title: Ten years results of the Canadian breast intensity modulated radiation therapy (IMRT) randomized controlled trial.
abstract: We report the long-term outcomes in patients enrolled in a multicenter randomized controlled trial comparing Intensity Modulated Radiation Therapy (IMRT) with standard wedge radiotherapy.
  
  
  
  Trial participants were assessed to compare long-term side effects between treatment arms. The primary endpoint was chronic breast pain assessed by trained observers blinded to treatment allocation. Secondary endpoints included cosmesis and quality of life measures.
  
  
  
  Median follow-up time was 9.8years and 241 patients were available for assessment. There was no significant difference in chronic pain between treatment arms (OR=0.74, range 0.432-1.271). There were also no differences for the secondary endpoints. Univariate and multivariate analyses identified young age (p=0.013) and pain during RT (p<0.001) to be associated with chronic pain. Acute moist desquamation was associated with late subcutaneous fibrosis (p=0.003) and telangiectasia (p=0.039). Pain during RT was associated with a long-term poorer self-assessed cosmetic outcome (p<0.001) and quality of life (p<0.001).
  
  
  
  Breast IMRT cannot be recommended for all patients to reduce long-term side effects. However, late toxicities were significantly correlated with acute side effects, which are increased in patients having poor dose distribution. Breast IMRT may hence be useful for selected patients.
authors.affiliation: Erasmus MC Cancer Institute, Radiation Oncology Department, Rotterdam, The Netherlands. Electronic address: j.p.pignol@erasmusmc.nl.
authors.forename: Jean-Philippe
authors.initials: JP
authors.lastname: Pignol
authors.affiliation: Vancouver Island Cancer Centre, Radiation Oncology Department, Victoria, Canada.
authors.forename: Pauline
authors.initials: P
authors.lastname: Truong
authors.affiliation: Sunnybrook Health Sciences Centre, Institute for Clinical Evaluative Sciences and Radiation Oncology Department, Toronto, Canada.
authors.forename: Eileen
authors.initials: E
authors.lastname: Rakovitch
authors.affiliation: Erasmus MC Cancer Institute, Radiation Oncology Department, Rotterdam, The Netherlands.
authors.forename: Margriet G
authors.initials: MG
authors.lastname: Sattler
authors.affiliation: Hamilton Health Sciences, Juravinski Cancer Centre, Hamilton, Canada.
authors.forename: Timothy J
authors.initials: TJ
authors.lastname: Whelan
authors.affiliation: Tom Baker Cancer Centre, Division of Radiation Oncology, Calgary, Canada.
authors.forename: Ivo A
authors.initials: IA
authors.lastname: Olivotto
mesh_terms: D000208:Acute Disease; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000473:pathology / Q000532:radiotherapy* / Q000534:rehabilitation; D059350:Chronic Pain / Q000209:etiology; D004311:Double-Blind Method; D004954:Esthetics; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D011788:Quality of Life; D011832:Radiation Injuries / Q000209:etiology; D011874:Radiometry / Q000379:methods; D050397:Radiotherapy, Intensity-Modulated / Q000009:adverse effects / Q000379:methods*; D013684:Telangiectasis / Q000209:etiology
keywords: Breast; Clinical trial; IMRT