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Radiotherapy is an essential treatment in the local control of breast cancer. Standard treatment is currently carried out in 15 daily sessions. At present, following the results of the phase III Fast-Foward trial and in view of the situation triggered by COVID-19, the number of sessions has been reduced to 5. We present the data of our series to evaluate the results of the extreme hypofractionation scheme as a radiotherapy treatment for breast cancer at the Multihospital Clinical Unit of Radiation Oncology of Aragón (UCMORA).

After implantation, 115 patients were treated with 3D conformal radiotherapy between April 2020 and May 2021 at UCMORA using the extreme hypofractionation scheme (26 Gy at 5.2 Gy per fraction in 5 fractions). Demographic, tumor, dosimetric and toxicity characteristics were analyzed.

The mean age was 63.5 years. 53 patients were treated at the Lozano Blesa Clinical Universitary Hospital and 62 at the Miguel Servet Universitary Hospital, in total 59 right and 56 left breasts. The predominant histology was infiltrating ductal carcinoma (84.3%), followed by infiltrating lobular carcinoma (10.4%), ductal carcinoma in situ (4.3%) and mucinous (0.9%). 51.7% were luminal A, 39.1% luminal B, 1.8% Her2 positive and 7.8% triple negative. In relation to staging, we found 4pTis, 8pT1a, 45pT1b, 58pT1c, 2Nx, 8N0, 1Nmi and 13N1a. Only 45% had acute toxicity at one month after the end of treatment, predominantly G1 radiodermatitis (86.6%), followed by G2 (11.2%) and G3 (2.2%). When analyzing the dose-volume histograms, values were obtained for ipsilateral lung V8 between 1.32 and 21.2%, for the heart, in case of left breast a median for V1.5 of 8.2% and 1.05% for V7; in case of right breast the median Dmed for the heart was 0.5Gy.

Ultra-hypofractionated whole breast radiotherapy as a radiation treatment for breast cancer is well tolerated, reduces costs and number of sessions, while increasing comfort for patients.