title: Accelerated hyperfractionation radiation therapy after lumpectomy and axillary lymph node dissection in patients with stage I or II breast cancer: pilot study.
abstract: OBJECTIVE
  To prospectively assess tolerance to accelerated hyperfractionation radiation therapy in patients undergoing breast-conservation therapy and to exclude, with 90% confidence, a 20% or greater risk of an acute toxic reaction of at least grade 3 (severe).
  
  
  METHODS
  Thirty-seven patients (aged 33-80 years) with evaluatable cases received 48 Gy in twice-daily 1.6-Gy fractions to the breast and regional lymph nodes (if three or more lymph nodes were involved) and a boost of 9.6 Gy in twice-daily 1.6-Gy fractions. Acute and late effects were scored by using the Radiation Therapy Oncology Group and European Organization for the Research and Treatment of Cancer radiation morbidity criteria.
  
  
  RESULTS
  One patient developed a grade 3 acute skin toxic reaction and another grade 3 (continuous) acute edema. There have been no grade 4 (life-threatening) acute toxic reactions, local recurrences, or cancer- or treatment-related deaths.
  
  
  CONCLUSIONS
  This breast-conservation accelerated hyperfractionation radiation therapy schedule is tolerable. Additional follow-up is necessary to determine long-term morbidity and cosmesis, and further study in a larger patient group is necessary to confirm efficacy.
authors.affiliation: Mayo Clinic, Rochester, MN 55905, USA.
authors.forename: P J
authors.initials: PJ
authors.lastname: Schomberg
authors.forename: T G
authors.initials: TG
authors.lastname: Shanahan
authors.forename: J N
authors.initials: JN
authors.lastname: Ingle
authors.forename: J H
authors.initials: JH
authors.lastname: Donohue
authors.forename: R R
authors.initials: RR
authors.lastname: Kuske
authors.forename: W C
authors.initials: WC
authors.lastname: Sternfeld
authors.forename: L
authors.initials: L
authors.lastname: Wold
authors.forename: S S
authors.initials: SS
authors.lastname: Cha
authors.forename: I A
authors.initials: IA
authors.lastname: Petersen
authors.forename: J S
authors.initials: JS
authors.lastname: Brindle
authors.forename: M Y
authors.initials: MY
authors.lastname: Halyard
authors.forename: J W
authors.initials: JW
authors.lastname: Bollinger
authors.forename: R
authors.initials: R
authors.lastname: Hawkins
authors.forename: T M
authors.initials: TM
authors.lastname: Pisansky
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000532:radiotherapy* / Q000601:surgery; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D008197:Lymph Node Excision; D015412:Mastectomy, Segmental; D008875:Middle Aged; D010865:Pilot Projects; D011446:Prospective Studies; D011878:Radiotherapy / Q000009:adverse effects; D011879:Radiotherapy Dosage