Abstract
AimTo report toxicity of hypofractionated whole-breast radiotherapy (HWBRT) in a large cohort of early-stage breast cancer (BCA) patients.Methods and MaterialsFrom 02/2009-05/2017, 1325 consecutive BCA patients were treated with 40.05 Gy/15 fractions, without boost with manually optimized IMRT. Median age: 62 (IQR:51.1-70.5) years. Chemotherapy was prescribed for 28% of patients, hormonal therapy for 80.3%, monoclonal antibodies for 8.2%. Ten% of patients <45 years, 23.8% obese, 5.9% diabetic, 34% hypertensive. ResultsMedian follow-up: 72.4 (IQR: 44.6-104.1) months. Acute RTOG toxicity was: 69.8% Grade(G)1, 14.3% G2 and 1.7% G3. Late SOMA-LENT toxicities were: edema-hyperpigmentation(E-H): G1 28.67%, G2 4.41%, G3 0.15%; fibrosis-atrophy-telangiectasia-pain(F-A-T-P): G1 14.6%, G2 3.2%, G3 0.8%, G4 0.1%. Median time to first occurrence was 6 and 18 months, respectively.Aesthetic result after surgery was excellent in 28.7%, good in 41.5%, acceptable in 20.3% and poor in 9.5% of patients. Change in breast appearance after radiotherapy was mild in 6.9%, moderate in 2.3% and marked in 1.3% of patients.Concomitant chemotherapy, obesity, smoking, use of bolus and planning target volume (PTV) were associated with higher acute toxicity. Patients ≥55 years old were less likely to experience acute toxicity. PTV and acute G2 toxicity were associated with ≥G2 E-H. PTV, concomitant chemotherapy, hypertension and ≥G2 acute toxicity were associated with increased risk of F-A-T-P. ConclusionHWBRT without boost demonstrated mild acute and late toxicity in a large cohort of consecutive patients. Timing of changes in breast appearance after radiotherapy was registered and patient, therapy and dosimetric predictive toxicity factors were identified.
181: Patient Experience Survey of Early-Stage Breast Cancer Patients Undergoing Whole Breast Radiotherapy
