Radiation therapy for the whole breast: Executive summary of an American Society for Radiation Oncology (ASTRO) evidence-based guideline

Smith, Benjamin D.; Bellon, Jennifer R.; Blitzblau, Rachel; Freedman, Gary M.; Haffty, Bruce G.; Hahn, Carol A.; Halberg, F.; Hoffman, Karen E.; Horst, Kathleen C.; Moran, Jean M.; Patton, Caroline; Perlmutter, Jane; Warren, Laura; Whelan, Timothy J.; Wright, Jean L.; Jagsi, Reshma

doi:10.1016/j.prro.2018.01.012

Cited by 479 publications

(371 citation statements)

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“…New data led ASTRO to conduct a task force to review the recommendations. The recent published evidence‐based guideline, suggests that HF is appropriate for treating the whole breast irrespective of age, chemotherapy use, and node status since there is no additional field to cover lymph node chains …”

Section: Discussionmentioning

confidence: 88%

Once‐weekly hypofractionated radiotherapy for breast cancer: First results of a phase II clinical trial

et al. 2019

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Hypofractionated radiotherapy (HF) in 15 or 16 daily fractions is well established as an alternative in early breast cancer after breast‐conserving surgery. Evidences for a whole‐breast treatment even shorter, in 5‐10 fractions, are still scarce. Women 50 years or older, with early breast tumor (pT1‐2pN0), after breast‐conserving surgery were eligible to enter in this phase II trial and received whole breast once‐weekly hypofractionated radiotherapy (wHF‐RT) to a total dose of 30 Gy, in 5 fractions of 6 Gy. During treatment and in post‐treatment follow‐up the toxicity was assessed and graduated according to the “Common Terminology Criteria for Adverse Events” (CTCAE), v3.0. Breast pictures for esthetic comparison were taken in 5 timepoints and 2 breast surgeons independently graduated the cosmetics changes. The trial was registered with ClinicalTrials.gov, number NCT01965483. From October 2013 to November 2015, 44 patients were enrolled in the trial and treated according to the protocol of wHF‐RT. The median age was 70.5 years (51‐88 years), and the median follow‐up was 22 months (9‐33 months). Skin erythema was the most common acute adverse event. At the end of radiation, 30 patients (68.2%) had any grade of radiation dermatitis. Concerning cosmetic appearance, there was no significant difference between pretreatment and 1 year assessments. The 2‐year overall survival and disease‐free survival were, respectively 96.8% and 97.7%. There was only one distant recurrence and no local or regional recurrence. Once‐weekly hypofractionated radiotherapy is a feasible and well tolerated alternative for early breast cancer adjuvant management with acceptable acute toxicity and esthetic outcomes.

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Section: Discussionmentioning

confidence: 88%

Once‐weekly hypofractionated radiotherapy for breast cancer: First results of a phase II clinical trial

et al. 2019

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“…Major updated guidelines stated that for women with invasive breast cancer receiving WBI, the preferred dose fractionation scheme is HF-WBI to a dose of 40 Gy in 15 fractions or 42.5 Gy in 16 fractions [35, 36]. …”

Section: Question 4: Is the Hypofractionated Treatment Approach Aftermentioning

confidence: 99%

Challenges in Radiotherapy

et al. 2019

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“…In the UK a standardised protocol of 50 Gy is delivered in 25 fractions of 2 Gy each over a period of 5 weeks while in the USA it similar: 40 Gy in 15 fractions, or 42.5 Gy in 16 fractions. 77,78 Standardised protocols are the norm for other cancers, with each tumour category having its own specific dosages and fractions. The issue with such generic treatment, as the LA-ICP-MS 2D spatial data have revealed, is that it does not deal with the considerable heterogeneity within each tumour type.…”

Section: Conclusion and Future Implicationsmentioning

confidence: 99%

Distributions of manganese in diverse human cancers provide insights into tumour radioresistance

Doble

Miklos²

2018

Metallomics

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Radiation therapy for the whole breast: Executive summary of an American Society for Radiation Oncology (ASTRO) evidence-based guideline

Cited by 479 publications

References 10 publications

Once‐weekly hypofractionated radiotherapy for breast cancer: First results of a phase II clinical trial

Once‐weekly hypofractionated radiotherapy for breast cancer: First results of a phase II clinical trial

Challenges in Radiotherapy

Distributions of manganese in diverse human cancers provide insights into tumour radioresistance

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