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Acute skin toxicity associated with a 1-week schedule of whole breast radiotherapy compared with a standard 3-week regimen delivered in the UK FAST-Forward Trial

Brunt, A. Murray; Wheatley, Duncan; Yarnold, John; Somaiah, Navita; Kelly, Stephen; Harnett, Adrian; Coles, Charlotte; Goodman, Andrew; Bahl, Amit; Churn, Mark; Zotova, Rada; Sydenham, Mark; Griffin, Clare L; Morden, James P; Bliss, Judith M

Acute skin toxicity associated with a 1-week schedule of whole breast radiotherapy compared with a standard 3-week regimen delivered in the UK FAST-Forward Trial Thumbnail


Authors

Duncan Wheatley

John Yarnold

Navita Somaiah

Stephen Kelly

Adrian Harnett

Charlotte Coles

Andrew Goodman

Amit Bahl

Mark Churn

Rada Zotova

Mark Sydenham

Clare L Griffin

James P Morden

Judith M Bliss



Abstract

BACKGROUND AND PURPOSE: FAST-Forward is a phase 3 clinical trial testing a 1-week course of whole breast radiotherapy against the UK standard 3-week regimen after primary surgery for early breast cancer. Two acute skin toxicity substudies were undertaken to test the safety of the test schedules with respect to early skin reactions. MATERIAL AND METHODS: Patients were randomly allocated to 40Gy/15 fractions (F)/3-weeks, 27Gy/5F/1-week or 26Gy/5F/1-week. Acute breast skin reactions were graded using RTOG (first substudy) and CTCAE criteria v4.03 (second substudy) weekly during treatment and for 4weeks after treatment ended. Primary endpoint was the proportion of patients within each treatment group with grade ?3 toxicity (RTOG and CTCAE, respectively) at any time from the start of radiotherapy to 4weeks after completion. RESULTS: 190 and 162 patients were recruited. In the first substudy, evaluable patients with grade 3 RTOG toxicity were: 40Gy/15F 6/44 (13.6%); 27Gy/5F 5/51 (9.8%); 26Gy/5F 3/52 (5.8%). In the second substudy, evaluable patients with grade 3 CTCAE toxicity were: 40Gy/15F 0/43; 27Gy/5F 1/41 (2.4%); 26Gy/5F 0/53. CONCLUSIONS: Acute breast skin reactions with two 1-week schedules of whole breast radiotherapy under test in FAST-Forward were mild.

Journal Article Type Article
Acceptance Date Feb 22, 2016
Online Publication Date Apr 1, 2016
Publication Date 2016-07
Journal Radiotherapy and Oncology
Print ISSN 0167-8140
Electronic ISSN 0167-8140
Publisher Elsevier
Peer Reviewed Peer Reviewed
Volume 120
Issue 1
Pages 114-118
DOI https://doi.org/10.1016/j.radonc.2016.02.027
Keywords breast cancer, radiotherapy, hypofractionation
Publisher URL http://dx.doi.org/10.1016/j.radonc.2016.02.027

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