Hypofractionated whole breast irradiation after conservative surgery for patients aged less than 60 years: a multi-centre comparative study

Authors

  • Icro Meattini Department of Experimental and Clinical Biomedical Sciences “M. Serio”, University of Florence, Florence, Italy; Radiation Oncology Unit, Oncology Department, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy
  • Philip Poortmans Radiation Oncology Department, Institut Curie, Paris, France
  • Youlia Kirova Radiation Oncology Department, Institut Curie, Paris, France
  • Calogero Saieva Cancer Risk Factors and Lifestyle Epidemiology Unit, Institute for Cancer Research, Prevention and Clinical Network (ISPRO), Florence, Italy
  • Luca Visani Department of Experimental and Clinical Biomedical Sciences “M. Serio”, University of Florence, Florence, Italy; Radiation Oncology Unit, Oncology Department, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy
  • Viola Salvestrini Department of Experimental and Clinical Biomedical Sciences “M. Serio”, University of Florence, Florence, Italy; Radiation Oncology Unit, Oncology Department, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy
  • Jiyoung Kim Department of Radiation Oncology, Ewha Womans University College of Medicine, Seoul, Republic of Korea
  • Wonguen Jung Department of Radiation Oncology, Ewha Womans University College of Medicine, Seoul, Republic of Korea
  • Emanuela Olmetto Department of Experimental and Clinical Biomedical Sciences “M. Serio”, University of Florence, Florence, Italy; Radiation Oncology Department, Institut Curie, Paris, France
  • Matteo Mariotti Department of Experimental and Clinical Biomedical Sciences “M. Serio”, University of Florence, Florence, Italy
  • Isacco Desideri Department of Experimental and Clinical Biomedical Sciences “M. Serio”, University of Florence, Florence, Italy; Radiation Oncology Unit, Oncology Department, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy
  • Alain Fourquet Radiation Oncology Department, Institut Curie, Paris, France
  • Lorenzo Livi Department of Experimental and Clinical Biomedical Sciences “M. Serio”, University of Florence, Florence, Italy; Radiation Oncology Unit, Oncology Department, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy
  • Kyubo Kim Department of Radiation Oncology, Ewha Womans University College of Medicine, Seoul, Republic of Korea

DOI:

https://doi.org/10.1080/0284186X.2019.1695061

Abstract

Background: For decades, conventional fractionated whole breast irradiation (CF-WBI) was used after breast conserving surgery (BCS). Pivotal phase-3 trials on hypofractionated-WBI (HF-WBI) showed its non-inferiority as compared to CF-WBI. However, younger patients are often not treated with HF-WBI. The aim of this multi-centre comparative study is to confirm the safety of HF-WBI in a real-life series of younger patients.

Material and methods: Between 2010 and 2016, a total of 786 patients aged less than 60 years old with early-stage breast cancer were treated with postoperative WBI after BCS in three breast cancer centres: 340 underwent HF-WBI while 446 were treated with CF-WBI. Acute toxicity was evaluated at the end of WBI. Late toxicity was evaluated at 6, 12, 24 and 36 months.

Results: At univariate logistic analysis, hypofractionation showed a significant protective effect in terms of acute oedema, acute wet desquamation, chronic oedema, chronic erythema/pigmentation and breast fibrosis. At multivariate logistic analysis, hypofractionation was an independent significant factor for acute oedema, acute wet desquamation, and chronic oedema. There were not differences in tumour-related outcomes.

Conclusions: HF-WBI showed significantly improved outcomes in terms of acute skin oedema, wet desquamation and chronic skin oedema. HF-WBI after BCS should be strongly encouraged to replace CF-WBI independently of age.

Downloads

Download data is not yet available.

Downloads

Additional Files

Published

2020-02-01

How to Cite

Meattini, I., Poortmans, P., Kirova, Y., Saieva, C., Visani, L., Salvestrini, V., … Kim, K. (2020). Hypofractionated whole breast irradiation after conservative surgery for patients aged less than 60 years: a multi-centre comparative study. Acta Oncologica, 59(2), 188–195. https://doi.org/10.1080/0284186X.2019.1695061

Issue

Vol. 59 No. 2 (2020): Acta Oncologica

Section

Articles