title: Final results from a multicenter prospective study ( JROSG 05-5) on postoperative radiotherapy for patients with ductal carcinoma in situ with an involved surgical margin or close margin widths of 1 mm or less.
abstract: This multicenter prospective study ( Japanese Radiation Oncology Study Group: JROSG 05-5) aimed to evaluate the effectiveness of postoperative radiotherapy (PORT) in patients with ductal carcinoma in situ (DCIS) with an involved surgical margin or close margin widths of ≤1 mm or less. PORT consisted of whole-breast irradiation (50 Gy in 25 fractions) followed by boost irradiation (10 Gy in 5 fractions). Eligibility criteria were as follows: (i) DCIS without an invasive carcinoma component, (ii) age between 20 and 80 years old, (iii) involved margin or close margin widths of ≤1 mm, (iv) refusal of re-resection, (v) performance status of 0-2, and (vi) written informed consent. The primary endpoint was ipsilateral breast tumor recurrence (IBTR), and secondary endpoints were overall survival (OS), relapse-free survival (RFS), recurrence patterns, and adverse events. A total of 37 patients from 12 institutions were enrolled from January 2007 to May 2009. The median follow-up time was 62 months (range, 28-85 months). The median pathological tumor size was 2.5 cm (range, 0.3-8.5 cm). Of the 37 patients, 21 had involved margins, and 16 had close margins. The 5-year IBTR, OS and RFS rates were 6% (95% confidence interval [CI]: 2-21), 97% (95% CI: 83-99) and 91% (95% CI: 77-97), respectively. Two patients developed local recurrence at the original site after 39 and 58 months. No severe adverse events were found. Our study suggests that this PORT regimen could be a treatment option for patients with DCIS with involved margin or close margin who don't desire re-resection.
authors.affiliation: Department of Radiation Oncology, Saitama Medical University, International Medical Center, 1397-1 Yamane, Hidaka-City, Saitama, 350-1298 Japan nshikama0525@gmail.com.
authors.forename: Naoto
authors.initials: N
authors.lastname: Shikama
authors.affiliation: Department of Radiation Oncology, St Luke's International Hospital, 9-1 Akashi-cho, Chuo-ku, Tokyo, 104-8560, Japan.
authors.forename: Kenji
authors.initials: K
authors.lastname: Sekiguchi
authors.affiliation: Department of Radiation Oncology, National Cancer Center East, 6-5-1 Kashiwanoha, Kashiwa-shi, Chiba, 277-8577, Japan.
authors.forename: Naoki
authors.initials: N
authors.lastname: Nakamura
authors.affiliation: Department of Radiology, The Jikei University Third Hospital, 4-11-1 Izumihonmachi, Komae-shi, Tokyo, 201-8601, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Sekine
authors.affiliation: Department of Radiation Oncology, Kanagawa Cancer Center, 2-3-2 Nakao, Asahi-ku, Yokohama, Kanagawa, 241-8515, Japan.
authors.forename: Yuko
authors.initials: Y
authors.lastname: Nakayama
authors.affiliation: Department of Radiology, Nishikobe Medical Center, 5-7-1 Kojidai, Nishi-ku, Kobe, Shogo, 651-2273, Japan.
authors.forename: Kazufumi
authors.initials: K
authors.lastname: Imanaka
authors.affiliation: Department of Radiation Oncology, Tokai University, 143 Shimokasuya, Isehara, Kanagawa, 259-1193, Japan.
authors.forename: Takeshi
authors.initials: T
authors.lastname: Akiba
authors.affiliation: Department of Radiology, Hirosaki University School of Medicine and Hospital, 53 Honmachi, Hirosaki, Aomori, 036-8563, Japan.
authors.forename: Masahiko
authors.initials: M
authors.lastname: Aoki
authors.affiliation: Department of Radiology, Hirosaki University School of Medicine and Hospital, 53 Honmachi, Hirosaki, Aomori, 036-8563, Japan.
authors.forename: Yoshiomi
authors.initials: Y
authors.lastname: Hatayama
authors.affiliation: Department of Radiation Oncology, Kurume University Hospital, 67 Asahimachi, Kurume-shi, Fukuoka, 830-0011, Japan.
authors.forename: Etsuyo
authors.initials: E
authors.lastname: Ogo
authors.affiliation: Department of Radiation Oncology, Showa University Hospital, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo, 142-8666, Japan.
authors.forename: Yoshikazu
authors.initials: Y
authors.lastname: Kagami
authors.affiliation: Department of Radiology, Dokkyo Medical University, Koshigaya Hospital, 2-1-50 Mimamikoshigaya, Koshigaya-shi, Saitama, 343-8555, Japan.
authors.forename: Miho
authors.initials: M
authors.lastname: Kawashima
authors.affiliation: Research Center for Charged Particle Therapy, National Institute of Radiological Sciences, 4-9-1 Anagawa, Inage-ku, Chiba-shi, Chiba, 263-8555, Japan.
authors.forename: Kumiko
authors.initials: K
authors.lastname: Karasawa
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000532:radiotherapy* / Q000601:surgery*; D002285:Carcinoma, Intraductal, Noninfiltrating / Q000532:radiotherapy* / Q000601:surgery*; D003131:Combined Modality Therapy; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D000072662:Margins of Excision; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D011184:Postoperative Period; D011446:Prospective Studies; D011880:Radiotherapy Planning, Computer-Assisted; D014057:Tomography, X-Ray Computed; D055815:Young Adult
keywords: breast cancer; breast conservation; ductal carcinoma in situ; margin width; radiotherapy