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- Title
Large scale experience of two ultrahypofractionated 5 fractions regimes after breast conserving surgery from a single centre.
- Authors
Sauvage, Louis-Marie; Loap, Pierre; Vu-Bezin, Jeremi; Cao, Kim; Kissel, Manon; Bringer, Solène; Maraadji, Safia; Fourquet, Alain; Kirova, Youlia
- Abstract
Ultra-hypofractionation breast radiotherapy is a safe alternative to moderate hypofractionation. This study reports the results of two ultrahypofractionated regimens used in clinical practice in a high-volume radiotherapy center in terms of efficacy and of tolerance. we included all patients treated in an adjuvant setting with five fractions after breast conserving surgery (BCS), for a histologically-confirmed invasive or in situ breast carcinoma. Radiotherapy regimens after BCS were either a 5-week schedule with 5 weekly fractions of 5,7 Gy or a one-week schedule with 5 daily fractions of 5,2 Gy. Adverse events were recorded and local-relapse free survival (LRFS), locoregional-relapse free survival (LRRFS), metastasis-free survival (MFS), for breast-cancer specific survival (BCSS) and overall survival (OS) were evaluated. Between December 2014 and December 2022, 396 patients (400 breasts) were treated with ultrahypofractionated radiotherapy. Five-year LRFS was 98.8% (95% confidence interval: 97.1%–100%), and 5-year OS was 96.0% (95%CI: 92.6–99.5%). Age was statistically associated with OS in univariate analysis (HR: 1.16, 95%CI: 1.04–1.42, p =.01). Four patients (1.0%) experienced acute grade 3 radiation-induced adverse events, and 8 patients (2.3%) acute grade 2 toxicities. Twenty-three patients (5.8%) experienced late toxicity, all of them being graded as grade 1. The use of the 5.7 Gy-weekly-fraction regimen and the delivery of a tumor bed boost were significantly associated with acute radiodermatitis (p <.01; p =.02; respectively) and late fibrosis (p <.01; p =.049; respectively). ultrahypofractionated radiotherapy was associated with an excellent tumor control rate in our 'real-life' cohort with low-risk breast cancer patients. However, delivery of a tumor bed boost and using weekly 5.7-Gy fractions were associated with an increased risk of acute and late cutaneous toxicities.
- Subjects
FRANCE; STATISTICS; CONFIDENCE intervals; ACADEMIC medical centers; LIFE expectancy; MULTIVARIATE analysis; CANCER relapse; RETROSPECTIVE studies; RADIODERMATITIS; FIBROSIS; RADIATION doses; DESCRIPTIVE statistics; ADVERSE health care events; PROGRESSION-free survival; HUMAN skin color; RADIATION injuries; BREAST tumors; OVERALL survival; EDEMA; LONGITUDINAL method
- Publication
Acta Oncologica, 2023, Vol 62, Issue 12, p1791
- ISSN
0284-186X
- Publication type
Article
- DOI
10.1080/0284186X.2023.2267170