Short course hypofractionated whole breast irradiation after conservative surgery: a single institution phase II study
Abstract Background To assess the oncologic outcomes of hypofractionated whole breast irradiation (Hypo-WBI). Methods Eligible patients had undergone breast conservative surgery for early breast cancer (pTis-2) and none/limited nodal involvement. Hypo-WBI consisted of 34 Gy in 10 daily fractions ove...
| Main Authors: | , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2017-12-01
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| Series: | Journal of Experimental & Clinical Cancer Research |
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| Online Access: | http://link.springer.com/article/10.1186/s13046-017-0640-z |
| _version_ | 1828756534426861568 |
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| author | Paola Pinnarò Carolina Giordano Alessia Farneti Adriana Faiella Giuseppe Iaccarino Valeria Landoni Diana Giannarelli Patrizia Vici Lidia Strigari Giuseppe Sanguineti |
| author_facet | Paola Pinnarò Carolina Giordano Alessia Farneti Adriana Faiella Giuseppe Iaccarino Valeria Landoni Diana Giannarelli Patrizia Vici Lidia Strigari Giuseppe Sanguineti |
| author_sort | Paola Pinnarò |
| collection | DOAJ |
| description | Abstract Background To assess the oncologic outcomes of hypofractionated whole breast irradiation (Hypo-WBI). Methods Eligible patients had undergone breast conservative surgery for early breast cancer (pTis-2) and none/limited nodal involvement. Hypo-WBI consisted of 34 Gy in 10 daily fractions over 2 weeks to the whole breast three-dimensional conformal radiotherapy (3DCRT), followed by a single fraction of 8 Gy to the tumor bed after 1 week (electrons). Primary endpoint is freedom from ipsilateral breast tumor recurrence (IBTR). Minimum follow up for living & event-free patients is 3 yrs.; median follow up time of the whole analyzed patient population is 5.4 yrs. (range: 1.8–11.4 yrs). Results Two hundred fifty-one patients were accrued from 2004 to 2013. All patients underwent local excision of the primary tumor to negative margins. Four patients failed in the ipsilateral breast after a median time of 3.2 years (range: 1.7–5.7 yrs) for a 5-year IBTR-free survival of 98.7% (95%CI: 97.3%–100%). IBTR-free survival was significantly higher for patients with invasive cancer than for patients with intraductal carcinoma (p = 0.036). Within patients with invasive tumors, no clear trends or associations were detected between IBTR and age, grading, molecular subtype, pT or pN stage. At 5 years, the actuarial rates of GR2 fibrosis and GR2+ teleangectasia are 2.4% (95%CI: 0–6.5%) and 7.1% (95%CI: 0.4–13.7%), respectively. Cosmesis was scored as excellent/good by ≈95% of patients and ≈60% of clinicians. Conclusions Hypo-WBI in 3 weeks allows excellent oncologic outcomes for invasive breast cancer after conservative surgery. Patients with intraductal carcinoma should be treated with Hypo-WBI only within a controlled study. Trial registration IRE-IFO Ethical and Scientific Committee (cod. RS61/04). |
| first_indexed | 2024-12-10T23:17:33Z |
| format | Article |
| id | doaj.art-7bae34afa89b4cb3bf45ade1dc8b02fb |
| institution | Directory Open Access Journal |
| issn | 1756-9966 |
| language | English |
| last_indexed | 2024-12-10T23:17:33Z |
| publishDate | 2017-12-01 |
| publisher | BMC |
| record_format | Article |
| series | Journal of Experimental & Clinical Cancer Research |
| spelling | doaj.art-7bae34afa89b4cb3bf45ade1dc8b02fb2022-12-22T01:29:47ZengBMCJournal of Experimental & Clinical Cancer Research1756-99662017-12-013611810.1186/s13046-017-0640-zShort course hypofractionated whole breast irradiation after conservative surgery: a single institution phase II studyPaola Pinnarò0Carolina Giordano1Alessia Farneti2Adriana Faiella3Giuseppe Iaccarino4Valeria Landoni5Diana Giannarelli6Patrizia Vici7Lidia Strigari8Giuseppe Sanguineti9Departments of Radiation Oncology, Regina Elena National Cancer InstituteDepartments of Radiation Oncology, Regina Elena National Cancer InstituteDepartments