Short course hypofractionated whole breast irradiation after conservative surgery

A single institution phase II study

Paola Pinnarò, Carolina Giordano, Alessia Farneti, Adriana Faiella, Giuseppe Iaccarino, Valeria Landoni, Diana Giannarelli, Patrizia Vici, Lidia Strigari, Giuseppe Sanguineti

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Background: To assess the oncologic outcomes of hypofractionated whole breast irradiation (Hypo-WBI). Methods: Eligible patients had undergone breast conservative surgery for early breast cancer (pTis-2) and none/limited nodal involvement. Hypo-WBI consisted of 34 Gy in 10 daily fractions over 2 weeks to the whole breast three-dimensional conformal radiotherapy (3DCRT), followed by a single fraction of 8 Gy to the tumor bed after 1 week (electrons). Primary endpoint is freedom from ipsilateral breast tumor recurrence (IBTR). Minimum follow up for living & event-free patients is 3 yrs.; median follow up time of the whole analyzed patient population is 5.4 yrs. (range: 1.8-11.4 yrs). Results: Two hundred fifty-one patients were accrued from 2004 to 2013. All patients underwent local excision of the primary tumor to negative margins. Four patients failed in the ipsilateral breast after a median time of 3.2 years (range: 1.7-5.7 yrs) for a 5-year IBTR-free survival of 98.7% (95%CI: 97.3%-100%). IBTR-free survival was significantly higher for patients with invasive cancer than for patients with intraductal carcinoma (p = 0.036). Within patients with invasive tumors, no clear trends or associations were detected between IBTR and age, grading, molecular subtype, pT or pN stage. At 5 years, the actuarial rates of GR2 fibrosis and GR2+ teleangectasia are 2.4% (95%CI: 0-6.5%) and 7.1% (95%CI: 0.4-13.7%), respectively. Cosmesis was scored as excellent/good by ≈95% of patients and ≈60% of clinicians. Conclusions: Hypo-WBI in 3 weeks allows excellent oncologic outcomes for invasive breast cancer after conservative surgery. Patients with intraductal carcinoma should be treated with Hypo-WBI only within a controlled study. Trial registration: IRE-IFO Ethical and Scientific Committee (cod. RS61/04).

Original languageEnglish
Article number191
JournalJournal of Experimental and Clinical Cancer Research
Volume36
Issue number1
DOIs
Publication statusPublished - Dec 27 2017

Fingerprint

Breast
Breast Neoplasms
Recurrence
Carcinoma, Intraductal, Noninfiltrating
Neoplasms
Conformal Radiotherapy
Gadiformes
Survival
Fibrosis
Electrons
Population

Keywords

  • Breast carcinoma in situ
  • Breast neoplasms
  • Dose hypofractionation
  • Local neoplasm recurrence
  • Radiotherapy

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

Cite this

@article{e76422722ffd44ecab5247f07837ebf7,
title = "Short course hypofractionated whole breast irradiation after conservative surgery: A single institution phase II study",
abstract = "Background: To assess the oncologic outcomes of hypofractionated whole breast irradiation (Hypo-WBI). Methods: Eligible patients had undergone breast conservative surgery for early breast cancer (pTis-2) and none/limited nodal involvement. Hypo-WBI consisted of 34 Gy in 10 daily fractions over 2 weeks to the whole breast three-dimensional conformal radiotherapy (3DCRT), followed by a single fraction of 8 Gy to the tumor bed after 1 week (electrons). Primary endpoint is freedom from ipsilateral breast tumor recurrence (IBTR). Minimum follow up for living & event-free patients is 3 yrs.; median follow up time of the whole analyzed patient population is 5.4 yrs. (range: 1.8-11.4 yrs). Results: Two hundred fifty-one patients were accrued from 2004 to 2013. All patients underwent local excision of the primary tumor to negative margins. Four patients failed in the ipsilateral breast after a median time of 3.2 years (range: 1.7-5.7 yrs) for a 5-year IBTR-free survival of 98.7{\%} (95{\%}CI: 97.3{\%}-100{\%}). IBTR-free survival was significantly higher for patients with invasive cancer than for patients with intraductal carcinoma (p = 0.036). Within patients with invasive tumors, no clear trends or associations were detected between IBTR and age, grading, molecular subtype, pT or pN stage. At 5 years, the actuarial rates of GR2 fibrosis and GR2+ teleangectasia are 2.4{\%} (95{\%}CI: 0-6.5{\%}) and 7.1{\%} (95{\%}CI: 0.4-13.7{\%}), respectively. Cosmesis was scored as excellent/good by ≈95{\%} of patients and ≈60{\%} of clinicians. Conclusions: Hypo-WBI in 3 weeks allows excellent oncologic outcomes for invasive breast cancer after conservative surgery. Patients with intraductal carcinoma should be treated with Hypo-WBI only within a controlled study. Trial registration: IRE-IFO Ethical and Scientific Committee (cod. RS61/04).",
keywords = "Breast carcinoma in situ, Breast neoplasms, Dose hypofractionation, Local neoplasm recurrence, Radiotherapy",
author = "Paola Pinnar{\`o} and Carolina Giordano and Alessia Farneti and Adriana Faiella and Giuseppe Iaccarino and Valeria Landoni and Diana Giannarelli and Patrizia Vici and Lidia Strigari and Giuseppe Sanguineti",
year = "2017",
month = "12",
day = "27",
doi = "10.1186/s13046-017-0640-z",
language = "English",
volume = "36",
journal = "Journal of Experimental and Clinical Cancer Research",
issn = "0392-9078",
publisher = "BioMed Central Ltd.",
number = "1",

