Hypofractionated Whole-Breast Radiotherapy and Concomitant Boost after Breast Conservation in Elderly Patients. Issue 2 (March 2016)

• Record Type: Journal Article
• Authors: Cante, Domenico; Franco, Pierfrancesco; Sciacero, Piera; Girelli, Giuseppe; Pasquino, Massimo; Borca, Valeria Casanova; Tofani, Santi; La Porta, Maria Rosa; Ricardi, Umberto
• Is Part Of: Tumori. Volume 102:Issue 2(2016)
• Page Start: 196
• Page End: 202
• Publication Date: 2016-03
• Subjects: Breast cancer -- Concomitant boost -- Elderly -- Hypofractionation -- Simultaneous integrated boost; Cancer -- Periodicals; 616.994
• DOI: 10.5301/tj.5000402
• Languages: English
• ISSNs: 0300-8916

Abstract

Aims: To report the 5- and 10-year results of accelerated hypofractionated whole-breast radiotherapy (WBRT) with concomitant boost to the tumor bed in 83 consecutive patients with early breast cancer aged >70 years. Methods: All patients were treated with breast conservation and hypofractionated WBRT. The prescription dose to the whole breast was 45 Gy (2.25 Gy/20 fractions) with an additional daily concomitant boost of 0.25 Gy to the surgical cavity (2.5 Gy/20 fractions up to 50 Gy). The maximum detected toxicity was scored according to the Common Terminology Criteria for Adverse Events, version 3.0. We considered as skin toxicity: erythema, edema, desquamation, ulceration, hemorrhage, necrosis, telangiectasia, fibrosis-induration, hyperpigmentation, retraction and atrophy. Cosmetic results were assessed as set by the Harvard criteria. Results: With a median follow-up of 60 months (range 36-88), no local recurrence was observed. The maximum detected acute skin toxicity was G0 in 57% of patients, G1 in 40% and G2 in 3%. Late skin and subcutaneous toxicity was generally mild with no ≥G3 events. The cosmetic results were excellent in 69% of patients, good in 22%, fair in 5%, and poor in 4%. Conclusions: The present results support the use of hypofractionation employing a concomitant boost to the lumpectomy cavity in women aged >70 years. This is a convenient treatment option for both this type of population and health-care providers.