Comparison of Acute and Late Toxicities With Daily Versus Every-Other-Day 5-Fraction Partial Breast Radiation Therapy

IF 3.5 3区医学 Q2 ONCOLOGY

Practical Radiation Oncology Pub Date : 2025-05-01 DOI:10.1016/j.prro.2025.01.006

Sean M. Parker MD , Ahmed Halima MD , Sudha Amarnath MD , Maria Claudia Moncaliano BS , Arya Patel BS , Connor Spera BS , Elizabeth Obi MD , Cole Billena MD , Zahraa Al-Hilli MD, MBA , Sheen Cherian MD , Rahul Tendulkar MD , Chirag Shah MD

{"title":"Comparison of Acute and Late Toxicities With Daily Versus Every-Other-Day 5-Fraction Partial Breast Radiation Therapy","authors":"Sean M. Parker MD , Ahmed Halima MD , Sudha Amarnath MD , Maria Claudia Moncaliano BS , Arya Patel BS , Connor Spera BS , Elizabeth Obi MD , Cole Billena MD , Zahraa Al-Hilli MD, MBA , Sheen Cherian MD , Rahul Tendulkar MD , Chirag Shah MD","doi":"10.1016/j.prro.2025.01.006","DOIUrl":null,"url":null,"abstract":"<div><h3>Purpose</h3><div>Partial breast irradiation (PBI) delivered with intensity modulated radiation therapy over 5 fractions every other day represents an attractive, convenient method of delivering adjuvant radiation therapy for well-selected patients without compromising oncologic or toxicity outcomes. Condensing this regimen to a week of treatment through consecutive daily delivery may further increase patient convenience, though a comparison of toxicities between daily and every other day regimens is limited.</div></div><div><h3>Methods and Materials</h3><div>We retrospectively reviewed 507 patients from an institutional registry undergoing PBI for ductal carcinoma in situ (DCIS) or early-stage breast cancer (T1-2N0/x) from 2015 to 2022. All patients received 30 Gy in 5 fractions with intensity modulated radiation therapy. Acute (toxicity within 90 days of treatment) and chronic toxicity were recorded.</div></div><div><h3>Results</h3><div>Of the 507 patients, 351 were treated every other day, and 159 were treated daily. Median follow-up was longer in the every-other-day group (2.4 vs 1.9 years, <em>P</em> < .001). With regards to acute toxicity, there was slightly reduced grade 1 to 2 dermatitis with daily treatment (39% every other day vs 35% daily, <em>P</em> = .06), while rates of fatigue (18% every other day vs 20% daily, <em>P</em> = .09) were similar. Rates of chronic toxicities were comparable between the two approaches, with no differences in the rates of chronic hyperpigmentation (14% every other day vs 14% daily, <em>P</em> = .97), telangiectasias (1% every other day vs 1% daily, <em>P</em> = .92), mild fibrosis/induration (13% every other day vs 13% daily, <em>P</em> = .91), and lymphedema (0% every other day vs 1% daily, <em>P</em> = .31).</div></div><div><h3>Conclusions</h3><div>Overall, 5-fraction PBI delivered daily appears to be well tolerated with similar acute and chronic toxicity to every other day fractionation.</div></div>","PeriodicalId":54245,"journal":{"name":"Practical Radiation Oncology","volume":"15 3","pages":"Pages e240-e244"},"PeriodicalIF":3.5000,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Practical Radiation Oncology","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S1879850025000086","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"ONCOLOGY","Score":null,"Total":0}

引用次数: 0

Abstract

Purpose

Partial breast irradiation (PBI) delivered with intensity modulated radiation therapy over 5 fractions every other day represents an attractive, convenient method of delivering adjuvant radiation therapy for well-selected patients without compromising oncologic or toxicity outcomes. Condensing this regimen to a week of treatment through consecutive daily delivery may further increase patient convenience, though a comparison of toxicities between daily and every other day regimens is limited.

Methods and Materials

We retrospectively reviewed 507 patients from an institutional registry undergoing PBI for ductal carcinoma in situ (DCIS) or early-stage breast cancer (T1-2N0/x) from 2015 to 2022. All patients received 30 Gy in 5 fractions with intensity modulated radiation therapy. Acute (toxicity within 90 days of treatment) and chronic toxicity were recorded.

Results

Of the 507 patients, 351 were treated every other day, and 159 were treated daily. Median follow-up was longer in the every-other-day group (2.4 vs 1.9 years, P < .001). With regards to acute toxicity, there was slightly reduced grade 1 to 2 dermatitis with daily treatment (39% every other day vs 35% daily, P = .06), while rates of fatigue (18% every other day vs 20% daily, P = .09) were similar. Rates of chronic toxicities were comparable between the two approaches, with no differences in the rates of chronic hyperpigmentation (14% every other day vs 14% daily, P = .97), telangiectasias (1% every other day vs 1% daily, P = .92), mild fibrosis/induration (13% every other day vs 13% daily, P = .91), and lymphedema (0% every other day vs 1% daily, P = .31).

Conclusions

Overall, 5-fraction PBI delivered daily appears to be well tolerated with similar acute and chronic toxicity to every other day fractionation.

查看原文本刊更多论文

每日和每隔一天五次部分乳房放射治疗的急性和晚期毒性比较。

目的/目的：部分乳房照射（PBI）与每隔一天（QOD）五次调强放射治疗（IMRT）相结合，是一种有吸引力的、方便的辅助放射治疗方法，可以为精心选择的患者提供辅助放射治疗，而不会影响肿瘤或毒性结果。通过连续每日给药将该方案压缩为一周的治疗可能进一步增加患者的便利性，尽管每日给药方案和每日给药方案之间的毒性比较有限。材料/方法：我们回顾性分析了2015年至2022年507例机构登记的因DCIS或早期乳腺癌（T1-2N0/x）接受PBI的患者。所有患者接受5次30 Gy的IMRT治疗。记录急性（治疗90天内的毒性）和慢性毒性。结果：507例患者中，351例接受QOD治疗，159例每日治疗。QOD组的中位随访时间更长（2.4年vs 1.9年）。结论：总体而言，每天进行五次部分乳房照射似乎耐受性良好，急性和慢性毒性与隔天进行一次照射相似。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Practical Radiation Oncology Medicine-Radiology, Nuclear Medicine and Imaging

CiteScore

5.20

自引率

6.10%

发文量

177

审稿时长

34 days

期刊介绍： The overarching mission of Practical Radiation Oncology is to improve the quality of radiation oncology practice. PRO''s purpose is to document the state of current practice, providing background for those in training and continuing education for practitioners, through discussion and illustration of new techniques, evaluation of current practices, and publication of case reports. PRO strives to provide its readers content that emphasizes knowledge "with a purpose." The content of PRO includes: Original articles focusing on patient safety, quality measurement, or quality improvement initiatives Original articles focusing on imaging, contouring, target delineation, simulation, treatment planning, immobilization, organ motion, and other practical issues ASTRO guidelines, position papers, and consensus statements Essays that highlight enriching personal experiences in caring for cancer patients and their families.