Concurrent use of aromatase inhibitors and hypofractionated radiation therapy

Table 1 Patients’ and tumors’ characteristics

Characteristics
Number of patients	66
Median age in years (range)	80 (56-92)
Stage, n (%)
I	28 (42.4)
II	23 (34.8)
III	10 (18)
IV	5 (5)
Histological type, n (%)
Invasive ductal carcinoma	54 (81.8)
Invasive lobular carcinoma	11 (16.6)
Other histology	1 (1.6)
Grade, n (%)
1	15 (22.7)
2	38 (57.6)
3	11 (16.6)
NR	2 (3.1)
Mitotic index, n (%)
Low	42 (63.6)
Intermediate	11 (16.7)
High	7 (10.6)
NR	6 (9.1)
Expression of endocrine receptors, % (median)
ER	100 (60-100)
PgR	100 (60–100)
HER2 status, n (%)
Positive	11 (16.6)
Negative	55 (83.4)

ER: Estrogen receptor; HER2: Human epidermal growth factor receptor 2; n: Number of patients; PgR: Progesterone receptor; NR: Not reported.

Table 2 Treatment characteristics

Treatments	n (%)
Surgery
Surgery
Yes (BCS)	35 (53.0)1
No	31 (47.0)
Axillary LND
Yes	17 (25.8)
No	49 (74.2)
Sentinel LN
Yes	20 (30.3)
No	46 (69.7)
Aromatase inhibitor
Letrozole	16 (24.2)
Anastrozole	47 (71.2)
Exemestane	3 (4.6)
RT
Position
Lateral decubitus	63 (95.4)
Dorsal decubitus	3 (4.6)
Source
Cobalt 60	57 (86.3)
RX 4 MV	8 (12.2)
RX 6 MV	1 (1.5)
Volume
Whole breast	66 (100)
Axillary LN	4 (6.1)
Susclavicular LN	3 (4.5)
Boost	35 (4.5)
Protocol for the whole breast
5 fractions of 6.5 Gy	63 (95)
Other fractionation	3 (5)
Protocol for the boost
2 fractions of 6.5 Gy	28 (42.4)
1 fraction of 6.5 Gy	5 (7.5)
Other fractionation	2 (3)
Median duration in days (range)	29 (25-52)

¹Including five patients with neoadjuvant endocrine therapy. BCS: Breast conservative surgery; LN: Lymph node; LND: Lymph node dissection; RT: Radiation therapy.

Table 3 Skin toxicity

Skin toxicity	n (%)
Acute toxicity
Grade 0	19 (28.8)
Grade 1	38 (57.6)
Grade 2	8 (12.1)
Grade 3	1 (1.5)
Grade 4	0 (0)
Long-term toxicity
Grade 0	31 (47.0)
Grade 1-2	35 (53.0)
Grade 3-4	0 (0)

Acute toxicity is scored according to the Common Toxicity Criteria for Adverse Events v3; long-term toxicity is scored according to the Late Effects Normal Tissue Task Force-Subjective, Objective, Management and Analytic scale.

Table 4 Reasons for discontinuating aromatase inhibitors therapy prior to 5 yr adjuvant therapy

Reasons for discontinuation	n (%)
Thromboembolic event	4 (6.0)
Progression	3 (4.5)
Patient death	5 (7.5)
Clinical intolerance	5 (7.5)
Total discontinuations	17 (25.5)