Hypofractionated whole breast irradiation after conservative surgery for patients aged less than 60 years: a multi-centre comparative study

Icro Meattini, Philip Poortmans, Youlia Kirova, Calogero Saieva, Luca Visani, Viola Salvestrini, Jiyoung Kim, Wonguen Jung, Emanuela Olmetto, Matteo Mariotti, Isacco Desideri, Alain Fourquet, Lorenzo Livi, Kyubo Kim

Research output: Contribution to journalArticlepeer-review

4 Scopus citations


Background: For decades, conventional fractionated whole breast irradiation (CF-WBI) was used after breast conserving surgery (BCS). Pivotal phase-3 trials on hypofractionated-WBI (HF-WBI) showed its non-inferiority as compared to CF-WBI. However, younger patients are often not treated with HF-WBI. The aim of this multi-centre comparative study is to confirm the safety of HF-WBI in a real-life series of younger patients. Material and methods: Between 2010 and 2016, a total of 786 patients aged less than 60 years old with early-stage breast cancer were treated with postoperative WBI after BCS in three breast cancer centres: 340 underwent HF-WBI while 446 were treated with CF-WBI. Acute toxicity was evaluated at the end of WBI. Late toxicity was evaluated at 6, 12, 24 and 36 months. Results: At univariate logistic analysis, hypofractionation showed a significant protective effect in terms of acute oedema, acute wet desquamation, chronic oedema, chronic erythema/pigmentation and breast fibrosis. At multivariate logistic analysis, hypofractionation was an independent significant factor for acute oedema, acute wet desquamation, and chronic oedema. There were not differences in tumour-related outcomes. Conclusions: HF-WBI showed significantly improved outcomes in terms of acute skin oedema, wet desquamation and chronic skin oedema. HF-WBI after BCS should be strongly encouraged to replace CF-WBI independently of age.

Original languageEnglish
Pages (from-to)188-195
Number of pages8
JournalActa Oncologica
Issue number2
StatePublished - 1 Feb 2020

Bibliographical note

Funding Information:
The authors are grateful to thank Matteo Casalotti (MD) for the initial data collection at University of Florence (Florence, Italy). The data that support the findings of this study are available on request from the corresponding author. The data are not publicly available due to privacy or ethical restrictions.

Publisher Copyright:
© 2019, © 2019 Acta Oncologica Foundation.


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