M J Cambra1, F Moreno2, X Sanz3, L Anglada4, M Mollà5,6, V Reyes5, M Arenas7, A Pedro8, R Ballester9, V García10, J Casals11, M Cusidó12, C Jimenez13, J M Escribà14,15, M Macià2, J M Solé16, A Arcusa17, M A Seguí18, S Gonzalez19, B Farrús6, A Biete6. 1. Department of Radiation Oncology, Hospital Universitari General de Catalunya-Grupo Quirónsalud (IOV-HGC-Quironsalud), Carrer Pedro i Pons 1, 08195, Sant Cugat del Vallés, Barcelona, Spain. mcambra@quironsalud.es. 2. Department of Radiation Oncology, Institut Català d'Oncologia L'Hospitalet, L'Hospitalet de Llobregat, Avda de la Granvia, 199, 08908, Barcelona, Spain. 3. Department of Radiation Oncology, Parc de Salut MAR, Passeig Marítim 25-29, 08003, Barcelona, Spain. 4. Department of Radiation Oncology, ICO Girona, Avda de França, s/n, 17007, Girona, Spain. 5. Department of Radiation Oncology, Hospital Vall d'Hebrón, Pg Vall d'Hebron 119, 129, 08035, Barcelona, Spain. 6. Department of Radiation Oncology, Hospital Clìnic, Universitat de Barcelona, Villarroel 170, 08036, Barcelona, Spain. 7. Department of Radiation Oncology, Hospital Universitari Sant Joan Reus, Avda del Dr. Josep Laporte, 2, 43204, Reus, Tarragona, Spain. 8. Department of Radiation Oncology, Hospital Plató, c/Plató, 21, 08006, Barcelona, Spain. 9. Department of Radiation Oncology, Institut Català D'Oncologia-Badalona, Carretera del Canyet, s/n, 08916, Badalona, Barcelona, Spain. 10. Department of Radiation Oncology, Hospital Arnau de Vilanova, Avda Alcalde Rovira Roure, 80, 25198, Lleida, Spain. 11. Department of Radiation Oncology, Hospital Quirón, Plaça Alfonso Comín, 5, 08023, Barcelona, Spain. 12. Department of Gynecology and Obstetrics, Hospital Universitari Dexeus-Grupo Quirónsalud, c/Sabino Arana, 5-19, 08028, Barcelona, Spain. 13. Biostatistics and Bioinformatic Expert, Olesa de Montserrat, c/Urgell 55 A, 08640, Barcelona, Spain. 14. Catalan Cancer Registry, Cancer Planning Directorate, L'Hospitalet de Llobregat, Avda de La Granvia, s/n, 08908, Barcelona, Spain. 15. Department of Clinical Sciences, University of Barcelona, Barcelona, Spain. 16. Department of Radiation Oncology, Consorci Sanitari de Terrassa, Ctra. Torrebonica s/n, 08227, Terrassa, Barcelona, Spain. 17. Department of Medical Oncology, Ctra. Torrebonica s/n, Consorci Sanitari de Terrassa, 08227, Terrassa, Barcelona, Spain. 18. Department of Medical Oncology, Corporació Sanitaria Parc Taulí, Parc Taulí 1, 08208, Sabadell, Barcelona, Spain. 19. Department of Medical Oncology, Hospital Universitari Mútua de Terrassa, Plaça del Doctor Robert, 5, 08221, Terrassa, Barcelona, Spain.
Abstract
PURPOSE: To evaluate the effect of boost radiotherapy on ipsilateral breast tumor recurrence (IBTR) for ductal carcinoma in situ (DCIS) after breast-conserving surgery and whole breast radiotherapy (WBRT) with or without boost. METHODS AND MATERIALS: Retrospective, multicentre study of 622 patients (624 tumors) diagnosed with pure DCIS from 1993-2011. RESULTS: Most tumors (377/624; 60.4%) received a boost. At a median follow-up of 8.8 years, IBTR occurred in 64 cases (10.3%). A higher percentage of patients with risk factors for IBTR received a boost (p < 0.05). Boost was not associated with lower rates of IBTR than WBRT alone (HR 0.75, 95% CI 0.42-1.35). On the univariate analyses, IBTR was significantly associated with tumor size (11-20 mm, HR 2.32, 95% CI 1.27-4.24; and > 20 mm, HR 2.10, 95% CI 1.14-3.88), re-excision (HR 1.76, 95% CI 1.04-2.96), and tamoxifen (HR 2.03, 95% CI 1.12-3.70). Boost dose > 16 Gy had a protective effect (HR 0.39, 95% CI 0.187-0.824). Multivariate analyses confirmed the independent associations between IBTR and 11-20 mm (p = 0.02) and > 20 mm (p = 0.009) tumours, and re-excision (p = 0.006). On the margin-stratified multivariate analysis, tamoxifen was a poor prognostic factor in the close/positive margin subgroup (HR 4.28 95% CI 1.23-14.88), while the highest boost dose ( > 16 Gy) had a significant positive effect (HR 0.34, 95% CI 0.13-0.86) in the negative margin subgroup. CONCLUSIONS: Radiotherapy boost did not improve the risk of IBTR. Boost radiotherapy was more common in patients with high-risk disease. Tumor size and re-excision were significant independent prognostic factors.
