title: The influence of simultaneous integrated boost, hypofractionation and oncoplastic surgery on cosmetic outcome and PROMs after breast conserving therapy.
abstract: BACKGROUND
  We retrospectively investigated the possible influence of a simultaneous integrated boost (SIB), hypofractionation and oncoplastic surgery on cosmetic outcome in 125 patients with stage I-II breast cancer treated with breast conserving therapy (BCT).
  
  
  METHODS
  The boost was given sequentially (55%) or by SIB (45%); fractionation was conventional (83%) or hypofractionated (17%); the surgical technique was a conventional lumpectomy (74%) or an oncoplastic technique (26%). We compared cosmetic results subjectively using a questionnaire independently completed by the patient and by the physician and objectively with the BCCT.core software. Independent-samples T-tests were used to compare outcome in different groups. Patients also completed the EORTC QLQ C30 and BR23.
  
  
  RESULTS
  Univariate analyses indicated no significant differences of the cosmetic results (P ≤ 0.05) for the type of boost or fractionation. However, the conventional lumpectomy group scored significantly better than the oncoplastic group in the BCCT.core evaluation, without a significant difference in the subjective cosmetic evaluation. Quality of life outcome was in favour of SIB, hypofractionation and conventional surgery.
  
  
  CONCLUSIONS
  Our study indicates that the current RT techniques seem to be safe for cosmetic outcome and quality of life. Further investigation is needed to verify the possible negative influence of oncoplastic surgery on the cosmetic outcome and the quality of life as this technique is especially indicated for patients with an unfavourable tumour/breast volume ratio.
authors.affiliation: Institute Verbeeten, Radiation Oncology Department, Postbus 90120, 5000 LA Tilburg, The Netherlands; Maastricht University, Department of Epidemiology, P.O. Box 616, 6200 MD Maastricht, The Netherlands. Electronic address: j.lansu@student.maastrichtuniversity.nl.
authors.forename: J T P
authors.initials: JT
authors.lastname: Lansu
authors.affiliation: Institute Verbeeten, Radiation Oncology Department, Postbus 90120, 5000 LA Tilburg, The Netherlands.
authors.forename: M
authors.initials: M
authors.lastname: Essers
authors.affiliation: Maastricht University, Department of Epidemiology, P.O. Box 616, 6200 MD Maastricht, The Netherlands.
authors.forename: A C
authors.initials: AC
authors.lastname: Voogd
authors.affiliation: Amphia Hospital, Breast Centre, Molengracht 21, 4818 CK Breda, The Netherlands.
authors.forename: E J T
authors.initials: EJ
authors.lastname: Luiten
authors.affiliation: Institute Verbeeten, Radiation Oncology Department, Postbus 90120, 5000 LA Tilburg, The Netherlands.
authors.forename: C
authors.initials: C
authors.lastname: Buijs
authors.affiliation: Institute Verbeeten, Radiation Oncology Department, Postbus 90120, 5000 LA Tilburg, The Netherlands.
authors.forename: N
authors.initials: N
authors.lastname: Groenendaal
authors.affiliation: Institute Verbeeten, Radiation Oncology Department, Postbus 90120, 5000 LA Tilburg, The Netherlands; Radboud University Medical Center, Department of Radiation Oncology, Nijmegen, The Netherlands.
authors.forename: P M H
authors.initials: PM
authors.lastname: Poortmans
mesh_terms: D000368:Aged; D001943:Breast Neoplasms / Q000628:therapy*; D016022:Case-Control Studies; D017024:Chemotherapy, Adjuvant; D015331:Cohort Studies; D005260:Female; D006801:Humans; D016462:Mammaplasty / Q000379:methods; D015412:Mastectomy, Segmental / Q000379:methods*; D008875:Middle Aged; D063868:Patient Outcome Assessment; D011788:Quality of Life; D000069473:Radiation Dose Hypofractionation; D018714:Radiotherapy, Adjuvant / Q000379:methods; D020266:Radiotherapy, Conformal / Q000379:methods*; D012189:Retrospective Studies; D011795:Surveys and Questionnaires; D016896:Treatment Outcome
keywords: Breast conserving therapy; Cosmetic results; Hypofractionation; Oncoplastic surgery; Quality of life (QOL); Simultaneous integrated boost (SIB)