title: 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.
abstract: 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.
  
  
  
  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.
  
  
  
  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.
  
  
  
  Acute breast skin reactions with two 1-week schedules of whole breast radiotherapy under test in FAST-Forward were mild.
authors.affiliation: University Hospitals of North Midlands & Keele University, Stoke-on-Trent, UK. Electronic address: Murray.Brunt@uhns.nhs.uk.
authors.forename: A Murray
authors.initials: AM
authors.lastname: Brunt
authors.affiliation: Royal Cornwall Hospital, UK.
authors.forename: Duncan
authors.initials: D
authors.lastname: Wheatley
authors.affiliation: The Institute of Cancer Research, London, UK.
authors.forename: John
authors.initials: J
authors.lastname: Yarnold
authors.affiliation: The Institute of Cancer Research and The Royal Marsden, London, UK.
authors.forename: Navita
authors.initials: N
authors.lastname: Somaiah
authors.affiliation: Derriford Hospital, Plymouth, UK.
authors.forename: Stephen
authors.initials: S
authors.lastname: Kelly
authors.affiliation: Norfolk and Norwich University Hospitals NHS Foundation Trust, UK.
authors.forename: Adrian
authors.initials: A
authors.lastname: Harnett
authors.affiliation: Cambridge University Hospital NHS Foundation Trust, UK.
authors.forename: Charlotte
authors.initials: C
authors.lastname: Coles
authors.affiliation: Torbay District General Hospital, UK.
authors.forename: Andrew
authors.initials: A
authors.lastname: Goodman
authors.affiliation: University Hospitals Bristol NHS Foundation Trust, UK.
authors.forename: Amit
authors.initials: A
authors.lastname: Bahl
authors.affiliation: Worcestershire Acute Hospitals NHS Trust, UK.
authors.forename: Mark
authors.initials: M
authors.lastname: Churn
authors.affiliation: Mount Vernon Hospital, UK.
authors.forename: Rada
authors.initials: R
authors.lastname: Zotova
authors.affiliation: ICR-CTSU, The Institute of Cancer Research, London, UK.
authors.forename: Mark
authors.initials: M
authors.lastname: Sydenham
authors.affiliation: ICR-CTSU, The Institute of Cancer Research, London, UK.
authors.forename: Clare L
authors.initials: CL
authors.lastname: Griffin
authors.affiliation: ICR-CTSU, The Institute of Cancer Research, London, UK.
authors.forename: James P
authors.initials: JP
authors.lastname: Morden
authors.affiliation: ICR-CTSU, The Institute of Cancer Research, London, UK.
authors.forename: Judith M
authors.initials: JM
authors.lastname: Bliss
mesh_terms: D001940:Breast / Q000528:radiation effects*; D001943:Breast Neoplasms / Q000532:radiotherapy*; D005260:Female; D006801:Humans; D011832:Radiation Injuries; D011855:Radiodermatitis; D011879:Radiotherapy Dosage; D012867:Skin / Q000528:radiation effects*
keywords: Breast cancer; Hypofractionation; Radiotherapy