الفهرس 
Title : Randomized trial comparing 3 schedules of hypofractionated whole breast irradiation in females with early stage breast cancer
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Abstract
Back ground and Purpose: This prospective randomized clinical trial aimed to evaluate the outcomes of one-week and once weekly schedules of hypofractionated whole breast irradiation (HF-WBI)against the standard WBIregimen, (40 Gy in 15 fractions in 3 weeks), in females with early-stage breast cancer after breast conservative surgery(BCS), in terms of acute and late toxicity according to the RTOG toxicity assessment, cosmetic outcome, and locoregional control.The trial also evaluated the patient-reported outcome measures (PROMS) of late adverse effects and quality of life according to the EORTC Quality of Life Questionnaire QLQ-BR 23 specific for breast cancer and treatment convenience. Methods and Materials: This non-inferiority randomized trial was conducted on 3 groups of female patients, at least 18 years with pTis, pT1-2, pN0-1, M0 breast cancer, after BCS with negative surgical margins. Patients were randomized to WBI to 27 Gy in 5 daily fractions over 1-week, 28.5 Gy in 5 weekly fractions over 5 weeks, or 40 Gy in 15 fractions over 3 weeks. Tumor bed boost and regional nodal irradiation were allowed. Internal mammary nodal irradiation was not allowed. There were no restrictions on age, breast size, tumor grade, or the use of adjuvant systemic treatment for eligible patients. The primary endpoints were: i) The proportion of patients with grade {u2265}3 acute toxicities according to RTOG acute radiation morbidity scoring criteria, ii)The cosmetic outcome measured by photographic assessment and EORTC cosmetic rating system (observer rating), and iii) locoregional tumor control. The secondary end points: i) Late toxicity according to RTOG/EORTC late radiation morbidity scoring schema, ii) Distant disease-free survival,iii) Overall survival, iv) patient-reported outcome measures (PROMS) of late adverse effects and quality of life according to EORTC QLQ-BR 23. Results:from November 2017 to November 2018, 152 eligible patients had WBI after BCS. The median age was 50.42±9.39 years, and the median follow-up period was 26.20±6.54 months. Local control was maintained in all 152 patients