Fractionation schemes in adjuvant radiotherapy for breast cancer: review of the evidence and therapeutic approach at the National Institute of Cancerology, Colombia

Siegel R, Miller K, Jemal A. Cancer statistics, 2019. CA Cancer J Clin. 2019;69(1):7-34. https://doi.org/10.3322/caac.21551

Ministerio de Salud y Protección Social; Departamento Administrativo de Ciencia Tecnología e Innovación en Salud (Colciencias). Guía de Práctica Clínica (GPC) para la detección temprana, tratamiento integral, seguimiento y rehabilitación de pacientes con cáncer de mama. Bogotá: Colciencias; 2013. Disponible en: https://www.minsalud.gov.co/sites/rid/1/Gu%C3%ADa%20de%20Pr%C3%A1ctica%20Cl%C3%ADnica%20%20de%20Cancer%20de%20Mama%20versi%C3%B3n%20completa.pdf

Borger J. The impact of surgical and pathological findings on radiotherapy of early breast cancer. Radiother Oncol. 1991;22(4):230-36. https://doi.org/10.1016/0167-8140(91)90154-9

EBCTCG (Early Breast Cancer Trialists’ Collaborative Group). Effect of radiotherapy after mastectomy and axillary surgery on 10-year recurrence and 20-year breast cancer mortality: meta-analysis of individual patient data for 8135 women in 22 randomised trials. Lancet. 2014;383(9935):2127-35. https://doi.org/10.1016/s0140-6736(14)60488-8

Whelan T, MacKenzie R, Julian J, Levine M, Shelley W, Grimard L, et al. Randomized trial of breast irradiation schedules after lumpectomy for women with lymph node-negative breast cancer. JNCI. 2002;94(15):1143-50. https://doi.org/10.1093/jnci/94.15.1143

The START Trialists' Group. The UK Standardisation of Breast Radiotherapy (START) Trial A of radiotherapy hypofractionation for treatment of early breast cancer: a randomised trial. Lancet Oncol. 2008;9(4):331-41. https://doi.org/10.1016/s1470-2045(08)70077-9

The START Trialists' Group. The UK Standardisation of Breast Radiotherapy (START) Trial B of radiotherapy hypofractionation for treatment of early breast cancer: a randomised trial. Lancet. 2008;371(9618):1098-107. https://doi.org/10.1016/s0140-6736(08)60348-7

Haviland J, Owen J, Dewar J, Agrawal R, Barrett J, Barrett-Lee P, et al. The UK Standardisation of Breast Radiotherapy (START) trials of radiotherapy hypofractionation for treatment of early breast cancer: 10-year follow-up results of two randomised controlled trials. Lancet Oncol. 2013;14(11):1086-94. https://doi.org/10.1016/S1470-2045(13)70386-3

Whelan T, Pignol J-P, Levine M, Julian J, MacKenzie R, Parpia S, et al. Long-term results of hypofractionated radiation therapy for breast cancer. N Engl J Med. 2010;362:513-20. https://doi.org/10.1056/nejmoa0906260

Lievens Y. Hypofractionated breast radiotherapy: financial and economic consequences. The Breast. 2010;19(3):192-7. https://doi.org/10.1016/j.breast.2010.03.003

Fisher B, Anderson S. Conservative surgery for the management of invasive and noninvasive carcinoma of the breast: NSABP trials. World J Surg. 1994;18(1):63-9. https://doi.org/10.1007/BF00348193

Overgaard M, Hansen P, Overgaard J, Rose C, Andersson M, Bach F, et al. Postoperative radiotherapy in high-risk premenopausal women with breast cancer who receive adjuvant chemotherapy. N Engl J Med. 1997;337(14):949-55. https://doi.org/10.1056/NEJM199710023371401

Arcangeli S, Greco C. Hypofractionated radiotherapy for organ-confined prostate cancer: is less more? Nat Rev Urol. 2016;13:400-8. https://doi.org/10.1038/nrurol.2016.106

NICE. Early and locally advanced breast cancer: diagnosis and management. Londres: National Institute for Health and Care Excellence; 2018. Disponible en: https://www.ncbi.nlm.nih.gov/books/NBK519155/

Smith B, Bellon J, Blitzblau R, Freedman G, Haffty B, Hahn C, et al. Radiation therapy for the whole breast: executive summary of an American Society for Radiation Oncology (ASTRO) evidence-based guideline. PRO. 2018;8(3):145-52. https://doi.org/10.1016/j.prro.2018.01.012

Cardoso F, Kyriakides S, Ohno S, Penault-Llorca F, Poortmans P, Rubio I, et al. Early breast cancer: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol. 2019;30(8):1194-220. https://doi.org/10.1093/annonc/mdz173

Gradishar W, Moran M, Abraham J, Aft R, Agnese D, Allison K, et al. Breast cancer, version 3.2022, NCCN Clinical Practice Guidelines in Oncology. J Natl Compr Canc Netw. 2022;20(6):691-722. https://doi.org/10.6004/jnccn.2022.0030

Meattini I, Becherini C, Boersma L, Kaidar-Person O, Nader G, Montero A, et al. European Society for Radiotherapy and Oncology Advisory Committee in Radiation Oncology Practice consensus recommendations on patient selection and dose and fractionation for external beam radiotherapy in early breast cancer. Lancet Oncol. 2022;23(1):e21-31. https://doi.org/10.1016/s1470-2045(21)00539-8

