title: Role of radiotherapy boost in women with ductal carcinoma in situ: a single-center experience in a series of 389 patients.
abstract: BACKGROUND
  The use of adjuvant radiotherapy in ductal carcinoma in situ is accepted by most radiation oncologists worldwide; the role of a boost on the tumor bed is however more controversial.
  
  
  METHODS
  We reviewed our Institute experience in DCIS treatment, focusing on main prognostic factors and impact of radiation boost on local relapse. A total of 389 patients treated between 1990 and 2007 were retrospectively analyzed. All patients received adjuvant radiotherapy after breast-conserving surgery for a median dose of 50 Gy; 190 patients (48.8%) received and additional radiation boost on the tumor bed.
  
  
  RESULTS
  At a mean follow up of 7.7 years, we recorded 26 local recurrence (6.7%). Concerning local relapse-free survival, at Cox regression univariate analyses <1 mm surgical margins (p < 0.0001) and young age (p = 0.01) emerged as significant unfavorable prognostic factors. At multivariate analysis Cox regression model, surgical margins (p < 0.001) and radiation boost (p = 0.014) resulted as the significant independent predictors of recurrence.
  
  
  CONCLUSIONS
  Our experience showed the negative prognostic impact of surgical margins <1 mm and the protective role of radiation boost on LR rate. Anyway, results from ongoing prospective Phase III studies are strongly necessary to better identify high-risk DCIS patients.
authors.affiliation: Radiotherapy Unit, University of Florence, FLargo G. A. Brambilla 3, lorence, Italy. icro.meattini@unifi.it
authors.forename: I
authors.initials: I
authors.lastname: Meattini
authors.forename: L
authors.initials: L
authors.lastname: Livi
authors.forename: D
authors.initials: D
authors.lastname: Franceschini
authors.forename: C
authors.initials: C
authors.lastname: Saieva
authors.forename: F
authors.initials: F
authors.lastname: Meacci
authors.forename: L
authors.initials: L
authors.lastname: Marrazzo
authors.forename: B
authors.initials: B
authors.lastname: Bendinelli
authors.forename: V
authors.initials: V
authors.lastname: Scotti
authors.forename: C
authors.initials: C
authors.lastname: De Luca Cardillo
authors.forename: J
authors.initials: J
authors.lastname: Nori
authors.forename: L
authors.initials: L
authors.lastname: Sanchez
authors.forename: L
authors.initials: L
authors.lastname: Orzalesi
authors.forename: P
authors.initials: P
authors.lastname: Bonomo
authors.forename: D
authors.initials: D
authors.lastname: Greto
authors.forename: M
authors.initials: M
authors.lastname: Bucciolini
authors.forename: S
authors.initials: S
authors.lastname: Bianchi
authors.forename: G
authors.initials: G
authors.lastname: Biti
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D014408:Biomarkers, Tumor / Q000032:analysis; D001943:Breast Neoplasms / Q000473:pathology / Q000517:prevention & control* / Q000532:radiotherapy* / Q000601:surgery; D002285:Carcinoma, Intraductal, Noninfiltrating / Q000473:pathology / Q000517:prevention & control* / Q000532:radiotherapy* / Q000601:surgery; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D015412:Mastectomy, Segmental / Q000379:methods*; D008875:Middle Aged; D015999:Multivariate Analysis; D060787:Neoplasm Grading; D009364:Neoplasm Recurrence, Local / Q000517:prevention & control*; D009367:Neoplasm Staging; D011379:Prognosis; D016016:Proportional Hazards Models; D011879:Radiotherapy Dosage; D018714:Radiotherapy, Adjuvant; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D016896:Treatment Outcome
chemical_list: D014408:Biomarkers, Tumor