Ultrahypofractionated Whole Breast Irradiation in Early-Stage Breast Cancer: An Italian Multicenter Observational Study.
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Palumbo Isabella, Becchetti Anna Giulia, D'Angelo Elisa, De Santis Maria Carmen, Fozza Alessandra, Lazzari Grazia, Falivene Sara, Baldissera Antonella, Ingrosso Gianluca, De Felice Francesca, Nuzzo Marianna, Anselmo Paola, Marazzi Fabio, Carnevale Maria Grazia, Blandino Gladys, Musu Anna Rita, Cucciarelli Francesca, Rago Luciana, Andrulli Angela Damiana, Mascioni Francesca, Ferraioli Piera, Macchia Gabriella, Antonello Michele, Prisco Agnese, La Rocca Eliana, Alessandro Marina, Fiorentino Alba, Fontana Antonella, Barbara Raffaele, Bacchiddu Simonetta, Bonzano Elisabetta, Campoccia Salvatrice, Bini Vittorio, Aristei Cynthia
Аннотация
METHODS AND MATERIALS: From 2020 to 2025, 2036 patients (median age 70 years; range, 19-93) were recruited from 28 Italian Radiation Oncology Centers. Inclusion criteria included: early-stage breast cancer (either invasive or ductal in situ carcinomas), age ≥ 18 years, breast-conserving surgery and delivery of ultrahypofractionated WBI by means of any radiation therapy (RT) technique. All patients received 26 Gy in 5 consecutive fractions of 5.2 Gy. Depending on risk factors for local relapse, some patients received a sequential or simultaneous integrated boost. Side effects were monitored at diverse time points for ≤2 years.
RESULTS: Median follow-up was 12 months (range, 1-55). The incidence of side effects was low, and they were mainly G1. The most frequent acute side effect (37.1%) was erythema, 90.2% were G1. Skin hyperpigmentation, the most frequent short-term late side effect, occurred in 12.2% of patients (95.7% G1) at 6 months, in 5.7% (98.4% G1) at 12 months, 5.7% (96% G1) at 18 months, and 4% (100% G1) at 24 months after the end of RT. In multivariate analysis, significant factors for acute side effects were active smoking and boost administration. Furthermore, age emerged as a protective factor, while a larger breast planning target volume was associated with increased side effects. Significant risk factors for late side effects were active smoking at +6 months and a larger planning target volume boost at +6 and +12 months after the end of RT.
CONCLUSIONS: In our large series of patients with early-stage breast cancer, ultrahypofractionated WBI appeared safe and feasible.