title: [Safety and efficacy of whole breast irradiation with a concomitant boost: analysis of 121 cases treated at the Institute of Cancerology of Lorraine].
abstract: OBJECTIVE
  To evaluate the safety and efficacy of whole breast irradiation with a concomitant boost.
  
  
  METHODS
  This is a retrospective study of 121 patients with node negative T1-T2 breast tumors inferior to 3 cm in diameter, previously treated by conservative surgery without chemotherapy. A dose of 50 Gy was delivered to the whole breast in 2 Gy daily fractions with 5 weekly treatments. A concomitant boost to the lumpectomy site delivered a total of 10 Gy in 1 Gy fractions twice a week. This would result in an equivalent tumour bed dose (assuming an α/β of 4) of approximately 65 Gy in 2 Gy fractions.
  
  
  RESULTS
  Over 7 years, 121 patients were treated. The median age was 67 years (range, 46-86 years). Stage distribution was: 115 T1, 6 T2; 116 tumors had positive hormonal receptors, 6 grade SBR3. With a median follow-up of 6 years (range, 1.4-11.4 years), 5-year overall survival was 98.2% (95% confidence interval [CI] 0.95-1), disease-free survival was 100% and local recurrence-free survival 100%. The maximum acute skin toxicity by the end of treatment was grade 2. Cosmetic outcomes were good on the long term. One spontaneous rib fracture was observed 1 year after radiotherapy among 76 patients.
  
  
  CONCLUSIONS
  The study shows that whole breast radiation therapy with a concomitant boost is safe and effective for selected patients with low risk of relapse, and gives excellent long term results. This protocol represents a good alternative to longer standard whole breast radiation therapy with sequential boost to the lumpectomy bed.
authors.affiliation: Département de radiothérapie, centre Alexis-Vautrin, institut de cancérologie de Lorraine, 6, avenue de Bourgogne, 54511 Vandœuvre-lès-Nancy, France. Electronic address: francois.renoult@gmail.com.
authors.forename: F
authors.initials: F
authors.lastname: Renoult
authors.affiliation: Département de radiothérapie, centre Alexis-Vautrin, institut de cancérologie de Lorraine, 6, avenue de Bourgogne, 54511 Vandœuvre-lès-Nancy, France.
authors.forename: C
authors.initials: C
authors.lastname: Marchal
authors.affiliation: Département de radiothérapie, centre Alexis-Vautrin, institut de cancérologie de Lorraine, 6, avenue de Bourgogne, 54511 Vandœuvre-lès-Nancy, France.
authors.forename: C
authors.initials: C
authors.lastname: Brunaud
authors.affiliation: Département de radiothérapie, centre Alexis-Vautrin, institut de cancérologie de Lorraine, 6, avenue de Bourgogne, 54511 Vandœuvre-lès-Nancy, France.
authors.forename: V
authors.initials: V
authors.lastname: Harter
authors.affiliation: Département de radiothérapie, centre Alexis-Vautrin, institut de cancérologie de Lorraine, 6, avenue de Bourgogne, 54511 Vandœuvre-lès-Nancy, France.
authors.forename: D
authors.initials: D
authors.lastname: Peiffert
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery; D018275:Carcinoma, Lobular / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery; D018572:Disease-Free Survival; D019583:Dose Fractionation, Radiation; D005260:Female; D005500:Follow-Up Studies; D005602:France; D006801:Humans; D058922:Inflammatory Breast Neoplasms / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery; D015412:Mastectomy, Segmental; D008875:Middle Aged; D012189:Retrospective Studies
keywords: Boost concomitant; Breast cancer; Cancer du sein; Douleurs; Hypofractionated; Hypofractionnement; Integrated boost; Local recurrence-free survival; Pain; Radiotherapy; Radiothérapie; Survie sans récidive locale; Traitement; Treatment