Hypofractionated volumetric‐modulated arc therapy for breast cancer: A propensity‐score‐weighted comparison of radiation‐related toxicity

We assessed the clinical benefit of combining volumetric-modulated arc therapy (VMAT) and hypofractionated radiotherapy (HF-RT) considering incidence radiation-related toxicities. After a retrospective review for breast cancer patients treated with adjuvant RT between 2005 2017, total 4209 three-dimensional conventional fractionation (CF-3D, 50.4 Gy/28 fractions) 1540 HF-RT (768 received HF-3D; 772, HF-VMAT; 40 Gy/15 were included. A 2229 (38.8%) regional node irradiation (RNI): 1642 (39.0%), 167 (21.7%) 420 (54.4%) RNI via CF-3D, HF-3D HF-VMAT, respectively. Acute/subacute late toxicities evaluated. Propensity scores calculated logistic regression. Grade 2+ acute/subacute was highest in CF-3D group (15.0%, 2.6% 1.6% respectively; P < .001). HF-VMAT reduced significantly compared to (odds ratio [OR] 0.11, .001) (OR 0.45, = .010). The 3-year cumulative rate 18.0% (20.1%, 10.9% 13.4% On sensitivity analysis, high group. Acute fewer after than or especially women who underwent RNI.