Hypofractionated Breast Radiation: Shorter Scheme, Lower Toxicity

Area of Science:

• Oncology
• Radiation Oncology
• Radiotherapy

Background:

• Assessing toxicity and cosmetic outcomes of 3-dimensional conformal radiotherapy (3D-CRT) with hypofractionated schedules.
• Identifying risk factors associated with hypofractionated radiotherapy for breast cancer.

Purpose of the Study:

• To evaluate the safety and efficacy of hypofractionated radiotherapy for breast cancer.
• To analyze toxicity and cosmetic results in patients treated with this schedule.
• To identify risk factors influencing outcomes.

Main Methods:

• Retrospective analysis of 143 breast cancer patients (stage 0-III) treated from 2006-2011.
• Hypofractionated schedule: 42.4 Gy in 16 fractions with whole breast irradiation and tumor bed boost.
• Median follow-up of 36 months, assessing acute skin toxicity, fibrosis, and cosmetic outcomes.

Main Results:

• 91% of patients achieved good or excellent cosmetic outcomes.
• Mild acute skin toxicity (62%) and moderate (7%); no grade 4 toxicity.
• Low rates of fibrosis (5% in boost area, 23% in non-boost area).
• Toxicity correlated with boost type and total dose; cosmetic outcomes associated with surgery type, boost type, and total dose.

Conclusions:

• Hypofractionated whole-breast irradiation with a simultaneous integrated boost is safe and effective.
• This technique yields good cosmetic results with acceptable toxicity.
• Risk factors for toxicity and cosmetic outcomes identified, guiding treatment personalization.