VMAT partial-breast irradiation: acute toxicity of hypofractionated schedules of 30 Gy in five daily fractions

• E. La Rocca ^[1] ; L. Lozza ^[1] ; M. Dispinzieri ^[1] ; C. Giandini ^[1] ; F. Bonfantini ^[2] ; R. Valdagni ^[3] ; S. Folli ^[4] ; E. Pignoli ^[2] ; S. Di Cosimo ^[5] ; M. C. De Santis ^[1]
  1. [1] Radiotherapy Unit 1, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
  2. [2] Medical Physics Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
  3. [3] Department of Oncology and Hemato-Oncology, Università Degli Studi Di Milan, Milano, Italy
  4. [4] Breast Surgery Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
  5. [5] Biomarker Unit, Department of Applied Research and Technological Development (DRAST), Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy

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• Localización: Clinical & translational oncology, ISSN 1699-048X, Vol. 22, Nº. 10, 2020, págs. 1802-1808
• Idioma: inglés
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• Resumen

  • Purpose To report acute toxicities in breast cancer (BC) patients (pts) recruited in a prospective trial and treated with accelerated partial-breast irradiation (APBI) using Volumetric Modulated Arc Therapy (VMAT) delivered with a hypofractionated schedule.

    Methods From March 2014 to June 2019, pts with early-stage BC (Stage I), who underwent breast conservative surgery (BCS), were recruited in a prospective study started at the National Cancer Institute of Milan. Pts received APBI with a hypofractionated schedule of 30 Gy in five daily fractions. Radiotherapy treatment (RT) was delivered using VMAT. Acute toxicity was assessed according to RTOG/EORTC criteria at the end of RT.

    Results Between March 2014 and June 2019, 151 pts were enrolled in this study. 79 Pts had right-side and 72 had left-side breast cancer. Median age was 69 (range 43–92). All pts presented with pathological stage IA BC, molecular classification was Luminal A in 128/151 (85%) and Luminal B in 23/151 (15%) cases. Acute toxicity, assessed at the end of RT, consisted of G1 erythema in 37/151 (24. 5%) pts and skin toxicities higher than G1, did not occur. Fibrosis G1 and G2 were reported in 41/151 (27. 1%) pts and in 2/151 pts (1. 3%), respectively. Edema G1 occurred in 8/151 (5. 3%) pts and asthenia G1 occurred in 1/151 (0. 6%) pts.

    Conclusions APBI with VMAT proved to be feasible and can be a valid alternative treatment option after BCS in selected early breast cancer pts according to ASTRO guidelines. A longer follow-up is needed to assess late toxicity.