High expectations.

Top Line: What is the real-world experience of acute toxicity for women receiving whole breast radiation? 

The Study: This report from the Michigan Radiation Oncology Quality Consortium describes patient-reported outcomes from nearly 9000 women treated with whole breast radiation at 27 centers. Just under half were treated with conventional fractionation (CF) and the rest with hypofractionation. Numerically, there were lower rates of patient-reported toxicity for HF compared to CF, but there were also big differences in the patient characteristics for those receiving HF and CF (i.e. age, race, and breast size). Given the known differences in toxicity outcomes for HF and CF, the goal here was mainly to describe factors associated with acute toxicity with each technique. Three patient-reported outcomes were analyzed in the study. Breast pain was reported by 37% of patients (29% HF, 36% CF), bothersome breast symptoms were reported by 51% (41% HF, 61% CF), and fatigue was reported by 23% (19% HF, 27% CF). Across the board, young age, higher BMI, larger breast volume, current or former smoking, and non-white race were frequently associated with higher rates of acute toxicity. Chemotherapy, boost, and regional nodal irradiation were treatment factors associated with higher rates of adverse acute toxicity. 

TBL: This large prospective cohort study describes real-world acute toxicity outcomes to inform women receiving both conventional and hypofractionated whole breast radiation. | Jagsi, J Clin Oncol 2020

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