Reduction in Radiation-Induced Morbidity by Use of an Intercurrent Boost in the Management of Early-Stage Breast Cancer

Trombetta, Mark; Julian, Thomas B; Valakh, Vladimir; Greenberg, Larisa; Labban, George; Khalid, Mian K; Werts, E Day; Parda, David

doi:10.1016/j.ijrobp.2009.06.056

Title: Reduction in Radiation-Induced Morbidity by Use of an Intercurrent Boost in the Management of Early-Stage Breast Cancer

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Abstract

Purpose: Electron or photon boost immediately following whole-breast irradiation performed after conservation surgery for early-stage breast cancer is the accepted standard of care. This regimen frequently results in Grade III dermatitis, causing discomfort or treatment interruption. Herein, we compare patients treated with whole-breast irradiation followed by boost compared with a cohort with a planned intercurrent radiation boost. Methods and Materials: The records of 650 consecutive breast cancer patients treated at Allegheny General Hospital (AGH) between 2000 and 2008 were reviewed. Selected for this study were 327 patients with T1 or T2 tumors treated with external beam radiotherapy postlumpectomy. One hundred and sixty-nine patients were treated by whole-breast radiotherapy (WBRT) followed by boost at completion. One hundred fifty-eight were treated with a planned intercurrent boost (delivered following 3,600 cGy WBRT). The mean whole breast radiation dose in the conventionally treated group was 5,032 cGy (range, 4500-5400 cGy), and the mean whole breast dose was 5,097 cGy (range, 4860-5040 cGy) in the group treated with a planned intercurrent boost. Results: The occurrence of Grade III dermatitis was significantly reduced in the WBRT/intercurrent boost group compared with the WBRT/boost group (0.6% vs. 8.9%), as was the incidence of treatment interruption (1.9% vs. 14.2%).more »« less

Authors:

Trombetta, Mark ^[1]; Julian, Thomas B ^[2]; Valakh, Vladimir ^[1]; Greenberg, Larisa ^[2]; Labban, George; Khalid, Mian K ^[3]; Werts, E Day; Parda, David ^[1]

Department of Radiation Oncology, Allegheny General Hospital, Pittsburgh, PA (United States)
Department of Human Oncology, Allegheny General Hospital, Pittsburgh, PA (United States)
Division of Hematology-Oncology, Western Pennsylvania Hospital, Pittsburgh, PA (United States)

Publication Date:: Sun Aug 01 00:00:00 EDT 2010

OSTI Identifier:: 21436102

Resource Type:: Journal Article

Journal Name:: International Journal of Radiation Oncology, Biology and Physics

Additional Journal Information:: Journal Volume: 77; Journal Issue: 5; Other Information: DOI: 10.1016/j.ijrobp.2009.06.056; PII: S0360-3016(09)01001-3; Copyright (c) 2010 Elsevier Science B.V., Amsterdam, The Netherlands, All rights reserved.; Journal ID: ISSN 0360-3016

Country of Publication:: United States

Language:: English

Subject:: 62 RADIOLOGY AND NUCLEAR MEDICINE; DERMATITIS; DISEASE INCIDENCE; ELECTRONS; MAMMARY GLANDS; NEOPLASMS; RADIOTHERAPY; SURGERY; BODY; DISEASES; ELEMENTARY PARTICLES; FERMIONS; GLANDS; LEPTONS; MEDICINE; NUCLEAR MEDICINE; ORGANS; RADIOLOGY; SKIN DISEASES; THERAPY

Citation Formats


                    Trombetta, Mark, Drexel University College of Medicine, Allegheny Campus, Pittsburgh, PA, Julian, Thomas B, Drexel University College of Medicine, Allegheny Campus, Pittsburgh, PA, Valakh, Vladimir, Greenberg, Larisa, Drexel University College of Medicine, Allegheny Campus, Pittsburgh, PA, Labban, George, Khalid, Mian K, Werts, E Day, Parda, David, and Drexel University College of Medicine, Allegheny Campus, Pittsburgh, PA. Reduction in Radiation-Induced Morbidity by Use of an Intercurrent Boost in the Management of Early-Stage Breast Cancer.  United States: N. p., 2010. 
        Web.  doi:10.1016/j.ijrobp.2009.06.056.

