Late cosmetic results of short fractionation for breast conservation

Olivotto, Ivo A.; Weir, Lorna; Kim-Sing, Charmaine; Bajdik, Chris; Trevisan, Caroline; Doll, Corrine M.; Lam, Wing-Yee; Basco, V.; Jackson, Stewart M.

doi:10.1016/s0167-8140(96)91824-1

Cited by 126 publications

(67 citation statements)

References 34 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Consequently, hypofractionated radiotherapy was thought to be harmful to patients and conventionally fractionated radiotherapy considered as standard of care in most countries [10], [11]. However, retrospective data indicated that the use of hypofractionated radiotherapy in 13-16 fractions using 2.5-3.3 Gy per fractions to decreased total doses of 39-43 Gy is not associated with high radiation-induced acute and late toxicity and seemed to result in local recurrence rates as low as those achieved with conventionally fractionated radiotherapy in the adjuvant setting [12,13,14,15]. These observations prompted research groups first from Ontario and later from the United Kingdom to compare adjuvant hypofractionated radiotherapy to adjuvant conventionally fractionated radiotherapy in preferentially early breast cancer.…”

Section: Introductionmentioning

confidence: 99%

Hypofractionated Radiotherapy as Adjuvant Treatment in Early Breast Cancer. A Review and Meta-Analysis of Randomized Controlled Trials

Budach

Bölke

Matuschek³

2015

Breast Care

View full text Add to dashboard Cite

Background: Adjuvant radiotherapy after breast-conserving surgery is indicated in the vast majority of breast cancer patients. Conventionally fractionated radiotherapy with 50 Gy in 25 fractions was considered standard of care for several decades. The recently publishes long-term results of randomized trials that have tested different moderately hypofractionated radiotherapy schedules that may change clinical practice. Patients and Methods: A Pubmed search was carried out to identify the relevant publications on hypofractionated radiotherapy in breast cancer. In total, 4 randomized controlled trials representing the results of 7,095 patients with 10 years of follow-up were identified. A meta-analysis on the primary end point ipsilateral breast cancer recurrence and a review of the toxicity data were performed. Results: Moderately hypofractionated radiotherapy using schedules such as 40 Gy in 15 fractions administered within 3 weeks are as efficient and safe as conventionally fractionated radiotherapy for most breast cancer patients who need adjuvant radiotherapy after breast-conserving surgery. In patients aged < 40 years, after neoadjuvant chemotherapy, and if regional lymph node radiotherapy is indicated, further data are needed. Conclusion: Moderately hypofractionated radiotherapy can be recommended as standard treatment after breast-conserving surgery in the majority of breast cancer patients.

show abstract

Section: Introductionmentioning

confidence: 99%

Hypofractionated Radiotherapy as Adjuvant Treatment in Early Breast Cancer. A Review and Meta-Analysis of Randomized Controlled Trials

Budach

Bölke

Matuschek³

2015

Breast Care

View full text Add to dashboard Cite

show abstract

“…A commonly used radiation fractionation schedule in most studies has been a total dose to the whole breast of 45-50 Gy in 1.8-2.0 Gy daily fractions, often with an additional boost to the tumor bed, resulting in treatment over 5-7 weeks. In comparison, the use of shorter fractionation schedules ranging from 40 to 45 Gy in 15-20 fractions has been reported in the United Kingdom and Canada [10,[15][16][17][18][19][20]. This approach is based on the radiobiologic model that a larger dose per fraction given over a shorter period of time is just as effective as the more traditional longer schedule [9].…”

mentioning

confidence: 99%

Whole-breast radiotherapy with shorter fractionation schedules following breast-conserving surgery: short-term morbidity and preliminary outcomes

et al. 2007

View full text Add to dashboard Cite

show abstract

“…Results of retrospective studies of hypofractionated RT in early breast cancer suggest satisfactory outcomes as regard tumor control and late adverse events [19] [20].…”

Section: Discussionmentioning

confidence: 97%

Concomitant Boost Radiotherapy after Conservative Breast Surgery in Early Breast Cancer

El-Hadaad¹,

Wahba²,

Elnahas³

et al. 2016

ABCR

View full text Add to dashboard Cite

Background: Radiation therapy after breast conserving surgery is a standard part of treatment for invasive breast cancer. Based on radiobiological models, it was found that shorter radiation schedules offered the promise of equivalent local control to standard radiation therapy by giving larger doses per fraction in shorter period of time. Methods: This study included 36 female patients with operable invasive stage I-II breast cancer. These patients underwent microscopic wide local excision of the primary tumor and lymph node dissection. They received adjuvant radiotherapy. The radiation dose was 40 Gy total dose in 15 fractions for whole breast and additional dose of 9 Gy in three consecutive fractions was delivered to tumour cavity simultaneously. Results: Mean age was 52 years (range: 30 -67); most patients were of stage II disease and Grade II was the most common one. Invasive ductal carcinoma was reported in 94.4% and 72.2% of patients were hormone receptor positive. After median follow-up of 52 months, all patients were alive and ipsilateral local recurrence was reported in 1 case only. Grade IV radiation toxicity was not observed; moist desquamation was the most common acute reaction (61%) with grade III in 5.5% followed by dry desquamation in 55.6% of grade I only. Grade I erythema was recorded in 41.7% and grade II in 11%. Fibrosis was the most frequent late reaction (44.3%) with grade II in 11% followed by telengectesia then pigmentation (41.7%, 33.3% respectively). Conclusion: The regimen used in this study appears promising with acceptable acute toxicities and convenient for our patients and has the advantage of economic use of radiation facilities. However, larger number of patients and longer period of follow-up are needed for further evaluation.

show abstract

Late cosmetic results of short fractionation for breast conservation

Cited by 126 publications

References 34 publications

Hypofractionated Radiotherapy as Adjuvant Treatment in Early Breast Cancer. A Review and Meta-Analysis of Randomized Controlled Trials

Hypofractionated Radiotherapy as Adjuvant Treatment in Early Breast Cancer. A Review and Meta-Analysis of Randomized Controlled Trials

Whole-breast radiotherapy with shorter fractionation schedules following breast-conserving surgery: short-term morbidity and preliminary outcomes

Concomitant Boost Radiotherapy after Conservative Breast Surgery in Early Breast Cancer

Contact Info

Product

Resources

About