PURPOSE: To evaluate the effect of boost radiotherapy on ipsilateral breast tumor recurrence (IBTR) for ductal carcinoma in situ (DCIS) after breast-conserving surgery and whole breast radiotherapy (WBRT) with or without boost. METHODS AND MATERIALS: Retrospective, multicentre study of 622 patients (624 tumors) diagnosed with pure DCIS from 1993-2011. RESULTS: Most tumors (377/624; 60.4%) received a boost. At a median follow-up of 8.8 years, IBTR occurred in 64 cases (10.3%). A higher percentage of patients with risk factors for IBTR received a boost (p < 0.05). Boost was not associated with lower rates of IBTR than WBRT alone (HR 0.75, 95% CI 0.42-1.35). On the univariate analyses, IBTR was significantly associated with tumor size (11-20 mm, HR 2.32, 95% CI 1.27-4.24; and > 20 mm, HR 2.10, 95% CI 1.14-3.88), re-excision (HR 1.76, 95% CI 1.04-2.96), and tamoxifen (HR 2.03, 95% CI 1.12-3.70). Boost dose > 16 Gy had a protective effect (HR 0.39, 95% CI 0.187-0.824). Multivariate analyses confirmed the independent associations between IBTR and 11-20 mm (p = 0.02) and > 20 mm (p = 0.009) tumours, and re-excision (p = 0.006). On the margin-stratified multivariate analysis, tamoxifen was a poor prognostic factor in the close/positive margin subgroup (HR 4.28 95% CI 1.23-14.88), while the highest boost dose ( > 16 Gy) had a significant positive effect (HR 0.34, 95% CI 0.13-0.86) in the negative margin subgroup. CONCLUSIONS: Radiotherapy boost did not improve the risk of IBTR. Boost radiotherapy was more common in patients with high-risk disease. Tumor size and re-excision were significant independent prognostic factors.
Authors: Aurelius Omlin; Maurizio Amichetti; David Azria; Bernard F Cole; Philippe Fourneret; Philip Poortmans; Diana Naehrig; Robert C Miller; Marco Krengli; Cristina Gutierrez Miguelez; David Morgan; Hadassah Goldberg; Luciano Scandolaro; Pauline Gastelblum; Mahmut Ozsahin; Dagmar Dohr; David Christie; Ulrich Oppitz; Ufuk Abacioglu; Guenther Gruber Journal: Lancet Oncol Date: 2006-08 Impact factor: 41.316
Authors: Harry Bartelink; Jean-Claude Horiot; Philip M Poortmans; Henk Struikmans; Walter Van den Bogaert; Alain Fourquet; Jos J Jager; Willem J Hoogenraad; S Bing Oei; Carla C Wárlám-Rodenhuis; Marianne Pierart; Laurence Collette Journal: J Clin Oncol Date: 2007-06-18 Impact factor: 44.544
Authors: I Meattini; L Livi; D Franceschini; C Saieva; F Meacci; L Marrazzo; B Bendinelli; V Scotti; C De Luca Cardillo; J Nori; L Sanchez; L Orzalesi; P Bonomo; D Greto; M Bucciolini; S Bianchi; G Biti Journal: Eur J Surg Oncol Date: 2013-03-20 Impact factor: 4.424
Authors: B Cutuli; N Wiezzane; I Palumbo; P Barbieri; M Guenzi; A Huscher; S Borghesi; C Delva; T Iannone; E Vianello; M-E Rosetto; C Aristei Journal: Cancer Radiother Date: 2016-06-22 Impact factor: 1.018
Authors: M J Silverstein; M D Lagios; P H Craig; J R Waisman; B S Lewinsky; W J Colburn; D N Poller Journal: Cancer Date: 1996-06-01 Impact factor: 6.860