Ultra-Hypofractionated RT May Offer Convenience in Elderly Breast Cancer
Whole or accelerated partial breast ultra-hypofractionated radiation in older patients with early breast cancer may reduce recurrence with low toxicity.
Ultra-hypofractionated radiotherapy (UHFRT) was well tolerated and reduced the rate of local recurrence in elderly patients with early-stage breast cancer, even among those with low endocrine therapy compliance, according to Bin Gui, MD.
CancerNetwork® spoke with Gui, a fourth-year radiation oncology resident at the Northwell Health Cancer Institute, about what he hoped colleagues would take away from results of a study assessing UHFRT among older patients with early-stage breast cancer presented at the 2024 American Society of Radiation Oncology (ASTRO) Annual Meeting.1
Gui explained that both whole breast (WBI) and accelerated partial breast irradiation (APBI) regimens were convenient and well tolerated for patients with early-stage breast cancer who were 65 years or older. He highlighted that there was 100% compliance with radiation therapy, even among those who could not comply with the addition of endocrine therapy. He concluded by stating that hypofractionated radiation may be a good option in this population, although additional prospective studies are necessary to confirm these findings.
Patients were treated using regimens employed in the phase 3 FAST-Forward trial (ISRCTN19906132) and another trial assessing APBI in breast cancer (NCT02104895).2,3
Results from the trial presented at ASTRO found that at a 10-month follow-up, no ipsilateral breast tumor recurrence (IBTR) occurred in the radiation cohort. Furthermore, there was an absence of grade 3 or 4 toxicities, and minimal low-grade (UHFRT alone, 2%; UHFRT plus ET; 0%) and late (2% vs 0%) toxicities were observed with radiation therapy.
Transcript:
In conclusion, this study demonstrates that ultra-hypofractionated radiation with either the FAST-Forward or APBI regimens offers a convenient and easily tolerated treatment approach for older [patients] who [want] to reduce the rate of their local recurrence. Furthermore, [apart from patients having] diminished compliance with endocrine therapy, their compliance with ultra-hypofractionated radiation was 100%. These regimens [may] offer patients great options to [improve] local control with low toxicity rates. Further prospective studies are necessary to confirm these initial findings.
Reference
- Gui B, Ojo O, Ottensoser L, et al. Ultra-Hypofractionated Radiation in Older Patients with Low Risk Early-Stage Breast Cancer. Presented at the 2024 American Society for Radiation Oncology (ASTRO) Annual Meeting; September 29 – October 2, 2024; Washington, DC. Poster 2683
- Brunt AM, Haviland JS, Wheatley DA, et al. One versus three weeks hypofractionated whole breast radiotherapy for early breast cancer treatment: the FAST-Forward phase III RCT. Health Technol Assess 2023;27(25). doi:10.3310/WWBF1044
- Meattini I, Marrazzo L, Saieva C, et al. Accelerated partial-breast irradiation compared with whole-breast irradiation for early breast cancer: long-term results of the randomized phase III APBI-IMRT-Florence trial. J Clin Oncol. 2020;38(35):4175-4183. doi:10.1200/JCO.20.00650.
