The purpose of this study was to evaluate the impact of breast size on acute and late side effects in breast cancer (BC) patients treated with hypofractionated radiotherapy (Hypo-RT). In this study we analyzed patients over 50 years with a diagnosis of early BC, candidate for Hypo-RT after conservative surgery. Acute and late skin toxicities were evaluated in accordance with the RTOG scale. Multivariable logistic analysis was performed using dosimetric/anatomical factors resulted associated with toxicity outcome in univariable analysis. Among patients treated between 2009 and 2015, 425 had at least 5 years of follow-up. At RT end, acute skin toxicity ≥ G2 and edema ≥ G2 occurred in 88 (20.7%) and 4 (0.9%) patients, respectively. The multivariable analysis showed association of skin toxicity with boost administration (p < 0.01), treated skin area (TSA) receiving more than 20 Gy (p = 0.027) and breast volume receiving 105% of the prescription dose (V105%) (p = 0.016), but not breast size. At 5 years after RT, fibrosis ≥ G1 occurred in 89 (20.9%) patients and edema ≥ G1 in 36 (8.5%) patients. Fibrosis resulted associated with breast volume ≥ 1000 cm3 (p = 0.04) and hypertension (p = 0.04). As for edema, multivariable logistic analysis showed a correlation with hypertension and logarithm of age, but not with boost administration. Breast volume had an unclear impact (p = 0.055). A recurrent association was found between acute and late toxicities and breast V105%, which is correlated with breast size. This may suggest that a more homogenous RT technique may be preferred for patients with larger breast size.
Hypofractionated whole-breast radiotherapy in large breast size patients : is it really a resolved issue? / R.R. Colciago, A. Cavallo, M.C. Magri, A. Vitullo, E. La Rocca, C. Giandini, F. Bonfantini, S. Di Cosimo, P. Baili, M. Sant, E. Pignoli, R. Valdagni, L. Lozza, M.C. De Santis. - In: MEDICAL ONCOLOGY. - ISSN 1357-0560. - 38:9(2021 Aug), pp. 107.1-107.9. [10.1007/s12032-021-01550-6]
|Titolo:||Hypofractionated whole-breast radiotherapy in large breast size patients : is it really a resolved issue?|
|Parole Chiave:||3D Conformal Radiotherapy; Breast cancer; Hypofractionated radiotherapy; Large breast size; Late toxicity|
|Settore Scientifico Disciplinare:||Settore MED/36 - Diagnostica per Immagini e Radioterapia|
|Data di pubblicazione:||ago-2021|
|Digital Object Identifier (DOI):||http://dx.doi.org/10.1007/s12032-021-01550-6|
|Appare nelle tipologie:||01 - Articolo su periodico|