This observational study does not include COVID-19 infected patients.
The aims of the study is to register radiotherapy induced acute and late effects in patients with early breast cancer with node negative tumors treated with whole breast irradiation fractionated 26 Gy in 5 daily fractions over 1 week, following breast conserving surgery with free margins. The treatment schedule for this particular patient group has been modified to meet the demands during the COVID-19 pandemic, balancing good cancer treatment with the protection of patients and health care professionals.
Standard fractionation for these patients would be 40 Gy in 15 fractions over 3 weeks. During the COVID-19 pandemic it is imperative that hospital visits are kept to the absolute minimum and that the complexity of radiotherapy planning and treatment is reduced to ease pressure on the work force, thus protecting patients and health care professionals from potential exposure to COVID-19. Breast radiotherapy accounts for about 30 percent of delivered treatments in a radiotherapy department and the reduction in treatment time from three weeks to one week is considered an effective measure in this context. The level 1- 2 evidence has not formally been delivered from the FAST Forward protocol where this schedule has been tested in a large study, including 4096 patients from 2911-2014. However, the 26 Gy in 5 fractions schedule has already demonstrated to be equivalent with 40 Gy in 15 fractions with respect to 3-year normal tissue outcome and imminent publication of the 5 year relapse data is anticipated. Meanwhile, the 26 Gy in 5 fractions over one week has been recommended as an alternative to standard fractionation in international and national guidelines.