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Hypofractionated whole breast radiotherapy with or without hypofractionated boost in early stage breast cancer patients: a mono-institutional analysis of skin and subcutaneous toxicity

Breast Cancer volume 26, pages 290–304 (2019)Cite this article

Abstract

Background

Our study evaluated skin and subcutaneous toxicity analyzing its correlation with patient- and treatment-related factors in a large mono-institutional series of women with early stage breast cancer treated with adjuvant hypofractionated whole breast radiotherapy (WBRT) with or without a sequential hypofractionated boost (HB).

Methods

Two hundred and nineteen patients, median age 62 years, received adjuvant hypofractionated WBRT in 16 fractions to a total dose of 42.4 Gy. Patients with negative prognostic factors received a HB of 2.65 Gy for 4 or 5 (patients with focal positive surgical margins) fractions. Systemic adjuvant treatments were hormonal therapy (HT) and/or chemotherapy (CHT) and/or Trastuzumab. Toxicities were assessed using the Common Terminology Criteria for Adverse Events (CTCAE 4.03) scale at 5th, 10th, 16th, 20th day from the start of radiotherapy (RT) and 1, 6 and 12 months after the end of RT. Univariate and multivariate analysis estimated toxicity predictive factors.

Results

No case of treatment interruption and no acute or late G3 toxicities occurred. In the univariate analysis HB administration resulted a risk factor for acute toxicity, while CHT administration and number of excised lymph nodes ≥ 10 resulted a risk factor for late toxicity. In the multivariate analysis none of the evaluated factors emerged a risk factor for acute and/or late toxicity.

Conclusions

Our results confirmed that hypofractionated WBRT even followed by a HB resulted safe and well tolerated. Longer follow-up is warranted to estimate late toxicity and treatment outcomes.

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Author information

Affiliations

  1. Radiation Oncology Section, Department of Surgical and Biomedical Sciences, University of Perugia and Perugia General Hospital, 06156, Perugia, Italy

    Isabella Palumbo, Valentina Lancellotta & Cynthia Aristei

  2. Radiation Oncology Section, University of Perugia, Perugia, Italy

    Cristina Mariucci, Anna Maria Podlesko & Simonetta Saldi

  3. Radiation Oncology Division, Perugia General Hospital, Perugia, Italy

    Lorenzo Falcinelli & Elisabetta Perrucci

  4. Medical Physics Unit, Perugia General Hospital, Perugia, Italy

    Marta Marcantonini

  5. Internal Medicine Endocrine and Metabolic Science Section, University of Perugia, Perugia, Italy

    Vittorio Bini

Authors
  1. Isabella Palumbo
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  2. Cristina Mariucci
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  3. Lorenzo Falcinelli
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  4. Elisabetta Perrucci
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  5. Valentina Lancellotta
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  6. Anna Maria Podlesko
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  7. Marta Marcantonini
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  8. Simonetta Saldi
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  9. Vittorio Bini
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  10. Cynthia Aristei
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Corresponding author

Correspondence to Isabella Palumbo.

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Ethical standards

The study was conducted in accordance with the Helsinki declaration as revised in 2000. Written informed consent was obtained from all patients.

Conflict of interest

The authors declare no conflict of interest.

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Palumbo, I., Mariucci, C., Falcinelli, L. et al. Hypofractionated whole breast radiotherapy with or without hypofractionated boost in early stage breast cancer patients: a mono-institutional analysis of skin and subcutaneous toxicity. Breast Cancer 26, 290–304 (2019). https://doi.org/10.1007/s12282-018-0923-z

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  • DOI: https://doi.org/10.1007/s12282-018-0923-z

Keywords

  • Breast cancer
  • Hypofractionated whole breast radiotherapy
  • Hyprofractionated boost
  • Skin toxicity
  • Subcutaneous toxicity