Details

Autor(en) / Beteiligte

• Vakaet, Vincent
• Van Hulle, Hans
• Van de Vijver, Koen
• Hilderson, Ingeborg
• Naert, Eline
• De Neve, Wilfried
• Vandorpe, Jo
• Hendrix, An
• Göker, Menekse
• Depypere, Herman
• Vergauwen, Glenn
• Van den Broecke, Rudy
• De Visschere, Pieter
• Braems, Geert
• Vandecasteele, Katrien
• Denys, Hannelore
• Veldeman, Liv

Titel

Safety of pre- or postoperative accelerated radiotherapy in 5 fractions: A randomized pilot trial

Ist Teil von

• Breast (Edinburgh), 2022-04, Vol.62, p.10-15

Ort / Verlag

Netherlands: Elsevier Ltd

Erscheinungsjahr

2022

Link zum Volltext

Quelle

Electronic Journals Library

Beschreibungen/Notizen

• Neo-adjuvant radiotherapy (NART) for breast cancer has shown promising survival results in retrospective trials. However, there are some obstacles such as a chemotherapy delay, an increased overall treatment time (OTT) and the risk of increasing surgical morbidity. Accelerated radiotherapy (RT) in 5 fractions allows to deliver NART in a very short time span and minimizes the delay of surgery and chemotherapy. This trial investigates this NART schedule for safety, feasibility and OTT. Twenty patients eligible for neo-adjuvant chemotherapy (NACT) and breast conserving surgery, were randomized between NART before NACT or NACT and postoperative RT. In both arms, RT treatment was given in 5 fractions to the whole breast with a simultaneously integrated boost (SIB) on the tumor(bed). Lymph node irradiation was given concomitantly in case of lymph node involvement. OTT was defined as the time from diagnosis to last surgery in the intervention group, while in the control group the time between diagnosis and last RT-fraction was used. In the intervention group NACT-delay was defined as time between diagnosis and start of chemotherapy. 20 patients were included, and 19 patients completed treatment. OTT was significantly shorter in the intervention group (mean 218 days, range 196–253) compared to the control group (mean 237, range 211–268, p = 0.001). The difference in mean duration from diagnosis to the first treatment was a non-significant 4 days longer (31 vs 27 days, p = 0.28), but the start of NACT after diagnosis was delayed by 21 days (48 vs 27 days, p < 0.001). NART did not result in additional surgery complications. This pilot trial is the first to report on accelerated NART in 5 fractions with SIB. NART before NACT resulted in a shorter OTT with good safety results. •Neo-adjuvant radiotherapy in 5 fractions with simultaneous integrated boost is feasible.•Overall treatment time is not increased with neo-adjuvant radiotherapy.•Initiation of chemotherapy is delayed by 21 days with neo-adjuvant radiotherapy.