Significance of Hypofractionated Radiotherapy in Postoperative Irradiation for Breast Cancer: An Asian Multi-institutional Prospective Study
Issued Date
2023-01-01
Resource Type
ISSN
09366555
eISSN
14332981
Scopus ID
2-s2.0-85159092897
Journal Title
Clinical Oncology
Rights Holder(s)
SCOPUS
Bibliographic Citation
Clinical Oncology (2023)
Suggested Citation
Okonogi N., Kono S., Karasawa K., Banu P.A., Xu X., Erawati D., Adylkhanov T., Jang W.I., E. Y., Calaguas M.J., Thephamongkhol K., Dung T.A., Ng W.N.P., Kato S. Significance of Hypofractionated Radiotherapy in Postoperative Irradiation for Breast Cancer: An Asian Multi-institutional Prospective Study. Clinical Oncology (2023). doi:10.1016/j.clon.2023.04.007 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/82782
Title
Significance of Hypofractionated Radiotherapy in Postoperative Irradiation for Breast Cancer: An Asian Multi-institutional Prospective Study
Author's Affiliation
Siriraj Hospital
Saitama Medical University International Medical Center
QST Hospital
The First Affiliated Hospital of Soochow University
St. Luke's Medical Center Quezon City
Korea Institute of Radiological and Medical Sciences
Tokyo Women's Medical University
National Cancer Institute
National Cancer Center of Mongolia
Dr. Soetomo General Academic Hospital
National Research Center for Oncology and Transplantation
Delta Hospital Limited
National Cancer Hospital
Saitama Medical University International Medical Center
QST Hospital
The First Affiliated Hospital of Soochow University
St. Luke's Medical Center Quezon City
Korea Institute of Radiological and Medical Sciences
Tokyo Women's Medical University
National Cancer Institute
National Cancer Center of Mongolia
Dr. Soetomo General Academic Hospital
National Research Center for Oncology and Transplantation
Delta Hospital Limited
National Cancer Hospital
Other Contributor(s)
Abstract
Aims: There is a need for the adequate distribution of healthcare resources in Southeast Asia. Many countries in the region have more patients with advanced breast cancer who are eligible for postmastectomy radiotherapy (PMRT). Therefore, it is critical that hypofractionated PMRT is effective in most of these patients. This study investigated the significance of postoperative hypofractionated radiotherapy in patients with breast cancer, including advanced breast cancer, in these countries. Materials and methods: Eighteen facilities in 10 Asian countries participated in this prospective, interventional, single-arm study. The study included two independent regimens: hypofractionated whole-breast irradiation (WBI) for patients who had undergone breast-conserving surgery and hypofractionated PMRT for patients who had undergone total mastectomy at a dose of 43.2 Gy in 16 fractions. In the hypofractionated WBI group, patients with high-grade factors received additional 8.1 Gy boost irradiation sessions for the tumour bed in three fractions. Results: Between February 2013 and October 2019, 227 and 222 patients were enrolled in the hypofractionated WBI and hypofractionated PMRT groups, respectively. The median follow-up periods in the hypofractionated WBI and hypofractionated PMRT groups were 61 and 60 months, respectively. The 5-year locoregional control rates were 98.9% (95% confidence interval 97.4–100.0) and 96.3% (95% confidence interval 93.2–99.4) in the hypofractionated WBI and hypofractionated PMRT groups, respectively. Regarding adverse events, grade 3 acute dermatitis was observed in 2.2% and 4.9% of patients in the hypofractionated WBI and hypofractionated PMRT groups, respectively. However, no other adverse events were observed. Conclusion: Although further follow-up is required, hypofractionated radiotherapy regimens for postoperative patients with breast cancer in East and Southeast Asian countries are effective and safe. In particular, the proven efficacy of hypofractionated PMRT indicates that more patients with advanced breast cancer can receive appropriate care in these countries. Hypofractionated WBI and hypofractionated PMRT are reasonable approaches that can contain cancer care costs in these countries. Long-term observation is required to validate our findings.