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Ten-year results of accelerated hypofractionated adjuvant whole-breast radiation with concomitant boost to the lumpectomy cavity after conserving surgery for early breast cancer

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An Author Correction to this article was published on 12 December 2017

This article has been updated

Abstract

Accelerated hypofractionated whole-breast radiotherapy (WBRT) is considered a standard therapeutic option for early breast cancer (EBC) in the postoperative setting after breast conservation (BCS). A boost to the lumpectomy cavity may further increase local control. We herein report on the 10-year results of a series of EBC patients treated after BCS with hypofractionated WBRT with a concomitant photon boost to the surgical bed over 4 weeks. Between 2005 and 2007, 178 EBC patients were treated with a basic course of radiotherapy consisting of 45 Gy to the whole breast in 20 fractions (2.25 Gy daily) with an additional boost dose of 0.25 Gy delivered concomitantly to the lumpectomy cavity, for an additional dose of 5 Gy. Median follow-up period was 117 months. At 10-year, overall, cancer-specific, disease-free survival and local control were 92.2% (95% CI 88.7–93.4%), 99.2% (95% CI 96.7–99.7%), 95.5% (95% CI 91.2–97.2%) and 97.3% (95% CI 94.5–98.9%), respectively. Only eight patients recurred. Four in-breast recurrences, two axillary node relapses and two metastatic localizations were observed. Fourteen patients died during the observation period due to other causes while breast cancer-related deaths were eight. At last follow-up, ≥G2 fibrosis and telangiectasia were seen in 7% and 5% of patients. No major lung and heart toxicities were observed. Cosmetic results were excellent/good in 87.8% of patients and fair/poor in 12.2%. Hypofractionated WBRT with concomitant boost to the lumpectomy cavity after BCS in EBC led to consistent clinical results at 10 years. Hence, it can be considered a valid treatment option in this setting.

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Change history

  • 12 December 2017

    An error inadvertently occurred in the discussion of the original publication when citing the local relapse rates of the EORTC 22881-10882 trial (‘boost vs no boost trial’).

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Acknowledgments

The Authors would like to thank all the professionals involved in the Breast Unit of the Ivrea Community Hospital and ASL Torino 4, Italy.

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Authors and Affiliations

  1. Radiotherapy Department, Ivrea Community Hospital, ASL TO4, Ivrea, Italy

    Domenico Cante, Piera Sciacero, Cristina Piva, Silvia Ferrario & Maria Rosa La Porta

  2. Medical Physics Department, Ivrea Community Hospital, ASL TO4, Ivrea, Italy

    Edoardo Petrucci, Massimo Pasquino & Valeria Casanova Borca

  3. Diagnostic Imaging Department, Ivrea Community Hospital, ASL TO4, Ivrea, Italy

    Silvia Bagnera & Sebastiano Patania

  4. Breast Surgery Department, Ivrea Community Hospital, ASL TO4, Ivrea, Italy

    Guido Mondini

  5. Medical Oncology Department, Ivrea Community Hospital, ASL TO4, Ivrea, Italy

    Giorgio Vellani

  6. Department of Oncology – Radiation Oncology, University of Turin, Via Genova 3, 10126, Turin, Italy

    Pierfrancesco Franco

Authors
  1. Domenico Cante
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  2. Edoardo Petrucci
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  3. Piera Sciacero
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  4. Cristina Piva
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  9. Massimo Pasquino
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  10. Valeria Casanova Borca
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  11. Giorgio Vellani
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  12. Maria Rosa La Porta
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  13. Pierfrancesco Franco
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Corresponding author

Correspondence to Pierfrancesco Franco.

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Conflict of interest

We declare that we do not have any conflict of interest.

Informed consent

Informed consent was obtained from all individual participants included in the study.

Ethical standards

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Ethical Approval

The present study has been reviewed and approved by the Ethical Review Board of Ivrea Community Hospital, ASLTO4, Ivrea, Italy.

Additional information

A correction to this article is available online at https://doi.org/10.1007/s12032-017-1056-5.

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Cante, D., Petrucci, E., Sciacero, P. et al. Ten-year results of accelerated hypofractionated adjuvant whole-breast radiation with concomitant boost to the lumpectomy cavity after conserving surgery for early breast cancer. Med Oncol 34, 152 (2017). https://doi.org/10.1007/s12032-017-1020-4

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