Implementation of 26 Gy in five fractions over 1 week adjuvant radiotherapy for breast cancer: Prospective report of acute skin toxicity and consideration of resource implications
Citation:
K. Nugent, E. Quinlan, S. Cleary, H. O'Driscoll, C. Rohan, J. Trousdell, J. Williams, M. Dunne, O Mc Ardle*, F.K. Duane*, Implementation of 26 Gy in five fractions over 1 week adjuvant radiotherapy for breast cancer: Prospective report of acute skin toxicity and consideration of resource implications, The Breast, 67, 2023, 55-61-Abstract:
Purpose:
In March 2020, a 1-week adjuvant breast radiotherapy schedule, 26 Gy in 5
fractions, was adopted to reduce the risk of COVID19 for staff and patients. This
study quantifies acute toxicity rates and the effect on linac capacity.
Materials and Methods:
This is a report of consecutive patients receiving ultrafractionated breast
radiotherapy (+/- sequential boost) Mar-Aug 2020. Virtual consultations assessed
acute skin toxicity during treatment and weeks 1, 2, 3 and 4 post treatment using
CTCAE V5 scoring criteria. The number of linac minutes saved was estimated
accounting for boost and DIBH use.
Results:
In total,128/135 (95%) patients, including 31/33 boost patients, completed at least
3/5 assessments. 0/128 (0%) reported moist desquamation not confined to skin folds
or minor bleeding (Grade 3). 41/128 (32%) reported brisk erythema, moist
desquamation confined to skin folds or breast swelling (Grade 2), 62/128 (48%)
reported faint erythema or dry desquamation (Grade 1) as their worst skin toxicity,
with the remaining 20% reporting no skin toxicity. The highest prevalence of grade 2
toxicity occurred week 1 following treatment (20%), reducing to 3% by week 4. There
was no difference in toxicity between those who received a boost versus not (p=
1.00). Delivering this schedule to 135 patients over six months saved 21,300 linac
minutes and 1485 hospital visits compared to a 3-week schedule.
Conclusion:
Rapidly implementing ultrahypofractionated breast radiotherapy is feasible and acute
toxicity rates are acceptable even when followed by boost.
Author's Homepage:
http://people.tcd.ie/fduaneDescription:
PUBLISHED
Author: Duane, Frances
Type of material:
Journal ArticleCollections
Series/Report no:
The Breast67
Availability:
Full text availableKeywords:
breast cancer, adjuvant radiotherapy, ultrafractionation, acute toxicity, resource implicationsSubject (TCD):
Cancer , BREAST CANCER , RadiotherapyDOI:
https://doi.org/10.1016/j.breast.2022.12.008Metadata
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