Introduction
Methods and materials
Study population
Treatment planning and toxicity assessment
Statistical methods
Results
42 Gy step (n = 17) | 40 Gy step (n = 31) | |
---|---|---|
Median age (years)(min-max) | 67 (52–76) | 65 (53–79) |
Median tumor size (mm) (min-max) | 10 (4–20) | 11 (5–20) |
Histology | ||
Invasive ductal carcinoma (IDC) | 82% | 90% |
Mucinous/tubular/other invasive carcinoma | 6% | - |
Ductal Carcinoma In Situ (DCIS) | 12% | 10% |
Nodal status | ||
pN0 | 100% | 100% |
Scarff & Bloom histology grade | ||
1 | 44% | 64% |
2 | 38% | 32% |
3 | 13% | 4% |
ER status | ||
Positive | 100% | 100% |
PR status (+) | ||
Positive | 69% | 77% |
Negative | 31% | 23% |
Her2 status | ||
Negative | 100% | 100% |
Planning target volume and normal tissue dosimetry
Characteristic | 42 Gy (n = 17) | 40 Gy (n = 31 patients, 32 tumors) | ||
---|---|---|---|---|
Median | Min - max | Median | Min - max | |
PTV coverage | ||||
V100% | 99 | 97 - 100 | 99 | 95 - 100 |
V95% | 100 | 100 - 100 | 100 | 99 - 100 |
V90% | 100 | 100 - 100 | 100 | 99 - 100 |
Ipsilateral breast | ||||
V32 Gy (%) | 35 | 13 - 48 | 40 | 21 - 50 |
V24 Gy (%) | 39 | 15 - 53 | 46 | 23 - 54 |
V16 Gy (%) | 43 | 16 - 57 | 49 | 24 - 57 |
V8 Gy (%) | 54 | 18 - 68 | 55 | 26 - 75 |
Non target breast | ||||
V40 Gy (%) | 10 | 3 - 18 | 8 | 3 - 18 |
V32 Gy (%) | 25 | 10 - 35 | 29 | 6 - 38 |
V20 Gy (%) | 32 | 12 - 44 | 35 | 8 - 45 |
V10 Gy (%) | 44 | 14 - 60 | 44 | 11 - 63 |
Ipsilateral lung | ||||
V20 Gy (%) | 0 | 0 - 1 | 0 | 0 - 1 |
V10 Gy (%) | 0 | 0 - 2 | 1 | 0 - 6 |
V5 Gy (%) | 3 | 0 - 5 | 4 | 0 - 12 |
Heart | ||||
V20 Gy (%) | 0 | 0 - 0 | 0 | 0 - 0 |
V10 Gy (%) | 0 | 0 - 0 | 0 | 0 - 1 |
V5 Gy (%) | 0 | 0 - 1 | 1 | 0 - 4 |
left breast cancer, n = 9 | left breast cancer, n = 13 |
Early side effects for 42 Gy cohort (Table3 and Figure1)
M1 | M2 | M6 | M12 | M18 | M24 | |||
---|---|---|---|---|---|---|---|---|
Early toxicities | ||||||||
Erythema | 42 Gy | (n = 17) | (n = 17) | (n = 17) | (n = 17) | (n = 17) | (n = 17) | |
Grade 0 | 3 | 7 | 17 | 16 | 17 | 17 | ||
Grade 1 | 7 | 3 | - | 1 | - | - | ||
Grade 2 | 4 | 6 | - | - | - | - | ||
Unknown | 3 | 1 | - | - | - | - | ||
40 Gy | (n =31) | (n =31) | (n = 31) | (n = 31) | (n = 31) | (n = 31) | ||
Grade 0 | 10 | 10 | 26 | 31 | 31 | 31 | ||
Grade 1 | 13 | 18 | 5 | - | - | - | ||
Grade 2 | 8 | 3 | - | - | - | - | ||
Unknown | - | - | - | - | - | - | ||
Dry desquamation | 42 Gy | (n = 17) | (n = 17) | (n = 17) | (n = 17) | (n = 17) | (n = 17) | |
Grade 0 | 10 | 11 | 16 | 17 | 17 | 17 | ||
