| Weekly concomitant boost in adjuvant radiotherapy for patients with early breast cancer: preliminary results on feasibility. | |
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MedLine Citation:
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PMID: 19112945 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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AIMS AND BACKGROUND: Recent advances in the management of patients with breast cancer are focused toward the reduction of overall treatment time of radiotherapy by delivering a dose biologically equivalent to a standard schedule. The aim of the present study was to evaluate the feasibility and preliminary toxicity of a moderately hypofractionated whole breast irradiation schedule with the addition of a concomitant boost delivered to the tumor bed once-a-week in patients with early breast cancer submitted to conservative surgery. MATERIALS: We selected patients with pT1c and pT2 N0/N+ M0 carcinoma of the breast with negative surgical margins. The basic course consisted of 4600 cGy prescribed to the ICRU 50 reference point dose and delivered in 20 fractions, 4 times a week for 5 weeks. Once a week, immediately after whole breast irradiation, a concomitant photon boost of 120 cGy was delivered to the lumpectomy area. Overall, according to the linear-quadratic model, the schedule provides a biologically equivalent dose of 87 Gy for breast tumor (assuming alpha/beta = 4 Gy), of 66 Gy for acute responding normal tissues (assuming alpha/beta = 10 Gy), and 99 Gy for late responding normal tissues (assuming alpha/beta = 3 Gy). Biologically, the schedule compares favorably with the 6-week conventional regimen consisting of 50 Gy, 2 Gy/fraction, followed by a 10 Gy boost (BED(tumor), 90 Gy; BED(acute effects), 72 Gy, and BED(late effects), 100 Gy). RESULTS: From November 2004 to April 2007, we tested this radiotherapy schedule in 176 patients. All enrolled patients had achieved a minimum follow-up of 6 months and were considered in detail for the evaluation of feasibility. Three clinical examinations were performed by a group of independent physicians at treatment end, after 1 month and after 6 months. According to the RTOG/EORTC Toxicity Criteria, of the 176 assessable patients at the end of radiotherapy, 58% showed grade 0-1 skin toxicity, 30% grade 2 and 12% grade 3. At one month of follow-up, grade 0 toxicity was observed in 47% of cases, grade 1 in 46% and grade 2 in 7%. At 6 months, late (skin and subcutaneous tissue) toxicity was assessed with the following scores: grade 0 in 68%, grade 1 in 26% and grade 2 in 6% of the patients. At 6 months, cosmesis was excellent, good and fair in 71%, 24% and 5% of patients, respectively. CONCLUSIONS: The explored adjuvant schedule planned to intensify the radiotherapy course for patients with early breast cancer by adding a weekly concomitant boost appears to be feasible and provides low local toxicity and excellent to good short-term cosmetic results. |
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Authors:
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Renzo Corvò; Stefania Giudici; Francesca Maggio; Monica Bevegni; Chiara Sampietro; Maria Rosaria Lucido; Marco Orsatti |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Tumori Volume: 94 ISSN: 0300-8916 ISO Abbreviation: Tumori Publication Date: 2008 Sep-Oct |
Date Detail:
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Created Date: 2008-12-30 Completed Date: 2009-01-13 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0111356 Medline TA: Tumori Country: Italy |
Other Details:
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Languages: eng Pagination: 706-11 Citation Subset: IM |
Affiliation:
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National Institute for Cancer Research and University, Genoa, Italy. renzo.corvo@unige.it |
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Aged Breast Neoplasms / pathology, radiotherapy*, surgery* Dose Fractionation Esthetics* Feasibility Studies Female Follow-Up Studies Humans Mastectomy, Segmental* Middle Aged Neoplasm Staging Radiotherapy, Adjuvant / adverse effects Skin / radiation effects* Treatment Outcome |
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