dc.contributor.author | Haviland, JS | |
dc.contributor.author | Mannino, M | |
dc.contributor.author | Griffin, C | |
dc.contributor.author | Porta, N | |
dc.contributor.author | Sydenham, M | |
dc.contributor.author | Bliss, JM | |
dc.contributor.author | Yarnold, JR | |
dc.contributor.author | START Trialists' Group, | |
dc.date.accessioned | 2017-11-03T09:37:32Z | |
dc.date.issued | 2018-01-01 | |
dc.identifier.citation | Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology, 2018, 126 (1), pp. 155 - 162 | |
dc.identifier.issn | 0167-8140 | |
dc.identifier.uri | https://repository.icr.ac.uk/handle/internal/897 | |
dc.identifier.eissn | 1879-0887 | |
dc.identifier.doi | 10.1016/j.radonc.2017.10.033 | |
dc.description.abstract | BACKGROUND AND PURPOSE: Adjuvant lymphatic radiotherapy (LNRT) is recommended for selected axillary node positive women with early breast cancer. We investigated whether hypofractionated LNRT is safe combined with similarly-hypofractionated breast/chest wall radiotherapy (RT). MATERIAL AND METHODS: The Standardisation of Breast Radiotherapy (START) pilot, A and B trials randomised women with early breast cancer to schedules of 2.67-3.3 Gy versus 2.0 Gy fractions (control). RT adverse effects were assessed by patients using the EORTC QLQ-BR23 and protocol-specific questions, and by physicians. Rates of arm/shoulder effects were compared between schedules for patients given LNRT. RESULTS: 864/5861 (14.7%) patients received LNRT (385 START-pilot, 318 START-A, 161 START-B). Prevalences of moderate/marked arm/shoulder effects were low up to 10 years. There were no significant differences between the hypofractionated and control groups for patient- and physician-assessed symptoms in START-A or START-B. In START-pilot, adverse effect rates were higher after 13 fractions of 3.3 Gy, consistent with effects reported in the breast/chest wall (significant for shoulder stiffness, HR 3.07, 95%CI 1.62-5.83, p = 0.001). CONCLUSIONS: The START trial results suggest that appropriately-dosed hypofractionated LNRT is safe in the long-term, according to patient and physician-assessed arm and shoulder symptoms. These findings are consistent with those reported after the same schedules delivered to the breast/chest wall. | |
dc.format | Print-Electronic | |
dc.format.extent | 155 - 162 | |
dc.language | eng | |
dc.language.iso | eng | |
dc.publisher | ELSEVIER IRELAND LTD | |
dc.rights.uri | https://creativecommons.org/licenses/by/4.0 | |
dc.subject | START Trialists' Group | |
dc.subject | Arm | |
dc.subject | Shoulder | |
dc.subject | Humans | |
dc.subject | Breast Neoplasms | |
dc.subject | Radiation Injuries | |
dc.subject | Radiotherapy, Adjuvant | |
dc.subject | Lymphatic Irradiation | |
dc.subject | Adult | |
dc.subject | Aged | |
dc.subject | Aged, 80 and over | |
dc.subject | Middle Aged | |
dc.subject | Female | |
dc.subject | Young Adult | |
dc.subject | United Kingdom | |
dc.subject | Radiation Dose Hypofractionation | |
dc.title | Late normal tissue effects in the arm and shoulder following lymphatic radiotherapy: Results from the UK START (Standardisation of Breast Radiotherapy) trials. | |
dc.type | Journal Article | |
dcterms.dateAccepted | 2017-10-29 | |
rioxxterms.funder | The Institute of Cancer Research | |
rioxxterms.identifier.project | Unspecified | |
rioxxterms.versionofrecord | 10.1016/j.radonc.2017.10.033 | |
rioxxterms.licenseref.uri | https://creativecommons.org/licenses/by/4.0 | |
rioxxterms.licenseref.startdate | 2018-01 | |
rioxxterms.type | Journal Article/Review | |
dc.relation.isPartOf | Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology | |
pubs.issue | 1 | |
pubs.notes | Not known | |
pubs.organisational-group | /ICR | |
pubs.organisational-group | /ICR/Primary Group | |
pubs.organisational-group | /ICR/Primary Group/ICR Divisions | |
pubs.organisational-group | /ICR/Primary Group/ICR Divisions/Clinical Studies | |
pubs.organisational-group | /ICR/Primary Group/ICR Divisions/Clinical Studies/Clinical Trials & Statistics Unit | |
pubs.organisational-group | /ICR | |
pubs.organisational-group | /ICR/Primary Group | |
pubs.organisational-group | /ICR/Primary Group/ICR Divisions | |
pubs.organisational-group | /ICR/Primary Group/ICR Divisions/Clinical Studies | |
pubs.organisational-group | /ICR/Primary Group/ICR Divisions/Clinical Studies/Clinical Trials & Statistics Unit | |
pubs.publication-status | Published | |
pubs.volume | 126 | |
pubs.embargo.terms | Not known | |
icr.researchteam | Clinical Trials & Statistics Unit | |
dc.contributor.icrauthor | Haviland, Joanne | |
dc.contributor.icrauthor | Griffin, Clare | |
dc.contributor.icrauthor | Porta, Nuria | |
dc.contributor.icrauthor | Sydenham, Mark | |
dc.contributor.icrauthor | Bliss, Judith | |
dc.contributor.icrauthor | Yarnold, John | |