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William J. Gradishar, MD, FACP, FASCO


Hypofractionated Radiotherapy for Locally Advanced Breast Cancer

By: Joshua D. Madera, MD
Posted: Thursday, October 26, 2023

The use of adjuvant locoregional hypofractionated radiotherapy may improve clinical outcomes for patients with locally advanced breast cancer, according to a presentation given at the 2023 American Society for Radiation Oncology (ASTRO) Annual Meeting (Abstract 1110). This treatment strategy may be used to target both the primary site and draining lymph node stations postoperatively, suggested Silvia Takanen, MD, of the Regina Elena National Cancer Institute, Rome, and colleagues.

From 2015 to 2019, a total of 58 women with stage II to IIIA locally advanced breast cancer were recruited for the study. All patients had previously undergone axillary dissection with conservative surgery (83%) or mastectomy (17%). Patients were subjected to adjuvant locoregional hypofractionated radiotherapy. Patients who underwent mastectomy without reconstruction or with temporary expander placement were asked to self-assess their cosmetic outcomes using the Harvard scale. Patients were assessed weekly and then at specified intervals after treatment to evaluate clinical outcomes and evidence of treatment-related toxicities.

The study authors reported overall survival, distant metastasis–free survival, and specific disease–free survival rates of 93.7%, 89.2%, and 80.8%, respectively. The overall rate of late treatment–related toxicity was 43.4% at the follow-up of 63 months. In addition, fibrosis, lymphedema, and telangiectasias were each observed in 1.7% of patients after treatment. Furthermore, of the 51 patients who completed the Harvard scale to assess their cosmetic outcomes, 51.7% rated their satisfaction as excellent; 22.4%, as good; 10.3%, as fair; and 3.4%, as poor.

Disclosure: Dr. Takanen reported no conflicts of interest.

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