scholarly journals Hypofractionated and hyper-hypofractionated radiation therapy in postoperative breast cancer treatment

2020 ◽  
Vol 66 (9) ◽  
pp. 1301-1306
Author(s):  
Marcel Fang ◽  
Gustavo Nader Marta
Keyword(s):  
Breast Cancer ◽  
Clinical Trials ◽  
Radiation Therapy ◽  
Cancer Patients ◽  
Phase Iii ◽  
Long Term Results ◽  
Adjuvant Radiation ◽  
Breast Cancer Patients ◽  
Safety And Efficacy

SUMMARY INTRODUCTION: Radiation therapy is widely used as adjuvant treatment in breast cancer patients. In the last decades, several studies have been designed to evaluate the safety and efficacy of hypofractionated breast radiation therapy. More recently, even shorter regimens with doses above 4 Gy (hyper-hypofractionation) have also been proposed. This study aims to present a narrative review of the various hypofractionation protocols used to treat breast cancer patients with a focus on clinical application. RESULTS: Long-term results from several phase III randomized controlled trials demonstrated the safety and efficacy of hypofractionated breast radiation therapy using 15 or 16 fractions for early and locally advanced disease. The results of the initial clinical trials of hyper-hypofractionation are also encouraging and it is believed that these regimens may become routine in the indication of adjuvant radiation therapy treatment after the ongoing studies on this subject have matured. CONCLUSIONS: The idea that normal tissues could present high toxicity at doses above 2 Gy was opposed by clinical trials that demonstrated that moderate hypofractionation had similar results regarding oncological and cosmetic outcomes compared to conventional fractionation. Cosmetic and toxicity results from hyper-fractionation studies are in principle favorable. However, the long-term oncological results of studies that used hyper-hypofractionation for the treatment of breast cancer patients are still awaited.

Adjuvant radiation therapy in young breast cancer patients: current state of the art and evidence-based algorithm

The Breast ◽  
2018 ◽  
Vol 41 ◽  
pp. S15
Author(s):  
Icro Meattini ◽  
Matteo Lambertini ◽  
Isacco Desideri ◽  
Alex De Caluwé ◽  
Orit Kaidar-Person ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Radiation Therapy ◽  
Cancer Patients ◽  
State Of The Art ◽  
Adjuvant Radiation ◽  
Evidence Based ◽  
Breast Cancer Patients ◽  
Adjuvant Radiation Therapy ◽  
Current State ◽  
Young Breast Cancer

scholarly journals EP-1305 Long-term results up to 15 years after IORT boost in breast cancer patients

2019 ◽  
Vol 133 ◽  
pp. S714-S715
Author(s):  
E. Sperk ◽  
M. Pez ◽  
G. Welzel ◽  
A. Keller ◽  
Y. Abo-Madyan ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Patients ◽  
Long Term Results ◽  
Breast Cancer Patients

scholarly journals The impact of the loco-regional treatment in elderly breast cancer patients: Hypo-fractionated exclusive radiotherapy, single institution long-term results

The Breast ◽  
2010 ◽  
Vol 19 (5) ◽  
pp. 413-416 ◽  
Author(s):  
Cyrus Chargari ◽  
Youlia M. Kirova ◽  
Fatima Laki ◽  
Alexia Savignoni ◽  
Thierry Dorval ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Patients ◽  
Long Term Results ◽  
Breast Cancer Patients ◽  
Single Institution ◽  
The Impact ◽  
Regional Treatment

Management of octogenarians with female breast cancer in a rural oncology program.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. e16513-e16513
Author(s):  
Mir Asif Alikhan ◽  
Dianne L Limesand ◽  
Mark Schmelzel ◽  
Thomas McGlone ◽  
David Powers ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Radiation Therapy ◽  
Cancer Patients ◽  
Ductal Carcinoma ◽  
Lobular Carcinoma ◽  
Stage Iii ◽  
Adjuvant Radiation ◽  
Breast Cancer Patients ◽  
Co Morbidity ◽  
Her 2

