COMPARATIVE ESTIMATION OF MORBIDITY RATE AND DEGREE OF SKIN LESIONS DURING HYPOFRACTIONATED AND TRADITIONAL RADIOTHERAPY OF BREAST CANCER
Background: Radiation therapy is a necessary step for the integrated treatment of breast cancer. The traditional scheme of treatment is the use of 2 Gray in 25 fractions to the total focal dose of 50 Gy. However, like any other treatment method, radiation therapy provides a variety of side effects on normal tissue in the irradiated field. To solve this problem it is necessary to develop suitable treatment regimens to achieve better local control with minimal risk on the normal tissues.
A variety of hypofractionated radiotherapy schedules has been proposed after surgery in the attempt to shorten the overall treatment time. The aim of the present study is to assess acute toxicity of using daily fractionation of 2.7 Gy to a total dose of 43.2 Gy to the whole breast in a monoinstitutional series.
Methods: Study design is non-randomised clinical trial. 132 Patients were evaluated for toxicity according to RTOG acute adverse effect criteria at the end of treatment and 3, 6 months after treatment. Mann-Whitney U test was used for comparing acute toxicity rate between patients treated with hypofractionation and traditional radiotherapy. A p value of ˂0.05 was taken as significant. The whole analysis was performed with SPSS ver.20 software.
Results: Hypofractionation is very well tolerated; more than 80% of patients had no toxicities at all with the treated schedule. The rate of mild toxicity (> grade 2) was minimum in these patients (p=0.023).
Conclusions: The results of our study, according to the large randomized trials, confirmed that hypofractionated is safe.
Ainur S. Baissalbayeva, http://orcid.org/0000-0002-7092-7448
Tasbolat A. Adylkhanov, http://orcid.org/0000-0002-9092-5060
Yevgeniya O. Kossymbayeva, http://orcid.org/0000-0003-2893-0384
Olga B. Andreeva, http://orcid.org/0000-0002-2802-9441
Aizhan A. Abiltaeva, http://orcid.org/0000-0002-0172-9202
Semey State Medical University, Oncology and visual diagnostics department,
Semey, Kazakhstan
1. Адылханов Т.А., Абильтаева А.А., Байсалбаева А.С. Возможности современной ядерной и лучевой диагностики метастатического рака молочной железы: обзор литературы. // Наука и Здравоохранение. 2015. №3. С. 37-46.
2. Акильжанова А.Р., Рахыпбеков Т.К. Медико-генетическое консультирование при заболеваниях молочной железы: возможности, проблемы, перспективы // Наука и Здравоохранение. 2010. №2, Т1., С. 15-19.
3. Мусаханова А.К., Базарбек Ж.Б., Елемесова Н.М., Шишкина О.В., Абдильдина З.Ж. Анализ заболеваемости злокачествен-ными новообразованиями в Восточно-Казахстанской области // Наука и Здравоохранение. 2010. №3. С. 213-216.
4. Сандыбаев М.Н., Манамбаева З.А., Жабагин К.Т., Байсалбаева А.С., Бауржан А., Камзин К.Ж. Заболеваемость злокачественными новообразованиями в Семейском регионе Восточно-Казахстанской области // Наука и Здравоохранение. 2012. №5. С. 151-152.
5. Bentzen S.M., Agrawal R.K., Aird E.G., Barrett J.M., Barrett-Lee P.J., Bentzen S.M., Bliss J.M., Brown J., Dewar J.A. et al 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): P. 1098-1107.
6. Cante D., Franco P., Sciacero P., Girelli G., Pasquino M., Casanova Borca V., Tofani S., Porta M. R., Ricardi U. Hypofractionated whole-breast radiotherapy and concomitant boost after breast conservation in elderly patients // Tumori. 2015. №1 (2). P. 12-22.
7. Cox J.D., Stetz J., Pajak T.F. Toxicity criteria of the Radiation Therapy Oncology Group (RTOG) and the European Organization for Research and Treatment of Cancer (EORTC) // Int J Radiat Oncol Biol Phys. 1995. №31(5). P. 1341-1346.
