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Comparison of hypofractionated and conventionally fractionated whole-breast irradiation for early breast cancer patients: a single-institute study of 1,098 patients

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Abstract

Purpose

To evaluate the efficacy and safety of hypofractionated whole-breast irradiation (HF-WBI) compared with conventionally fractionated (CF) WBI.

Materials and methods

Patients with early breast cancer (stages 0–II and <3 positive lymph nodes) who had undergone breast-conserving surgery were eligible for the HF-WBI study. HF-WBI was administered at 43.2 Gy in 16 fractions over 3.2 weeks to the whole breast with an additional tumor-bed boost of 8.1 Gy in 3 fractions over 3 days for positive surgical margins or those <5 mm. CF-WBI was administered at 50 Gy in 25 fractions over 5 weeks to the whole breast with an additional tumor-bed boost of 16 Gy in 8 fractions over 1.4 weeks to 6 Gy in 3 fractions over 3 days, depending on margin status.

Results

From April 1, 2006, to December 31, 2010, 717 patients were registered and 734 breasts were treated by HF-WBI. In the same period, 381 patients and 393 breasts who matched the study criteria chose CF-WBI, so the total number of patients in this comparison was 1,098. Grade 2 acute skin reactions were observed for 24 patients (3 %) in the HF-WBI group and 53 patients (14 %) in the CF-WBI (p < 0.001) group. The median follow-up period was 27 months. Two cases of intrabreast tumor recurrence were observed in each treatment group. Regional lymph node recurrence was observed in 1 HF-WBI patient and 2 CF-WBI patients.

Conclusion

HF-WBI is superior to CF-WBI in terms of acute skin reaction and has the same short-term efficacy.

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Conflict of interest

The authors report no conflict of interest or financial support for this study.

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Authors and Affiliations

  1. Department of Radiology, Faculty of Medicine, Juntendo University, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan

    Kumiko Karasawa, Hiroaki Kunogi, Takahisa Hirai, Hidehiro Hojo, Hisako Hirowatari, Hiromi Izawa, Kana Ito, Keisuke Sasai & Tomohisa Furuya

  2. Department of Medical Physics for Advanced Radiotherapy, Graduate School of Medicine, Juntendo University, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan

    Kumiko Karasawa, Kana Ito, Motohiro Kawashima, Tomohisa Furuya, Satoru Sugimoto, Chie Kurokawa & Shuichi Ozawa

  3. Department of Breast Surgery, Faculty of Medicine, Juntendo University, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan

    Mitsue Saito

  4. Research Center Hospital for Charged Particle Therapy, National Institute of Radiological Sciences, 4-9-1 Anagawa, Inage-ku, Chiba, Chiba, 263-8555, Japan

    Kumiko Karasawa

Authors
  1. Kumiko Karasawa
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  2. Hiroaki Kunogi
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  3. Takahisa Hirai
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  4. Hidehiro Hojo
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  7. Kana Ito
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  8. Keisuke Sasai
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  9. Motohiro Kawashima
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  11. Satoru Sugimoto
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  12. Chie Kurokawa
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  13. Shuichi Ozawa
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  14. Mitsue Saito
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Corresponding author

Correspondence to Kumiko Karasawa.

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Karasawa, K., Kunogi, H., Hirai, T. et al. Comparison of hypofractionated and conventionally fractionated whole-breast irradiation for early breast cancer patients: a single-institute study of 1,098 patients. Breast Cancer 21, 402–408 (2014). https://doi.org/10.1007/s12282-012-0406-6

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  • DOI: https://doi.org/10.1007/s12282-012-0406-6

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