Concurrent use of aromatase inhibitors and hypofractionated radiation therapy.
OBJECTIVE
To retrospectively assess the acute and long-term toxicity using aromatase inhibitors (AI) therapy concurrently with hypofractionated radiotherapy (HFRT) in breast cancer patients.


METHODS
From November 1999 to October 2007, 66 patients were treated with breast HFRT and concurrent AI. In 63 patients (95.5%), HFRT delivered a total dose of 32.5 Gy to the whole breast within 5 wk (five fractions, one fraction per week). Other fractionations were chosen in three patients for the patients' personal convenience. A subsequent boost to the tumor bed was delivered in 35 patients (53.0%). Acute toxicities were scored according to the Common Toxicity Criteria for Adverse Events v3. Late toxicity was defined as any toxicity occurring more than 6 mo after completion of HFRT and was scored according to the Late Effects Normal Tissue Task Force-Subjective, Objective, Management and Analytic scale.


RESULTS
At the end of the HFRT course, 19 patients (28.8%) had no irradiation-related toxicity. Acute grade 1-2 epithelitis was observed in 46 patients (69.7%). One grade 3 toxicity (1.5%) was observed. With a median follow-up of 34 mo (range: 12-94 mo), 31 patients (47%) had no toxicity, and 35 patients (53%) presented with grade 1-2 fibrosis. No grade 3 or greater delayed toxicity was observed.


CONCLUSIONS
We found that AI was well tolerated when given concurrently with HFRT. All toxicities were mild to moderate, and no treatment disruption was necessary. Further prospective assessment is warranted.
Cyrus Chargari, Pablo Castro-Pena, Ivan Toledano, Marc A Bollet, François Campana, Patricia De Cremoux, Alain Fourquet, Youlia M Kirova, Department of Radiation Oncology, Institut Curie, 75005 Paris, France.
Cyrus
C
Chargari
Pablo
P
Castro-Pena
Ivan
I
Toledano
Marc A
MA
Bollet
Alexia
A
Savignoni
Paul
P
Cottu
Fatima
F
Laki
François
F
Campana
Patricia
P
De Cremoux
Alain
A
Fourquet
Youlia M
YM
Kirova