Alleviating Morbidity From Locally Advanced Breast Cancer Using a Practical and Short Radiation Therapy Regimen: Results of the HYPORT Palliative Studies

Purpose: Locally advanced breast cancers lead to debilitating local symptoms. Treatment of these women encountered com-monly in less resourced countries is not backed by strong evidence. We formulated the HYPORT and HYPORT B phase 1/2 studies to evaluate the safety and efficacy of hypofractionated palliative breast radiation therapy.Methods and Materials: Two studies (35 Gy/10 fractions; HYPORT ) and (26 Gy to breast/32 Gy tumor boost in 5 fractions; HYPORT B) were designed with increasing hypofractionation to save overall treatment time from 10 to 5 days. We report the acute toxicity, symptomatic, metabolic response, and quality of life (QOL) changes after radiation therapy.Results: Fifty-eight patients, the majority of whom were pretreated with systemic therapy, completed the treatment. No grade 3 toxicity was reported. Response assessment at 3 months showed improvement in ulceration (58% vs 22%, P = .013) and bleeding (22% vs 0%, P = .074) within the HYPORT study. Similarly, in the HYPORT B study, ulceration (64% and 39%, P = .2), fungating (26% and 0%, P = .041), bleeding (26% and 4.3%, P = .074), and discharge (57% and 8.7%, P = .003) was reduced. Metabolic response was noted in 90% and 83% of patients, respectively, in the 2 studies. Improvement in the QOL scores were evident in both studies. Only 10% of the patients relapsed locally within 1 year.Conclusions: Palliative ultrahypofractionated radiation therapy to the breast is well tolerated, is effective, and results in a dura-ble response with improved QOL. This could be considered a standard for locoregional symptom control.& COPY; 2023 Elsevier Inc. All rights reserved.