Benefit of Radiation Boost After Whole-Breast Radiotherapy

Journal Article · Sun Nov 15 04:00:00 EST 2009 · International Journal of Radiation Oncology, Biology and Physics

DOI:https://doi.org/10.1016/j.ijrobp.2008.12.038· OSTI ID:21367496

Livi, Lorenzo ^[1]; Borghesi, Simona ^[1]; Saieva, Calogero ^[2]; Fambrini, Massimiliano ^[3]; Iannalfi, Alberto; Greto, Daniela; Paiar, Fabiola; Scoccianti, Silvia; Simontacchi, Gabriele ^[1]; Bianchi, Simonetta ^[4]; Cataliotti, Luigi ^[5]; Biti, Giampaolo ^[1]

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1. Radiotherapy Unit, University of Florence, Florence (Italy)
2. Molecular and Nutritional Epidemiology Unit, ISPO, Cancer Prevention and Research Institute, Florence (Italy)
3. Department of Gynaecology, Perinatology and Human Reproduction, University of Florence, Florence (Italy)
4. Department of Pathology, University of Florence, Florence (Italy)
5. Department of Surgery, University of Florence, Florence (Italy)

Purpose: To determine whether a boost to the tumor bed after breast-conserving surgery (BCS) and radiotherapy (RT) to the whole breast affects local control and disease-free survival. Methods and Materials: A total of 1,138 patients with pT1 to pT2 breast cancer underwent adjuvant RT at the University of Florence. We analyzed only patients with a minimum follow-up of 1 year (range, 1-20 years), with negative surgical margins. The median age of the patient population was 52.0 years (+-7.9 years). The breast cancer relapse incidence probability was estimated by the Kaplan-Meier method, and differences between patient subgroups were compared by the log rank test. Cox regression models were used to evaluate the risk of breast cancer relapse. Results: On univariate survival analysis, boost to the tumor bed reduced breast cancer recurrence (p < 0.0001). Age and tamoxifen also significantly reduced breast cancer relapse (p = 0.01 and p = 0.014, respectively). On multivariate analysis, the boost and the medium age (45-60 years) were found to be inversely related to breast cancer relapse (hazard ratio [HR], 0.27; 95% confidence interval [95% CI], 0.14-0.52, and HR 0.61; 95% CI, 0.37-0.99, respectively). The effect of the boost was more evident in younger patients (HR, 0.15 and 95% CI, 0.03-0.66 for patients <45 years of age; and HR, 0.31 and 95% CI, 0.13-0.71 for patients 45-60 years) on multivariate analyses stratified by age, although it was not a significant predictor in women older than 60 years. Conclusion: Our results suggest that boost to the tumor bed reduces breast cancer relapse and is more effective in younger patients.

• OSTI ID: 21367496
• Journal Information: International Journal of Radiation Oncology, Biology and Physics, Journal Name: International Journal of Radiation Oncology, Biology and Physics Journal Issue: 4 Vol. 75; ISSN IOBPD3; ISSN 0360-3016
• Country of Publication: United States
• Language: English

Related Subjects

62 RADIOLOGY AND NUCLEAR MEDICINE
BODY
DISEASES
GLANDS
MAMMARY GLANDS
MATHEMATICS
MEDICINE
MULTIVARIATE ANALYSIS
NEOPLASMS
NUCLEAR MEDICINE
ORGANIC COMPOUNDS
ORGANIC NITROGEN COMPOUNDS
ORGANS
RADIOLOGY
RADIOTHERAPY
STATISTICS
SURGERY
TAMOXIFEN
THERAPY