}

TY - JOUR

T1 - Short course hypofractionated whole breast irradiation after conservative surgery

T2 - A single institution phase II study

AU - Pinnarò, Paola

AU - Giordano, Carolina

AU - Farneti, Alessia

AU - Faiella, Adriana

AU - Iaccarino, Giuseppe

AU - Landoni, Valeria

AU - Giannarelli, Diana

AU - Vici, Patrizia

AU - Strigari, Lidia

AU - Sanguineti, Giuseppe

PY - 2017/12/27

Y1 - 2017/12/27

N2 - Background: To assess the oncologic outcomes of hypofractionated whole breast irradiation (Hypo-WBI). Methods: Eligible patients had undergone breast conservative surgery for early breast cancer (pTis-2) and none/limited nodal involvement. Hypo-WBI consisted of 34 Gy in 10 daily fractions over 2 weeks to the whole breast three-dimensional conformal radiotherapy (3DCRT), followed by a single fraction of 8 Gy to the tumor bed after 1 week (electrons). Primary endpoint is freedom from ipsilateral breast tumor recurrence (IBTR). Minimum follow up for living & event-free patients is 3 yrs.; median follow up time of the whole analyzed patient population is 5.4 yrs. (range: 1.8-11.4 yrs). Results: Two hundred fifty-one patients were accrued from 2004 to 2013. All patients underwent local excision of the primary tumor to negative margins. Four patients failed in the ipsilateral breast after a median time of 3.2 years (range: 1.7-5.7 yrs) for a 5-year IBTR-free survival of 98.7% (95%CI: 97.3%-100%). IBTR-free survival was significantly higher for patients with invasive cancer than for patients with intraductal carcinoma (p = 0.036). Within patients with invasive tumors, no clear trends or associations were detected between IBTR and age, grading, molecular subtype, pT or pN stage. At 5 years, the actuarial rates of GR2 fibrosis and GR2+ teleangectasia are 2.4% (95%CI: 0-6.5%) and 7.1% (95%CI: 0.4-13.7%), respectively. Cosmesis was scored as excellent/good by ≈95% of patients and ≈60% of clinicians. Conclusions: Hypo-WBI in 3 weeks allows excellent oncologic outcomes for invasive breast cancer after conservative surgery. Patients with intraductal carcinoma should be treated with Hypo-WBI only within a controlled study. Trial registration: IRE-IFO Ethical and Scientific Committee (cod. RS61/04).

AB - Background: To assess the oncologic outcomes of hypofractionated whole breast irradiation (Hypo-WBI). Methods: Eligible patients had undergone breast conservative surgery for early breast cancer (pTis-2) and none/limited nodal involvement. Hypo-WBI consisted of 34 Gy in 10 daily fractions over 2 weeks to the whole breast three-dimensional conformal radiotherapy (3DCRT), followed by a single fraction of 8 Gy to the tumor bed after 1 week (electrons). Primary endpoint is freedom from ipsilateral breast tumor recurrence (IBTR). Minimum follow up for living & event-free patients is 3 yrs.; median follow up time of the whole analyzed patient population is 5.4 yrs. (range: 1.8-11.4 yrs). Results: Two hundred fifty-one patients were accrued from 2004 to 2013. All patients underwent local excision of the primary tumor to negative margins. Four patients failed in the ipsilateral breast after a median time of 3.2 years (range: 1.7-5.7 yrs) for a 5-year IBTR-free survival of 98.7% (95%CI: 97.3%-100%). IBTR-free survival was significantly higher for patients with invasive cancer than for patients with intraductal carcinoma (p = 0.036). Within patients with invasive tumors, no clear trends or associations were detected between IBTR and age, grading, molecular subtype, pT or pN stage. At 5 years, the actuarial rates of GR2 fibrosis and GR2+ teleangectasia are 2.4% (95%CI: 0-6.5%) and 7.1% (95%CI: 0.4-13.7%), respectively. Cosmesis was scored as excellent/good by ≈95% of patients and ≈60% of clinicians. Conclusions: Hypo-WBI in 3 weeks allows excellent oncologic outcomes for invasive breast cancer after conservative surgery. Patients with intraductal carcinoma should be treated with Hypo-WBI only within a controlled study. Trial registration: IRE-IFO Ethical and Scientific Committee (cod. RS61/04).

KW - Breast carcinoma in situ

KW - Breast neoplasms

KW - Dose hypofractionation

KW - Local neoplasm recurrence

KW - Radiotherapy

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U2 - 10.1186/s13046-017-0640-z

DO - 10.1186/s13046-017-0640-z

M3 - Article

VL - 36

JO - Journal of Experimental and Clinical Cancer Research

JF - Journal of Experimental and Clinical Cancer Research

SN - 0392-9078

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