title: Hypofractionation and concomitant boost to deliver adjuvant whole-breast radiation in ductal carcinoma in situ (DCIS): a subgroup analysis of a prospective case series.
abstract: To report the four-year outcomes of accelerated hypofractionated whole-breast radiotherapy (WBRT) with a concomitant boost (CB) to the tumor bed in ductal carcinoma in situ (DCIS), we performed a subgroup analysis of 103 patients affected with DCIS within a cohort of 960 early breast cancer patients treated with breast conservation and hypofractionated WBRT. Prescription dose to the whole breast was 45 Gy (2.25 Gy/20 fractions) with an additional daily CB of 0.25 Gy to the surgical cavity (2.5 Gy/20 fractions up to 50 Gy). With a median follow-up of 48 months (range 12-91), no local recurrence was observed. Maximum detected acute skin toxicity was as follows: G0 in 35 % of patients, G1 in 54 %, G2 in 9 % and G3 in 2 %. Late skin and subcutaneous toxicity were generally mild with only 1 % of patients experiencing ≥G3 events (telangiectasia). No major lung and heart toxicity were detected. Cosmetic results were excellent in 50 % of patients, good in 37 %, fair in 9 % and poor in 4 %. Quality of life had a generally favorable profile both within the functioning and symptoms domains. The present result supports the hypothesis that DCIS patients could be safely treated with a hypofractionated schedule employing a CB to the lumpectomy cavity.
authors.affiliation: Radiotherapy Department, ASL TO4, Ivrea Community Hospital, Ivrea, Italy.
authors.forename: Domenico
authors.initials: D
authors.lastname: Cante
authors.forename: Pierfrancesco
authors.initials: P
authors.lastname: Franco
authors.forename: Piera
authors.initials: P
authors.lastname: Sciacero
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Girelli
authors.forename: Anna Maria
authors.initials: AM
authors.lastname: Marra
authors.forename: Massimo
authors.initials: M
authors.lastname: Pasquino
authors.forename: Giuliana
authors.initials: G
authors.lastname: Russo
authors.forename: Valeria
authors.initials: V
authors.lastname: Casanova Borca
authors.forename: Guido
authors.initials: G
authors.lastname: Mondini
authors.forename: Ovidio
authors.initials: O
authors.lastname: Paino
authors.forename: Gianmauro
authors.initials: G
authors.lastname: Numico
authors.forename: Santi
authors.initials: S
authors.lastname: Tofani
authors.forename: Maria Rosa
authors.initials: MR
authors.lastname: La Porta
authors.forename: Umberto
authors.initials: U
authors.lastname: Ricardi
mesh_terms: D001943:Breast Neoplasms / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery; D002285:Carcinoma, Intraductal, Noninfiltrating / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery; D019583:Dose Fractionation, Radiation; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015412:Mastectomy, Segmental; D008875:Middle Aged; D060787:Neoplasm Grading; D009364:Neoplasm Recurrence, Local / Q000188:drug therapy / Q000473:pathology; D009367:Neoplasm Staging; D011379:Prognosis; D011446:Prospective Studies; D011788:Quality of Life; D011880:Radiotherapy Planning, Computer-Assisted; D018714:Radiotherapy, Adjuvant