of Radiation Oncology, Regina Elena National Cancer InstituteDepartments of Radiation Oncology, Regina Elena National Cancer InstituteLaboratory of Medical Physics and Expert Systems, Regina Elena National Cancer InstituteLaboratory of Medical Physics and Expert Systems, Regina Elena National Cancer InstituteDepartments of Statistics, Regina Elena National Cancer InstituteDepartments of Clinical Oncology, Regina Elena National Cancer InstituteLaboratory of Medical Physics and Expert Systems, Regina Elena National Cancer InstituteDepartments of Radiation Oncology, Regina Elena National Cancer InstituteAbstract Background To assess the oncologic outcomes of hypofractionated whole breast irradiation (Hypo-WBI). Methods Eligible patients had undergone breast conservative surgery for early breast cancer (pTis-2) and none/limited nodal involvement. Hypo-WBI consisted of 34 Gy in 10 daily fractions over 2 weeks to the whole breast three-dimensional conformal radiotherapy (3DCRT), followed by a single fraction of 8 Gy to the tumor bed after 1 week (electrons). Primary endpoint is freedom from ipsilateral breast tumor recurrence (IBTR). Minimum follow up for living & event-free patients is 3 yrs.; median follow up time of the whole analyzed patient population is 5.4 yrs. (range: 1.8–11.4 yrs). Results Two hundred fifty-one patients were accrued from 2004 to 2013. All patients underwent local excision of the primary tumor to negative margins. Four patients failed in the ipsilateral breast after a median time of 3.2 years (range: 1.7–5.7 yrs) for a 5-year IBTR-free survival of 98.7% (95%CI: 97.3%–100%). IBTR-free survival was significantly higher for patients with invasive cancer than for patients with intraductal carcinoma (p = 0.036). Within patients with invasive tumors, no clear trends or associations were detected between IBTR and age, grading, molecular subtype, pT or pN stage. At 5 years, the actuarial rates of GR2 fibrosis and GR2+ teleangectasia are 2.4% (95%CI: 0–6.5%) and 7.1% (95%CI: 0.4–13.7%), respectively. Cosmesis was scored as excellent/good by ≈95% of patients and ≈60% of clinicians. Conclusions Hypo-WBI in 3 weeks allows excellent oncologic outcomes for invasive breast cancer after conservative surgery. Patients with intraductal carcinoma should be treated with Hypo-WBI only within a controlled study. Trial registration IRE-IFO Ethical and Scientific Committee (cod. RS61/04).http://link.springer.com/article/10.1186/s13046-017-0640-zBreast neoplasmsBreast carcinoma in situRadiotherapyDose hypofractionationLocal neoplasm recurrence |
| spellingShingle | Paola Pinnarò Carolina Giordano Alessia Farneti Adriana Faiella Giuseppe Iaccarino Valeria Landoni Diana Giannarelli Patrizia Vici Lidia Strigari Giuseppe Sanguineti Short course hypofractionated whole breast irradiation after conservative surgery: a single institution phase II study Journal of Experimental & Clinical Cancer Research Breast neoplasms Breast carcinoma in situ Radiotherapy Dose hypofractionation Local neoplasm recurrence |
| title | Short course hypofractionated whole breast irradiation after conservative surgery: a single institution phase II study |
| title_full | Short course hypofractionated whole breast irradiation after conservative surgery: a single institution phase II study |
| title_fullStr | Short course hypofractionated whole breast irradiation after conservative surgery: a single institution phase II study |
| title_full_unstemmed | Short course hypofractionated whole breast irradiation after conservative surgery: a single institution phase II study |
| title_short | Short course hypofractionated whole breast irradiation after conservative surgery: a single institution phase II study |
| title_sort | short course hypofractionated whole breast irradiation after conservative surgery a single institution phase ii study |
| topic | Breast neoplasms Breast carcinoma in situ Radiotherapy Dose hypofractionation Local neoplasm recurrence |
| url | http://link.springer.com/article/10.1186/s13046-017-0640-z |
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