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Acute toxicity and health-related quality of life after accelerated whole breast irradiation in 5 fractions with simultaneous integrated boost

Hans Van Hulle, Vincent Vakaet (UGent) , Christel Monten (UGent) , Pieter Deseyne, Max Schoepen (UGent) , Cato Colman, Leen Paelinck (UGent) , Annick Van Greveling (UGent) , Giselle Post (UGent) , Bruno Speleers (UGent) , et al.
(2021) BREAST. 55. p.105-111
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Abstract
Introduction: Acceleration of radiotherapy in 5 fractions for breast cancer can reduce the burden of treatment. We report on acute toxicity after whole-breast irradiation with a simultaneous integrated boost in 5 fractions over 10-12 days. Material and methods: Acute toxicity and health-related quality of life (HRQoL) of 200 patients, randomized between a 15or 5-fractions schedule, were collected, using the CTCAE toxicity scoring system, the Multidimensional Fatigue Inventory, EORTC QLQ-C30 and BR23 and the BREAST-Q questionnaire. The prescribed dose to the breast was either 15*2.67 Gy (40.05 Gy) or 5*5.7 Gy (28.5 Gy). 90% of patients received a SIB to a cumulative dose of 46.8 Gy (15*3.12 Gy) or 31 Gy (5*6.2 Gy). Results: Physician-assessed toxicity was lower for the 5-fractions group. A significant difference was observed for breast pain (p = 0.002), fatigue (p < 0.0001), breast edema (p = 0.001) and dermatitis (p = 0.003). Patients treated in 5 fractions reported better mean HRQoL scores for breast symptoms (p = 0.001) and physical well-being (p = 0.001). A clinically important deterioration in HRQoL of 10 points or more was also less frequently observed in the latter group for physical functioning (p = 0.0005), social functioning (p = 0.0007), fatigue (p = 0.003), breast symptoms (p = 0.0002) and physical wellbeing (p = 0.002). Conclusion: In this single institute study, acute toxicity of accelerated breast radiotherapy in 5 fractions over 10-12 days seems to compare favourably to hypofractionated breast radiotherapy in 15 fractions. Less breast edema, dermatitis, desquamation, breast pain and fatigue are seen. Social and physical functioning are also less disturbed and patients have a better future perspective.
Keywords
Surgery, General Medicine, Breast cancer, Radiotherapy, Acceleration, RADIOTHERAPY HYPOFRACTIONATION, RADIATION-THERAPY, CANCER, DELINEATION, SCHEDULE, SURGERY, TRIAL

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MLA
Van Hulle, Hans, et al. “Acute Toxicity and Health-Related Quality of Life after Accelerated Whole Breast Irradiation in 5 Fractions with Simultaneous Integrated Boost.” BREAST, vol. 55, 2021, pp. 105–11, doi:10.1016/j.breast.2020.12.009.
APA
Van Hulle, H., Vakaet, V., Monten, C., Deseyne, P., Schoepen, M., Colman, C., … Veldeman, L. (2021). Acute toxicity and health-related quality of life after accelerated whole breast irradiation in 5 fractions with simultaneous integrated boost. BREAST, 55, 105–111. https://doi.org/10.1016/j.breast.2020.12.009
Chicago author-date
Van Hulle, Hans, Vincent Vakaet, Christel Monten, Pieter Deseyne, Max Schoepen, Cato Colman, Leen Paelinck, et al. 2021. “Acute Toxicity and Health-Related Quality of Life after Accelerated Whole Breast Irradiation in 5 Fractions with Simultaneous Integrated Boost.” BREAST 55: 105–11. https://doi.org/10.1016/j.breast.2020.12.009.
Chicago author-date (all authors)
Van Hulle, Hans, Vincent Vakaet, Christel Monten, Pieter Deseyne, Max Schoepen, Cato Colman, Leen Paelinck, Annick Van Greveling, Giselle Post, Bruno Speleers, Katrien Vandecasteele, Marcus Mareel, Wilfried De Neve, and Liv Veldeman. 2021. “Acute Toxicity and Health-Related Quality of Life after Accelerated Whole Breast Irradiation in 5 Fractions with Simultaneous Integrated Boost.” BREAST 55: 105–111. doi:10.1016/j.breast.2020.12.009.
Vancouver
1.
Van Hulle H, Vakaet V, Monten C, Deseyne P, Schoepen M, Colman C, et al. Acute toxicity and health-related quality of life after accelerated whole breast irradiation in 5 fractions with simultaneous integrated boost. BREAST. 2021;55:105–11.
IEEE
[1]
H. Van Hulle et al., “Acute toxicity and health-related quality of life after accelerated whole breast irradiation in 5 fractions with simultaneous integrated boost,” BREAST, vol. 55, pp. 105–111, 2021.
@article{8686875,
  abstract     = {{Introduction: Acceleration of radiotherapy in 5 fractions for breast cancer can reduce the burden of treatment. We report on acute toxicity after whole-breast irradiation with a simultaneous integrated boost in 5 fractions over 10-12 days.

Material and methods: Acute toxicity and health-related quality of life (HRQoL) of 200 patients, randomized between a 15or 5-fractions schedule, were collected, using the CTCAE toxicity scoring system, the Multidimensional Fatigue Inventory, EORTC QLQ-C30 and BR23 and the BREAST-Q questionnaire. The prescribed dose to the breast was either 15*2.67 Gy (40.05 Gy) or 5*5.7 Gy (28.5 Gy). 90% of patients received a SIB to a cumulative dose of 46.8 Gy (15*3.12 Gy) or 31 Gy (5*6.2 Gy).

Results: Physician-assessed toxicity was lower for the 5-fractions group. A significant difference was observed for breast pain (p = 0.002), fatigue (p < 0.0001), breast edema (p = 0.001) and dermatitis (p = 0.003). Patients treated in 5 fractions reported better mean HRQoL scores for breast symptoms (p = 0.001) and physical well-being (p = 0.001). A clinically important deterioration in HRQoL of 10 points or more was also less frequently observed in the latter group for physical functioning (p = 0.0005), social functioning (p = 0.0007), fatigue (p = 0.003), breast symptoms (p = 0.0002) and physical wellbeing (p = 0.002).

Conclusion: In this single institute study, acute toxicity of accelerated breast radiotherapy in 5 fractions over 10-12 days seems to compare favourably to hypofractionated breast radiotherapy in 15 fractions. Less breast edema, dermatitis, desquamation, breast pain and fatigue are seen. Social and physical functioning are also less disturbed and patients have a better future perspective.}},
  author       = {{Van Hulle, Hans and Vakaet, Vincent and Monten, Christel and Deseyne, Pieter and Schoepen, Max and Colman, Cato and Paelinck, Leen and Van Greveling, Annick and Post, Giselle and Speleers, Bruno and Vandecasteele, Katrien and Mareel, Marcus and De Neve, Wilfried and Veldeman, Liv}},
  issn         = {{0960-9776}},
  journal      = {{BREAST}},
  keywords     = {{Surgery,General Medicine,Breast cancer,Radiotherapy,Acceleration,RADIOTHERAPY HYPOFRACTIONATION,RADIATION-THERAPY,CANCER,DELINEATION,SCHEDULE,SURGERY,TRIAL}},
  language     = {{eng}},
  pages        = {{105--111}},
  title        = {{Acute toxicity and health-related quality of life after accelerated whole breast irradiation in 5 fractions with simultaneous integrated boost}},
  url          = {{http://doi.org/10.1016/j.breast.2020.12.009}},
  volume       = {{55}},
  year         = {{2021}},
}
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