1. Ultra-hypofractionated whole breast adjuvant radiotherapy in the real-world setting: single experience with 271 elderly/frail patients treated with 3D and IMRT technique
- Author
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Maria Alessia Zerella, Samantha Dicuonzo, Samuele Frassoni, Mattia Zaffaroni, Marianna Alessandra Gerardi, Anna Morra, Damaris Patricia Rojas, Simona Arculeo, Luca Bergamaschi, Cristiana Fodor, Francesca Emiro, Consiglia Piccolo, Vincenzo Bagnardi, Federica Cattani, Viviana Galimberti, Paolo Veronesi, Roberto Orecchia, Maria Cristina Leonardi, Barbara Alicja Jereczek-Fossa, Zerella, M, Dicuonzo, S, Frassoni, S, Zaffaroni, M, Gerardi, M, Morra, A, Rojas, D, Arculeo, S, Bergamaschi, L, Fodor, C, Emiro, F, Piccolo, C, Bagnardi, V, Cattani, F, Galimberti, V, Veronesi, P, Orecchia, R, Leonardi, M, and Jereczek-Fossa, B
- Subjects
Cancer Research ,Frail Elderly ,Breast Neoplasms ,General Medicine ,Once-weekly ultra-hypofractionated radiotherapy ,Whole breast adjuvant radiotherapy ,Breast cancer ,Oncology ,3DCRT ,Humans ,Female ,Radiotherapy, Adjuvant ,Radiotherapy, Intensity-Modulated ,Neoplasm Recurrence, Local ,Radiotherapy, Conformal ,IMRT ,Original Article – Cancer Research ,Aged - Abstract
Purpose The purpose of the study was to evaluate the toxicity, local control, overall and disease-free survival of elderly breast cancer (BC) patients treated with adjuvant once-weekly ultra-hypofractionated radiotherapy (RT) either with intensity-modulated RT (IMRT) or 3D conformal RT (3DCRT). Methods From July 2011 to July 2018, BC patients receiving 5.7 Gy once a week for 5 weeks to the whole breast after breast-conserving surgery were considered for the study. Inclusion criteria were: T1–T3 invasive BC, no or limited axillary involvement, age ≥ 65 years or women with commuting difficulties or disabling diseases. Results A total of 271 patients were included in the study. Median age was 76 (46–86) years. Most of BC were T1 (77%), while the remaining were T2 (22.2%) and T3 (0.4%). Axillary status was negative in 68.3% of the patients. The only severe acute toxicity (G3) at the end of RT was erythema (0.4%), registered in the 3DCRT group; no G3 edema or epitheliolysis was recorded. With 18 months of median follow-up, severe early–late toxicity (G3) was reported in terms of fibrosis and breast retraction, both with an incidence of 1.4%, mostly in the 3DCRT group. Oncological outcomes at a median follow-up of 2.9 years reported 249/271 (91.9%) patients alive and free from any event and 5 (1.8%) isolated locoregional recurrences. At 3 years, disease-free survival and overall survival were 94.9% and 97.8%, respectively. Breast volume > 500 cm3 was reported as predictive for moderate–severe (≥ G2) acute toxicity. Conclusions Weekly ultra-hypofractionated whole breast RT seems feasible and effective. Toxicity was mild, local control was acceptable, and overall survival was 97.8% at 3 years. Rates of severe toxicity were reduced with the IMRT technique. Supplementary Information The online version contains supplementary material available at 10.1007/s00432-021-03907-w.
- Published
- 2022