Five-year Local Control in a Phase II Study of Hypofractionated Intensity Modulated Radiation Therapy With an Incorporated Boost for Early Stage Breast Cancer

Journal Article · Thu Nov 15 04:00:00 EST 2012 · International Journal of Radiation Oncology, Biology and Physics

DOI:https://doi.org/10.1016/J.IJROBP.2012.01.091· OSTI ID:22149620

Anderson, Penny R. ^[1]; Bleicher, Richard J. ^[2]; Litwin, Samuel; Tianyu, Li ^[3]; Swaby, Ramona F. ^[4]; Ma, Chang-Ming Charlie; Jinsheng, Li ^[1]; Sigurdson, Elin R. ^[2]; Watkins-Bruner, Deborah ^[5]; Morrow, Monica ^[6]; Goldstein, Lori J. ^[4]

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1. Department of Radiation Oncology, Fox Chase Cancer Center, Philadelphia, Pennsylvania (United States)
2. Department of Surgical Oncology, Fox Chase Cancer Center, Philadelphia, Pennsylvania (United States)
3. Department of Biostatistics, Fox Chase Cancer Center, Philadelphia, Pennsylvania (United States)
4. Department of Medical Oncology, Fox Chase Cancer Center, Philadelphia, Pennsylvania (United States)
5. School of Nursing, Emory University, Atlanta, Georgia (United States)
6. Department of Surgical Oncology, Memorial Sloan-Kettering Cancer Center, New York, New York (United States)

Purpose: Conventional radiation fractionation of 1.8-2 Gy per day for early stage breast cancer requires daily treatment for 6-7 weeks. We report the 5-year results of a phase II study of intensity modulated radiation therapy (IMRT), hypofractionation, and incorporated boost that shortened treatment time to 4 weeks. Methods and Materials: The study design was phase II with a planned accrual of 75 patients. Eligibility included patients aged {>=}18 years, Tis-T2, stage 0-II, and breast conservation. Photon IMRT and an incorporated boost was used, and the whole breast received 2.25 Gy per fraction for a total of 45 Gy, and the tumor bed received 2.8 Gy per fraction for a total of 56 Gy in 20 treatments over 4 weeks. Patients were followed every 6 months for 5 years. Results: Seventy-five patients were treated from December 2003 to November 2005. The median follow-up was 69 months. Median age was 52 years (range, 31-81). Median tumor size was 1.4 cm (range, 0.1-3.5). Eighty percent of tumors were node negative; 93% of patients had negative margins, and 7% of patients had close (>0 and <2 mm) margins; 76% of cancers were invasive ductal type: 15% were ductal carcinoma in situ, 5% were lobular, and 4% were other histology types. Twenty-nine percent of patients 29% had grade 3 carcinoma, and 20% of patients had extensive in situ carcinoma; 11% of patients received chemotherapy, 36% received endocrine therapy, 33% received both, and 20% received neither. There were 3 instances of local recurrence for a 5-year actuarial rate of 2.7%. Conclusions: This 4-week course of hypofractionated radiation with incorporated boost was associated with excellent local control, comparable to historical results of 6-7 weeks of conventional whole-breast fractionation with sequential boost.

• OSTI ID: 22149620
• Journal Information: International Journal of Radiation Oncology, Biology and Physics, Journal Name: International Journal of Radiation Oncology, Biology and Physics Journal Issue: 4 Vol. 84; ISSN IOBPD3; ISSN 0360-3016
• Country of Publication: United States
• Language: English

Related Subjects

62 RADIOLOGY AND NUCLEAR MEDICINE
CARCINOMAS
CHEMOTHERAPY
FRACTIONATION
HISTOLOGY
MAMMARY GLANDS
PATIENTS
PHOTONS
RADIOTHERAPY