Hypofractionated whole-breast radiotherapy and concomitant boost after breast conservation in elderly patients.
OBJECTIVE
To report the 5- and 10-year results of accelerated hypofractionated whole-breast radiotherapy (WBRT) with concomitant boost to the tumor bed in 83 consecutive patients with early breast cancer aged &gt;70 years.


METHODS
All patients were treated with breast conservation and hypofractionated WBRT. The prescription dose to the whole breast was 45 Gy (2.25 Gy/20 fractions) with an additional daily concomitant boost of 0.25 Gy to the surgical cavity (2.5 Gy/20 fractions up to 50 Gy). The maximum detected toxicity was scored according to the Common Terminology Criteria for Adverse Events, version 3.0. We considered as skin toxicity: erythema, edema, desquamation, ulceration, hemorrhage, necrosis, telangiectasia, fibrosis-induration, hyperpigmentation, retraction and atrophy. Cosmetic results were assessed as set by the Harvard criteria.


RESULTS
With a median follow-up of 60 months (range 36-88), no local recurrence was observed. The maximum detected acute skin toxicity was G0 in 57% of patients, G1 in 40% and G2 in 3%. Late skin and subcutaneous toxicity was generally mild with no ≥G3 events. The cosmetic results were excellent in 69% of patients, good in 22%, fair in 5%, and poor in 4%.


CONCLUSIONS
The present results support the use of hypofractionation employing a concomitant boost to the lumpectomy cavity in women aged &gt;70 years. This is a convenient treatment option for both this type of population and health-care providers.
Radiotherapy Department, Ivrea Community Hospital, ASL TO4, Ivrea - Italy.
Domenico
D
Cante
Department of Oncology - Radiation Oncology, University of Turin, Turin - Italy.
Pierfrancesco
P
Franco
Radiotherapy Department, Ivrea Community Hospital, ASL TO4, Ivrea - Italy.
Piera
P
Sciacero
Radiotherapy Department, Ivrea Community Hospital, ASL TO4, Ivrea - Italy.
Giuseppe
G
Girelli
Medical Physics Department, Ivrea Community Hospital, ASL TO4, Ivrea - Italy.
Massimo
M
Pasquino
Medical Physics Department, Ivrea Community Hospital, ASL TO4, Ivrea - Italy.
Valeria
V
Casanova Borca
Medical Physics Department, Ivrea Community Hospital, ASL TO4, Ivrea - Italy.
Santi
S
Tofani
Radiotherapy Department, Ivrea Community Hospital, ASL TO4, Ivrea - Italy.
Maria Rosa La
MR
Porta
Department of Oncology - Radiation Oncology, University of Turin, Turin - Italy.
Umberto
U
Ricardi
D000368:Aged; D000369:Aged, 80 and over; D001940:Breast / Q000473:pathology / Q000528:radiation effects*; D001943:Breast Neoplasms / Q000532:radiotherapy* / Q000601:surgery; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008207:Lymphatic Metastasis; D015412:Mastectomy, Segmental; D060787:Neoplasm Grading; D009361:Neoplasm Invasiveness; D009364:Neoplasm Recurrence, Local / Q000517:prevention & control*; D009367:Neoplasm Staging; D000069473:Radiation Dose Hypofractionation; D011832:Radiation Injuries / Q000209:etiology* / Q000473:pathology; D018714:Radiotherapy, Adjuvant / Q000009:adverse effects / Q000379:methods*; D012189:Retrospective Studies; D012307:Risk Factors; D012867:Skin / Q000473:pathology / Q000528:radiation effects*; D016896:Treatment Outcome