Favorable safety profile of moderate hypofractionated over normofractionated radiotherapy in breast cancer patients: a multicentric prospective real-life data farming analysis

• Published in: Radiation oncology (London, England) England), 2022-04, Vol.17 (1), p.80-80, Article 80
• Main Authors: Issoufaly, Irfane, Petit, Claire, Guihard, Sébastien, Eugène, Rémi, Jung, Loic, Clavier, Jean Baptiste, Servagi Vernat, Stéphanie, Bellefqih, Sara, Verret, Benjamin, Bonnet, Naïma, Deutsch, Éric, Rivera, Sofia
• Format: Article
• Language: English
• Subjects: Acute toxicity; Aged; Aged, 80 and over; Agriculture; Body mass index; Breast - abnormalities; Breast cancer; Breast Neoplasms - radiotherapy; Cancer; Cancer therapies; Care and treatment; Chemotherapy; Clinical trials; Data-farming; Dermatitis; Edema; Farming; Female; Fractionation; Humans; Hyperpigmentation; Hypertrophy; Hypofractionation; Life Sciences; Lumpectomy; Mastectomy; Methods; Middle Aged; Multivariate analysis; Oncology, Experimental; Pain; Patient outcomes; Patients; Population studies; Prospective Studies; Radiation therapy; Radiotherapy; Real-life data; Regression analysis; Risk analysis; Risk factors; Software; Structured Query Language-SQL; Surgery; Toxicity; Tumors
• ISSN: 1748-717X; 1748-717X
• DOI: 10.1186/s13014-022-02044-z

Moderately hypofractionated whole-breast radiotherapy (HFRT) has proven to be as safe and efficient as normofractionated radiotherapy (NFRT) in randomized trials resulting in major changes in clinical practice. Toxicity rates observed in selected clinical trial patients may differ from those observed in unselected patients with possible comorbidities and frailty in real-life. This study aimed to examine the influence of HFRT versus NFRT on acute toxicity and identify risks factors of dermatitis in real-life patients. Prospective data from breast cancer patients, treated with locoregional radiotherapy were collected between November 2015 and February 2020 in 3 comprehensive cancer centers. Through a systematic data-farming strategy, acute toxicity evaluation forms (CTCAEv4.0) were prospectively completed and extracted electronically. The results from each center were then anonymously merged into a single database for analysis. A Chi-2 test was used to compare HFRT and NFRT. Furthermore, risk factors of dermatitis were identified in a sub-study (622 patients) by multivariate logistic regression analysis. In total, 3518 T0-4 N0-3 mostly M0 (85.8%) breast cancer patients with a median age of 60.7 (24-96 years old) were analyzed. Acute grade 2-3 dermatitis, grade 1-3 breast oedema, and grade 1-2 hyperpigmentation were less frequent with HFRT versus NFRT: respectively 8.9% versus 35.1% (Chi-2 = 373.7; p