Trastuzumab and Hypofractionated Whole Breast Radiotherapy: A Victorious Combination?

Santis, Maria Carmen De; Bonfantini, F.; Salvo, Francesca Di; Fiorentino, Alba; Riboldi, Valentina; Cosimo, Serena Di; Bianchi, Giulia; Gennaro, Massimiliano; Cosentino, V.; Sant, Milena; Pignoli, E.; Valdagni, Riccardo; Lozza, Laura

doi:10.1016/j.clbc.2017.08.011

Cited by 14 publications

(6 citation statements)

References 35 publications

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“…ARD is the most common toxicity occurring during the course of RT or shortly afterwards (5). In previous studies, the prevalence of grade ≥2 ARD ranged between 3% and 76% (9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26). Considering this wide range, additional studies are needed.…”

Section: Discussionmentioning

confidence: 99%

Radiation Dermatitis and Pneumonitis in Patients Irradiated for Breast Cancer

EGGERT,

YU,

RADES

2023

In Vivo

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Background/Aim: Adjuvant radiotherapy (RT) for breast cancer can be associated with acute dermatitis (ARD) and pneumonitis (RP). Prevalence and risk factors were characterized. Patients and Methods: This study included 489 breast cancer patients receiving adjuvant RT with conventional fractionation (CF) ± sequential or simultaneous integrated boost, or hypo-fractionation ± sequential boost. RTregimen and 15 characteristics were investigated for grade ≥2 ARD and RP. Results: Prevalence of grade ≥2 ARD and RP was 25.3% and 2.5%, respectively. On univariate analyses, ARD was significantly associated with CF and radiation boost (p<0.0001), age ≤60 years (p=0.008), and systemic treatment (p=0.002). On multivariate analysis, and age (p=0.009) were associated with ARD. Chronic inflammatory disease was significantly associated with RP on univariate (p=0.007) and multivariate (p=0.016) analyses. Conclusion: Risk factors for grade ≥2 ARD and RP were determined that may help identify patients who require closer monitoring during and after RT.Breast cancer is the most common cancer type in females in Western countries (1, 2). Many of these women with nonmetastatic disease receive breast conserving surgery or mastectomy followed by local or loco-regional irradiation (3,4). Adjuvant radiotherapy (RT) may be associated with adverse events including acute radiation dermatitis (ARD) and radiation pneumonitis (RP) (5,6). ARD was reported to have a negative impact on the patients' quality of life, and RP can even be fatal (7, 8). In the literature, the prevalence of clinically relevant grade ≥2 ARD ranges between 3% and 76%, with higher rates in patients treated with conventional fractionation (CF) than in patients receiving hypofractionation (HF) (9-26). ARD usually develops during the second to third week of radiotherapy, becomes more severe during the further RT-course and possibly the first post-RT week, and disappears a few weeks after completion of RT (5). In contrast, RP is considered a subacute effect of RT, which often develops only several weeks or months following RT (6). The prevalence of RP after RT of breast cancer ranges between 0.8% and 19. 6% (6, 10, 27-33). Considering the comparably wide ranges regarding the prevalence of ARD and RP, it becomes obvious that additional studies are required to more precisely define the prevalence of these two RT-related side effects in breast cancer patients. Our present study evaluated the prevalence in a cohort of breast cancer patients irradiated between 2016 and 2019. Moreover, it aimed to determine risk factors for ARD and RP, in order to contribute to early identification of patients at risk who would benefit from closer monitoring of adverse events during and after the RT-course. Patients and MethodsThe present retrospective study investigated grade ≥2 ARD and grade ≥2 RP in 489 female breast cancer patients treated with adjuvant radiotherapy between 2016 and 2019. The original study protocol and an amendment were approved by the ethics committee of the University of Lü...

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Section: Discussionmentioning

confidence: 99%

Radiation Dermatitis and Pneumonitis in Patients Irradiated for Breast Cancer

EGGERT,

YU,

RADES

2023

In Vivo

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“… 122 , 123 Hypofractionation up to 42.4 Gy in 16 fr appears safe based on retrospective study. 124 To the best of our knowledge, there are no current data describing the combination of ultrahypofractionated breast RT with trastuzumab.…”

Section: Resultsmentioning

confidence: 99%

Safety and Tolerability of Metastasis-Directed Radiation Therapy in the Era of Evolving Systemic, Immune, and Targeted Therapies

Guimond¹,

Tsai²,

Hosni³

et al. 2022

Advances in Radiation Oncology

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“…The preoperative and postoperative combination of radiotherapy and taxanes is not only effective and safe but is also linked to better survival, especially in the setting of patients suffering a loss of hormonal receptor expression and Her-2 enriched phenotypes. In addition, the synchronic delivery of cardiotoxic agents, such as trastuzumab, pertuzumab, or a combination of both, plus locoregional radiotherapy, has been shown to be safe and well tolerated without increasing adverse cardiac effects, not only with conventional but also with hypofractionated schemes, even when the internal mammary chain has to be irradiated [ 60 , 61 , 62 , 63 , 64 , 65 ]. Furthermore, new high conformal radiation techniques and systems used to track body motion (SGRT, Surface Guided Radiation Therapy) help minimize the dose in nearby healthy organs at risk and improve treatment precision and safety.…”

Section: Clinical Outcomesmentioning

confidence: 99%

Preoperative Radio(Chemo)Therapy in Breast Cancer: Time to Switch the Perspective?

Montero

Ciérvide

2022

Current Oncology

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Aim: Radiation therapy represents, together with surgery and systemic treatment, the triad on which the current management of patients with breast cancer is based, achieving high control and survival rates. In recent years we have witnessed a (r)evolution in the conception of breast cancer treatment. The classic scheme of surgery followed by systemic treatment and radiotherapy is being subverted and it is becoming more and more frequent to propose the primary administration of systemic treatment before surgery, seeking to maximize its effect and favoring not only the performance of more conservative surgeries but also, in selected cases, increasing the rates of disease-free survival and overall survival. Radiotherapy is also evolving toward a change in perspective: considering preoperative primary administration of radiotherapy may be useful in selected groups. Advances in radiobiological knowledge, together with technological improvements that are constantly being incorporated into clinical practice, support the administration of increasingly reliable, precise, and effective radiotherapy, as well as its safe combination with antitumor drugs or immunotherapy in the primary preoperative context. In this paper, we present a narrative review of the usefulness of preoperative radiotherapy for breast cancer patients and the possibilities for its combination with other therapies.

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Trastuzumab and Hypofractionated Whole Breast Radiotherapy: A Victorious Combination?

Cited by 14 publications

References 35 publications

Radiation Dermatitis and Pneumonitis in Patients Irradiated for Breast Cancer

Radiation Dermatitis and Pneumonitis in Patients Irradiated for Breast Cancer

Safety and Tolerability of Metastasis-Directed Radiation Therapy in the Era of Evolving Systemic, Immune, and Targeted Therapies

Preoperative Radio(Chemo)Therapy in Breast Cancer: Time to Switch the Perspective?

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