title: Comparison of two radiotherapeutic hypofractionated schedules in the application of tumor bed boost.
abstract: OBJECTIVE
  Evaluation of related radiation toxicity and efficacy in terms of local control of 2 radiotherapeutic hypofractionated schedules in the application of tumor bed boost by using 2 different planning techniques.
  
  
  METHODS
  Eighty-one patients with stage I-II disease were retrospectively selected with either concomitant (group A) or sequential (group B) boost for the tumor bed. In group A, 27 patients were treated with a total dose of 46 Gy to the whole breast and 54 Gy to the tumor bed in 20 concomitant fractions. In group B, 54 patients were treated with a total dose of 42.4 Gy in 16 fractions to the whole breast and 53 Gy to the tumor bed by 4 sequential fractions. The boost was administered with multiple photon-beam fields. The median follow-up time was 24 months.
  
  
  RESULTS
  The statistical analysis for the 2 groups of the study showed that skin toxicity was significantly worse in group A (P < .05, Kruskal-Wallis H test). For groups A and B at the completion of radiation therapy, grade 1 skin toxicity was observed in 18/27 patients (66.6%) and 13/54 patients (24.1%), respectively, whereas grade 2/3 was observed in 9/27 patients (33.3%) vs. 5/54 patients (9.3%), respectively (P < .001). One year after irradiation, in group A and in group B, the skin toxicity was of grade 1 in 6/27 patients (22.2%) vs. 2/54 patients (3.7%), respectively (P = .008). Within 2 years, the breast returned to its original form in all patients. No patient showed local disease recurrence.
  
  
  CONCLUSIONS
  The accelerated hypofractionated schedules in the application of the tumor bed boost by using the 2 different planning techniques appears to be effective and well tolerated.
authors.affiliation: First Radiology Department, Aretaieion Hospital, Medical School, Kapodistrian University of Athens, Greece. annazygo1@yahoo.gr
authors.forename: Anna
authors.initials: A
authors.lastname: Zygogianni
authors.forename: Vassilios
authors.initials: V
authors.lastname: Kouloulias
authors.forename: George
authors.initials: G
authors.lastname: Kyrgias
authors.forename: Christina
authors.initials: C
authors.lastname: Armpilia
authors.forename: Christos
authors.initials: C
authors.lastname: Antypas
authors.forename: Kiki
authors.initials: K
authors.lastname: Theodorou
authors.forename: John
authors.initials: J
authors.lastname: Kouvaris
mesh_terms: D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000473:pathology / Q000532:radiotherapy*; D019583:Dose Fractionation, Radiation; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D060787:Neoplasm Grading; D009364:Neoplasm Recurrence, Local / Q000473:pathology / Q000532:radiotherapy*; D011379:Prognosis; D011832:Radiation Injuries / Q000175:diagnosis*; D011880:Radiotherapy Planning, Computer-Assisted; D020266:Radiotherapy, Conformal; D012189:Retrospective Studies
keywords: Breast cancer; Concomitant; Radiotherapy; Sequential; Toxicity; Tumor bed