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01.07.2014 | Original article

Hypofractionation with simultaneous integrated boost for early breast cancer

Results of the German multicenter phase II trial (ARO-2010-01)

verfasst von: Kathrin Dellas, MD, Dr. Reinhard Vonthein, Jörg Zimmer, MD, Stefan Dinges, MD, Alexander D. Boicev, MD, Peter Andreas, MD, Dorothea Fischer, MD, Cornelia Winkler, MD, Prof. Dr. Andreas Ziegler, Prof. Jürgen Dunst, MD, ARO Study Group

Erschienen in: Strahlentherapie und Onkologie | Ausgabe 7/2014

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Abstract

Purpose

To evaluate the feasibility of hypofractionation with SIB in all settings in Germany to prepare a multicenter treatment comparison.

Methods

Eligible patients had histopathologically confirmed breast cancer operated by BCS. Patients received WBI 40.0 Gy in 16 fractions of 2.5 Gy. A SIB with 0.5 Gy per fraction was administered to the tumor bed, thereby giving 48.0 Gy in 16 fractions to the boost-PTV sparing heart, LAD, lung, contralateral breast. The primary study objective was feasibility, administration of specified dose in 16 fractions within 22–29 days with adherence to certain dose constraints (heart; LAD; contralateral breast); secondary endpoints were toxicity, QoL.

Results

151 patients were recruited from 7 institutions between 07/11-10/12. 10 patients met exclusion criteria prior to irradiation. All but two patients (99 %) received the prescribed dose in the PTVs. Adherence to dose constraints and time limits was achieved in 89 % (95 % CI 82 % to 93 %). 11 AE were reported in 10 patients; five related to concurrent endocrine therapy. Two of the AEs were related to radiotherapy: grade 3 hot flushes in two cases. QoL remained unchanged.

Conclusion

Hypofractionation with a SIB is feasible and was well tolerated in this study.

Clarke M, Collins R, Darby S et al, Early Breast Cancer Trialists’ Collaborative Group (EBCTCG) (2005) Effects of radiotherapy and of differences in the extent of surgery for early breast cancer on local recurrence and 15-year survival: an overview of the randomised trials. Lancet 366:2087–2106PubMedCrossRef

Darby S, McGale P, Correa C et al (2011) Effect of radiotherapy after breast-conserving surgery on 10-year recurrence and 15-year breast cancer death: meta-analysis of individual patient data for 10,801 women in 17 randomised trials. Lancet 378:1707–1716PubMedCrossRef

Whelan TJ, Julian J, Wright J et al (2000) Does locoregional RT improve survival in breast cancer? A meta-analysis. J Clin Oncol 18:1220–1229PubMed

Bartelink H, Horiot JC, Poortmans P et al (2007) Impact of a higher radiation dose on local control and survival in breast-conserving therapy of early breast cancer: 10-year results of the randomized boost versus no boost EORTC 22881-10882 trial. J Clin Oncol 22:3259–3326CrossRef

Livi L, Borghesi S, Saieva C et al (2009) Benefit of radiation boost after whole-breast radiotherapy. Int J Radiat Oncol Biol Phys 75:1029–1034PubMedCrossRef

Azria D, Auvray H, Barillot I et al (2008) Ductal carcinoma in situ: role of the boost. Cancer Radiother 12:571–576PubMedCrossRef

Whelan TJ, Pignol JP, Levine MN et al (2010) Long-term results of hypofractionated radiation therapy for breast cancer. N Engl J Med 362:513–520PubMedCrossRef

START Trialists’ Group, Bentzen SM, Agrawal RK, Aird EG et al (2008) The UK Standardization of Breast Radiotherapy (START) Trial A of radiotherapy hypofractionation for treatment of early breast cancer: a randomised trial. Lancet Oncol 9:331–341PubMedCrossRef

START Trialists’ Group, Bentzen SM, Agrawal RK, Aird EG et al (2008) The UK Standardization of Breast Radiotherapy (START) Trial B of radiotherapy hypofractionation for treatment of early breast cancer: a randomised trial. Lancet 371:1098–1107PubMedCrossRef

10.

Owen JR, Ashton A, Bliss JM et al (2006) Effect of radiotherapy fraction size on tumour control in patients with early-stage breast cancer after local tumour excision: long-term results of a randomized trial. Lancet Oncol 7:467–471PubMedCrossRef

11.

Sedlmayer F, Sautter-Bihl ML, Budach W et al (2013) Breast Cancer Expert Panel of the German Society of Radiation Oncology (DEGRO). Is the simultaneously integrated boost (SIB) technique for early breast cancer ready to be adopted for routine adjuvant radiotherapy? Statement of the German and the Austrian Societies of Radiooncology (DEGRO/ÖGRO). Strahlenther Onkol 189:193–196PubMedCrossRef

12.

Sedlmayer F, Sautter-Bihl ML, Budach W et al (2013) Breast Cancer Expert Panel of the German Society of Radiation Oncology (DEGRO). DEGRO practical guidelines: radiotherapy of breast cancer I. Radiotherapy following breast conserving therapy for invasive breast cancer. Strahlenther Onkol 189:825–833PubMedCentralPubMedCrossRef

13.

Chadha M, Vongtama D, Friedmann P et al (2012) Comparative acute toxicity from whole breast irradiation using 3-week accelerated schedule with concomitant boost and the 6.5-week conventional schedule with sequential boost for early-stage breast cancer. Clin Breast Cancer 12:57–62PubMedCrossRef

14.

Van Parijs HM, Vinh-Hung V et al (2012) Short course radiotherapy with simultaneous integrated boost for stage I–II breast cancer, early toxicities of a randomized clinical trial. Radiat Oncol 7:80PubMedCentralPubMedCrossRef

15.

Scorsetti M, Alongi F, Fogliata A et al (2012) Phase I–II study of hypofractionated simultaneous integrated boost using volumetric modulated arc therapy for adjuvant radiation therapy in breast cancer patients: a report of feasibility and early toxicity results in the first 50 treatments. Radiat Oncol 28:145CrossRef

16.

Darby SC, Ewertz M, McGale P et al (2012) Risk of ischemic heart disease in women after radiotherapy for breast cancer. N Engl J Med 368:987–998CrossRef

Titel: Hypofractionation with simultaneous integrated boost for early breast cancer
Results of the German multicenter phase II trial (ARO-2010-01)
verfasst von: Kathrin Dellas, MD
Dr. Reinhard Vonthein
Jörg Zimmer, MD
Stefan Dinges, MD
Alexander D. Boicev, MD
Peter Andreas, MD
Dorothea Fischer, MD
Cornelia Winkler, MD
Prof. Dr. Andreas Ziegler
Prof. Jürgen Dunst, MD
ARO Study Group
Publikationsdatum: 01.07.2014
Verlag: Springer Berlin Heidelberg
Erschienen in: Strahlentherapie und Onkologie / Ausgabe 7/2014
Print ISSN: 0179-7158
Elektronische ISSN: 1439-099X
DOI: https://doi.org/10.1007/s00066-014-0658-5

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Hypofractionation with simultaneous integrated boost for early breast cancer

Results of the German multicenter phase II trial (ARO-2010-01)