title: Does an integrated boost increase acute toxicity in prone hypofractionated breast irradiation? A randomized controlled trial.
abstract: The safety of a simultaneous integrated boost (SIB) in combination with prone hypofractionated whole-breast irradiation (WBI) was investigated.
  
  
  
  167 patients were randomized between WBI with a sequential boost (SeB) or SIB. All patients were treated in prone position to 40.05Gy in 15 fractions to the whole breast. In the control arm, a SeB of 10Gy in 4 fractions (negative surgical margins) or 14.88Gy in 6 fractions (transsection) was prescribed. In the experimental arm a SIB of 46.8 or 49.95Gy (negative and positive surgical margins, respectively) was prescribed.
  
  
  
  Patient age was the only significantly different parameter between treatment arms with patients in the SIB arm being slightly older. In both arms, 6/83 patients developed moist desquamation. Grade 2/3 dermatitis was significantly more frequent in the SeB arm (38/83vs 24/83 patients, p=0.037). In the SIB and SeB arm, respectively, 36 patients (43%) and 51 patients (61%) developed pruritus (p=0.015). The incidence of oedema was lower in the SIB arm (59vs 68 patients), but not statistically significant (p=0.071).
  
  
  
  The primary endpoint, moist desquamation, was not significantly different between treatment arms.
authors.affiliation: Dept. of Radiation Oncology, Ghent University Hospital, Belgium.
authors.forename: Leen
authors.initials: L
authors.lastname: Paelinck
authors.affiliation: Dept. of Radiation Oncology, Liège University Hospital, Belgium.
authors.forename: Akos
authors.initials: A
authors.lastname: Gulyban
authors.affiliation: Dept. of Radiation Oncology, Liège University Hospital, Belgium.
authors.forename: Ferenc
authors.initials: F
authors.lastname: Lakosi
authors.affiliation: Dept. of Radiation Oncology, Ghent University Hospital, Belgium.
authors.forename: Tom
authors.initials: T
authors.lastname: Vercauteren
authors.affiliation: Dept. of Radiation Oncology, Ghent University Hospital, Belgium; Dept. of Radiotherapy and Experimental Cancer Research, Ghent University, Belgium.
authors.forename: Werner
authors.initials: W
authors.lastname: De Gersem
authors.affiliation: Dept. of Radiotherapy and Experimental Cancer Research, Ghent University, Belgium.
authors.forename: Bruno
authors.initials: B
authors.lastname: Speleers
authors.affiliation: Dept. of Radiation Oncology, Ghent University Hospital, Belgium; Dept. of Radiotherapy and Experimental Cancer Research, Ghent University, Belgium.
authors.forename: Christel
authors.initials: C
authors.lastname: Monten
authors.affiliation: Dept. of Radiation Oncology, Ghent University Hospital, Belgium.
authors.forename: Thomas
authors.initials: T
authors.lastname: Mulliez
authors.affiliation: Dept. of Radiation Oncology, Liège University Hospital, Belgium.
authors.forename: Patrick
authors.initials: P
authors.lastname: Berkovic
authors.affiliation: Dept. of Radiation Oncology, Ghent University Hospital, Belgium.
authors.forename: Annick
authors.initials: A
authors.lastname: van Greveling
authors.affiliation: Dept. of Radiation Oncology, Ghent University Hospital, Belgium.
authors.forename: Frederik
authors.initials: F
authors.lastname: Decoster
authors.affiliation: Dept. of Radiation Oncology, Liège University Hospital, Belgium.
authors.forename: Philippe
authors.initials: P
authors.lastname: Coucke
authors.affiliation: Dept. of Radiation Oncology, Ghent University Hospital, Belgium; Dept. of Radiotherapy and Experimental Cancer Research, Ghent University, Belgium.
authors.forename: Wilfried
authors.initials: W
authors.lastname: De Neve
authors.affiliation: Dept. of Radiation Oncology, Ghent University Hospital, Belgium; Dept. of Radiotherapy and Experimental Cancer Research, Ghent University, Belgium. Electronic address: liv.veldeman@uzgent.be.
authors.forename: Liv
authors.initials: L
authors.lastname: Veldeman
mesh_terms: D000368:Aged; D001940:Breast / Q000528:radiation effects*; D001943:Breast Neoplasms / Q000532:radiotherapy*; D005260:Female; D006801:Humans; D008875:Middle Aged; D016684:Prone Position; D000069473:Radiation Dose Hypofractionation; D011879:Radiotherapy Dosage
keywords: Breast cancer; Hypofractionation; Prone; Simultaneous integrated boost; Whole-breast irradiation