title: Hypofractionated radiation therapy for breast cancer: long-term results in a series of 85 patients.
abstract: OBJECTIVE
  Whole-breast irradiation after conservative surgery is the standard treatment for early breast cancer. The purpose of this study is to report the late toxicity, cosmetic result, and disease control in a group of patients treated with hypofractionated radiotherapy (RT) comparing results with retrospective data of a control group who underwent conventional RT.
  
  
  METHODS
  From 2006 to 2008, 85 patients were treated with hypofractionated schedule to dose of 45 Gy, 2.25 Gy/fr, followed by a boost. We evaluated late toxicity, cosmetic result, and disease control. The data were compared to a control group of 70 patients who underwent conventional RT before 2006.
  
  
  RESULTS
  At 8 years of follow-up, the cumulative incidence of late skin toxicity was 6.2 in the hypofractionated RT group and 7.5 in the standard RT group (p = 0.94). The cumulative incidence of late subcutaneous tissue toxicity was 11.6 in the hypofractionated RT group and 18.7 in the standard RT group (p = 0.23). Cosmetic outcome was rated as excellent or good in 84/85 patients of the hypofractionated RT group and in 68/70 patients of the conventional RT group (p = 0.7). No statistically significant differences were found in terms of local control (p = 0.05), disease-free survival (p = 0.06), or overall survival (p = 0.17) between the 2 groups.
  
  
  CONCLUSIONS
  The present analysis, focused on long-term effects, disease control, and survival, confirms, in a daily practice setting, the low incidence of skin atrophy and fibrosis, the satisfactory cosmetic outcome, and the high grade of local and distant disease control with hypofractionated schedule.
authors.affiliation: Radiotherapy, University Hospital "Maggiore della Carità," Novara - Italy.|Department of Translational Medicine, University of "Piemonte Orientale," Novara - Italy.
authors.forename: Letizia
authors.initials: L
authors.lastname: Deantonio
authors.affiliation: Radiotherapy, University Hospital "Maggiore della Carità," Novara - Italy.
authors.forename: Salvatore
authors.initials: S
authors.lastname: Cozzi
authors.affiliation: Department of Translational Medicine, University of "Piemonte Orientale," Novara - Italy.|Biostatistics and Clinical Epidemiology, University of "Piemonte Orientale," Novara - Italy.
authors.forename: Sara
authors.initials: S
authors.lastname: Tunesi
authors.affiliation: Medical Physics, University Hospital "Maggiore della Carità," Novara - Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: Brambilla
authors.affiliation: Radiotherapy, University Hospital "Maggiore della Carità," Novara - Italy.
authors.forename: Laura
authors.initials: L
authors.lastname: Masini
authors.affiliation: Radiotherapy, University Hospital "Maggiore della Carità," Novara - Italy.
authors.forename: Carla
authors.initials: C
authors.lastname: Pisani
authors.affiliation: Radiotherapy, University Hospital "Maggiore della Carità," Novara - Italy.
authors.forename: Giuseppina
authors.initials: G
authors.lastname: Gambaro
authors.affiliation: Department of Translational Medicine, University of "Piemonte Orientale," Novara - Italy.|Biostatistics and Clinical Epidemiology, University of "Piemonte Orientale," Novara - Italy.
authors.forename: Corrado
authors.initials: C
authors.lastname: Magnani
authors.affiliation: Radiotherapy, University Hospital "Maggiore della Carità," Novara - Italy.|Department of Translational Medicine, University of "Piemonte Orientale," Novara - Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: Krengli
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery; D003131:Combined Modality Therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D053208:Kaplan-Meier Estimate; D015412:Mastectomy, Segmental; D008875:Middle Aged; D060787:Neoplasm Grading; D009367:Neoplasm Staging; D016016:Proportional Hazards Models; D000069473:Radiation Dose Hypofractionation; D011879:Radiotherapy Dosage; D011880:Radiotherapy Planning, Computer-Assisted; D018714:Radiotherapy, Adjuvant; D016896:Treatment Outcome