Hypofractionated whole-breast irradiation (HF-WBI) may result in better quality of life and lower rate of acute toxic effects in patients with breast cancer compared to conventionally fractionated whole-breast irradiation (CF-WBI), according to a study published online ahead of print in JAMA Oncology.
Simona Shaitelman, MD, Med, of The University of Texas MD Anderson Cancer Center and fellow researchers conducted an unblended, randomized trial on 287 women with stage 0 to II breast cancer where whole-breast irradiation was recommended.
They were given either HF-WBI or CF-WBI dose fractionations in order to assess for acute and six-month toxic effects and quality of life measured against National Cancer Institute Common Toxicity Criteria as well as Functional Assessment of Cancer Therapy for Patients with Breast Cancer (FACT-B).
Both treatment arms were found to be well-matched for baseline characteristics such as FACT-B total score, individual quality of life such as lack of energy, and trouble with meeting family needs.
Physician-reported effects such as acute dermatitis, breast pain, hyperpigmentation, and fatigue were lower in patients who received HF-WBI. In addition, overall grade 2 or higher acute toxic effects were less observed in HF-WBI compared to CF-WBI, along with fatigue and lack of energy.
Upon multivariable regression, HF-WBI was found to be superior in terms of patient-reported lack of energy and trouble meeting family needs.
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“Treatment with HF-WBI appears to yield lower rates of acute toxic effects than CF-WBI as well as less fatigue and less trouble meeting family needs six months after completing radiation therapy,” the authors concluded.
- Shaitelman SF, Schlembach PJ, Arzu I, et al. Acute and Short-term Toxic Effects of Conventionally Fractionated vs Hypofractionated Whole-Breast Irradiation: A Randomized Clinical Trial. JAMA Oncology. doi:10.1001/jamaoncol.2015.2666. [epub ahead of print]. August 6, 2015.