Yarnold J, Ashton A, Bliss J, Homewood J, Harper C, Hanson J, et al. Fractionation sensitivity and dose response of late adverse effects in the breast after radiotherapy for early breast cancer: long-term results of a randomised trial. Rad Onc. 2005;75(1):9-17. https://doi.org/10.1016/j.radonc.2005.01.005

Kunkler I, Williams L, Jack W, Cameron D, Dixon J. Breast-conserving surgery with or without irradiation in women aged 65 years or older with early breast cancer (PRIME II): a randomised controlled trial. Lancet Oncol. 2015;16(3):266-73. https://doi.org/10.1016/s1470-2045(14)71221-5

Hughes K, Schnaper L, Bellon J, Cirrincione C, Berry D, McCormick B, et al. Lumpectomy plus tamoxifen with or without irradiation in women age 70 years or older with early breast cancer: long-term follow-up of CALGB 9343. J Clin Oncol. 2013;31(19):2382-7. https://doi.org/10.1200/jco.2012.45.2615

Veronesi U, Cascinelli N, Mariani L, Greco M, Saccozzi R, Luini A, et al. Twenty-year follow-up of a randomized study comparing breast-conserving surgery with radical mastectomy for early breast cancer. N Engl J Med. 2002;347(16):1227-32. https://doi.org/10.1056/NEJMoa020989

Shaitelman S, Schlembach P, Arzu I, Ballo M, Bloom E, Buchholz D, et al. Acute and short-term toxic effects of conventionally fractionated vs hypofractionated whole-breast irradiation: a randomized clinical trial. JAMA Oncol. 2015;1(7):931. https://doi.org/10.1001/jamaoncol.2015.2666

Jagsi R, Griffith K, Boike T, Walker E, Nurushev T, Grills I, et al. Differences in the acute toxic effects of breast radiotherapy by fractionation schedule: comparative analysis of physician-assessed and patient-reported outcomes in a large multicenter cohort. JAMA Oncol. 2015;1(7):918. https://doi.org/10.1001/jamaoncol.2015.2590

Murray A, Haviland J, Wheatley D, Sydenham M, Alhasso A, Bloomfield D, et al. Hypofractionated breast radiotherapy for 1 week versus 3 weeks (FAST-Forward): 5-year efficacy and late normal tissue effects results from a multicentre, non-inferiority, randomised, phase 3 trial. Lancet. 2020;395(10237):1613-26. https://doi.org/10.1016/s0140-6736(20)30932-6

Yaremko H, Locke G, Chow R, Lock M, Dinniwell R, Yaremko B. Cost minimization analysis of hypofractionated radiotherapy. Curr Oncol. 2021;28(1):716-25. https://doi.org/10.3390/curroncol28010070

Vicini F, Winter K, Freedman G, Arthur D, Hayman J, Rosenstein B, et al. NRG RTOG 1005: a phase III trial of hypo fractionated whole breast irradiation with concurrent boost vs. conventional whole breast irradiation plus sequential boost following lumpectomy for high risk early-stage breast cancer. Int J Radiat Oncol Biol Phys. 2022;114(3):S1. https://doi.org/10.1016/j.ijrobp.2022.07.2320

Offersen B, Alsner J, Nielsen H, Jakobsen E, Nielsen M, Krause M, et al. Hypofractionated versus standard fractionated radiotherapy in patients with early breast cancer or ductal carcinoma in situ in a randomized phase iii trial: the DBCG HYPO trial. J Clin Oncol. 2020;38(31):3615-25. https://doi.org/10.1200/JCO.20.01363

Wang S-L, Fang H, Song Y-W, Wang W-H, Hu C, Liu Y-P, et al. Hypofractionated versus conventional fractionated postmastectomy radiotherapy for patients with high-risk breast cancer: a randomised, non-inferiority, open-label, phase 3 trial. Lancet Oncol. 2019;20(3):P352-60. https://doi.org/10.1016/s1470-2045(18)30813-1

Poppe M. RT CHARM: phase III randomized trial of hypofractionated post mastectomy radiation with breast reconstruction. [citado 2024 mzo. 7]. Disponible en: https://clinicaltrials.gov/study/NCT03414970

Liu L, Yang Y, Guo Q, Ren B, Peng Q, Zou L, et al. Comparing hypofractionated to conventional fractionated radiotherapy in postmastectomy breast cancer: a meta-analysis and systematic review. Rad Oncol. 2020;15(1):17. https://doi.org/10.1186/s13014-020-1463-1

Poortmans P, Weltens C, Fortpied C, Kirkove C, Peignaux-Casasnovas K, Budach V, et al. Internal mammary and medial supraclavicular lymph node chain irradiation in stage I-III breast cancer (EORTC 22922/10925): 15-year results of a randomised, phase 3 trial. Lancet Oncol. 2020;21(12):1602-10. https://doi.org/10.1016/s1470-2045(20)30472-1

Thorsen L, Overgaard J, Matthiessen L, Berg M, Stenbygaard L, Pedersen A, et al. Internal mammary node irradiation in patients with node-positive early breast cancer: fifteen-year results from the Danish Breast Cancer Group internal mammary node study. J Clin Oncol. 2022;40(36):4198-206. https://doi.org/10.1200/jco.22.00044