FAST- Forward radiotherapy in breast cancer patients from a Turkish cohort: a study on acute skin toxicity

Abstract

OBJECTIVE This study aimed to evaluate early skin reactions in patients with breast cancer treated with the FAST-Forward radiotherapy regimen after surgery. METHODS Between December 2019 and August 2022, 60 patients with breast cancer received the FAST-Forward radiotherapy protocol: 26 Gy delivered in five fractions of 5.2 Gy each, using tangential field-in-field techniques.Treatments were administered on consecutive weekdays, and skin reactions were graded using the Radiation Therapy Oncology Group (RTOG) system in the second and sixth weeks after radiotherapy. The radiotherapy area and contralateral breast were photographed, and the patients were asked to report any breast swelling as a subjective symptom. RESULTS The median patient age was 71 years (range: 51-86). All had T1-2 and N0-1 disease and received adju-vant radiotherapy following surgery. In the second week after radiotherapy, 7 patients (11.6%) had grade 1 skin reactions and 1 patient (1.6%) had a grade 2 reaction. By the sixth week, five of the seven grade 1 reactions had resolved, with one remaining in grade 1 and one increasing to grade 2. The initial grade 2 reaction improved to a grade 1 reaction. None of the patients reported breast swelling in the second and sixth weeks after radiotherapy. CONCLUSION Considering the impact of skin reactions on the patients' quality of life, the FAST-Forward protocol appears to be a safe and comfortable option for patients who meet the appropriate criteria. Copyright (c) 2024, Turkish Society for Radiation Oncology