A prospective feasibility study on extreme hypofractionation in adjuvant radiation of breast cancer in a tertiary cancer center in India
INTRODUCTION: Breast cancer is the most common cancer among women in India at present, having overtaken cancer cervix. Treatment of breast cancer is a multimodality approach. Adjuvant radiation therapy plays a major role in the treatment of breast cancer. Standard of care in adjuvant therapy changed...
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| Format: | Article |
| Language: | English |
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Wolters Kluwer Medknow Publications
2025-07-01
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| Series: | Annals of Oncology Research and Therapy |
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| Online Access: | https://journals.lww.com/10.4103/aort.aort_48_24 |
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| author | Sri Sai Tejaswini Muddana Vijay Anand Reddy Palkonda Madhuri Kavikondala Prashant Upadhyaya Vijay Karan Reddy Shilpa Reddy Keesara Karthik Pathri Shravanthi Reddy Bussyaku Padma Ganesan P. Sathish Kumar R. Rajasekaran Delhi Babu Mohan |
| author_facet | Sri Sai Tejaswini Muddana Vijay Anand Reddy Palkonda Madhuri Kavikondala Prashant Upadhyaya Vijay Karan Reddy Shilpa Reddy Keesara Karthik Pathri Shravanthi Reddy Bussyaku Padma Ganesan P. Sathish Kumar R. Rajasekaran Delhi Babu Mohan |
| author_sort | Sri Sai Tejaswini Muddana |
| collection | DOAJ |
| description | INTRODUCTION:
Breast cancer is the most common cancer among women in India at present, having overtaken cancer cervix. Treatment of breast cancer is a multimodality approach. Adjuvant radiation therapy plays a major role in the treatment of breast cancer. Standard of care in adjuvant therapy changed from conventional fractionation to hypofractionation with the advent of START A and START B trials. In 2020, the Fast Forward Trial group released their 5-year results showing noninferiority results in patients treated with 27/26 Gy in 5 fractions compared to 40 Gy in 15 fractions. Studies supporting the extreme hypofractionated regimen are not available in the Indian scenario. The purpose of this study is to evaluate the feasibility of extreme hypofractionated radiation in breast cancer in Indian setup and to assess the acute toxicities of patients during and postradiation.
AIMS AND OBJECTIVES:
To study the feasibility and acute toxicities of 1-week extreme hypofractionated regimen adjuvant radiation therapy for breast cancers in Indian scenario.
MATERIALS AND METHODS:
A total of 25 patients who are pathologically proven breast cancer, invasive ductal carcinoma (IDC) grade 1–3, postsurgery breast-conserving surgery and mastectomy, pT1-T3 or N0-N1, irrespective of hormonal receptor and Her 2 neu and chemotherapy are enrolled into the study during a period of September 2021–May 2022. Patients received 27 Gy in 5 fractions at 5.4 Gy per fraction to the whole breast/chest wall with a sequential boost of 11 Gy in 3 fractions at 3.67 Gy per fraction as boost to the tumor bed in patients who underwent breast conservation surgery. Patients have been evaluated for acute toxicities as per the common terminology criteria for adverse events 3.0 during radiation and up to 1-month postradiation therapy. Patient-reported breast cancer-specific quality of life has been evaluated using the validated European Organization for Research and Treatment of Cancer Breast Cancer-Specific Quality of Life Questionnaire at the time of simulation (baseline), treatment completion, and first, follow-up.
RESULTS:
Acute skin toxicities are not noticed during radiation in the majority of patients. They developed skin reactions during 2–4 weeks postradiation, which subsided within 4 weeks. Twenty (80%) patients had Grade 1 reactions, 2 (8%) patients had Grade 0, and 3 (12%) patients had Grade 2 acute skin toxicities like patchy moist desquamation, which started in the 2nd week and resolved in 4 weeks after radiation. In terms of patient quality of life, acute breast-related symptoms were analyzed, and 5 (20%) patients complained of moderate breast symptoms such as pain, swelling, and skin problems immediately after the completion of radiation therapy, which subsided at 1-month postradiation.
