Hypofractionated radiation treatment following mastectomy in early breast cancer: The <scp>C</scp>hristchurch experience

Ko, Dong-Hwan; Norriss, Andrew; Harrington, C.; Robinson, Bridget A.; James, Melissa

doi:10.1111/1754-9485.12242

Cited by 21 publications

(15 citation statements)

References 9 publications

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“…One series reports a 5-year local recurrence-free survival of 97.6%, 5-year overall survival of 74.7% and 5-year breast cancer survival of 77.7%. 8 This compares favourably with figures for CFRT after a mastectomy. Late toxicity and especially cardiac toxicity for HFRT following a mastectomy, however, is not well documented.…”

Section: Introductionsupporting

confidence: 52%

“…Although randomised evidence comparing HFRT versus CFRT following mastectomy is lacking, long term outcome data from HFRT series indicate good breast cancer outcomes. One series reports a 5‐year local recurrence‐free survival of 97.6%, 5‐year overall survival of 74.7% and 5‐year breast cancer survival of 77.7% . This compares favourably with figures for CFRT after a mastectomy.…”

Section: Introductionmentioning

confidence: 96%

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Ischaemic heart disease following conventional and hypofractionated radiation treatment in a contemporary breast cancer series

James

Swadi

et al. 2018

J Med Imag Rad Onc

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Section: Introductionsupporting

confidence: 52%

Section: Introductionmentioning

confidence: 96%

Ischaemic heart disease following conventional and hypofractionated radiation treatment in a contemporary breast cancer series

James

Swadi

et al. 2018

J Med Imag Rad Onc

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“…This meta-analysis indicated that HFRT and CFRT were equally effective with respect to overall survival (OS), disease-free survival (DFS), locoregional recurrence (LRR), and distant metastasis (DM) after breast mastectomy. In recent small retrospective cohort studies, HF PMRT was shown to be effective with acceptable toxicity [38][39][40][41]. In a recent phase 2 trial [42], 67 women with clinical stage II to IIIa breast cancer who received a HF PMRT regimen of 36.6 Gy over 11 fractions to the chest wall and the draining regional lymph nodes with a scar boost of 4 fractions of 3.33 Gy revealed that after a median follow-up of 32 months, patients with isolated ipsilateral chest wall tumor recurrences were 3.0%, the 3-year estimated overall survival was 92.0% (95% CI, 78.9~97.1), the 3year estimated local recurrence-free survival was 89.2% (95% CI, 74.8~95.6), the 3-year estimated distant recurrence-free survival was 90.3% (95% CI, 79.7~95.6), and low toxicity was reported.…”

Section: Discussionmentioning

confidence: 99%

Comparing hypofractionated to conventional fractionated radiotherapy in postmastectomy breast cancer: a meta-analysis and systematic review

Liu¹,

Yang²,

Guo³

et al. 2020

Radiat Oncol

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Purpose: To compare the efficacy and toxicity of hypofractionated radiotherapy versus conventional fractionated radiotherapy in postmastectomy breast cancer using meta-analysis. Methods: The PubMed, EMbase, Cochrane Library, Google Scholar, Wan Fang and CNKI databases were searched to identify controlled clinical trials comparing hypofractionated radiotherapy versus conventional fractionated radiotherapy in postmastectomy breast cancer. Overall survival (OS) was the primary endpoint, and disease-free survival (DFS), locoregional recurrence (LRR), distant metastasis (DM), acute skin toxicity, acute lung toxicity, late skin toxicity, lymphedema,, shoulder restriction, and late cardiac related toxicity were the secondary endpoints. Results: Twenty-five controlled clinical trials involving 3871 postmastectomy breast cancer patients were included in this meta-analysis according to the selection criteria. The meta-analysis revealed that there were no significant differences in OS (OR = 1.08, 95% CI = 0.87~1.33, P = 0.49), DFS (OR = 1.13, 95% CI = 0.91~1.40, P = 0.28), LRR (OR = 1.01, 95% CI = 0.76~1.33, P = 0.96), DM (OR = 1.16, 95% CI = 0.85~1.58, P = 0.34), acute skin toxicity (OR = 0.94, 95% CI = 0.67~1.32, P = 0.72), acute lung toxicity (OR = 0.94, 95% CI = 0.74~1.20, P = 0.62), late skin toxicity (OR = 0.98, 95% CI = 0.75~1.27, P = 0.88), lymphedema (OR = 0.99, 95% CI = 0.77~1.28, P = 0.94), shoulder restriction (OR = 0.75, 95% CI = 0.43~1.31, P = 0.31), or late cardiac related toxicity (OR = 1.17, 95% CI = 0.82~1.65, P = 0.39) between the two groups. Conclusions: The results of this study show that compared to conventional fractionated radiotherapy, hypofractionated radiotherapy is not significantly different with respect to efficacy or toxicity in postmastectomy breast cancer. Additional large randomized clinical trials are needed to further confirm this conclusion.

