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

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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 ; , (2016)
  • Publisher: Elsevier
  • Journal: volume 120, issue 1, pages 114-118 (issn: 0167-8140, eissn: 1879-0887)
  • Related identifiers: doi: 10.1016/j.radonc.2016.02.027, pmc: PMC4998960
  • Subject: /dk/atira/pure/researchoutput/pubmedpublicationtype/D017428 | /dk/atira/pure/researchoutput/pubmedpublicationtype/D016449 | Comparative Study | /dk/atira/pure/researchoutput/pubmedpublicationtype/D016428 | /dk/atira/pure/researchoutput/pubmedpublicationtype/D013485 | /dk/atira/pure/researchoutput/pubmedpublicationtype/D003160 | Phase III randomised trial | Breast cancer | Hypofractionation | Radiology Nuclear Medicine and imaging | Clinical Trial, Phase III | Oncology | Research Support, Non-U.S. Gov't | Randomized Controlled Trial | Hematology | Radiotherapy | Journal Article | R1

Background and purpose<p>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.</p>Material and methods<p>Patients were randomly allocated to 40 Gy/15 fractions (F)/3-weeks, 27 Gy/5F/1-week or 26 Gy/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 4 weeks 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 4 weeks after completion.</p>Results<p>190 and 162 patients were recruited. In the first substudy, evaluable patients with grade 3 RTOG toxicity were: 40 Gy/15F 6/44 (13.6%); 27 Gy/5F 5/51 (9.8%); 26 Gy/5F 3/52 (5.8%). In the second substudy, evaluable patients with grade 3 CTCAE toxicity were: 40 Gy/15F 0/43; 27 Gy/5F 1/41 (2.4%); 26 Gy/5F 0/53.</p>Conclusions<p>Acute breast skin reactions with two 1-week schedules of whole breast radiotherapy under test in FAST-Forward were mild.</p>
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