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Comorbidities and intensity-modulated radiotherapy with simultaneous integrated boost in elderly breast cancer patients

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Abstract

Purpose

To evaluate the impact of comorbidity assessment on compliance to intensity modulated radiotherapy with simultaneous integrated boost (SIB-IMRT) in elderly patients affected by early stage breast cancer (BC).

Materials and methods

40 consecutive patients were treated with SIB-IMRT (50 Gy in 25 fractions to the whole breast, and simultaneously 60 Gy to the surgical bed) for invasive BC after conserving surgery. Inclusion criteria were: age ≥ 70 years, pT1-2 disease, pN0-1, no neoadjuvant chemotherapy, non-metastatic disease. Charlson comorbidity index was used for comorbidity evaluation.

Results

Median follow-up was 44 months. At the time of the analysis, OS and LC rates were 100%. All patients completed the SIB-IMRT without interruptions. Acute skin toxicity was recorded as follows: grade 0 in 5 patients (12.5%), grade 1 in 25 cases (62.5%), and grade 2 in 10 patients (25%). Regarding late adverse events, skin toxicity was registered as follows: grade 0 in 27 patients (67.5%) and grade 1 in 13 cases (32.5%). No toxicity ≥grade 2 was registered. At statistical analysis, the presence of comorbidities and the breast volume >700 cc were related to skin grade 2 acute toxicity (p = 0.01, p = 0.04). In terms of cosmetic results, 98 and 2% of patients considered the result as good/excellent and as fair after RT, respectively. No patients had a poor cosmetic outcome.

Conclusion

The present study showed the feasibility of SIB-IMRT in early stage BC elderly patients and that the absence of comorbidity reduced the risk of acute radiation toxicity.

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Authors and Affiliations

  1. Radiation Oncology Department, Sacro Cuore-Don Calabria Hospital, Via Don Sempreboni 5, Negrar, 37024, Verona, Italy

    Alba Fiorentino, Rosario Mazzola, Niccolò Giaj Levra, Sergio Fersino, Francesco Ricchetti & Filippo Alongi

  2. Statistic Science Faculty, University of Palermo, Palermo, Italy

    Gioacchino Di Paola

  3. Medical Oncology, Sacro Cuore-Don Calabria Hospital, Negrar, Verona, Italy

    Stefania Gori

  4. Breast Surgery, Sacro Cuore-Don Calabria Hospital, Negrar, Verona, Italy

    Alberto Massocco

  5. University of Brescia, Brescia, Italy

    Filippo Alongi

Authors
  1. Alba Fiorentino
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  2. Rosario Mazzola
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  3. Niccolò Giaj Levra
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  4. Sergio Fersino
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  6. Gioacchino Di Paola
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  7. Stefania Gori
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  9. Filippo Alongi
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Corresponding author

Correspondence to Alba Fiorentino.

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The authors declare that they have no conflict of interest.

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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.

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

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Fiorentino, A., Mazzola, R., Giaj Levra, N. et al. Comorbidities and intensity-modulated radiotherapy with simultaneous integrated boost in elderly breast cancer patients. Aging Clin Exp Res 30, 533–538 (2018). https://doi.org/10.1007/s40520-017-0802-z

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  • DOI: https://doi.org/10.1007/s40520-017-0802-z

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