8. Curran D., van Dongen J. P., Aaronson N.K., Kiebert G., Fentiman I. S., Mignolet F., Bartelink H. Quality of life of early-stage breast cancer patients treated with radical mastectomy or breast-conserving procedures: results of EORTC Trial 10801. The European Organization for Research and Treatment of Cancer (EORTC), Breast Cancer Co-operative Group (BCCG) // Eur J Cancer. 1998. №34(3). P. 307-314.
9. Darby S., McGale P., Correa C., Taylor C., Arriagada R., Clarke M., Cutter D., Davies C., Ewertz M., Godwin J. et al. Effect of radiotherapy after breast-conserving surgery on 10-year recurrence and 15-year breast cancer death: meta-analysis of individual patient data for 10,801 women in 17 randomised trials // Lancet. 2011. №378(9804). P. 1707-1716.
10. Dwyer P., Hickey B., Burmeister E., Burmeister B. Hypofractionated whole-breast radiotherapy: impact on departmental waiting times and cost // J Med Imaging Radiat Oncol. 2010. №54(3). P. 229-234.
11. Engels C.C., Kiderlen M., Bastiaannet E., Mooyaart A.L., van Vlierberghe R., Smit V.T., Kuppen P.J., van de Velde C.J., Liefers G.J. The clinical prognostic value of molecular intrinsic tumor subtypes in older breast cancer patients: A FOCUS study analysis // Mol Oncol. 2015. №2. P. 256-61.
12. Haviland J.S., Owen J.R., Dewar J.A., Agrawal R.K., Barrett J., Barrett-Lee P.J., Dobbs H.J., Hopwood P., Lawton P.A., Magee B.J. 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). P. 1086-1094.
13. Hennequin C., Guillerm S., & Quero L. Radiotherapy in elderly patients, recommendations for the main localizations: Breast, prostate and gynaecological cancers // Cancer Radiother. 2015. №19(6-7). P. 397-403.
14. Hopwood P., Haviland J.S., Sumo G., Mills J., Bliss J.M., Yarnold J.R. Comparison of patient-reported breast, arm, and shoulder symptoms and body image after radiotherapy for early breast cancer: 5-year follow-up in the randomised Standardisation of Breast Radiotherapy (START) trials // Lancet Oncol. 2010. №11(3). P. 231-240.
15. Hrycushko B.A., Gutierrez A.N., Goins B., Yan W., Phillips W.T., Otto P.M., Bao A. Radiobiological characterization of post-lumpectomy focal brachytherapy with lipid nanoparticle-carried radionuclides // Phys Med Biol. 2011. 56(3). P. 703-719.
16. Kaufmann A., Schmidt H., Ostheimer C., Ullrich J., Landenberger M., Vordermark D. Quality of life in very elderly radiotherapy patients: a prospective pilot study using the EORTC QLQ-ELD14 module // Support Care Cancer. 2015. №23(7). P.1883-1892.
17. Kovarik J., Svoboda V.H. Early tolerance of different organs to fast fractionation in clinical practice // Int J Radiat Oncol Biol Phys. 1995. №32(5). P.1451-1454.
18. Lee T.S., Kilbreath S.L., Refshauge K.M., Pendlebury S.C., Beith J.M., Lee M.J. Quality of life of women treated with radiotherapy for breast cancer // Support Care Cancer. 2008. №16(4). P. 399-405.
19. Lievens Y. Hypofractionated breast radiotherapy: financial and economic consequences // Breast. 2010. №19(3). P. 192-197.
20. Montagna E., Bagnardi V., Rotmensz N., Viale G., Renne G., Cancello G., Balduzzi A., Scarano E., Veronesi P. et al. Breast cancer subtypes and outcome after local and regional relapse // Ann Oncol. 2012. №23(2). P. 324-331.
21. Mukesh M., Harris E., Jena R., Evans P., Coles C. Relationship between irradiated breast volume and late normal tissue complications: a systematic review // Radiother Oncol. 2012. №104(1). P. 1-10.
22. Overgaard M., Christensen J.J. Postoperative radiotherapy in DBCG during 30 years. Techniques, indications and clinical radiobiological experience // Acta Oncol. 2008. №47(4). P.639-653.
