Table 4.
Acute and late skin and subcutaneous tissue toxicities reported with hypofractionated WBI + SIB.
| Author/year | Type of study | n | MFU (months) | RT schedule | ChT | ET | Acute skin toxicity | Late skin and subcutaneous tissue toxicity |
|---|---|---|---|---|---|---|---|---|
| Formenti 2007 [23] | Prospective | 91 | 12 | WBI: 40.5 Gy@2.7 Gy | 33.30% | 80% | G0-1: 58.55% | G3-4: 0 |
| SIB: 48 Gy@3.2 Gy | G2: 8.1% | |||||||
| G3: 0.9% | ||||||||
| Freedman 2007 [24] | Prospective | 75 | 69 | WBI: 45 Gy@2.25 Gy | 44% | 69% | G0-1: 77% | NR |
| SIB: 56 Gy@2.8 Gy | G2: 23% | |||||||
| Morganti 2009 [25] | Retrospective | 332 | 31 | A: WBI: 50.4 Gy@1.8 Gy | A: 64.9% | A: 63.4% | A: G2: 33.6% | NR |
| SeqB: 10 Gy@2Gy | B: 38.4% | B: 77.8% | G3: 3.1% | |||||
| B: WBI: 40 Gy@2.5 Gy | C: 76.5% | C: 69.6% | B: G2: 13.1% | |||||
| SIB: 44 Gy@2.75 Gy | G3: 1% | |||||||
| C: WBI: 50 Gy@2Gy | C: G2: 45.1% | |||||||
| SIB: 60 Gy@2.4 Gy | G3: 2% | |||||||
| Cante 2011 [26] | Prospective | 463 | 60 | WBI: 45 Gy@2.25 Gy | 27% | 90% | G0-1: 68% | G1: 18% |
| SIB: 50 Gy@2.5 Gy | G2: 30% | G2: 2% | ||||||
| G3: 2% | ||||||||
| Van Parijs 2012 [27] | Randomized | 69 | 28 | A: WBI: 50 Gy@2Gy | 53% | 80% | A: G0-1: 71.85% | G ≥ 1: |
| SeqB: 66 Gy@2Gy | G2: 21.9% | 60% (A) vs. 30% (B), p = 0.056 | ||||||
| B: WBI: 42 Gy@2.8 Gy | G3: 6.25% | |||||||
| SIB: 51 Gy@3.4 Gy | B: G0-1: 64.9% | |||||||
| G2: 27% | ||||||||
| G3: 8.1% | ||||||||
| p = 0.94 | ||||||||
| Franco 2014 [28] | Prospective | 82 | 12 | WBI: 45 Gy@2.25 Gy | 25% | 79% | G0 41 %; G1 53 %; G2 6 %; G3 < 1 % | G2 fibrosis 2 % |
| SIB: 50 Gy@2.5 Gy | G2 hyperpigmentation 2 % | |||||||
| De Rose 2016 [29] | Prospective | 144 | 24 | WBI: 40.5 Gy@2.7 Gy | 15% | 83% | G2: 8% | G1: 14% |
| SIB: 48 Gy@3.2 Gy | ||||||||
| Paelinck 2017 [30] | Randomized | 167 | NR | A: WBI: 40,05 Gy@2.678 Gy | 51.50% | 85% | A: G2-3: 29% | (n = 150) |
| Van Hulle 2021 [31] | SIB: 46.8–49.95 Gy@3.12–3.33 Gy | B: G2-3: 46% | G3-4: 0 | |||||
| B: WBI: 40.05 Gy@2.678 Gy | p = 0.037 | |||||||
| SeqB: 10–14.88 Gy@2.5–2.48 Gy | ||||||||
| Bautista 2018 [32] | Retrospective | 34 | 48 | WBI: 45 Gy@2.25 Gy | 53% | 77% | G0: 53% | G1: 6% |
| SIB: 56 Gy@2.8 Gy | G1: 47% | |||||||
| Fiorentino 2019 [33] | Retrospective | 80 | 45 | A: WBI: 50 Gy@2Gy | 8.75% | 91.25% | A: G1: 62.5% | G1: 19% |
| SIB: 60 Gy@2.4 Gy | G2: 25% | |||||||
| B: WBI: 40.5 Gy@2.7 Gy | B: G1: 52.5% | |||||||
| SIB: 48 Gy@3.2 Gy | G2: 2.5% | |||||||
| Lertbutsayanukul 2020[34] | Retrospective | 114 | 86 | A: WBI: 50 Gy@2Gy | 53.50% | 83% | A: G1-2: 91.3% | G1-2: 100% |
| SIB: 65 Gy@2.6 Gy | B: G1-2: 73.7% | |||||||
| B: WBI: 43.2 Gy@2.7 Gy | p = 0.048 | |||||||
| SIB: 52.8 Gy@3.3 Gy | ||||||||
| Krug 2020 [35] | Randomized | 446 | NR | A: IMRT WBI: 50.4 Gy@1.8 Gy | 43.50% | NR | A: G2: 29.1% | NR |
| SIB: 64.4 Gy@2.3 Gy | G3: 3.5% | |||||||
| B: 3DCRT WBI: 50.4 Gy@1.8 Gy | B: G2: 20.1% | |||||||
| SeqB: 16 Gy@2Gy | G3: 2.3% | |||||||
| p = 0.02 | ||||||||
| Dong 2021 [36] | Retrospective | 185 | 26 | A: WBI: 42.56 Gy@2.66 Gy | 70% | 76% | A: G0-1: 82% | A: G0-1: 94% |
| SIB: 48 Gy@3Gy | G2-4: 18% | G2-4: 6% | ||||||
| B: WBI: 50 Gy@2Gy | B: G0-1: 70% | B: G0-1: 96% | ||||||
| SeqB: 10 Gy@2Gy | G2-4: 30% | G2-4: 4% | ||||||
| Pfaffendorf 2022 [37] | Prospective | 274 | 60 | WBI: 40 Gy@2.5 Gy | 37% | 87% | NR | G1: 28% |
| SIB: 48 Gy@3Gy | G2: 7.3% | |||||||
| G3: 0.7% |
MFU: median follow-up; RT: radiation therapy; ChT/TT: chemotherapy/targeted therapy; ET: endocrine therapy; WBI: whole breast irradiation; SIB: simultaneous boost; SeqB: sequential boost; NR: not reported.