Hypofractionated Radiation Therapy for Breast Ductal Carcinoma In Situ

Journal Article · Sun Dec 01 04:00:00 EST 2013 · International Journal of Radiation Oncology, Biology and Physics

DOI:https://doi.org/10.1016/J.IJROBP.2013.08.026· OSTI ID:22278289

Hathout, Lara ^[1]; Hijal, Tarek ^[2]; Théberge, Valérie ^[3]; Fortin, Bernard ^[1]; Vulpe, Horia ^[2]; Hogue, Jean-Charles ^[4]; Lambert, Christine ^[2]; Bahig, Houda ^[1]; others, and

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1. Department of Radiation Oncology, Hôpital Maisonneuve-Rosemont, Centre affilié à l'Université de Montréal, Montreal, Quebec (Canada)
2. Department of Radiation Oncology, McGill University Health Centre, Montreal, Quebec (Canada)
3. Department of Radiation Oncology, Centre hospitalier universitaire de Québec, L'Hôtel-Dieu de Québec, Quebec (Canada)
4. Centre des maladies du sein Deschênes-Fabia, Quebec (Canada)

Purpose: Conventional radiation therapy (RT) administered in 25 fractions after breast-conserving surgery (BCS) is the standard treatment for ductal carcinoma in situ (DCIS) of the breast. Although accelerated hypofractionated regimens in 16 fractions have been shown to be equivalent to conventional RT for invasive breast cancer, few studies have reported results of using hypofractionated RT in DCIS. Methods and Materials: In this multicenter collaborative effort, we retrospectively reviewed the records of all women with DCIS at 3 institutions treated with BCS followed by hypofractionated whole-breast RT (WBRT) delivered in 16 fractions. Results: Between 2003 and 2010, 440 patients with DCIS underwent BCS followed by hypofractionated WBRT in 16 fractions for a total dose of 42.5 Gy (2.66 Gy per fraction). Boost RT to the surgical bed was given to 125 patients (28%) at a median dose of 10 Gy in 4 fractions (2.5 Gy per fraction). After a median follow-up time of 4.4 years, 14 patients had an ipsilateral local relapse, resulting in a local recurrence-free survival of 97% at 5 years. Positive surgical margins, high nuclear grade, age less than 50 years, and a premenopausal status were all statistically associated with an increased occurrence of local recurrence. Tumor hormone receptor status, use of adjuvant hormonal therapy, and administration of additional boost RT did not have an impact on local control in our cohort. On multivariate analysis, positive margins, premenopausal status, and nuclear grade 3 tumors had a statistically significant worse local control rate. Conclusions: Hypofractionated RT using 42.5 Gy in 16 fractions provides excellent local control for patients with DCIS undergoing BCS.

• OSTI ID: 22278289
• Journal Information: International Journal of Radiation Oncology, Biology and Physics, Journal Name: International Journal of Radiation Oncology, Biology and Physics Journal Issue: 5 Vol. 87; ISSN IOBPD3; ISSN 0360-3016
• Country of Publication: United States
• Language: English

Related Subjects

62 RADIOLOGY AND NUCLEAR MEDICINE
CARCINOMAS
FRACTIONATED IRRADIATION
MAMMARY GLANDS
RADIOTHERAPY
RECEPTORS
SURGERY