23. Palazzoni G., Nardone L., Cianciulli M., Ciresa M., Ausili-Cefaro G. Dose fractionation and biological optimization in breast cancer // Rays. 2004. №29(3). P.333-338.
24. Riou O., Fenoglietto P., Bourgier C., Lauche O., Boulbair F., Charissoux M., Ducteil A., Ailleres N., Lemanski C., Azria D. Feasibility of accelerated partial breast irradiation with volumetric-modulated arc therapy in elderly and frail patients // Radiat Oncol. 2015. №10. P. 209.
25. Whelan T.J., Kim D.H., Sussman J. Clinical experience using hypofractionated radiation schedules in breast cancer // Semin Radiat Oncol. 2008. № 18(4). P.257-264.
26. Wobb J.L., Shah C., Jawad M.S., Wallace M., Dilworth J.T., Grills I.S., Ye H., Chen P.Y. Comparison of chronic toxicities between brachytherapy-based accelerated partial breast irradiation and whole breast irradiation using intensity modulated radiotherapy // Breast. 2015. №24 (6). P. 739-744.
27. Wong K., Delaney G.P., Barton M.B. Estimation of the optimal number of radiotherapy fractions for breast cancer: A review of the evidence // Radiother Oncol. 2015. №116(2). P.174-178.
28. Wu S., He Z., Guo J., Li F., Lin Q., Guan X. Dosimetric comparison of normal structures associated with accelerated partial breast irradiation and whole breast irradiation delivered by intensity modulated radiotherapy for early breast cancer after breast conserving surgery // Clin Transl Oncol. 2014. №16(1). P.69-76.
References:
1. Adylkhanov T.A., Abiltaeva A.A., Baysalbaeva A.S. Vozmozhnosti sovremennoi yadernoi i luchevoi diagnostiki metastaticheskogo raka molochnoi zhelezy: obzor literatury [Possibilities of modern nuclear and radiation diagnosis in metastatic breast cancer: Literature review]. Nauka i Zdravookhranenie [Science & Healthcare]. 2015. №3. pp. 37-46.
2. Akilzhanova A.R., Rahyipbekov T.K. Mediko-geneticheskoe konsultirovanie pri zabolevaniyakh molochnoi zhelezy: vozmozhnosti, problem i perspektivyi [Genetic counseling in breast diseases: possibilities, problems, perspectives]. Nauka i Zdravookhranenie [Science & Healthcare]. 2010. №2, Т1, pp. 15-19.
3. Musakhanova A.K., Bazarbek Zh.B., Elemesova N.M., Shishkina O.V., Abdildina Z.Zh. Analiz zabolevaemosti zlokachestvennymi novoobrazovaniyami v Vostochno-Kazakhstanskoi oblasti [Analysis of cancer incidence in the East-Kazakhstan]. Nauka i Zdravookhranenie [Science & Healthcare]. 2010. №3. pp. 213-216.
4. Sandybaev M.N., Manambaeva Z.A., Zhabagin K.T., Baysalbaeva A.S., Baurzhan A., Kamzin K.Zh. Zabolevaemost zlokachestvennymi novoobrazovaniyami v Semeiskom regione Vostochno-Kazahstanskoy oblasti [Morbidity of malignant tumors in semey region of East Kazakhstan]. Nauka i Zdravookhranenie [Science & Healthcare]. 2012. №5. pp. 151-152.
5. Bentzen S.M., Agrawal R.K., Aird E.G., Barrett J.M., Barrett-Lee P.J., Bentzen S.M., Bliss J.M., Brown J., Dewar J.A. et al 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): P. 1098-1107.
6. Cante D., Franco P., Sciacero P., Girelli G., Pasquino M., Casanova Borca V., Tofani S., Porta M. R., Ricardi U. Hypofractionated whole-breast radiotherapy and concomitant boost after breast conservation in elderly patients. Tumori. 2015. №1 (2). P. 12-22.
7. Cox J. D., Stetz J., Pajak T. F. Toxicity criteria of the Radiation Therapy Oncology Group (RTOG) and the European Organization for Research and Treatment of Cancer (EORTC). Int J Radiat Oncol Biol Phys. 1995. №31(5). P. 1341-1346.
