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Journal of Experimental & Clinical Cancer Research
Published in: Journal of Experimental & Clinical Cancer Research 1/2017

Open Access 01-12-2017 | Research

Short course hypofractionated whole breast irradiation after conservative surgery: a single institution phase II study

Authors: Paola Pinnarò, Carolina Giordano, Alessia Farneti, Adriana Faiella, Giuseppe Iaccarino, Valeria Landoni, Diana Giannarelli, Patrizia Vici, Lidia Strigari, Giuseppe Sanguineti

Published in: Journal of Experimental & Clinical Cancer Research | Issue 1/2017

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Abstract

Background

To assess the oncologic outcomes of hypofractionated whole breast irradiation (Hypo-WBI).

Methods

Eligible patients had undergone breast conservative surgery for early breast cancer (pTis-2) and none/limited nodal involvement. Hypo-WBI consisted of 34 Gy in 10 daily fractions over 2 weeks to the whole breast three-dimensional conformal radiotherapy (3DCRT), followed by a single fraction of 8 Gy to the tumor bed after 1 week (electrons). Primary endpoint is freedom from ipsilateral breast tumor recurrence (IBTR). Minimum follow up for living & event-free patients is 3 yrs.; median follow up time of the whole analyzed patient population is 5.4 yrs. (range: 1.8–11.4 yrs).

Results

Two hundred fifty-one patients were accrued from 2004 to 2013. All patients underwent local excision of the primary tumor to negative margins. Four patients failed in the ipsilateral breast after a median time of 3.2 years (range: 1.7–5.7 yrs) for a 5-year IBTR-free survival of 98.7% (95%CI: 97.3%–100%). IBTR-free survival was significantly higher for patients with invasive cancer than for patients with intraductal carcinoma (p = 0.036). Within patients with invasive tumors, no clear trends or associations were detected between IBTR and age, grading, molecular subtype, pT or pN stage. At 5 years, the actuarial rates of GR2 fibrosis and GR2+ teleangectasia are 2.4% (95%CI: 0–6.5%) and 7.1% (95%CI: 0.4–13.7%), respectively. Cosmesis was scored as excellent/good by ≈95% of patients and ≈60% of clinicians.

Conclusions

Hypo-WBI in 3 weeks allows excellent oncologic outcomes for invasive breast cancer after conservative surgery. Patients with intraductal carcinoma should be treated with Hypo-WBI only within a controlled study.

Trial registration

IRE-IFO Ethical and Scientific Committee (cod. RS61/04).
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Metadata
Title
Short course hypofractionated whole breast irradiation after conservative surgery: a single institution phase II study
Authors
Paola Pinnarò
Carolina Giordano
Alessia Farneti
Adriana Faiella
Giuseppe Iaccarino
Valeria Landoni
Diana Giannarelli
Patrizia Vici
Lidia Strigari
Giuseppe Sanguineti
Publication date
01-12-2017
Publisher
BioMed Central
Published in
Journal of Experimental & Clinical Cancer Research / Issue 1/2017
Electronic ISSN: 1756-9966
DOI
https://doi.org/10.1186/s13046-017-0640-z

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