Seven-year follow-up on 334 patients treated by breast conserving surgery and short course radical postoperative radiotherapy: A report of the Yorkshire breast cancer group

Ash, D.; Benson, E. A.; Sainsbury, Jrc; Round, C.; Head, Christine

doi:10.1016/s0936-6555(05)80808-8

Cited by 67 publications

(30 citation statements)

References 7 publications

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“…Clinical reports from various centres have shown almost equivalent results between short and standard RT schedules [9][10][11][18][19][20][21][22][23][24][25][26][27] , and it would be interesting to have an overview of the current situation in this field.…”

Section: Review Of Clinical Studiesmentioning

confidence: 99%

Hypofractionated radiotherapy in the treatment of early breast cancer

Plataniotis

2010

WJR

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Radiotherapy (RT) after tumorectomy in early breast cancer patients is an established treatment modality which conventionally takes 6-7 wk to complete. Shorter RT schedules have been tested in large multicentre randomized trials and have shown equivalent results to that of standard RT (50 Gy in 25 fractions) in terms of local tumor control, patient survival and late post-radiation effects. Some of those trials have now completed 10 years of follow-up with encouraging results for treatments of 3-4 wk and a total RT dose to the breast of 40-42.5 Gy with or without boost. A reduction of 50% in treatment time makes those RT schedules attractive for both patients and health care providers and would have a significant impact on daily RT practice around the world, as it would accelerate patient turnover and save health care resources. However, in hypofractionated RT, a higher (than the conventional 1.8-2 Gy) dose per fraction is given and should be managed with caution as it could result in a higher rate of late postradiation effects in breast, heart, lungs and the brachial plexus. It is therefore advisable that both possible dose inhomogeneity and normal tissue protection should be taken into account and the appropriate technology such as three-dimensional/intensity modulated radiation therapy employed in clinical practice, when hypofractionation is used.

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Section: Review Of Clinical Studiesmentioning

confidence: 99%

Hypofractionated radiotherapy in the treatment of early breast cancer

Plataniotis

2010

WJR

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“…Consequently, hypofractionated radiotherapy was thought to be harmful to patients and conventionally fractionated radiotherapy considered as standard of care in most countries [10], [11]. However, retrospective data indicated that the use of hypofractionated radiotherapy in 13-16 fractions using 2.5-3.3 Gy per fractions to decreased total doses of 39-43 Gy is not associated with high radiation-induced acute and late toxicity and seemed to result in local recurrence rates as low as those achieved with conventionally fractionated radiotherapy in the adjuvant setting [12,13,14,15]. These observations prompted research groups first from Ontario and later from the United Kingdom to compare adjuvant hypofractionated radiotherapy to adjuvant conventionally fractionated radiotherapy in preferentially early breast cancer.…”

Section: Introductionmentioning

confidence: 99%

Hypofractionated Radiotherapy as Adjuvant Treatment in Early Breast Cancer. A Review and Meta-Analysis of Randomized Controlled Trials

Budach

Bölke

Matuschek³

2015

Breast Care

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Background: Adjuvant radiotherapy after breast-conserving surgery is indicated in the vast majority of breast cancer patients. Conventionally fractionated radiotherapy with 50 Gy in 25 fractions was considered standard of care for several decades. The recently publishes long-term results of randomized trials that have tested different moderately hypofractionated radiotherapy schedules that may change clinical practice. Patients and Methods: A Pubmed search was carried out to identify the relevant publications on hypofractionated radiotherapy in breast cancer. In total, 4 randomized controlled trials representing the results of 7,095 patients with 10 years of follow-up were identified. A meta-analysis on the primary end point ipsilateral breast cancer recurrence and a review of the toxicity data were performed. Results: Moderately hypofractionated radiotherapy using schedules such as 40 Gy in 15 fractions administered within 3 weeks are as efficient and safe as conventionally fractionated radiotherapy for most breast cancer patients who need adjuvant radiotherapy after breast-conserving surgery. In patients aged < 40 years, after neoadjuvant chemotherapy, and if regional lymph node radiotherapy is indicated, further data are needed. Conclusion: Moderately hypofractionated radiotherapy can be recommended as standard treatment after breast-conserving surgery in the majority of breast cancer patients.

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“…A good or excellent cosmetic outcome was found in 76.8% of patients, a result similar to that reported in the present study. Other series and trials using different hypofractionation regimens report good or excellent outcomes in 64%-89% of patients [16][17][18][19] . Of the evaluable patients in the present study, 70% did not develop late skin toxicity, a figure markedly lower than the 87% of patients with no late skin toxicity in the cco study 6 .…”

Section: Discussionmentioning

confidence: 95%