8. Curran D., van Dongen J. P., Aaronson N.K., Kiebert G., Fentiman I. S., Mignolet F., Bartelink H. Quality of life of early-stage breast cancer patients treated with radical mastectomy or breast-conserving procedures: results of EORTC Trial 10801. The European Organization for Research and Treatment of Cancer (EORTC), Breast Cancer Co-operative Group (BCCG). Eur J Cancer. 1998. №34(3). P. 307-314.
9. Darby S., McGale P., Correa C., Taylor C., Arriagada R., Clarke M., Cutter D., Davies C., Ewertz M., Godwin J. et al. Effect of radiotherapy after breast-conserving surgery on 10-year recurrence and 15-year breast cancer death: meta-analysis of individual patient data for 10,801 women in 17 randomised trials. Lancet. 2011. №378 (9804). P. 1707-1716.
10. Dwyer P., Hickey B., Burmeister E., Burmeister B. Hypofractionated whole-breast radiotherapy: impact on departmental waiting times and cost. J Med Imaging Radiat Oncol. 2010. №54(3). P. 229-234.
11. Engels C.C., Kiderlen M., Bastiaannet E., Mooyaart A.L., van Vlierberghe R., Smit V.T., Kuppen P.J., van de Velde C.J., Liefers G.J. The clinical prognostic value of molecular intrinsic tumor subtypes in older breast cancer patients: A FOCUS study analysis. Mol Oncol. 2015. №2. P. 256-61.
12. Haviland J.S., Owen J.R., Dewar J.A., Agrawal R.K., Barrett J., Barrett-Lee P.J., Dobbs H.J., Hopwood P., Lawton P.A., Magee B.J. 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). P. 1086-1094.
13. Hennequin C., Guillerm S., & Quero L. Radiotherapy in elderly patients, recommendations for the main localizations: Breast, prostate and gynaecological cancers. Cancer Radiother. 2015. №19(6-7). P. 397-403.
14. Hopwood P., Haviland J.S., Sumo G., Mills J., Bliss J.M., Yarnold J.R. Comparison of patient-reported breast, arm, and shoulder symptoms and body image after radiotherapy for early breast cancer: 5-year follow-up in the randomised Standardisation of Breast Radiotherapy (START) trials. Lancet Oncol. 2010. №11(3). P. 231-240.
15. Hrycushko B.A., Gutierrez A.N., Goins B., Yan W., Phillips W.T., Otto P.M., Bao A. Radiobiological characterization of post-lumpectomy focal brachytherapy with lipid nanoparticle-carried radionuclides. Phys Med Biol. 2011. 56(3). P. 703-719.
16. Kaufmann A., Schmidt H., Ostheimer C., Ullrich J., Landenberger M., Vordermark D. Quality of life in very elderly radiotherapy patients: a prospective pilot study using the EORTC QLQ-ELD14 module. Support Care Cancer. 2015. №23(7). P.1883-1892.
17. Kovarik J., Svoboda V.H. Early tolerance of different organs to fast fractionation in clinical practice. Int J Radiat Oncol Biol Phys. 1995. №32(5). P.1451-1454.
18. Lee T.S., Kilbreath S.L., Refshauge K.M., Pendlebury S.C., Beith J.M., Lee M.J. Quality of life of women treated with radiotherapy for breast cancer. Support Care Cancer. 2008. №16(4). P. 399-405.
19. Lievens Y. Hypofractionated breast radiotherapy: financial and economic consequences. Breast. 2010. №19(3). P. 192-197.
20. Montagna E., Bagnardi V., Rotmensz N., Viale G., Renne G., Cancello G., Balduzzi A., Scarano E., Veronesi P. et al. Breast cancer subtypes and outcome after local and regional relapse. Ann Oncol. 2012. №23(2). P. 324-331.
21. Mukesh M., Harris E., Jena R., Evans P., Coles C. Relationship between irradiated breast volume and late normal tissue complications: a systematic review. Radiother Oncol. 2012. №104(1). P. 1-10.
