Abstract：
OBJECTIVE: FAST-Forward and UK-FAST-trials have demonstrated the safety and efficacy of five-fraction breast adjuvant radiation therapy (RT) and have become the standard of care for selected early breast cancer patients. In response to the additional burden caused by the COVID-19 pandemic, we implemented \"One-Week Breast RT,\" an innovative program delivering five-fraction whole breast RT in a complete 5-day workflow. The primary objective of this study was to demonstrate the feasibility and safety of our program. The secondary objective was to evaluate cosmetic results.
METHODS: A total of 120 patients treated from February 2021 to March 2022, received whole breast RT without lymph node irradiation nor boost, with 26 Gy in five fractions over one week. Inverse planning with restricted optimization parameters offers systematic deep inspiration breath-hold aimed to provide treatment plans compliant with FAST-Forward recommendations. Toxicity and cosmetic evaluations were prospectively registered prior (pre-RT), at the end (end-RT), and 6 months after RT (6 months) based on Common Terminology Criteria for Adverse Events v. 4.03 and Harvard scale.
RESULTS: With a median age of 70 years (interquartile range (IQR): 66-74) and a median follow-up of 6 months (IQR: 6.01-6.25), most patients (93.3%) completed their RT in one week from baseline to the end of the treatment consultation. The most common acute toxicities (at end-RT) were skin-related: radio-dermatitis (72%), induration (35%), hyperpigmentation (8%), and breast edema (16%). The rate of radio-dermatitis decreased from end-RT to 6 months (71.7% vs 5.4%, P< 0.001). No patient experienced grade ≥3 toxicity. At 6 months, cosmetic results were generally good or excellent (94.1%).
CONCLUSIONS: This study confirms the feasibility and acute safety of the \"One-Week Breast RT\" in real life. Favorable toxicity profiles and good cosmetic outcomes are in line with FAST-Forward results. A prospective national cohort, aimed at decreasing treatment burden, maintaining safety, efficacy, and improving RT workflow efficiency with longer follow-up is ongoing.
METHODS: A total of 120 patients treated from February 2021 to March 2022, received whole breast RT without lymph node irradiation nor boost, with 26 Gy in five fractions over one week. Inverse planning with restricted optimization parameters offers systematic deep inspiration breath-hold aimed to provide treatment plans compliant with FAST-Forward recommendations. Toxicity and cosmetic evaluations were prospectively registered prior (pre-RT), at the end (end-RT), and 6 months after RT (6 months) based on Common Terminology Criteria for Adverse Events v. 4.03 and Harvard scale.
RESULTS: With a median age of 70 years (interquartile range (IQR): 66-74) and a median follow-up of 6 months (IQR: 6.01-6.25), most patients (93.3%) completed their RT in one week from baseline to the end of the treatment consultation. The most common acute toxicities (at end-RT) were skin-related: radio-dermatitis (72%), induration (35%), hyperpigmentation (8%), and breast edema (16%). The rate of radio-dermatitis decreased from end-RT to 6 months (71.7% vs 5.4%, P< 0.001). No patient experienced grade ≥3 toxicity. At 6 months, cosmetic results were generally good or excellent (94.1%).
CONCLUSIONS: This study confirms the feasibility and acute safety of the \"One-Week Breast RT\" in real life. Favorable toxicity profiles and good cosmetic outcomes are in line with FAST-Forward results. A prospective national cohort, aimed at decreasing treatment burden, maintaining safety, efficacy, and improving RT workflow efficiency with longer follow-up is ongoing.
摘要：
目的：FAST-Forward和UK-FAST试验已证明了5次乳腺辅助放疗（RT）的安全性和有效性，并已成为选定的早期乳腺癌患者的护理标准。为了应对COVID-19大流行造成的额外负担，我们实施了“一周乳房RT，“一项创新计划，在完整的5天工作流程中提供5个部分的全乳房RT。这项研究的主要目的是证明我们计划的可行性和安全性。次要目的是评估美容结果。
方法：从2021年2月至2022年3月，共120例患者接受了全乳放疗，无淋巴结照射或增强，在一周内分为五个部分的26Gy。具有受限优化参数的逆向计划提供了系统的深吸气屏气，旨在提供符合FAST-Forward建议的治疗计划。毒性和化妆品评估在之前(RT前)进行了前瞻性登记，在结尾（end-RT），和RT后6个月（6个月）基于常见术语标准不良事件v.4.03和哈佛量表。
结果：中位年龄为70岁（四分位距（IQR）：66-74），中位随访时间为6个月（IQR：6.01-6.25），大多数患者(93.3%)在从基线到治疗会诊结束的一周内完成RT.最常见的急性毒性（在RT结束时）是皮肤相关的：放射性皮炎（72％），硬结(35%)，色素沉着过度（8%），和乳房水肿（16％）。放射性皮炎的发生率从RT末下降到6个月（71.7％vs5.4％，P<0.001)。无患者出现≥3级毒性。6个月时,美容效果一般良好或优异(94.1%)。
结论：这项研究证实了“一周乳房RT”在现实生活中的可行性和急性安全性。有利的毒性概况和良好的美容结果与FAST-Forward结果一致。一个潜在的国家队列，旨在减轻治疗负担，维护安全,功效,并通过更长的随访提高RT工作流程的效率。
方法：从2021年2月至2022年3月，共120例患者接受了全乳放疗，无淋巴结照射或增强，在一周内分为五个部分的26Gy。具有受限优化参数的逆向计划提供了系统的深吸气屏气，旨在提供符合FAST-Forward建议的治疗计划。毒性和化妆品评估在之前(RT前)进行了前瞻性登记，在结尾（end-RT），和RT后6个月（6个月）基于常见术语标准不良事件v.4.03和哈佛量表。
结果：中位年龄为70岁（四分位距（IQR）：66-74），中位随访时间为6个月（IQR：6.01-6.25），大多数患者(93.3%)在从基线到治疗会诊结束的一周内完成RT.最常见的急性毒性（在RT结束时）是皮肤相关的：放射性皮炎（72％），硬结(35%)，色素沉着过度（8%），和乳房水肿（16％）。放射性皮炎的发生率从RT末下降到6个月（71.7％vs5.4％，P<0.001)。无患者出现≥3级毒性。6个月时,美容效果一般良好或优异(94.1%)。
结论：这项研究证实了“一周乳房RT”在现实生活中的可行性和急性安全性。有利的毒性概况和良好的美容结果与FAST-Forward结果一致。一个潜在的国家队列，旨在减轻治疗负担，维护安全,功效,并通过更长的随访提高RT工作流程的效率。
