AI Article Synopsis
- The study assessed long-term outcomes and late toxicity of two types of postmastectomy radiotherapy: conventional fractionated (CF) and hypofractionated (HF) treatment.
- A patient cohort of 1640 breast cancer cases was tracked over a median follow-up of about 72 months, finding no significant differences in locoregional recurrence-free survival, disease-free survival, or overall survival between the two treatment types.
- While HF-PMRT showed higher late skin and subcutaneous toxicity, it resulted in lower incidents of lung and brachial plexus toxicity compared to CF-PMRT, indicating HF-PMRT's feasibility with similar effectiveness and some varying side effects.
Article Abstract
Objective: We evaluated the long-term outcomes and late toxicity of conventional fractionated (CF) and hypofractionated (HF) postmastectomy radiotherapy (PMRT) in terms of locoregional recurrence-free survival (LRRFS), disease-free survival (DFS), overall survival (OS), and late toxicity.
Methods: A cohort of 1640 of breast cancer patients receiving PMRT between January 2004 and December 2014 were enrolled. Nine hundred eighty patients were treated with HF-PMRT: 2.65 Gy/fraction to a total of 42.4-53 Gy and 660 patients were treated with CF-PMRT: 2 Gy/fraction to a total of 50-60 Gy.
Results: The median follow-up time was 71.8 months (range 41.5-115.9 months). No significant difference was found in the rates of 5-year LRRFS, DFS, and OS of HF-PMRT vs CF-PMRT; 96% vs. 94% (p = 0.373), 70% vs. 72% (p = 0.849), and 73% vs. 74% (p = 0.463), respectively. We identified a cohort of 937 eligible breast cancer patients who could receive late toxicities assessment. With a median follow-up time of this patient cohort of 106.3 months (range 76-134 months), there was a significant higher incidence of grade 2 or more late skin (4% vs 1%) and subcutaneous (7% vs 2%) toxicity in patients treated with HF-PMRT vs CF-PMRT. Patients who received additional radiation boost were significantly higher in the HF-PMRT group. Grade 2 or more late RTOG/EORTC lung toxicity was significant lesser in HF-PMRT vs CF-PMRT (9% vs 16%). Grade 1 brachial plexopathy was also significant lesser in HF-PMRT vs CF-PMRT (2% vs 8%). Heart toxicity and lymphedema were similar in both groups.
Conclusions: HF-PMRT is feasible to deliver with comparable long-term efficacy to CF-PMRT. HF-PMRT had higher grade 2 or more skin and subcutaneous toxicity but less lung and brachial plexus toxicity.
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| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6790998 | PMC |
| http://dx.doi.org/10.1186/s13014-019-1378-x | DOI Listing |
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View Article and Find Full Text PDFConventional versus hypofractionated postmastectomy radiotherapy: a report on long-term outcomes and late toxicity.
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Article Synopsis
- The study assessed long-term outcomes and late toxicity of two types of postmastectomy radiotherapy: conventional fractionated (CF) and hypofractionated (HF) treatment.
- A patient cohort of 1640 breast cancer cases was tracked over a median follow-up of about 72 months, finding no significant differences in locoregional recurrence-free survival, disease-free survival, or overall survival between the two treatment types.
- While HF-PMRT showed higher late skin and subcutaneous toxicity, it resulted in lower incidents of lung and brachial plexus toxicity compared to CF-PMRT, indicating HF-PMRT's feasibility with similar effectiveness and some varying side effects.
Use of hypofractionated post-mastectomy radiotherapy reduces health costs by over $2000 per patient: An Australian perspective.
J Med Imaging Radiat Oncol
February 2016
Rural Clinical School Faculty of Medicine, University of New South Wales, Coffs Harbour, Australia.
Introduction: The most recent clinical practice guidelines released by Cancer Australia draw attention to unanswered questions concerning the health economic considerations associated with hypofractionated radiotherapy. This study aimed to quantify and compare the healthcare costs at a regional Australian radiotherapy institute with respect to conventionally fractionated post-mastectomy radiotherapy (Cf-PMRT) versus hypofractionated post-mastectomy radiotherapy (Hf-PMRT) administration.
Methods: Medical records of 196 patients treated with post-mastectomy radiotherapy at the NSW North Coast Cancer Institute from February 2008 to June 2014 were retrospectively reviewed.
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