An accelerated hypofractionated schedule with a daily concomitant boost after breast conservation surgery: the feasibility and toxicity

Aims and background: reduction of overall treatment time of postoperative irradiation and evaluation of the feasibility and preliminary toxicity of an accelerated hypofractionated whole breast irradiation with an addition of a concomitant daily boost in patients with early breast cancer submitted to conservation surgery. materials: between june 2010 and september 2011,122 patients underwent accelerated hypofractionated adjuvant radiation after conservation surgery (pt1 or pt2,pn0-n1). radiotherapy consisted of 45 gy,to the whole breast in 20 fractions with 2.25 gy/fraction; an additional daily boost dose of 0.25 gy was concomitantly delivered to the lumpectomy cavity,total dose 5 gy. toxicity was assessed at the end of radiation therapy and at 3,6,and 12 months using the rtog/eortc toxicity scale. cosmetic results were assessed in agreement with the harvard criteria. results: median follow-up was 31 months,74% showed grade 0-skin toxicity,20% grade 2,and 6% grade 3. at 3 months of follow-up,grade 0 skin toxicity was observed in 51% of cases; grade 1 in 36%,and grade 2 in 13%. at 6 months,late skin and subcutaneous tissue toxicities were scored as grade 0 in 71%,grade 1 in 18%,and grade 2 in 11% of patients.at 1 year almost all the patients showed grade 0-skin toxicity. 97% of patients showed excellent or good cosmetic results. conclusions: accelerated hypofractionated radiotherapy for early breast cancer with concomitant electron boost seems to be feasible providing consistent clinical results with acceptable toxicity profile. © 2016 national cancer institute,cairo university.