapy to total dose of 40.05 Gy in 15 daily fractional doses of 2.67 Gy. Elective irradiation was performed in the supraclavicular region in 169 patients, with the same fractioning. 100% of the sample had surgery, 84.3% received chemotherapy (66.21% postoperative and 18.1% neoadjuvant).Results: Sixty-seven patients (23.1%) had grade 2 skin toxicity after the treatment. No severe acute skin toxicity was reported.Conclusion: The hypofractionation schedule used in breast cancer is feasible and has not demonstrated increased acute skin toxicity.
Downloads
References
Fisher B, Anderson S, Redmond R, Wolmark N, Wickerham DL, Cronin W. Re-analysis and results after 12 years of follow-up in a randomized clinical trial comparing total mastectomy with lumpectomy with or without irradiation in the treatment of breast cancer. N Engl J Med 1995;333:1456-61.
NIH Consensus Conference. Treatment of early-stage breast cancer. JAMA. 1991;265:391-5.
Whelan T, MacKenzie R, Julian J, Levine M, Shelley W, Grimard L, el al. Randomized Trial of Breast Irradiation Schedules After Lumpectomy for Women With Lymph Node-Negative Breast Cancer. J Natl Cancer Inst.2002; 94:1143-50.
Curran D, Van Dongen JP, Aaronson NK, el al. Quality of life of early-stage breast cancer patients treated with radical mastectomy or breast-conserving procedures: results of EORTC trial 10801. Eur J Cancer 1998; 34:307-14.
Veronesi U, Luini A, Del Vecchio M, Greco M, Galimberti V, Merson M, el al. Radiotherapy after breast-conserving surgery in
women with localized cancer of the breast. N Engl J Med 1993; 328:1633-4.
Bartelink H, Horiot JC, Poortmans PM. Impact of a Higher
Radiation Dose on Local Control and Survival in BreastConserving Therapy of Early Breast Cancer: 10-Year Results of the Randomized Boost Versus No Boost EORTC 22881-10882 Trial. J Clin Oncol. 2007;25:3259-65.
Agrawal RK, Alhasso A, Barrett-Lee PJ, Bliss JM, Bliss P, el al. First results of the randomised UK FAST Trial of radiotherapy hypofractionation for treatment of early breast cancer (CRUKE/04/015). Radiother Oncol. 2011;100:93-100.
Bentzen SM, Agrawal RK, Aird EG, Barrett JM, Barrett-Lee PJ,
Bentzen SM, el al. The UK Standardisation of Breast Radiotherapy (START) Trial B of radiotherapy hypofractionation for treatment of early breast cancer: a randomised trial. Lancet. 2008; 371:1098107.
Bentzen SM, Agrawal RK, Aird EG, Barrett JM, Barrett-Lee PJ, Bliss JM, el al. The UK Standardisation of Breast Radiotherapy (START) Trial A of radiotherapy hypofractionation for treatment of early breast cancer: a randomised trial. Lancet Oncol. 2008; 9:331-41.
Fisher B, Anderson S, Bryant J, el al. Twenty-year follow-up of a randomized trial comparing total mastectomy, lumpectomy, and lumpectomy plus irradiation for the treatment of invasive breast cancer. N Engl J Med 2002;347:1233-41.
Powell S, Cooke J, Parsons C. Radiation induced brachial plexus injury: follow-up of two different fractionation schedules. Radiother Oncol 1990;18:213- 20.
Owen JR, Ashton A, Bliss JM, Homewood J, el al. Effect of radiotherapy fraction size on tumour control in patients with early-stage breast cancer after local tumour excision: long-term results of a randomised trial. Lancet Oncol 2006;7:467-71.
Plataniotis GA, Theofanopoulou MA, Sotiriadou K, Kyrgias G. Hypofractionated radiotherapy for breast cancer patients treated by breast-conserving surgery: short-term morbidity and preliminary results. Breast Cancer. 2010;17:42-47 DOI 10.1007/s12282009-0102-3.
Yarnold J, Ashton A, Bliss J, el al. Fractionation sensitivity and dose response of late adverse effects in the breast after radiotherapy for early breast cancer: Long-term results of a rando- mised trial. Radiother Oncol 2005;75:9-17.
Whelan TJ, Pignol JP, Levine MN, Julian JA, MacKenzie R, Parpia S, el al. Long-Term Results of Hypofractionated Radiation Therapy for Breast Cancer. N Engl J Med. 2010;362:513-20.
Cox JD, Stetz J, Paja TF. Toxicity criteria of the Radiation Therapy Oncology Group (RTOG) and the European organization for research and treatment of cancer (EORTC). Int J Radiat Oncol Biol Phys. 1995;31:1341-1346.
Baillet F, Housset M, Maylin C, Boisserie G, Bettahar R, Delanian S, el al. The use of a specific hypofractionated radiation therapy regimen versus classical fractionation in the treatment of breast cancer: a randomized study of 230 patients. Int J Radiat Oncol Biol Phys 1990;19:1131-3.
Yarnold J, Bentzen SM, Coles C, Haviland J. Hypofractionated whole-breast radiotherapy for women with early breast cancer:
myths and realites. Int. J. Radiat Oncol Biol. Phys. 2011;79:1-9.
Bates TD. The 10-year results of a prospective trial of postoperative radiotherapy delivered in 3 fractions per week versus 2 fractions per week in breast carcinoma. Br J Radiol 1988;61: 625-30.
Yarnold JR, Owen JR, Bliss JM, Regan J, Broad B, Davidson J, el al. Randomised comparison of a 13 fraction schedule with a conventional 25 fraction schedule of radiotherapy after local excision of early breast cancer. Preliminary analysis. Br J Cancer. 1994; 70 (Suppl) XXII (04),10.
Downloads
Published
Versions
- 2013-10-21 (2)
- 2013-10-21 (1)
Issue
Section
License
Copyright (c) 2013 Acta Médica Costarricense
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
Los autores que publican en la revista Acta Médica Costarricense pueden distribuir, copiar, remezclar, retocar, leer, descargar, imprimir, buscar y crear a partir de su obra de modo no comercial, indicando los créditos a la revista y sus autores y compartir su obra en las mismas condiciones. Para ello se aplica la licencia Creative Commons Reconocimiento-NoComercial-CompartirIgual 4.0 Internacional(CC BY-NC-SA 4.0)
