Table 3.
Summary of Recent HF WBI Studies
| Study Name |
Inclusion Criteria |
# of Patients |
WBI Dose |
Boost Dose |
Regional Nodal RT |
Local Recurrence |
Toxicity |
|---|---|---|---|---|---|---|---|
| Manuscript Study | pTis-T2, pN2a, M0 | 83 | 36.63 Gy in 11 fractions | 13.32 Gy in 4 fractions | Allowed | 2.4% IBTR (crude) | Acute Skin: -Grade 2: 34% Late Skin: -Grade 2: 1.2% -Grade 3: 1.2% |
| Shaitelman et al (12) | Stage 0–II | 287 | 50 Gy in 25 fractions or 42.56 Gy in 16 fractions | 10–12.5 Gy in 4–5 fractions | -- | -- | Acute skin toxicity in 50 Gy arm: 77.9% Acute skin toxicity in 42.56 Gy arm: 46.4% Significant decrease in pruritis, breast pain, hyperpigmentation, and fatigue with HF-WBI. |
| Nandi et al (13) | pTis-T4, pN0-3, M0 after BCS or mastectomy | 135 | 40 Gy in 16 fractions | Only in BCS patients: 16 Gy total | Allowed | No local failure, but distant metastases observed | Acute Skin (BCS): -Grade 2: 24% -Grade 3: 4.8% Acute Skin (Mastectomy): -Grade 2: 6% |
| ARO 2010-10 (17) | pT0-T4, pN0-N1, M0 | 141 | 40 Gy in 16 fractions | 0.5 Gy SIB for 16 fractions | No | -- | Acute Skin: -Grade 2: 22% (3D) -Grade 2: 9% (IMRT) |
| Freedman et al (18, 19) | pTis-T2, pN0-N1, M0 | 75 | 45 Gy in 20 fractions | 2.8 Gy SIB for 20 fractions | No | 5 year rate −2.7% | Acute Skin: -Grade 2: 23% |
| Formenti et al (20) | Stage I–II | 91 | 40.5 Gy in 15 fractions | 0.5 Gy SIB 15 fractions | No | 1.1% local regional recurrence rate (crude) | Acute Skin: -Grade 1–2: 67% |
| Mulliez et al (21) | pTis-T2, pN0, M0. Bra cup >C | 100 | 40.05 in 15 fractions | 10 Gy in 4 fractions (not mandatory) | No | -- | Prone position decreased Grade 2–3 dermatitis 50% (p<0.001) and 3 fold decrease in Grade 2 edema (p=0.005) |
| Pinnaro et al (23) | pTis-T2, pN0-1, M0 | 39 | 34 Gy in 10 fractions | 8 Gy in a single fraction | No | -- | Acute Skin: -Grade 2: 10% Late Skin: -Grade 1: 28% |
| Cante et al (22) | pT1-T2, pNx/N0-1, M0 | 375 | 45 Gy in 20 fractions | 0.25 Gy SIB for 20 fractions | No | No local failure at 5 years. 1.1% regional failure | Late Skin: -Grade 2: 4.5% |
| Dragun et al (24) | pTis-T2, pNx/N0-N1, M0 | 42 | 30 Gy in 5 fractions once weekly | Optional used either 10 Gy in 5 fractions or 6 Gy once | No | Acute >Grade 2: -Dermatitis: 19% -Pain: 11.9% -Fatigue: 9.5% -Breast edema: 2.4% |