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Radiation Oncology
Published in: Radiation Oncology 1/2020

Open Access 01-12-2020 | Breast Cancer | Research

Acute toxicity of normofractionated intensity modulated radiotherapy with simultaneous integrated boost compared to three-dimensional conformal radiotherapy with sequential boost in the adjuvant treatment of breast cancer

Authors: David Krug, Christine Köder, Matthias F. Häfner, Nathalie Arians, Semi B. Harrabi, Stefan A. Koerber, Tobias Forster, Ingmar Schlampp, Christof Sohn, Joerg Heil, Holger Hof, Juliane Hörner-Rieber, Jürgen Debus

Published in: Radiation Oncology | Issue 1/2020

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Abstract

Background

Intensity-modulated radiotherapy (IMRT) improves dose homogeneity and late toxicity compared to simple tangential techniques in adjuvant whole-breast radiotherapy for patients with breast cancer. Simultaneous-integrated boost (SIB) radiotherapy shortens the overall treatment time and improves dose homogeneity. However, prospective randomized trials regarding IMRT with SIB for adjuvant radiotherapy in breast cancer are lacking.

Methods

The IMRT-MC2 (MINT) trial is a phase III prospective randomized controlled trial comparing IMRT with SIB (Arm A: whole breast 28 × 1.8 Gy, Boost 28 × 2.3 Gy) to 3D-conformal radiotherapy with a sequential boost (Arm B: whole breast 28 × 1.8 Gy, boost 8 × 2 Gy) in patients with breast cancer after BCS. Indication for boost radiotherapy was defined as age < 70 years or age > 70 years with presence of additional risk factors. This is a retrospective analysis of acute toxicity at one of two trial sites.

Results

Five hundred two patients were randomized, of which 446 patients were eligible for this analysis. There was no statistically significant difference in terms of any grade radiation dermatitis between the two treatment arms at the end of treatment (p = 0.26). However, radiation dermatitis grade 2/3 (29.1% vs. 20.1 and 3.5% vs. 2.3%) occurred significantly more often in Arm A (p = 0.02). Breast/chest wall pain at the first follow-up visit was significantly more common in patients treated on Arm B (p = 0.02).

Conclusions

Treatment on both arms was well tolerated, however there were some differences regarding radiodermatitis and breast pain. Further analyses are ongoing.

Trial registration

clinicaltrials.​gov, NCT01322854, registered 24th March 2011.
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Metadata
Title
Acute toxicity of normofractionated intensity modulated radiotherapy with simultaneous integrated boost compared to three-dimensional conformal radiotherapy with sequential boost in the adjuvant treatment of breast cancer
Authors
David Krug
Christine Köder
Matthias F. Häfner
Nathalie Arians
Semi B. Harrabi
Stefan A. Koerber
Tobias Forster
Ingmar Schlampp
Christof Sohn
Joerg Heil
Holger Hof
Juliane Hörner-Rieber
Jürgen Debus
Publication date
01-12-2020
Publisher
BioMed Central
Published in
Radiation Oncology / Issue 1/2020
Electronic ISSN: 1748-717X
DOI
https://doi.org/10.1186/s13014-020-01652-x

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