S283
Clinical - Breast
ESTRO 2026
Antonello 14 , Sara Falivene 15 , Simonetta Bacchiddu 16 , Sara Pedretti 17 , Francesca Cucciarelli 18,19 , Alba Fiorentino 20 , Vittorio Bini 21 , Cynthia Aristei 22,23 1 Radiation Oncology, Perugia General Hospital, Perugia, Italy. 2 Radiotherapy Unit, University of Perugia, Perugia, Italy. 3 Radiotherapy Unit, Perugia General Hospital, Perugia, Italy. 4 Radiotherapy Unit, Centro di Riferimento Oncologico della Basilicata (IRCCS-CROB), Rionero in Vulture, Italy. 5 Radiation Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy. 6 Struttura Complessa di Radioterapia Oncologica, Ospedale San Francesco, Nuoro, Italy. 7 Dipartimento Radioterapia, Azienda Ospedaliero-Universitaria Policlinico Umberto I, Roma, Italy. 8 Dipartimento Radioterapia, Sapienza, Università di Roma, Roma, Italy. 9 UOC Radioterapia Oncologica, Gemelli Molise Hospital, Campobasso, Italy. 10 UOC Radioterapia Oncologica, Università Cattolica S. Cuore, Campobasso, Italy. 11 UOC Radioterapia Oncologica, Ospedale Generale Provinciale di Macerata, Macerata, Italy. 12 SC Radioterapia Oncologica, Ospedale di Città di Castello, Città di Castello, Italy. 13 SC Radioterapia Oncologica, Ospedale S. Maria Goretti, Latina, Italy. 14 U.O.C. Radioterapia Oncologica, Azienda U.l.S.S Serenissima Ospedale dell’angelo, Mestre, Italy. 15 Department of Radiotherapy, ASL Napoli1 Centro - Ospedale del Mare, Napoli, Italy. 16 Service of Radiation Therapy, San Bortolo Hospital, Vicenza, Italy. 17 Radiation Oncology, ASST Spedali civili di brescia, Brescia, Italy. 18 UO Radioterapia, Azienda Ospedaliero- Universitaria, Ancona, Italy. 19 UO Radioterapia, Ospedali Riuniti di Ancona, Ancona, Italy. 20 UOC Radioterapia Oncologica, Ospedale Generale Regionale F. Miulli, Acquaviva delle Fonti (BA), Acquaviva delle Fonti, Italy. 21 Section of Internal Medicine and Endocrine and Metabolic Sciences, Università di Perugia, Perugis, Italy. 22 Radiation Oncology Section, University of Perugia, Perugia, Italy. 23 Radiation Oncology Section, Perugia General Hospital, Perugia, Italy Purpose/Objective: Breast-conserving surgery (BCS) followed by adjuvant radiotherapy is the standard of care for early-stage breast cancer, ensuring excellent local control and survival outcomes. In recent years, moderately hypofractionated regimens have largely replaced conventional schedules, and the phase III FAST- Forward trial demonstrated that ultra- hypofractionated whole-breast irradiation (WBI) delivered as 26 Gy in five fractions over one week is non-inferior in terms of tumor control and late normal-tissue toxicity. As survival rates continue to improve, the long-term burden of treatment and its impact on health-related quality of life (QoL) have become increasingly relevant. To evaluate patient- reported outcomes after ultra-hypofractionated WBI, a
reported outcomes were measured using QLQ EORTC BR23 domains. Results: Median age was 49 years old, 33% T1 and 67% of the patients had T2 disease, 90% had N0 disease and only 10% had N1. Dedicated nodal irradiation was delivered in 6% of patients. Tumor bed boost was delivered in 68% of patients. At a median interval from the end of radiation therapy of 16 months;late toxicities were minimal. Breast induration was absent in 70%, 21% had grade I. 50% of patients had no breast edema,G1 in 45% and 5% G2. More than 90% of the cases were cosmetically scored as good to excellant. 68% of the patients reported no breast pain compared to 31% who complained of mild pain. Other patient reported outcomes such as limited arm movement were observed only in few patients (2.4% experienced limited arm mobility and 14% parasthesia). Statistical analysis showed that the single high-dose boost did not significantly increase breast induration (p=0.193), pain (p=0.25), or impair cosmetic outcomes (p=0.378). However, it caused a higher incidence of mild breast edema (31% vs. 62% P 0.026) Conclusion: Ultrahypofractionated radiation therapy with single boost dose can be safely applied without impaired cosmetic outcome, ideal and convenient to patients as well as busy departments. References: Murray Brunt A, Haviland JS, Wheatley DA, Sydenham MA, Alhasso A, Bloomfield DJ, et al. Hypofractionated breast radiotherapy for 1 week versus 3 weeks (FAST- Forward): 5-year efficacy and late normal tissue effects results from a multicentre, non-inferiority, randomised, phase 3 trial. Lancet. 2020;395(10237):1613–26. Brunt AM, Haviland J, Sydenham M, Algurafi H, Alhasso A, Bliss P, et al. FAST phase III RCT of radiotherapy hypofractionation for treatment of early breast cancer: 10-year results (CRUKE/04/015). Int J Radiat Oncol Biol Phys. 2018;102(5):1603–4.Montero A, Ciervide R, Garcia- Aranda M, et al. PO-1135 Ultra-hypofractionated whole-breast radiotherapy with integrated boost for early breast cancer. Radiother Oncol. 2021;161:S942-3 Keywords: breast, reconstruction, cosmesis
Poster Discussion 2653
QoL after ultra-hypofractionated whole breast irradiation in early-stage breast cancer: results from an Italian multi-centre observational study Anna Giulia Becchetti 1 , Isabella Palumbo 2,3 , Grazia Lazzari 4 , Luciana Rago 4 , Maria Carmen De Santis 5 , Anna Rita Musu 6 , Francesca De Felice 7,8 , Gabriella
Macchia 9,10 , Francesca Mascioni 11 , Marina Alessandro 12 , Antonella Fontana 13 , Michele
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