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Multicenter Study
. 2024 Nov;31(6):1071-1079.
doi: 10.1007/s12282-024-01621-2. Epub 2024 Jul 24.

Uptake of ultra-hypofractionated radiation therapy following breast-conserving surgery among patients with early-stage breast cancer: a multi-institutional questionnaire survey

Haruka Uezono  1 , Tsuyoshi Onoe  2 , Naoto Shikama  3 , Yuka Ono  4 , Hidenari Hirata  5 , Yoshinori Ito  6 , Koichi Yasuda  7 , Nobuki Imano  8   9 , Koyo Kikuchi  10 , Tairo Kashihara  11 , Terufumi Kawamoto  3   12 , Naoki Nakamura  13
Affiliations
Multicenter Study

Uptake of ultra-hypofractionated radiation therapy following breast-conserving surgery among patients with early-stage breast cancer: a multi-institutional questionnaire survey

Haruka Uezono et al. Breast Cancer. 2024 Nov.

Abstract

Background: In patients with early-stage breast cancer following breast surgery, ultra-hypofractionated (UHF) breast/chest wall radiation therapy (RT) has been shown to be non-inferior to a moderate-hypofractionated (MHF) regimen, with a minimal risk of breast induration, in the FAST-Forward trial, and UHF is now becoming the standard regimen in Europe. Herein, we aimed to investigate Japanese patients' attitudes toward the UHF regimen.

Methods: A questionnaire-based survey was conducted at 13 RT centers in nine prefectures across Japan. All patients underwent breast-conserving surgery, followed by either conventional fractionation (2 Gy/fr) or MHF (2.66 Gy/fr) whole-breast irradiation (WBI) with or without a tumor bed boost. The questionnaire consisted of 13 questions mainly addressing quality-of-life during RT. Key questions included an 11-point scale (0-10) for rating the patients' enthusiasm for the UHF regimen and prioritization of the following treatment-related effects: treatment efficacy, acute/late adverse effects, physical/emotional/financial burden, and breast cosmesis. The patient and treatment characteristics were assessed by a physician.

Results: In total, 247 questionnaires were administered between November 2022 and June 2023. The age distribution was as follows: < 50:50 s:60 s: ≥ 70 = 59 (24%):76 (30%):63 (26%):49 (20%). Sixty-nine percent of patients rated their enthusiasm for the UHF regimen at ≥ 6 out of 10 points (45% rated 10/10). Treatment efficacy was the highest priority for most patients (89%), whereas breast cosmesis the lowest priority (53%).

Conclusions: Patients' enthusiasm for UHF-WBI was observed across the cohort. These results could motivate researchers and clinicians to introduce UHF regimens in clinical practice.

Keywords: Breast-conserving therapy; Patients’ preference; Ultra-hypofractionated whole-breast irradiation.

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References

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