22. Overgaard M., Christensen J.J. Postoperative radiotherapy in DBCG during 30 years. Techniques, indications and clinical radiobiological experience. Acta Oncol. 2008. №47(4). P.639-653.
23. Palazzoni G., Nardone L., Cianciulli M., Ciresa M., Ausili-Cefaro G. Dose fractionation and biological optimization in breast cancer. Rays. 2004. №29(3). P.333-338.
24. Riou O., Fenoglietto P., Bourgier C., Lauche O., Boulbair F., Charissoux M., Ducteil A., Ailleres N., Lemanski C., Azria D. Feasibility of accelerated partial breast irradiation with volumetric-modulated arc therapy in elderly and frail patients. Radiat Oncol. 2015. №10. P. 209.
25. Whelan T.J., Kim D.H., Sussman J. Clinical experience using hypofractionated radiation schedules in breast cancer. Semin Radiat Oncol. 2008. № 18(4). P.257-264.
26. Wobb J.L., Shah C., Jawad M.S., Wallace M., Dilworth J.T., Grills I.S., Ye H., Chen P.Y. Comparison of chronic toxicities between brachytherapy-based accelerated partial breast irradiation and whole breast irradiation using intensity modulated radiotherapy. Breast. 2015. №24 (6). P. 739-744.
27. Wong K., Delaney G.P., Barton M.B. Estimation of the optimal number of radiotherapy fractions for breast cancer: A review of the evidence. Radiother Oncol. 2015. №116(2). P.174-178.
28. Wu S., He Z., Guo J., Li F., Lin Q., Guan X. Dosimetric comparison of normal structures associated with accelerated partial breast irradiation and whole breast irradiation delivered by intensity modulated radiotherapy for early breast cancer after breast conserving surgery. Clin Transl Oncol. 2014. №16(1). P.69-76.
Количество просмотров: 516
Категория статей:
Оригинальные исследования
Библиографическая ссылка
Байсалбаева А.С., Адылханов Т.А., Косымбаева Е.О., Андреева О.Б., Абильтаева А.А. Сравнительная оценка частоты и степеней поражения кожи при гипофракционированной и традиционной лучевой терапии рака молочной железы / / Наука и Здравоохранение. 2016. №6. С. 40-49. Baissalbayeva A.S., Adylkhanov T.A., Kossymbayeva Y.O., Andreeva O.B., Abiltaeva A.A. Comparative estimation of morbidity rate and degree of skin lesions during hypofractionated and traditional radiotherapy of breast cancer. Nauka i Zdravookhranenie [Science & Healthcare]. 2016, 6, pp. 40-49. Байсалбаева А.С., Адылханов Т.А., Косымбаева Е.О., Андреева О.Б., Абильтаева А.А. Сүт безі обырының гипофракционды және дәстүрлі сәулелі терапиясында тері зақымдануының жиілігі мен дәрежесін салыстырмалы бағалау / / Ғылым және Денсаулық сақтау. 2016. №6. Б. 40-49.Похожие публикации:
МЕХАНИКАЛЫҚ САРҒАЮ ОПЕРАЦИЯСЫ КЕЗІНДЕ КОАГУЛОПАТИЯЛЫҚ ҚАН КЕТУДІҢ АЛДЫН АЛУ ӘДІСІ
ОПТИМИЗАЦИЯ РЕЗУЛЬТАТОВ АУТОДЕРМОПЛАСТИКИ ПРИ ЛЕЧЕНИИ ГРАНУЛИРУЮЩИХ ГНОЙНЫХ РАН
BASICS OF REHABILITATION OF CHILDREN AFTER OPERATIONS ON THE COLON AND ANORECTAL AREA
HEALTH INDICATORS OF FIRST-YEAR-OF-LIFE CHILDREN IN THE REPUBLIC OF KAZAKHSTAN FOR 2013-2022
ОЦЕНКА УДОВЛЕТВОРЕННОСТИ ТРУДОВОЙ ДЕЯТЕЛЬНОСТЬЮ ВРАЧЕЙ АНЕСТЕЗИОЛОГОВ-РЕАНИМАТОЛОГОВ ГОРОДА АСТАНА