Weekly radiotherapy in elderly breast cancer patients: a comparison between two hypofractionation schedules

Abstract

Purpose

Weekly irradiation in breast cancer in elderly patients is a treatment option, whose tolerance may be influenced by the fractionation used. The objective of this study is to compare the tolerance and long-term side effects of two different fractionations.

Materials and methods

47 elderly patients were recruited after conservative or radical treatment that also received irradiation with a dose per fraction of 6.25 Gy or 5 Gy for one session per week, 6 sessions in total. The long-term tolerance results are compared by assessing toxicity using CTCAE version 5.0 scales for dermatitis, telangectasia, fibrosis and pain of the irradiated breast. In addition, objective parameters of skin status (erythema, hyperpigmentation, elasticity and hydration) by a multi-probe MultiSkin Test-Center system were obtained and compared between groups.

Results

After an average follow-up of 5 years, all patients were free of disease and with complete local control. A total of 20 patients with 6.25 Gy fractionation and 27 patients with 5 Gy fractionation have been included. Patients treated with lower fractionation had a lower incidence of dermatitis, telangectasia, fibrosis, or local pain. The decrease in elasticity measured by the multi-probe system was smaller with the fractionation of 5 Gy. No differences were observed in the other objective parameters.

Conclusion

Weekly irradiation with 5 Gy fractionation is better tolerated than with higher fractionation.

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Data availability

All data are avalaible for analysis and review in electronic records.

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Funding

This study has no received any funding

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Correspondence to A. Manuel.

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Conflict of interest

All authors declare they have no conflict of interest excepte Dr Algara that has received consulting honoraria from Sysmex and Aristo and speaking honoraria from Siemens and Roche.

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All procedures performed in this study were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki declaration and its later amendments.

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All patients signed an informed consent.

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Zhao, M., Sanz, J., Rodríguez, N. et al. Weekly radiotherapy in elderly breast cancer patients: a comparison between two hypofractionation schedules. Clin Transl Oncol 23, 372–377 (2021). https://doi.org/10.1007/s12094-020-02430-7

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Keywords

  • Breast cancer
  • Elderly patients
  • Radiotherapy
  • Weekly hypofractionation