Acute skin toxicity of conventional fractionated versus hypofractionated radiotherapy in breast cancer patients receiving regional node irradiation: the real-life prospective multicenter HYPOBREAST cohort

BMC Cancer

Research

Jean-Christophe Faivre¹  Claire Charra-Brunaud¹  Didier Peiffert²  Marie Bruand²  Emmanuel Desandes³  Xavier Liem⁴  David Pasquier⁵  Sébastien Guihard⁶  Jean-Baptiste Clavier⁶  Charles Marchand Crety⁷  Assia Lamrani-Ghaouti⁸  Julia Salleron⁹ 

[1] Academic Department of Radiation Therapy & Brachytherapy, Institut de Cancérologie de Lorraine – Unicancer, 6 avenue de Bourgogne - CS, 30 519 54519, Vandoeuvre-lès-Nancy cedex, France;Academic Department of Radiation Therapy & Brachytherapy, Institut de Cancérologie de Lorraine – Unicancer, 6 avenue de Bourgogne - CS, 30 519 54519, Vandoeuvre-lès-Nancy cedex, France;EA 4360 APEMAC, Université de Lorraine, Nancy, France;EA 4360 APEMAC, Université de Lorraine, Nancy, France;Service en Charge des Données de Santé, Institut de Cancérologie de Lorraine, 54519, Vandœuvre-lès-Nancy, France;Service de Radiothérapie, Centre Oscar Lambret, 59000, Lille, France;Service de Radiothérapie, Centre Oscar Lambret, 59000, Lille, France;RIStAL, UMR 9189, Université de Lille, 59000, Lille, France;Service de Radiothérapie, ICANS - Institut de Cancérologie Strasbourg Europe, 67200, Strasbourg, France;Service de Radiothérapie, Institut Jean Godinot, 51100, Reims, France;UNICANCER, R&D Department, 75013, Paris, France;Unité de biostatistiques, Institut de Cancérologie de Lorraine, 54519, Vandœuvre-lès-Nancy, France;

关键词: Breast neoplasms;    Adjuvant radiotherapy;    Radiation dose;    Hypofractionation;    Radiotherapy dose fractionation;    Conformal radiotherapy;    Radiotherapy;    Intensity-modulated;    Observational study;    Prospective studies;   

DOI  :  10.1186/s12885-022-10402-z

 received in 2022-05-22, accepted in 2022-12-05,  发布年份 2022

来源: Springer

【 摘 要 】

BackgroundLarge-scale trials have shown that hypofractionated adjuvant breast radiotherapy was as effective in terms of survival and local control as conventional fractionated radiotherapy, and acute toxicity was reduced with hypofractionated radiotherapy. However, there is a lack of data about the toxicity of breast with regional nodal irradiation (RNI). The aim of this study was to assess the effect of fractionation on radiation-related acute skin toxicity in patients receiving RNI in addition to whole-breast or chest wall irradiation, using real-life data.MethodsWe conducted a prospective, multicenter cohort study with systematic computerized data collection integrated into Mosaiq®. Three comprehensive cancer centers used a standardized form to prospectively collect patient characteristics, treatment characteristics and toxicity.ResultsBetween November 2016 and January 2022, 1727 patients were assessed; 1419 (82.2%) and 308 (17.8%) patients respectively received conventional fractionated and hypofractionated radiation therapy. Overall, the incidence of acute grade 2 or higher dermatitis was 28.4% (490 patients). Incidence was lower with hypofractionated than with conventional fractioned radiation therapy (odds ratio (OR) 0.34 [0.29;0.41]). Two prognostic factors were found to increase the risk of acute dermatitis, namely 3D (vs IMRT) and breast irradiation (vs chest wall).ConclusionUsing real-life data from unselected patients with regional nodal irradiation, our findings confirm the decreased risk of dermatitis previously reported with hypofractionated radiation therapy in clinical trials. Expansion of systematic data collection systems to include additional centers as well as dosimetric data is warranted to further evaluate the short- and long-term effects of fractionation in real life.

【 授权许可】

CC BY   
© The Author(s) 2022

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