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                    Trombetta, Mark, Drexel University College of Medicine, Allegheny Campus, Pittsburgh, PA, Julian, Thomas B, Drexel University College of Medicine, Allegheny Campus, Pittsburgh, PA, Valakh, Vladimir, Greenberg, Larisa, Drexel University College of Medicine, Allegheny Campus, Pittsburgh, PA, Labban, George, Khalid, Mian K, Werts, E Day, Parda, David, & Drexel University College of Medicine, Allegheny Campus, Pittsburgh, PA. Reduction in Radiation-Induced Morbidity by Use of an Intercurrent Boost in the Management of Early-Stage Breast Cancer.  United States.  https://doi.org/10.1016/j.ijrobp.2009.06.056

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                    Trombetta, Mark, Drexel University College of Medicine, Allegheny Campus, Pittsburgh, PA, Julian, Thomas B, Drexel University College of Medicine, Allegheny Campus, Pittsburgh, PA, Valakh, Vladimir, Greenberg, Larisa, Drexel University College of Medicine, Allegheny Campus, Pittsburgh, PA, Labban, George, Khalid, Mian K, Werts, E Day, Parda, David, and Drexel University College of Medicine, Allegheny Campus, Pittsburgh, PA. 2010.  
        "Reduction in Radiation-Induced Morbidity by Use of an Intercurrent Boost in the Management of Early-Stage Breast Cancer".  United States.  https://doi.org/10.1016/j.ijrobp.2009.06.056.

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@article{osti_21436102,

  title        = {Reduction in Radiation-Induced Morbidity by Use of an Intercurrent Boost in the Management of Early-Stage Breast Cancer},

  author       = {Trombetta, Mark and Drexel University College of Medicine, Allegheny Campus, Pittsburgh, PA and Julian, Thomas B and Drexel University College of Medicine, Allegheny Campus, Pittsburgh, PA and Valakh, Vladimir and Greenberg, Larisa and Drexel University College of Medicine, Allegheny Campus, Pittsburgh, PA and Labban, George and Khalid, Mian K and Werts, E Day and Parda, David and Drexel University College of Medicine, Allegheny Campus, Pittsburgh, PA},

  abstractNote = {Purpose: Electron or photon boost immediately following whole-breast irradiation performed after conservation surgery for early-stage breast cancer is the accepted standard of care. This regimen frequently results in Grade III dermatitis, causing discomfort or treatment interruption. Herein, we compare patients treated with whole-breast irradiation followed by boost compared with a cohort with a planned intercurrent radiation boost. Methods and Materials: The records of 650 consecutive breast cancer patients treated at Allegheny General Hospital (AGH) between 2000 and 2008 were reviewed. Selected for this study were 327 patients with T1 or T2 tumors treated with external beam radiotherapy postlumpectomy. One hundred and sixty-nine patients were treated by whole-breast radiotherapy (WBRT) followed by boost at completion. One hundred fifty-eight were treated with a planned intercurrent boost (delivered following 3,600 cGy WBRT). The mean whole breast radiation dose in the conventionally treated group was 5,032 cGy (range, 4500-5400 cGy), and the mean whole breast dose was 5,097 cGy (range, 4860-5040 cGy) in the group treated with a planned intercurrent boost. Results: The occurrence of Grade III dermatitis was significantly reduced in the WBRT/intercurrent boost group compared with the WBRT/boost group (0.6% vs. 8.9%), as was the incidence of treatment interruption (1.9% vs. 14.2%). With a median follow-up of 32 months and 27 months, respectively, no significant difference in local control was identified. Conclusions: Patients treated with intercurrent boost developed less Grade III dermatitis and unplanned treatment interruptions with similar local control.},

  doi          = {10.1016/j.ijrobp.2009.06.056},

  url          = {https://www.osti.gov/biblio/21436102},
  journal      = {International Journal of Radiation Oncology, Biology and Physics},

  issn         = {0360-3016},

  number       = 5,

  volume       = 77,

  place        = {United States},

  year         = {Sun Aug 01 00:00:00 EDT 2010},

  month        = {Sun Aug 01 00:00:00 EDT 2010}

}

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