Hypofractionated Postmastectomy Radiation Therapy

Abstract

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European Society for Radiotherapy and Oncology Advisory Committee in Radiation Oncology Practice consensus recommendations on patient selection and dose and fractionation for external beam radiotherapy in early breast cancer

“…At around 5 years of median follow-up, the risk of locoregional recurrence was similar between treatment arms and no significant increase in late NTE was observed. The only significant difference described was the reduced severity of acute skin toxicity in patients treated with hypofractionation, which is reassuringly consistent with recent observations [32][33][34] . Further evidence is awaited from other groups, which are conducting clinical trials to investigate this clinical setting, including in France (NCT03127995), the USA (NCT02700386,…”

Increasing use of post‐mastectomy hypofractionated radiation therapy for breast cancer in Victoria

“…brachial plexus and lung), and the related toxicities, such as brachial plexopathy and lymphoedema. While the overall risk of radiation‐induced brachial plexopathy is reported to be low in multiple earlier studies in women receiving HFRT in the modern era of advanced RT techniques, 14 concerns remain regarding the risk of these toxicities in the longer term 28 . It is important to be aware that the risk of plexopathy after nodal irradiation remains constant and may manifest decade after treatment, 28 and the risk may be higher in women receiving chemotherapy as well 29 .…”

“…12 Over the years, there has been increasing interest and emerging evidence suggesting that post-mastectomy HFRT is an acceptable regimen (Table 1). 13,14 In the UK START-A and START-B trials, 15% (336/2236) and 8% (177/22,215) of women, respectively, had mastectomies, and there was no evidence of difference in local recurrence and adverse effects in the subgroup of women who had postmastectomy HFRT. [5][6][7] In the UK FAST-Forward trial (comparing 40 Gy in 15 fractions with 26 Gy in 5 fractions), approximately 6% of women had mastectomies, and again, there was no evidence of significant difference in adverse effects in the post-mastectomy subgroup.…”

miR125-Centered ceRNETs in Breast Cancer. Clinical, Molecular and Ethical Aspects in Personalized Medicine

“…Moreover, radiotherapy along with BCS has been shown to lead to higher long term overall survival rates and better local regional control, lowering local recurrence risks [57]. Therefore, patients with early stage BC, hypofractionated whole breast irradiation following breast conserving surgery now represent the standard of care based on randomized data with long-term efficacy and toxicity outcomes and postmastectomy radiation therapy represents a standard approach for patients with locally advanced BC [58].…”