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Ultra-Hypofractionated vs. Moderate Fractionated Whole Breast Three Dimensional Conformal Radiotherapy during the
Olivera Ivanov1,2, Aleksandra Milovančev1,3, Borislava Petrović2,4
1Faculty of Medicine, University of Novi Sad, 21000 Novi Sad, Serbia.
Medicina (Kaunas, Lithuania)
|June 24, 2022
Summary
Ultra-hypofractionated radiotherapy for breast cancer shows comparable toxicity and cosmetic outcomes to moderate hypofractionation. This shorter treatment regimen also reduced SARS-CoV-2 infection risk and lowered radiation doses to the lungs and heart.
Area of Science:
- Radiation Oncology
- Breast Cancer Treatment
- Oncologic Imaging
Background:
- Reducing radiotherapy treatment time is crucial during pandemics like COVID-19.
- Minimizing radiation-induced tissue toxicity is a key concern for breast cancer patients.
- Comparing different radiotherapy fractionation schedules is essential for optimizing patient care.
Purpose of the Study:
- To investigate compliance, toxicity, and cosmetic outcomes of ultra-hypofractionated versus moderately fractionated radiotherapy for breast cancer during the COVID-19 pandemic.
- To compare clinical and dosimetric parameters between the two fractionation regimens.
- To assess the impact of reduced treatment time on patient safety and treatment adherence.
Main Methods:
- A pilot prospective randomized study involving 60 early breast cancer patients post-surgery.
- Patients were assigned to either ultra-hypofractionated (26 Gy/5 fractions/1 week) or moderate hypofractionated (3D conformal radiotherapy) whole-breast irradiation.
- Compliance, dosimetric data, acute/late skin and subcutaneous toxicity (CTCAE v5, RESS), cosmetic results, and 18-month clinical follow-up were analyzed.
Main Results:
- The 5-fraction group showed a significantly lower prevalence of SARS-CoV-2 infection and treatment delays (p=0.05).
- Both groups had comparable Grade 1 acute skin toxicity, Grade 1 subcutaneous tissue toxicity, Grade 1 late skin toxicity, and cosmetic results.
- The 5-fraction group achieved significantly lower ipsilateral lung doses, and left breast cancer patients received lower heart and LAD doses (p<0.01).
Conclusions:
- Ultra-hypofractionated radiotherapy is a safe and effective alternative to moderate hypofractionation for breast cancer, with similar toxicity and cosmetic outcomes.
- This regimen offers significant dosimetric advantages, reducing radiation exposure to the lungs and heart.
- Shorter radiotherapy schedules may be crucial for minimizing risks of acute and late radiation-induced toxicities, especially during public health crises.
