Relation between Hypofractionated Radiotherapy, Toxicity and Outcome in Early Breast Cancer

Abstract

To compare adjuvant conventional radiotherapy (C-RT) to hypofractionated schedule (HF-RT) in early breast cancer. Between May 2012 and September 2015, 120 patients were included in the analysis. All patients underwent conservative surgery and adjuvant RT. RT was delivered in C-RT (50 Gy; 2 Gy/fr) or HF-RT (42.5 Gy; 2.66 Gy/fr), followed by a tumor bed boost (10 Gy; 2 Gy/fr). RT-induced toxicity was recorded and compared between groups. Toxicity results were graded according to the Common Terminology Criteria for Adverse Events guidelines. A multivariate analysis was performed of the factors associated with acute toxicity onset. Mild acute skin toxicity was observed in 71.7% of patients. No grade 4 toxicity was observed. From the multivariate analysis, Breast volume and RT fractionation significantly affected acute radiation-related toxicity. No increase in late toxic effects has been reported between C-RT and HF-RT schedules. Overall, the 2-year disease free survival was 94.4%. HF-RT represents a valid adjuvant treatment option in early breast cancer patients, without negative impact on acute and late radiation sequelae, as well as tumor control.

Matrix metalloproteases and TIMPs as prognostic biomarkers in breast cancer patients treated with radiotherapy: A pilot study

“…De Felice et al found that higher irradiated breast volume and conventional RT have a negative effect on acute skin toxicity. 18 Matrix metalloproteases (MMPs) are a family of enzymes that differ in their structure, substrate specificity, sequence homology, cellular localization and secretion. For this reason, they are divided into different subfamilies: collagenases, gelatinases, matrilysins, stromelysins, membrane type MMPs and others MMPs.…”

“…In addition, RT can be combined with surgery and/or systemic therapy. 18 In BC, the most commonly used RT regimens are conventional RT (45)(46)(47)(48)(49)(50) Gy in fractions of 2 Gy) and hypofractionated RT (normally 42.5 Gy in fractions of 2.66 Gy). 19 The efficacy obtained with RT can vary according to the chosen RT regimen and to increased radioresistance in patients.…”

Toxicity of Hypofractionated Radiotherapy Following Breast Conservative Surgery in Breast Cancer

“…Breast cancer is the most common cancer in women worldwide. Based on tumor and patient characteristics, treatment involves a multimodality approach which includes a combination of surgery with or without radiotherapy and/or systemic therapy [1].…”

“…This will result in reduced costs and waiting patient list and making treatment more acceptable for patients and hence decrease patient psychological morbidity associated with a long treatment course [1].…”

“…Data concerning acute and late radiation-related toxicities are now mature [6] [7]. However, inspite significant data and support of hypofractionated radiotherapy it's not yet being used extensively worldwide [1].…”