{"id":6170,"date":"2020-08-10T10:13:16","date_gmt":"2020-08-10T09:13:16","guid":{"rendered":"https:\/\/www.library.sath.nhs.uk\/research\/?p=6170"},"modified":"2021-07-01T08:53:06","modified_gmt":"2021-07-01T07:53:06","slug":"ten-year-results-of-fast-a-randomized-controlled-trial-of-5-fraction-whole-breast-radiotherapy-for-early-breast-cancer-2020","status":"publish","type":"post","link":"https:\/\/www.library.sath.nhs.uk\/research\/2020\/08\/10\/ten-year-results-of-fast-a-randomized-controlled-trial-of-5-fraction-whole-breast-radiotherapy-for-early-breast-cancer-2020\/","title":{"rendered":"Ten-Year Results of FAST: A Randomized Controlled Trial of 5-Fraction Whole-Breast Radiotherapy for Early Breast Cancer (2020)"},"content":{"rendered":"

Type of publication:<\/strong>
\nRandomised controlled trial<\/p>\n

Author(s):<\/strong>
\nBrunt A.M.; Haviland J.S.; Sydenham M.; Bliss J.M.; *Agrawal R.K.; Algurafi H.; Alhasso A.; Barrett-Lee P.; Passant H.; Bliss P.; Bloomfield D.; Tremlett J.; Bowen J.; Donovan E.; Goodman A.; Harnett A.; Hogg M.; Kumar S.; Quigley M.; Sherwin L.; Stewart A.; Syndikus I.; Tsang Y.; Venables K.; Wheatley D.; Yarnold J.R.<\/p>\n

Citation:<\/strong>
\nJournal of Clinical Oncology; October 2020, 38, no. 28, 3261-3272.<\/p>\n

Abstract:<\/strong>
\nPURPOSE: Previous studies of hypofractionated adjuvant whole-breast radiotherapy for early breast cancer established a 15- or 16-fraction (fr) regimen as standard. The FAST Trial (CRUKE\/04\/015) evaluated normal tissue effects (NTE) and disease outcomes after 5-fr regimens. Ten-year results are presented. METHOD(S): Women >= 50 years of age with low-risk invasive breast carcinoma (pT1-2 pN0) were randomly assigned to 50 Gy\/25 fr (5 weeks) or 30 or 28.5 Gy in 5 fr of 6.0 or 5.7 Gy (1 week). The primary end point was change in photographic breast appearance at 2 and 5 years; secondary end points were physician assessments of NTE and local tumor control. Odds ratios (ORs) from longitudinal analyses compared regimens. RESULT(S): A total of 915 women were recruited from 18 UK centers (2004-2007). Five-year photographs were available for 615\/862 (71%) eligible patients. ORs for change in photographic breast appearance were 1.64 (95% CI, 1.08 to 2.49; P = .019) for 30 Gy and 1.10 (95% CI, 0.70 to 1.71; P = .686) for 28.5 Gy versus 50 Gy. alpha\/beta estimate for photographic end point was 2.7 Gy (95% CI, 1.5 to 3.9 Gy), giving a 5-fr schedule of 28 Gy (95% CI, 26 to 30 Gy) estimated to be isoeffective with 50 Gy\/25 fr. ORs for any moderate\/marked physician-assessed breast NTE (shrinkage, induration, telangiectasia, edema) were 2.12 (95% CI, 1.55 to 2.89; P < .001) for 30 Gy and 1.22 (95% CI, 0.87 to 1.72; P = .248) for 28.5 Gy versus 50 Gy. With 9.9 years median follow-up, 11 ipsilateral breast cancer events (50 Gy: 3; 30 Gy: 4; 28.5 Gy: 4) and 96 deaths (50 Gy: 30; 30 Gy: 33; 28.5 Gy: 33) have occurred. CONCLUSION(S): At 10 years, there was no significant difference in NTE rates after 28.5 Gy\/5 fr compared with 50 Gy\/25 fr, but NTE were higher after 30 Gy\/5 fr. Results confirm the published 3-year findings that a once-weekly 5-fr schedule of whole-breast radiotherapy can be identified that appears to be radiobiologically comparable for NTE to a conventionally fractionated regimen.<\/p>\n

Link to full-text<\/a> [open access - no password required]<\/p>\n

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