CONCLUSION:
One-week hypofractionation in breast cancer radiation therapy is feasible in the Indian subset of population. Majority of patients developed Grade 1 and 2 acute skin toxicity, which resolved without any intervention. There were no grade 3 and 4 acute toxicities during radiation. Few patients reported moderate breast symptoms immediately after completion of radiation therapy, which subsided within 1 month. |
| format | Article |
| id | doaj-art-e8e4c4de8435409fa8fd771e1a4fc77d |
| institution | Kabale University |
| issn | 2772-8382 2772-8390 |
| language | English |
| publishDate | 2025-07-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Annals of Oncology Research and Therapy |
| spelling | doaj-art-e8e4c4de8435409fa8fd771e1a4fc77d2025-08-20T03:28:55ZengWolters Kluwer Medknow PublicationsAnnals of Oncology Research and Therapy2772-83822772-83902025-07-015212012710.4103/aort.aort_48_24A prospective feasibility study on extreme hypofractionation in adjuvant radiation of breast cancer in a tertiary cancer center in IndiaSri Sai Tejaswini MuddanaVijay Anand Reddy PalkondaMadhuri KavikondalaPrashant UpadhyayaVijay Karan ReddyShilpa Reddy KeesaraKarthik PathriShravanthi Reddy BussyakuPadma GanesanP. Sathish KumarR. RajasekaranDelhi Babu MohanINTRODUCTION: Breast cancer is the most common cancer among women in India at present, having overtaken cancer cervix. Treatment of breast cancer is a multimodality approach. Adjuvant radiation therapy plays a major role in the treatment of breast cancer. Standard of care in adjuvant therapy changed from conventional fractionation to hypofractionation with the advent of START A and START B trials. In 2020, the Fast Forward Trial group released their 5-year results showing noninferiority results in patients treated with 27/26 Gy in 5 fractions compared to 40 Gy in 15 fractions. Studies supporting the extreme hypofractionated regimen are not available in the Indian scenario. The purpose of this study is to evaluate the feasibility of extreme hypofractionated radiation in breast cancer in Indian setup and to assess the acute toxicities of patients during and postradiation. AIMS AND OBJECTIVES: To study the feasibility and acute toxicities of 1-week extreme hypofractionated regimen adjuvant radiation therapy for breast cancers in Indian scenario. MATERIALS AND METHODS: A total of 25 patients who are pathologically proven breast cancer, invasive ductal carcinoma (IDC) grade 1–3, postsurgery breast-conserving surgery and mastectomy, pT1-T3 or N0-N1, irrespective of hormonal receptor and Her 2 neu and chemotherapy are enrolled into the study during a period of September 2021–May 2022. Patients received 27 Gy in 5 fractions at 5.4 Gy per fraction to the whole breast/chest wall with a sequential boost of 11 Gy in 3 fractions at 3.67 Gy per fraction as boost to the tumor bed in patients who underwent breast conservation surgery. Patients have been evaluated for acute toxicities as per the common terminology criteria for adverse events 3.0 during radiation and up to 1-month postradiation therapy. Patient-reported breast cancer-specific quality of life has been evaluated using the validated European Organization for Research and Treatment of Cancer Breast Cancer-Specific Quality of Life Questionnaire at the time of simulation (baseline), treatment completion, and first, follow-up. RESULTS: Acute skin toxicities are not noticed during radiation in the majority of patients. They developed skin reactions during 2–4 weeks postradiation, which subsided within 4 weeks. Twenty (80%) patients had Grade 1 reactions, 2 (8%) patients had Grade 0, and 3 (12%) patients had Grade 2 acute skin toxicities like patchy moist desquamation, which started in the 2nd week and resolved in 4 weeks after radiation. In terms of patient quality of life, acute breast-related symptoms were analyzed, and 5 (20%) patients complained of moderate breast symptoms such as pain, swelling, and skin problems immediately after the completion of radiation therapy, which subsided at 1-month postradiation. CONCLUSION: One-week hypofractionation in breast cancer radiation therapy is feasible in the Indian subset of population. Majority of patients developed Grade 1 and 2 acute skin toxicity, which resolved without any intervention. There were no grade 3 and 4 acute toxicities during radiation. Few patients reported moderate breast symptoms immediately after completion of radiation therapy, which subsided within 1 month.https://journals.lww.com/10.4103/aort.aort_48_24breasthypofractionationradiation therapy |
| spellingShingle | Sri Sai Tejaswini Muddana Vijay Anand Reddy Palkonda Madhuri Kavikondala Prashant Upadhyaya Vijay Karan Reddy Shilpa Reddy Keesara Karthik Pathri Shravanthi Reddy Bussyaku Padma Ganesan P. Sathish Kumar R. Rajasekaran Delhi Babu Mohan A prospective feasibility study on extreme hypofractionation in adjuvant radiation of breast cancer in a tertiary cancer center in India Annals of Oncology Research and Therapy breast hypofractionation radiation therapy |
| title | A prospective feasibility study on extreme hypofractionation in adjuvant radiation of breast cancer in a tertiary cancer center in India |
| title_full | A prospective feasibility study on extreme hypofractionation in adjuvant radiation of breast cancer in a tertiary cancer center in India |
| title_fullStr | A prospective feasibility study on extreme hypofractionation in adjuvant radiation of breast cancer in a tertiary cancer center in India |
| title_full_unstemmed | A prospective feasibility study on extreme hypofractionation in adjuvant radiation of breast cancer in a tertiary cancer center in India |
| title_short | A prospective feasibility study on extreme hypofractionation in adjuvant radiation of breast cancer in a tertiary cancer center in India |
| title_sort | prospective feasibility study on extreme hypofractionation in adjuvant radiation of breast cancer in a tertiary cancer center in india |
| topic | breast hypofractionation radiation therapy |
| url | https://journals.lww.com/10.4103/aort.aort_48_24 |
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