Hypofractionated radiotherapy does not increase acute toxicity in large-breasted women: results from a prospectively collected series.
OBJECTIVE
To compare the acute toxicity of hypofractionated whole breast radiotherapy (HypoRT) to conventionally fractionated radiotherapy (ConvRT) in large-breasted women with early stage disease.


METHODS
Women with breast volume>1500 cm, body mass index>30 kg/m, or separation>25 cm treated with HypoRT or ConvRT from 2005 through 2010 were identified from a prospective database and included in the analysis. Acute toxicity was scored for each treated breast.


RESULTS
Ninety-two patients were treated to 96 breasts. The median body mass index was 33 kg/m and median breast volume was 1932 cm for the ConvRT group compared with 32.4 kg/m and 1825 cm for the HypoRT group. Maximum acute skin toxicity consisted of focal moist desquamation in 26% and 11% of the ConvRT and HypoRT patients, respectively (P=0.002). Breast volume was the only patient factor significantly associated with moist desquamation on multivariable analysis (P=0.01). Among those with a breast volume >2500 cm, focal moist desquamation occurred in 40.7% (11/27) compared with 11.1% (7/63) in patients with breast volume <2500 cm (P=0.002).


CONCLUSIONS
Among obese and large-breasted women, there was no increase in acute skin toxicity with the use of HypoRT. HypoRT should be considered in obese and large-breasted women when advanced planning techniques are used.
Department of Radiation and Cellular Oncology, University of Chicago Hospitals, Chicago, IL.
Kimberly S
KS
Corbin
Paige L
PL
Dorn
Supriya K
SK
Jain
Hania A
HA
Al-Hallaq
Yasmin
Y
Hasan
Steven J
SJ
Chmura
D000368:Aged; D000369:Aged, 80 and over; D015992:Body Mass Index; D001943:Breast Neoplasms / Q000532:radiotherapy* / Q000601:surgery; D002285:Carcinoma, Intraductal, Noninfiltrating / Q000532:radiotherapy / Q000601:surgery; D019583:Dose Fractionation, Radiation; D005260:Female; D006801:Humans; D008875:Middle Aged; D009765:Obesity / Q000209:etiology; D011446:Prospective Studies; D011832:Radiation Injuries / Q000209:etiology; D011878:Radiotherapy / Q000009:adverse effects*; D012867:Skin / Q000473:pathology / Q000528:radiation effects