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Short course hypofractionated whole breast irradiation after conservative surgery: A single institution phase II study
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نویسنده
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pinnarò p. ,giordano c. ,farneti a. ,faiella a. ,iaccarino g. ,landoni v. ,giannarelli d. ,vici p. ,strigari l. ,sanguineti g.
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منبع
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journal of experimental and clinical cancer research - 2017 - دوره : 36 - شماره : 1
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چکیده
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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). © 2017 the author(s).
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کلیدواژه
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Breast carcinoma in situ; Breast neoplasms; Dose hypofractionation; Local neoplasm recurrence; Radiotherapy
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آدرس
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departments of radiation oncology,regina elena national cancer institute,via elio chianesi 53,rome,00144, Italy, departments of radiation oncology,regina elena national cancer institute,via elio chianesi 53,rome,00144, Italy, departments of radiation oncology,regina elena national cancer institute,via elio chianesi 53,rome,00144, Italy, departments of radiation oncology,regina elena national cancer institute,via elio chianesi 53,rome,00144, Italy, laboratory of medical physics and expert systems,regina elena national cancer institute,rome, Italy, laboratory of medical physics and expert systems,regina elena national cancer institute,rome, Italy, departments of statistics,regina elena national cancer institute,rome, Italy, departments of clinical oncology,regina elena national cancer institute,rome, Italy, laboratory of medical physics and expert systems,regina elena national cancer institute,rome, Italy, departments of radiation oncology,regina elena national cancer institute,via elio chianesi 53,rome,00144, Italy
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Authors
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