Grade 1 | 2 | 1 | 1 | - | - | - | ||
Grade 2 | 2 | 4 | - | - | - | - | ||
Unknown | 3 | 1 | - | - | - | - | ||
40 Gy | (n =31) | (n =31) | (n = 31) | (n = 31) | (n = 31) | (n = 31) | ||
Grade 0 | 19 | 26 | 31 | 31 | 31 | 31 | ||
Grade 1 | 4 | 3 | - | - | - | - | ||
Grade 2 | 2 | - | - | - | - | - | ||
Unknown | 6 | 2 | - | - | - | - | ||
Moist desquamation | 42 Gy | (n = 17) | (n = 17) | (n = 17) | (n = 17) | (n = 17) | (n = 17) | |
Grade 0 | 13 | 15 | 17 | 17 | 17 | 17 | ||
Grade 1 | - | - | - | - | - | - | ||
Grade 2 | 1 | 1 | - | - | - | - | ||
Unknown | 3 | 1 | - | - | - | - | ||
40 Gy | (n =31) | (n =31) | (n = 31) | (n = 31) | (n = 31) | (n = 31) | ||
Grade 0 | 24 | 28 | 31 | 31 | 31 | 31 | ||
Grade 1 | 1 | 1 | - | - | - | - | ||
Grade 2 | - | - | - | - | - | - | ||
Unknown | 6 | 2 | - | - | - | - | ||
Late toxicities | ||||||||
Fibrosis or retraction | 42 Gy | (n = 17) | (n = 17) | (n = 17) | (n = 17) | (n = 17) | (n = 17) | |
Grade 0 | 17 | 17 | 6 | 4 | 1 | - | ||
Grade 1 | - | - | 7 | 10 | 6 | 5 | ||
Grade 2 | - | - | 3 | 2 | 3 | 1 | ||
Grade 3 | - | - | 1 | 1 | - | - | ||
Unknown | - | - | - | - | 7 | 11 | ||
40 Gy | (n =31) | (n =31) | (n = 31) | (n = 31) | (n = 31) | (n = 31) | ||
Grade 0 | 31 | 30 | 23 | 19 | 9 | 8 | ||
Grade 1 | - | 1 | 5 | 10 | 15 | 19 | ||
Grade 2 | - | - | 2 | 1 | 3 | 2 | ||
Grade 3 | - | - | - | 1 | - | - | ||
Unknown | - | - | 1 | - | 4 | 2 | ||
Breast pain | 42 Gy | (n = 17) | (n = 17) | (n = 17) | (n = 17) | (n = 17) | (n = 17) | |
Grade 0 | 9 | 6 | 6 | 5 | 3 | 2 | ||
Grade 1 | 5 | 10 | 7 | 9 | 6 | 2 | ||
Grade 2 | - | - | 3 | 2 | 3 | 2 | ||
Grade 3 | - | - | 1 | 1 | - | - | ||
Unknown | 3 | 1 | - | - | 5 | 11 | ||
40 Gy | (n =31) | (n =31) | (n = 31) | (n = 31) | (n = 31) | (n = 31) | ||
Grade 0 | 11 | 14 | 17 | 16 | 12 | 12 | ||
Grade 1 | 11 | 13 | 11 | 10 | 10 | 12 | ||
Grade 2 | 3 | 2 | 2 | 5 | 4 | 5 | ||
Grade 3 | - | - | - | - | - | - | ||
Unknown | 6 | 2 | 1 | - | 5 | 2 | ||
Telangiectasia | 42 Gy | (n = 17) | (n = 17) | (n = 17) | (n = 17) | (n = 17) | (n = 17) | |
Grade 0 | 17 | 17 | 15 | 12 | 7 | 4 | ||
Grade 1 | - | - | - | - | 2 | 1 | ||
Grade 2 | - | - | 1 | 3 | 2 | - | ||
Grade 3 | - | - | 1 | 2 | 1 | 1 | ||
Unknown | - | - | - | - | 5 | 11 | ||
40 Gy | (n =31) | (n =31) | (n = 31) | (n = 31) | (n = 31) | (n = 31) | ||
Grade 0 | 29 | 30 | 29 | 25 | 19 | 17 | ||
Grade 1 | 1 | - | - | 3 | 3 | 6 | ||
Grade 2 | 1 | 1 | 1 | 2 | 5 | 6 | ||
Grade 3 | - | - | - | - | - | - | ||
Unknown | - | - | 1 | 1 | 4 | 2 |