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First results of the randomised UK FAST Trial of radiotherapy hypofractionation for treatment of early breast cancer (CRUKE/04/015)

Agrawal, Rajiv K., Alhasso, Abdulla, Barrett-Lee, Peter, Bliss, Judith M., Bliss, Peter, Bloomfield, David, Bowen, Joanna, Brunt, A. Murray, Donovan, Ellen, Emson, Marie, Goodman, Andrew, Harnett, Adrian, Havilan, Joanne S., Kaggwa, Ronald, Morden, James P., Robinson, Anne, Simmons, Sandra, Stewart, Alan, Sydenham, Mark A., Syndikus, Isabel, Tremlett, Jean, Tsang, Yat, Wheatley, Duncan, Venables, Karen and Yarnold, John R. 2011. First results of the randomised UK FAST Trial of radiotherapy hypofractionation for treatment of early breast cancer (CRUKE/04/015). Radiotherapy and Oncology 100 (1) , pp. 93-100. 10.1016/j.radonc.2011.06.026

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Background and purpose: Randomised trials testing 15- or 16-fraction regimens of adjuvant radiotherapy in women with early breast cancer have reported favourable outcomes compared with standard fractionation. To evaluate hypofractionation further, two 5-fraction schedules delivering 1 fraction per week have been tested against a 25-fraction regimen. Materials and methods: Women aged P50 years with node negative early breast cancer were randomly assigned after microscopic complete tumour resection to 50 Gy in 25 fractions versus 28.5 or 30 Gy in 5 once-weekly fractions of 5.7 or 6.0 Gy, respectively, to the whole breast. The primary endpoint was 2-year change in photographic breast appearance. Results: Nine hundred and fifteen women were recruited from 2004 to 2007. Seven hundred and twentynine patients had 2-year photographic assessments. Risk ratios for mild/marked change were 1.70 (95% CI 1.26–2.29, p < 0.001) for 30 Gy and 1.15 (0.82–1.60, p = 0.489) for 28.5 Gy versus 50 Gy. Three-year rates of physician-assessed moderate/marked adverse effects in the breast were 17.3% (13.3–22.3%, p < 0.001) for 30 Gy and 11.1% (7.9–15.6%, p = 0.18) for 28.5 Gy compared with 9.5% (6.5–13.7%) after 50 Gy. With a median follow-up in survivors of 37.3 months, 2 local tumour relapses and 23 deaths have occurred. Conclusion: At 3 years median follow-up, 28.5 Gy in 5 fractions is comparable to 50 Gy in 25 fractions, and significantly milder than 30 Gy in 5 fractions, in terms of adverse effects in the breast. � 2011 Elsevier Ireland Ltd. All rights reserved. Radiotherapy and Oncology 100 (2011) 93–100

Item Type: Article
Date Type: Publication
Status: Published
Schools: Medicine
Subjects: R Medicine > R Medicine (General)
R Medicine > RC Internal medicine > RC0254 Neoplasms. Tumors. Oncology (including Cancer)
Uncontrolled Keywords: Breast cancer; Radiotherapy; Hypofractionation
Publisher: Elsevier
ISSN: 0167-8140
Last Modified: 10 Oct 2017 14:09

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