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21.04.2020 | Original Article

Adjuvant breast inversely planned intensity-modulated radiotherapy with simultaneous integrated boost for early stage breast cancer

Results from a phase II trial

verfasst von: Jin Meng, Wenzhi Huang, Xin Mei, Xiaoli Yu, Ziqiang Pan, Jinli Ma, Xuejun Ma, Jiayi Chen, Xiaomao Guo, Zhaozhi Yang

Erschienen in: Strahlentherapie und Onkologie | Ausgabe 9/2020

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Abstract

Purpose

To report early toxicity and 5‑year clinical outcomes of adjuvant breast inversely planned intensity-modulated radiotherapy with simultaneously integrated boost (IMRT-SIB) after breast-conserving surgery for early stage breast cancer patients.

Patients and methods

In all, 467 patients including 406 invasive breast cancer and 61 ductal carcinoma in situ (DCIS) were enrolled in a single institutional phase II trial. All patients underwent IMRT-SIB treatment to irradiate the whole breast and the tumor bed. Doses to whole breast and surgical bed were 45 and 60 Gy, respectively, delivered in 25 fractions over 5 weeks. The grade of maximum acute skin toxicity during treatment was recorded. Lung toxicity was noted within 6 months and patient-reported cosmetic outcomes were recorded at the 12 month follow-up after the end of radiotherapy. Clinical outcomes were assessed during follow-up.

Results

Median follow-up time was 5.46 years. Median age was 46 years old (range 22–70 years old). No patient with DCIS had a local recurrence or distant metastasis. Among 406 patients with invasive breast cancer, the unadjusted 5‑year actuarial rate of locoregional control was 98.7% (95% confidence interval [CI] 97.5–100), and distant metastasis-free survival 98.7% (95% CI 97.4–100), respectively. Acute skin toxicity was recorded at grade 0–1 in 76.5% of patients, and grade 2 in 23.5% of patients. None of these patients had grade 3 or more than grade 3 skin toxicity. Grade 1 pneumonitis was found in 25.3% of patients. Assessment of patient reported cosmetic outcomes at the 12 month follow-up showed good or excellent outcome in 86.5% of cases.

Conclusions

The use of inversely planned IMRT-SIB as part of breast-conserving therapy results in optimal 5‑year tumor control and minor early toxicities.

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Titel: Adjuvant breast inversely planned intensity-modulated radiotherapy with simultaneous integrated boost for early stage breast cancer
Results from a phase II trial
verfasst von: Jin Meng
Wenzhi Huang
Xin Mei
Xiaoli Yu
Ziqiang Pan
Jinli Ma
Xuejun Ma
Jiayi Chen
Xiaomao Guo
Zhaozhi Yang
Publikationsdatum: 21.04.2020
Verlag: Springer Berlin Heidelberg
Erschienen in: Strahlentherapie und Onkologie / Ausgabe 9/2020
Print ISSN: 0179-7158
Elektronische ISSN: 1439-099X
DOI: https://doi.org/10.1007/s00066-020-01611-1

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Springer Medizin

Adjuvant breast inversely planned intensity-modulated radiotherapy with simultaneous integrated boost for early stage breast cancer

Results from a phase II trial

Abstract

Purpose

Patients and methods

Results

Conclusions

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