Radiotherapy boost dose-escalation for invasive breast cancer after breast-conserving surgery: 2093 Patients treated with a prospective margin-directed policy

Lorenzo Livi, Icro Meattini, Davide Franceschini, Calogero Saieva, Fiammetta Meacci, Livia Marrazzo, Elena Gerlain, Isacco Desideri, Vieri Scotti, Jacopo Nori, Luis Jose Sanchez, Lorenzo Orzalesi, Pierluigi Bonomo, Daniela Greto, Simonetta Bianchi, Giampaolo Biti

Research output: Contribution to journalArticlepeer-review

Abstract

Purpose: To investigate the outcome of invasive early breast cancer patients that underwent breast-conserving surgery and adjuvant radiotherapy (RT), treated with a prospective margin-directed institutional policy for RT boost dose, based on final margins status (FMS). Methods and materials: A total of 2093 patients were treated between 2000 and 2008. 10 Gy boost was prescribed in case of FMS > 5 mm; 16 Gy boost with FMS between 2 and 5 mm; 20 Gy boost in case of FMS <2 mm or positive. Results: After a median follow up of 5.2 years, we recorded 41 local relapse (LR, 2%). Concerning LR free survival, age at diagnosis, nuclear grade, hormonal status, T-stage, adjuvant hormonal therapy and adjuvant chemotherapy emerged as significant parameters (p-values from log rank test 5 mm. At multivariate analysis, higher nuclear grade (p = 0.045), triple negative subtype (p = 0.036) and higher T-stage (p = 0.02) resulted as the independent predictors of LR occurrence. Conclusions: Our experience showed that a margin-directed policy of RT boost dose-escalation seems to reduce the negative impact of FMS on LR, but it is not able to overcome the unfavorable effect of higher nuclear grade, higher T stage and triple negative subtype.

Original languageEnglish
Pages (from-to)273-278
Number of pages6
JournalRadiotherapy and Oncology
Volume108
Issue number2
DOIs
Publication statusPublished - Aug 2013

Keywords

  • Breast-conserving surgery
  • Dose escalation
  • Invasive breast cancer
  • Radiotherapy boost
  • Tumor margins

ASJC Scopus subject areas

  • Oncology
  • Radiology Nuclear Medicine and imaging
  • Hematology

Fingerprint Dive into the research topics of 'Radiotherapy boost dose-escalation for invasive breast cancer after breast-conserving surgery: 2093 Patients treated with a prospective margin-directed policy'. Together they form a unique fingerprint.

Cite this