PURPOSE: To determine whether the effect of an additional "boost" radiation after breast conservative therapy (BCT) on local control depends on age and evaluate the impact of a treatment policy with a threshold for age. PATIENTS AND METHODS: We used data from EORTC 22881-10882 trial, with median follow-up of 77.4 months. Patients receiving BCT and 50Gy whole breast irradiation were randomized to no boost and 16Gy boost (N=5318). RESULTS: In univariate analysis, a boost reduced local failure by a factor of 2 (P<0.0001). Multivariate analysis showed local control increased with age (P=0.0003). There was no evidence that the relative effect of a boost on local control depends on age (P=0.97) However in younger patients the 5-year local failure was higher, therefore the absolute reduction was greater. If the threshold-age for boost treatment were set at 40 years, 8.4% of the study population would receive a boost, resulting in a 5-year local failure of 6.1% in the study population. Changing the threshold-age to 60 years, 67% of the study population would receive a boost and the 5-year local failure would be reduced to 4.4%. CONCLUSIONS: In younger patients a boost dose resulted in a greater absolute reduction of local failure. The relative risk reduction was however similar for all ages. Applying a treatment policy with a threshold-age of 60 would result in 0.6% increase in local failure in the total study population, while sparing the boost to 1/3 of the patients.
RCT Entities:
PURPOSE: To determine whether the effect of an additional "boost" radiation after breast conservative therapy (BCT) on local control depends on age and evaluate the impact of a treatment policy with a threshold for age. PATIENTS AND METHODS: We used data from EORTC 22881-10882 trial, with median follow-up of 77.4 months. Patients receiving BCT and 50Gy whole breast irradiation were randomized to no boost and 16Gy boost (N=5318). RESULTS: In univariate analysis, a boost reduced local failure by a factor of 2 (P<0.0001). Multivariate analysis showed local control increased with age (P=0.0003). There was no evidence that the relative effect of a boost on local control depends on age (P=0.97) However in younger patients the 5-year local failure was higher, therefore the absolute reduction was greater. If the threshold-age for boost treatment were set at 40 years, 8.4% of the study population would receive a boost, resulting in a 5-year local failure of 6.1% in the study population. Changing the threshold-age to 60 years, 67% of the study population would receive a boost and the 5-year local failure would be reduced to 4.4%. CONCLUSIONS: In younger patients a boost dose resulted in a greater absolute reduction of local failure. The relative risk reduction was however similar for all ages. Applying a treatment policy with a threshold-age of 60 would result in 0.6% increase in local failure in the total study population, while sparing the boost to 1/3 of the patients.
Authors: José Luis Guinot; M Isabel Tortajada; María Carrascosa; Vicente Crispín; Ana Otero; Belén Ríos; Eleonor Rivin; Miguel Santos; Pablo Soler; Leoncio Arribas Journal: Clin Transl Oncol Date: 2012-02 Impact factor: 3.405
Authors: F A Calvo; C V Sole; S Rivera; R Meiriño; S Lizarraga; M A Infante; E Boldo; C Ferrer; H Marsiglia; E Deutsch Journal: Clin Transl Oncol Date: 2014-03-19 Impact factor: 3.405
Authors: David J Sher; Eve Wittenberg; Alphonse G Taghian; Jennifer R Bellon; Rinaa S Punglia Journal: Int J Radiat Oncol Biol Phys Date: 2007-10-29 Impact factor: 7.038
Authors: Marc A Bollet; Alexia Savignoni; Leanne De Koning; Carine Tran-Perennou; Catherine Barbaroux; Armelle Degeorges; Brigitte Sigal-Zafrani; Geneviève Almouzni; Paul Cottu; Rémy Salmon; Nicolas Servant; Alain Fourquet; Patricia de Cremoux Journal: Breast Cancer Res Date: 2009-07-28 Impact factor: 6.466