Ultra-hypofractionated 5-fraction radiation therapy for early breast cancer into whole breast and regional nodes: experience in a tertiary hospital.

IF 2.8 3区 医学 Q2 ONCOLOGY
Eva María Tejada Ortigosa, Inés Ollinger Casin, Isabela Gaztelu Blanco, Gema Muñiz Romero, Roberto de Haro Piedra
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引用次数: 0

Abstract

Introduction: Post-surgery radiotherapy to the breast and regional lymph nodes decreases locoregional tumour recurrence and related mortality. The FAST-Forward approach, with 5 daily fractions, shows non-inferiority to the conventional 15-fraction scheme with similar safety. Authors suggest Simultaneous Integrated Boost (SIB) for the tumour bed and regional nodal irradiation (RNI) for comparable toxicity.

Objectives and purposes: To describe acute and delayed toxicity in adjuvant radiotherapy patients using FAST-Forward scheme with SIB and analyze associations with patient characteristics.

Materials and methods: An observational, descriptive, retrospective study on 120 early breast cancer patients (pT1-3, pN0-1, M0), treated with surgery and adjuvant radiotherapy using the FAST-Forward scheme with SIB at our center. Some also received RNI. Study conducted from June 2021 to October 2023.

Results: Median age: 55 years (range 30-86). Main histological type: infiltrating ductal carcinoma (80%), with Luminal A as predominant molecular subtype (58.5%). Stage IA tumours (61%), pT1c (40%), G2 (50%). Treatment included: neoadjuvant chemotherapy (18.3%), adjuvant chemotherapy (23.5%), hormonal treatment (82.5%), surgery (99%). Radiotherapy with SIB in 90% of conservative surgeries with a median dose 30 Gy (range: 29-33.6). There was no significant association between acute/chronic toxicity and SIB found. However, there was increased risk of acute induration with neoadjuvant chemotherapy. Adjuvant chemotherapy was linked to significant rates of acute and delayed hyperpigmentation. The acute toxicity in first 6 months post-radiotherapy was only G1. The most frequent late toxicities were G1 indurations, edema, hyperpigmentation.

Conclusions: The FAST-Forward scheme with SIB and RNI in 5 daily fractions seems well-tolerated without severe acute or delayed toxicity.

超低分割五分位放射治疗早期乳腺癌全乳及局部淋巴结:某三级医院经验
导言:术后乳房及局部淋巴结放疗可降低局部肿瘤复发率及相关死亡率。使用5个每日分数的FAST-Forward方法与传统的15分数方案相比,具有相似的安全性。作者建议同时综合增强(SIB)用于肿瘤床和区域淋巴结照射(RNI)的毒性相当。目的和目的:描述使用FAST-Forward方案的SIB辅助放疗患者的急性和延迟毒性,并分析与患者特征的关联。材料与方法:对我院120例早期乳腺癌患者(pT1-3, pN0-1, M0)进行观察性、描述性、回顾性研究,采用FAST-Forward方案配合SIB进行手术和辅助放疗。一些还接受了RNI。研究时间为2021年6月至2023年10月。结果:中位年龄:55岁(范围30-86岁)。主要组织学类型:浸润性导管癌(80%),以管腔A分子亚型为主(58.5%)。IA期肿瘤(61%),pT1c期(40%),G2期(50%)。治疗方式包括:新辅助化疗(18.3%)、辅助化疗(23.5%)、激素治疗(82.5%)、手术(99%)。90%的保守手术采用SIB放疗,中位剂量为30 Gy(范围:29-33.6)。急性/慢性毒性与SIB之间未发现显著关联。然而,新辅助化疗会增加急性硬化的风险。辅助化疗与急性和延迟性色素沉着的显著率相关。放疗后前6个月急性毒性仅为G1。最常见的晚期毒性是G1期硬化、水肿、色素沉着。结论:SIB和RNI每日5次的FAST-Forward方案似乎耐受性良好,没有严重的急性或延迟毒性。
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来源期刊
CiteScore
6.20
自引率
2.90%
发文量
240
审稿时长
1 months
期刊介绍: Clinical and Translational Oncology is an international journal devoted to fostering interaction between experimental and clinical oncology. It covers all aspects of research on cancer, from the more basic discoveries dealing with both cell and molecular biology of tumour cells, to the most advanced clinical assays of conventional and new drugs. In addition, the journal has a strong commitment to facilitating the transfer of knowledge from the basic laboratory to the clinical practice, with the publication of educational series devoted to closing the gap between molecular and clinical oncologists. Molecular biology of tumours, identification of new targets for cancer therapy, and new technologies for research and treatment of cancer are the major themes covered by the educational series. Full research articles on a broad spectrum of subjects, including the molecular and cellular bases of disease, aetiology, pathophysiology, pathology, epidemiology, clinical features, and the diagnosis, prognosis and treatment of cancer, will be considered for publication.
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