e16513 Background: Despite the fact that chronological age alone does not determine tolerance to cancer treatment, there is a general perception that elderly cancer patients do not receive standard treatment. We sought to review breast cancer patients above 80 years in our practice. Methods: Retrospective analysis was performed ofall women with breast cancer over the age of 80 either at the time of diagnosis or at the time of relapse since July 2005 till July 2011. Results: There were total of 492 breast cancer patients seen during the study period, 207 below 65, 213 between 66-79 and 70 above 80. 59 women met the study criteria. The median age was 86 (81to 99 years). 47 had activities of independent living, 8 were in an assisted living facility and 4 in nursing homes. Median Charlson Co morbidity Index was 2 (0-5). Pathological types: DCIS 2, Invasive ductal carcinoma 50, invasive lobular carcinoma 6 and 1 had apocrine carcinoma. 50 had ER+, PR+ and Her-, 2 patients had triple negative disease and 4 Her+. 2 patients had stage 0, 22 stage I, 23 Stage II, 7 stage III and 5 stage IV. All patients stage 0-III had surgical management, 39 had breast conservative surgery with sentinel node biopsy and 15 had mastectomy. Out of 28 patients referred for adjuvant radiation therapy 17 received it. 49 patients received hormone treatment (39 aromatase inhibitors- AIs and 14 tamoxifen) Chemotherapy was offered but refused by two stage III patients. 2 Her + patients received and tolerated well trastuzumab based chemotherapy. After a median follow up of 48 months (8-120 months) there was 1 local recurrence, 1 distant relapse and 14 deaths ( 11 from other causes 3 from breast cancer). Conclusions: In ourpractice, a majority of octogenarians and nonagenarians live independently and have minimal co morbidities and tolerate standard surgical and hormonal treatment. Although radiation therapy would be considered optional in this group of women, it was offered based on predicted longevity. Mortality form other causes was higher than that from breast cancer ( 18% vs 5%).

Association of fatigue and insomnia with inflammatory cytokine and hematopoetic stem cell levels in breast cancer patients undergoing adjuvant radiation therapy.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e12048-e12048
Author(s):  
Fei-Fei Liu ◽  
Willa Wei Shi ◽  
M McCusker ◽  
Madeline Li ◽  
Jie Su ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Radiation Therapy ◽  
Stem Cell ◽  
Cancer Patients ◽  
Inflammatory Cytokine ◽  
Adjuvant Radiation ◽  
Breast Cancer Patients ◽  
Adjuvant Radiation Therapy ◽  
General Fatigue ◽  
Hematopoetic Stem Cell

e12048 Background: Fatigue and insomnia are frequent conditions experienced by breast cancer patients during adjuvant radiation therapy (RT). Our group reported that fatigue correlates with reduced CD34+ circulating hematopoetic stem cell (HSC) levels. Our current study examined the role of inflammatory cytokines in mediating fatigue and insomnia following adjuvant RT. Methods: Phlebotomies were conducted on 148 breast cancer patients undergoing adjuvant RT at five time points: prior to RT (D1), after two (D2) and five (D5) days of treatment, during the final week of RT (Df), and one month post-RT completion (M1). CD34+, CD45+, circulating blood cell (CBC), and 17 inflammatory cytokine levels were assessed. Patients also completed questionnaires at each time point, including the multidimensional fatigue inventory (MIF-21), insomnia severity index (ISI), and hospital anxiety and depression scale (HADS). Results: CD34+, CD45+ and CBC levels decreased during treatment with adjuvant RT, with the lowest levels observed at Df (p<0.001). General fatigue significantly worsened throughout treatment from D1 to Df, returning to baseline at M1, (p<0.001; adjusted for insomnia, depression and anxiety). General fatigue worsened as CD34+ counts, hemoglobin and CBCs increased (p<0.001). Insomnia increased with reduced CD34+, CD45+ and CBCs (p<0.05). TGF-β1, MCP-1, MMP-2, IL-1ra and IFN-α2a cytokine expression varied throughout RT (p<0.01), most significantly at Df. Elevated MCP-1, TNF-RII and TNF-a levels correlated with worsening general fatigue, increased insomnia, and reduced activity and motivation (p<0.001). MMP-2 increased as IL-1ra, CD34+, CD45+ and CBC counts decreased (p<0.001). Further, the 52 patients who received prior adjuvant chemotherapy had elevated levels of fatigue, insomnia and anxiety, which correlated with high HSCs levels. Conclusions: Our findings demonstrate that fatigue and insomnia are associated with reduced HSCs and increased MCP-1, TNF-RII and TNF-a pro-inflammatory cytokines. This examination of the effect of RT on fatigue and insomnia is one of the most comprehensive longitudinal clinical evaluations of its kind.

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