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“…15 Ko et al, analyzed retrospective data of 133 PMRT patients in Christchurch Hospital, New Zealand and reported high local control rate (97.6%) and less toxicities with HFRT (40 Gy/16 fractions). 16 Elsayed et al, published another prospective trial of 47 patients receiving PMRT with conventional versus hypofractionation (42.72 Gy/16F). 17 The results were equivalent in terms of OS, DFS and adverse effects and observed HFRT to be advantageous in terms of reduced workload and cost of treatment.…”

Section: Discussionmentioning

confidence: 99%

Hypofractionated radiotherapy in post mastectomy locally advanced breast cancer: a study from a regional cancer center in North East India

et al. 2018

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Background: Adjuvant radiotherapy has increased local-regional and overall survival rates in breast cancer. Conventional fractionation delivering 50-60 Gray (Gy) over 5-6weeks is a standard approach. A shorter duration of hypofractionated treatment will be more convenient for patients and treatment providers if found safe and equally effective. Methods: Around 50 high risk breast cancer patients who underwent mastectomy were enrolled and randomized into the study arms-CF (Conventional Fractionation) Arm (50Gy/25 Fr @ 2 Gy/fraction/day 5 days a week over 5weeks) and HF (Hypo-Fractionation) arm (40.05 Gy/15 Fr @ 2.67 Gy/fraction/day 5 days a week over 3weeks). Treatment related acute and late toxicities, loco-regional recurrence; distant metastasis and survival rates were recorded for comparison. Results: Twenty-five patients were enrolled in each arm with baseline characters well matched. At median follow up of 44 months, OS was 80% in HF arm against 64% in CF arm (p-value: 0.292). HF arm also showed better DFS at 4 years of 76% compared to 64% in CF arm (p-value: 0.411). Although the difference was not significant statistically, the Hazard Ratio of 1.543 (95% CI: 0.549-4.339) for DFS and 1.801 (95% CI: 0.603-5.377) for OS indicated trends towards better outcomes in HF arm in terms of disease control and survival. Acute and late toxicities were also lesser in HF arm, though not statistically significant (all p-values >0.05). Conclusions:In post mastectomy setting, HFRT is comparable to CFRT in terms of safety and efficacy, will be more convenient for patients and care givers and hence can be a routine standard practice.

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Hypofractionated radiation treatment following mastectomy in early breast cancer: The Christchurch experience

Cited by 21 publications

References 9 publications

Ischaemic heart disease following conventional and hypofractionated radiation treatment in a contemporary breast cancer series

Ischaemic heart disease following conventional and hypofractionated radiation treatment in a contemporary breast cancer series

Comparing hypofractionated to conventional fractionated radiotherapy in postmastectomy breast cancer: a meta-analysis and systematic review

Hypofractionated radiotherapy in post mastectomy locally advanced breast cancer: a study from a regional cancer center in North East India

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