Fiorenza De Rose1, Antonella Fogliata2, Davide Franceschini1, Cristina Iftode1, Pierina Navarria1, Tiziana Comito1, Ciro Franzese1, Bethania Fernandes3, Giovanna Masci4, Rosalba Torrisi4, Corrado Tinterri5, Alberto Testori5, Armando Santoro4, Marta Scorsetti6. 1. Humanitas Research Hospital and Cancer Center, Radiotherapy and Radiosurgery Dept, Milan, Rozzano, Italy. 2. Humanitas Research Hospital and Cancer Center, Radiotherapy and Radiosurgery Dept, Milan, Rozzano, Italy. Electronic address: antonella.fogliata@humanitas.it. 3. Humanitas Research Hospital and Cancer Center, Pathology Dept, Milan, Rozzano, Italy. 4. Humanitas Research Hospital and Cancer Center, Medical Oncology Dept, Milan, Rozzano, Italy. 5. Humanitas Research Hospital and Cancer Center, Breast Surgery Dept, Milan, Rozzano, Italy. 6. Humanitas Research Hospital and Cancer Center, Radiotherapy and Radiosurgery Dept, Milan, Rozzano, Italy; Humanitas University, Biomedical Science Faculty, Milan, Rozzano, Italy.
Abstract
INTRODUCTION: To evaluate acute toxicity and cosmetic outcomes of hypofractionated simultaneous integrated boost (SIB) as adjuvant treatment after breast-conserving surgery and adjuvant chemotherapy and to review the association of chemotherapy and short fractionation with boost. MATERIALS AND METHODS: Patients presenting early-stage breast cancer were enrolled in a phase II trial. All patients received VMAT-SIB technique to the whole breast and tumor bed in 15 fractions, for a total dose of 40.5 and 48 Gy. Acute and late skin toxicities and breast pain were recorded. Cosmetic outcomes were also assessed as excellent/good or fair/poor. RESULTS: Between August 2010 and December 2015, 787 consecutive patients were treated and had at least 2 year follow-up. A subset of 175 patients underwent adjuvant chemotherapy (median age of 55 years) and was analysed. The median follow up was 39 months (range 24-80). At the end of RT treatment, skin toxicity was G1 in 51.1% of patients, G2 in 9.7%. At 2 years of follow up, it was G1 in 13.5% of patients, no cases ≥ G2; cosmetic outcome was excellent in 63.5% and good in 36.5% of the patients. No significant difference compared to the patients without systemic therapy was observed. CONCLUSION: Hypofractionated VMAT-SIB in patients who had undergone adjuvant systemic therapy was safe and well tolerated in terms of acute and early late settings and cosmesis. Our data confirmed the results of other studies published on the association of hypofractionation and chemotherapy or concomitant boost.
INTRODUCTION: To evaluate acute toxicity and cosmetic outcomes of hypofractionated simultaneous integrated boost (SIB) as adjuvant treatment after breast-conserving surgery and adjuvant chemotherapy and to review the association of chemotherapy and short fractionation with boost. MATERIALS AND METHODS:Patients presenting early-stage breast cancer were enrolled in a phase II trial. All patients received VMAT-SIB technique to the whole breast and tumor bed in 15 fractions, for a total dose of 40.5 and 48 Gy. Acute and late skin toxicities and breast pain were recorded. Cosmetic outcomes were also assessed as excellent/good or fair/poor. RESULTS: Between August 2010 and December 2015, 787 consecutive patients were treated and had at least 2 year follow-up. A subset of 175 patients underwent adjuvant chemotherapy (median age of 55 years) and was analysed. The median follow up was 39 months (range 24-80). At the end of RT treatment, skin toxicity was G1 in 51.1% of patients, G2 in 9.7%. At 2 years of follow up, it was G1 in 13.5% of patients, no cases ≥ G2; cosmetic outcome was excellent in 63.5% and good in 36.5% of the patients. No significant difference compared to the patients without systemic therapy was observed. CONCLUSION: Hypofractionated VMAT-SIB in patients who had undergone adjuvant systemic therapy was safe and well tolerated in terms of acute and early late settings and cosmesis. Our data confirmed the results of other studies published on the association of hypofractionation and chemotherapy or concomitant boost.
Authors: Francesco Deodato; Alessio G Morganti; Gabriella Macchia; Savino Cilla; Milly Buwenge; Alice Zamagni; Ilario Ammendolia; Claudio Zamagni; Giovanni P Frezza; Vincenzo Valentini Journal: Breast Cancer (Dove Med Press) Date: 2020-11-12
Authors: S Dicuonzo; M C Leonardi; D P Rojas; B A Jereczek-Fossa; S Raimondi; G Corrao; V Bagnardi; M A Gerardi; A Morra; M A Zerella; M Zaffaroni; F Pansini; F Cattani; R Luraschi; C Fodor; P Veronesi; R Orecchia Journal: Clin Transl Oncol Date: 2021-02-03 Impact factor: 3.405