Safety and efficacy of whole breast irradiation with a concomitant boost: Analysis of 121 cases treated at the institut de cancérologie de Lorraine

Abstract : PURPOSE: To evaluate the safety and efficacy of whole breast irradiation with a concomitant boost. PATIENTS AND MATERIALS: This is a retrospective study of 121 patients with node negative T1-T2 breast tumors inferior to 3 cm in diameter, previously treated by conservative surgery without chemotherapy. A dose of 50 Gy was delivered to the whole breast in 2 Gy daily fractions with 5 weekly treatments. A concomitant boost to the lumpectomy site delivered a total of 10 Gy in 1 Gy fractions twice a week. This would result in an equivalent tumour bed dose (assuming an α/β of 4) of approximately 65 Gy in 2 Gy fractions. RESULTS: Over 7 years, 121 patients were treated. The median age was 67 years (range, 46-86 years). Stage distribution was: 115 T1, 6 T2; 116 tumors had positive hormonal receptors, 6 grade SBR3. With a median follow-up of 6 years (range, 1.4-11.4 years), 5-year overall survival was 98.2% (95% confidence interval [CI] 0.95-1), disease-free survival was 100% and local recurrence-free survival 100%. The maximum acute skin toxicity by the end of treatment was grade 2. Cosmetic outcomes were good on the long term. One spontaneous rib fracture was observed 1 year after radiotherapy among 76 patients. CONCLUSIONS: The study shows that whole breast radiation therapy with a concomitant boost is safe and effective for selected patients with low risk of relapse, and gives excellent long term results. This protocol represents a good alternative to longer standard whole breast radiation therapy with sequential boost to the lumpectomy bed.
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Submitted on : Monday, June 18, 2018 - 11:03:06 AM
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F. Renoult, C. Marchal, C. Brunaud, V. Harter, D. Peiffert. Safety and efficacy of whole breast irradiation with a concomitant boost: Analysis of 121 cases treated at the institut de cancérologie de Lorraine. Cancer Radiothérapie, Elsevier Masson, 2014, 18 (3), pp.165 - 170. ⟨10.1016/j.canrad.2014.02.004⟩. ⟨hal-01817631⟩

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