Hypofractionated Regional Nodal Irradiation for Women With Node-Positive Breast Cancer

Bellefqih, S.; Elmajjaoui, Sanaa; Aarab, Jihan; Khalil, J.; Afif, M.; Lachgar, A.; Kacemi, H. El; Kebdani, Tayeb; Benjaafar, Noureddine

doi:10.1016/j.ijrobp.2016.11.010

Cited by 39 publications

(31 citation statements)

References 27 publications

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“…The median follow-up time was 64 months (range, 11 to 88 months), and the 5-year OS, DFS, locoregional recurrence (LRR)-free survival, and distant metastasis (DM)-free survival was 86.6, 84.4, 93.9 and 83.1%, respectively. During study follow-up, no acute symptomatic pneumonitis, cardiac events, brachial plexopathy or rib fractures occurred, and the incidence of grade 2-4 lymphedema was 5.8% [48]. The above findings suggest that the HFRT schedule may be acceptable in breast cancer patients who require RNI.…”

Section: Discussionmentioning

confidence: 67%

“…A higher dose per treatment fraction might increase the risk of toxicities in the setting of regional nodal irradiation (RNI) [46], but hypofractionated RNI was not observed to increase toxicity in one randomized clinical trial [12]. Two recent studies reported that the efficacy and safety of hypofractionated RNI were acceptable [47,48]. One was based on UK START trials, with 864/5861 patients who experienced adjuvant lymphatic radiotherapy (LNRT) (PMRT 202/864, 23.4%) assessed using the EORTC QLQ-BR23 scale, protocol-specific questions and by physicians [47].…”

Section: Discussionmentioning

confidence: 99%

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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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Section: Discussionmentioning

confidence: 67%

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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“…The ultrahypo‐fractionated scheme, delivering a dose of 28/30‐Gy in once weekly fractions over 5 weeks or 26‐Gy in 5 daily fractions over 1 week as per the FAST and FAST Forward trials, should be considered and discussed on a case‐by‐case basis (patients requiring RT with N‐negative tumors that do not require a boost). Radiation boost on the tumor bed does not provide any benefit in OS and can be omitted for patients > 40 years without risk factors (LVI, high grade, hormone‐negative and positive surgical margins) 3,4 …”

Section: Priority Chemotherapy Radiotherapymentioning

confidence: 99%

Management of breast cancer during COVID‐19 pandemic in Morocco

Ismaili

Majjaoui

2020

Breast J

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“…Obviously, the morbidity associated with radiation plexopathy in the setting of chemotherapy‐induced neuropathy is immensely more severe than either single entity alone. Despite attempts to decrease damage to the brachial plexus by adjusting the tangents and fractions of radiation, these complications are at times unavoidable as seen in patients receiving high dose boost therapy, intraoperative radiation therapy, or salvage radiotherapy to previously treated areas . Unfortunately, other conservative measures including hyperbaric oxygen and combination pentoxifyllin‐tocopherol therapy have not been proven to be beneficial in the amelioration of RIBP …”

Section: Radiation‐induced Brachial Plexopathymentioning

confidence: 99%

Microneurosurgical treatment options in peripheral nerve compression syndromes after chemotherapy and radiation treatment

Chang

Rose

Rossi

et al. 2018

Journal of Surgical Oncology

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Chemotherapy-induced peripheral neuropathy and radiation-induced brachial plexopathy are extremely debilitating conditions which can occur after treatment of malignancy. Unfortunately, the diagnosis can be elusive, and this dilemma is further compounded by the lack of efficacious therapeutics to prevent the onset of neurotoxicity before initiating chemotherapy or radiation or to treat these sequelae after treatment. However, microsurgical nerve decompression can provide these patients with a viable option to treat this complication. K E Y W O R D S chemotherapy-induced peripheral neuropathy (CIPN), microsurgery treatment nerve decompression, peripheral nerve compression, radiation brachial plexopathy J Surg Oncol. 2018;118:793-799.wileyonlinelibrary.com/journal/jso

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Hypofractionated Regional Nodal Irradiation for Women With Node-Positive Breast Cancer

Cited by 39 publications

References 27 publications

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

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

Management of breast cancer during COVID‐19 pandemic in Morocco

Microneurosurgical treatment options in peripheral nerve compression syndromes after chemotherapy and radiation treatment

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