Randomised comparison of a 13 fraction schedule with a conventional 25 fraction schedule of radiotherapy after local excision of early breast cancer: preliminary analysis

Yarnold, J.R.; Owen, Joshua B.; Bliss, Judith M.; Regan, John D.; Broad, B.; Davidson, J.; Harrington, Gabriel Mateus Bernardo

doi:10.1016/0960-9776(93)90129-4

Cited by 9 publications

(4 citation statements)

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“…The studies done up to present have too few patients to detect small differences in local recurrence rates at such high levels of tumour control. As pointed out by Yarnold et al (1994), large numbers of patients are needed for a meaningful comparison. Yarnold et al (1994) surveyed different institutions in the UK about their radiotherapy treatment schedules after BCS.…”

Section: Comparison Of Different Fractionation Schemesmentioning

confidence: 99%

“…As pointed out by Yarnold et al (1994), large numbers of patients are needed for a meaningful comparison. Yarnold et al (1994) surveyed different institutions in the UK about their radiotherapy treatment schedules after BCS. In table 3 under Yarnold et al (1995) we list the most utilized schedules according to the survey.…”

Section: Comparison Of Different Fractionation Schemesmentioning

confidence: 99%

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Analysis of a large number of clinical studies for breast cancer radiotherapy: estimation of radiobiological parameters for treatment planning

Guerrero

2003

Phys. Med. Biol.

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Numerous studies of early-stage breast cancer treated with breast conserving surgery (BCS) and radiotherapy (RT) have been published in recent years. Both external beam radiotherapy (EBRT) and/or brachytherapy (BT) with different fractionation schemes are currently used. The present RT practice is largely based on empirical experience and it lacks a reliable modelling tool to compare different RT modalities or to design new treatment strategies. The purpose of this work is to derive a plausible set of radiobiological parameters that can be used for RT treatment planning. The derivation is based on existing clinical data and is consistent with the analysis of a large number of published clinical studies on early-stage breast cancer. A large number of published clinical studies on the treatment of early breast cancer with BCS plus RT (including whole breast EBRT with or without a boost to the tumour bed, whole breast EBRT alone, brachytherapy alone) and RT alone are compiled and analysed. The linear quadratic (LQ) model is used in the analysis. Three of these clinical studies are selected to derive a plausible set of LQ parameters. The potential doubling time is set a priori in the derivation according to in vitro measurements from the literature. The impact of considering lower or higher T(pot) is investigated. The effects of inhomogeneous dose distributions are considered using clinically representative dose volume histograms. The derived LQ parameters are used to compare a large number of clinical studies using different regimes (e.g., RT modality and/or different fractionation schemes with different prescribed dose) in order to validate their applicability. The values of the equivalent uniform dose (EUD) and biologically effective dose (BED) are used as a common metric to compare the biological effectiveness of each treatment regime. We have obtained a plausible set of radiobiological parameters for breast cancer: alpha = 0.3 Gy(-1), alpha/beta = 10 Gy and sub-lethal damage repair time T(rep) = 1 h (mono-exponential behaviour is assumed). This set of parameters is consistent with in vitro experiments and with previously reported analyses. Using this set of parameters, we have found that most of the studies, using BCS plus whole breast RT and a boost to the tumour bed, have EUDs ranging from 60-70 Gy. No correlation is found between BED and the local recurrence rate. The treatments of BCS plus brachytherapy alone have a wide range of EUD (30-50 Gy), which is significantly lower than the treatments with whole breast EBRT plus a boost of the tumour bed. The studies with different fractionation schemes for whole breast EBRT also show a significant variation of EUD. Carefully designed clinical studies with large numbers of patients are required to determine clinically the relative effectiveness of these treatment variations. The derived LQ parameter set based on clinical data is consistent with in vitro experiments and previous studies. As demonstrated in the present work, these radiobiological parameters can be pot...

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Section: Comparison Of Different Fractionation Schemesmentioning

confidence: 99%

Section: Comparison Of Different Fractionation Schemesmentioning

confidence: 99%

Analysis of a large number of clinical studies for breast cancer radiotherapy: estimation of radiobiological parameters for treatment planning

Guerrero

2003

Phys. Med. Biol.

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“…Data from randomized trials that compared hypofractionated radiation therapy with conventional radiation therapy, demonstrated no difference in late radiation morbidity or local recurrence [16][17][18][19][20][21]. A shorter fractionation schedule will lessen the burden of treatment for women, and will have important quality-of-life benefits with respect to convenience and less time away from home and work.…”

Section: Meta-analyses and Randomized Controlled Trials (At Least 18mentioning

confidence: 99%

Accelerated Hypofractionated Radiation in Carcinoma Breast

Alam¹

2016

Arch Can Res

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Aim: Comparison of two different radiation fractionation schedules is done in post mastectomy breast cancer cases in relation to loco regional control, acute and late toxicities, survival and overall treatment time (O.T.T). The patient, tumor and treatment related parameters have also been studied. Materials and Methods:Between December 2011 and December 2013, hundred patients of stage II to III carcinoma breast treated with surgery and chemotherapy received adjuvant radiation therapy with two different fractionation regimes:• (Regimen-1, 50 patients) -42.5 Gray/16 fractions/3.1 weeks @ 2.6 Gray/ fraction (#)• (Regimen-2, 50 patients) -50 Gray/25 fractions/5 weeks @ 2 Gray/fraction (#)Assessment was done for loco regional and distant control rate, acute and late radiation toxicities, and quality of life related parameters.

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“…La implementación del esquema del hipofraccionamiento en cáncer de mama en el IOSE está apoyada por los datos de estos ensayos fase III, que compararon el tratamiento con RTE hipofraccionada versus RTE de esquema convencional, en mujeres con cáncer de mama. 2,7,8,14,17,19,20 El ensayo RMH/GOC 12 aleatorizó 1410 pacientes con cáncer de mama T1-3 N0-1 en tres ramas de tratamiento: 50Gy/25fx, 39Gy/13fx y 42,9Gy/13fx. Con base en un análisis de 158 eventos de recaída local del tumor ipsilateral, se demostró que la sensibilidad estimada de cáncer de mama por fracción de tamaño (valor α/β) es de 4,0 Gy, para cualquier cambio en la apariencia de mama, un valor bajo que permite el hipofraccionamiento sin perjudicar tejidos sanos.…”

Section: Discussionunclassified

Toxicidad cutánea a corto plazo de pacientes con cáncer de mama tratados con radioterapia hipofraccionada

Ruíz

Reyes

García

et al. 2020

AMC

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Randomised comparison of a 13 fraction schedule with a conventional 25 fraction schedule of radiotherapy after local excision of early breast cancer: preliminary analysis

Cited by 9 publications

References 0 publications

Analysis of a large number of clinical studies for breast cancer radiotherapy: estimation of radiobiological parameters for treatment planning

Analysis of a large number of clinical studies for breast cancer radiotherapy: estimation of radiobiological parameters for treatment planning

Accelerated Hypofractionated Radiation in Carcinoma Breast

Toxicidad cutánea a corto plazo de pacientes con cáncer de mama tratados con radioterapia hipofraccionada

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