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Abstract：
BACKGROUND: The \'FAST-forward\', study published in April 2020, demonstrated the effectiveness of an extremely hypofractionated radiotherapy schedule, delivering the total radiation dose in five sessions over the course of 1 week. We share our department\'s experience regarding patients treated with this regimen in real-world clinical settings, detailing outcomes related to short-term toxicity and efficacy.
METHODS: A descriptive observational study was conducted on 160 patients diagnosed with breast cancer. Between July 2020 and December 2021, patients underwent conservative surgery followed by a regimen of 26 Gy administered in five daily fractions.
RESULTS: The median age was 64 years (range: 43-83), with 82 patients (51.3%) treated for left-sided breast cancer, 77 patients (48.1%) for right-sided breast cancer, and 1 instance (0.6%) of bilateral breast cancer. Of these, 66 patients had pT1c (41.3%), 70.6% were infiltrative ductal carcinomas, and 11.3% were ductal carcinoma in situ. Most tumours exhibited intermediate grade (41.9%), were hormone receptor positive (81.3%), had low Ki-67 (Ki-67 < 20%; 51.9%) and were Her 2 negative (85%). The majority of surgical margins were negative (99.4%). Among the patients, 72.5% received hormonotherapy, and 23.8% received chemotherapy. Additionally, 26 patients (16.3%) received an additional tumour boost following whole breast irradiation (WHBI) of 10 Gy administered in five sessions of 2 Gy over a week. The median planning target volume (PTV) was 899 cm3 (range: 110-2509 cm3). Early toxicity was primarily grade I radiodermatitis, affecting 117 patients (73.1%). During a median follow-up of 15 months (range: 3.9-28.77), only one patient experienced a local relapse, which required mastectomy.
CONCLUSIONS: The implementation of this highly hypofractionated regimen in early-stage breast cancer appears feasible and demonstrates minimal early toxicity. However, a more extended follow-up duration would be required to evaluate long-term toxicity and efficacy accurately.
METHODS: A descriptive observational study was conducted on 160 patients diagnosed with breast cancer. Between July 2020 and December 2021, patients underwent conservative surgery followed by a regimen of 26 Gy administered in five daily fractions.
RESULTS: The median age was 64 years (range: 43-83), with 82 patients (51.3%) treated for left-sided breast cancer, 77 patients (48.1%) for right-sided breast cancer, and 1 instance (0.6%) of bilateral breast cancer. Of these, 66 patients had pT1c (41.3%), 70.6% were infiltrative ductal carcinomas, and 11.3% were ductal carcinoma in situ. Most tumours exhibited intermediate grade (41.9%), were hormone receptor positive (81.3%), had low Ki-67 (Ki-67 < 20%; 51.9%) and were Her 2 negative (85%). The majority of surgical margins were negative (99.4%). Among the patients, 72.5% received hormonotherapy, and 23.8% received chemotherapy. Additionally, 26 patients (16.3%) received an additional tumour boost following whole breast irradiation (WHBI) of 10 Gy administered in five sessions of 2 Gy over a week. The median planning target volume (PTV) was 899 cm3 (range: 110-2509 cm3). Early toxicity was primarily grade I radiodermatitis, affecting 117 patients (73.1%). During a median follow-up of 15 months (range: 3.9-28.77), only one patient experienced a local relapse, which required mastectomy.
CONCLUSIONS: The implementation of this highly hypofractionated regimen in early-stage breast cancer appears feasible and demonstrates minimal early toxicity. However, a more extended follow-up duration would be required to evaluate long-term toxicity and efficacy accurately.
摘要：
背景：\'FAST-forward\'，2020年4月发表的研究证明了极小分割放射治疗方案的有效性，在1周内分五次提供总辐射剂量。我们分享我们部门关于在现实世界的临床环境中使用该方案治疗的患者的经验，详细说明与短期毒性和疗效相关的结果。
方法：对160例诊断为乳腺癌的患者进行了一项描述性观察研究。在2020年7月至2021年12月之间，患者接受了保守手术，然后每天分五次进行26Gy的方案。
结果：中位年龄为64岁（范围：43-83），82例患者（51.3%）接受左侧乳腺癌治疗，77例（48.1%）右侧乳腺癌患者，双侧乳腺癌1例(0.6%)。其中,66例患者pT1c（41.3%），70.6%为浸润性导管癌,11.3%为导管原位癌。大多数肿瘤表现为中级（41.9%），激素受体阳性（81.3%），Ki-67较低（Ki-67<20％；51.9％），Her2阴性（85％）。大多数手术切缘为阴性（99.4％）。在患者中,72.5%接受激素治疗，23.8%接受化疗。此外,26名患者（16.3％）在一周内进行5次2Gy的全胸照射（WHBI）后，接受了10Gy的额外肿瘤增强治疗。中位计划目标体积（PTV）为899cm3（范围：110-2509cm3）。早期毒性主要是I级放射性皮炎,影响117例患者（73.1%）。在15个月的中位随访期间（范围：3.9-28.77），只有一名患者出现局部复发,需要乳房切除术.
结论：在早期乳腺癌中实施这种高分割方案似乎是可行的，并且显示出最小的早期毒性。然而,为了准确评估长期毒性和疗效,需要延长随访时间.
方法：对160例诊断为乳腺癌的患者进行了一项描述性观察研究。在2020年7月至2021年12月之间，患者接受了保守手术，然后每天分五次进行26Gy的方案。
结果：中位年龄为64岁（范围：43-83），82例患者（51.3%）接受左侧乳腺癌治疗，77例（48.1%）右侧乳腺癌患者，双侧乳腺癌1例(0.6%)。其中,66例患者pT1c（41.3%），70.6%为浸润性导管癌,11.3%为导管原位癌。大多数肿瘤表现为中级（41.9%），激素受体阳性（81.3%），Ki-67较低（Ki-67<20％；51.9％），Her2阴性（85％）。大多数手术切缘为阴性（99.4％）。在患者中,72.5%接受激素治疗，23.8%接受化疗。此外,26名患者（16.3％）在一周内进行5次2Gy的全胸照射（WHBI）后，接受了10Gy的额外肿瘤增强治疗。中位计划目标体积（PTV）为899cm3（范围：110-2509cm3）。早期毒性主要是I级放射性皮炎,影响117例患者（73.1%）。在15个月的中位随访期间（范围：3.9-28.77），只有一名患者出现局部复发,需要乳房切除术.
结论：在早期乳腺癌中实施这种高分割方案似乎是可行的，并且显示出最小的早期毒性。然而,为了准确评估长期毒性和疗效,需要延长随访时间.
