title: Hypofractionated Radiotherapy for Breast Cancer Including Risk-adapted Boost: Update on Tolerance and Efficacy of an Accelerated START A Regime.
abstract: OBJECTIVE
  To present an update of a prospective study evaluating an accelerated hypofractionated whole breast irradiation (WBI) schedule of the START A trial plus hypofractionated boost in breast cancer patients.
  
  
  METHODS
  One hundred and forty consecutive patients ≥55 years were included in this study. Patients received postoperative WBI with 13×3.2 Gy to 41.6 Gy plus a boost of 3.0 Gy/fraction to 9-12 Gy applied in <3.5 weeks, depending on the resection margin. Prospectively planned follow-up (FU) visits, including objective and subjective assessment of treatment tolerance, were performed at 0 and 8 weeks, as well as one, two, four or more years following radiotherapy (RT).
  
  
  RESULTS
  The 3-year rates of local control, nodal control, disease-free and overall survival were 99%, 100%, 96% and 91%, respectively. Cosmetic outcome was very good with 99% (n=110/111), 98% (n=99/101) and 100% (n=59/59) of the patients being satisfied or very satisfied one, two and four years after RT, respectively.
  
  
  CONCLUSIONS
  Acceleration of the START A regime with 41.6 Gy WBI plus additional boost of 9-12 Gy remained effective and well-tolerated.
authors.affiliation: Department of Radiation Oncology, University Hospital Zurich, Zurich, Switzerland Department of Radiation Oncology, University of Lübeck, Lübeck, Germany.
authors.forename: Stefan
authors.initials: S
authors.lastname: Janssen
authors.affiliation: Department of Radiation Oncology, University Hospital Zurich, Zurich, Switzerland.
authors.forename: Christoph
authors.initials: C
authors.lastname: Glanzmann
authors.affiliation: Department of Radiation Oncology, University Hospital Zurich, Zurich, Switzerland.
authors.forename: Stephanie
authors.initials: S
authors.lastname: Lang
authors.affiliation: Department of Radiation Oncology, University Hospital Zurich, Zurich, Switzerland.
authors.forename: Sarah
authors.initials: S
authors.lastname: Verlaan
authors.affiliation: Department of Radiation Oncology, University Hospital Zurich, Zurich, Switzerland.
authors.forename: Tino
authors.initials: T
authors.lastname: Streller
authors.affiliation: Department of Radiation Oncology, University Hospital Zurich, Zurich, Switzerland.
authors.forename: Claudia
authors.initials: C
authors.lastname: Linsenmeier
authors.affiliation: Department of Radiation Oncology, University of Lübeck, Lübeck, Germany.
authors.forename: Dirk
authors.initials: D
authors.lastname: Rades
authors.affiliation: Department of Radiation Oncology, University Hospital Zurich, Zurich, Switzerland gabriela.studer@usz.ch.
authors.forename: Gabriela
authors.initials: G
authors.lastname: Studer
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000532:radiotherapy*; D002285:Carcinoma, Intraductal, Noninfiltrating / Q000532:radiotherapy*; D019583:Dose Fractionation, Radiation; D005260:Female; D006801:Humans; D008875:Middle Aged; D011878:Radiotherapy / Q000009:adverse effects; D015996:Survival Rate
keywords: Breast cancer; boost; hypofractionated radiotherapy