A prospective clinical study of early breast cancer treated with hypofractionated simultaneous integrated boost IMRT/ VMAT after breast conservative surgery / 中华放射医学与防护杂志

ABSTRACT

Objective@#To evaluate the efficacy, toxicity and cosmetic outcomes of hypofractionated simultaneous integrated boost intensity-modulated radiotherapy (IMRT-SIB) after breast conservative surgery (BCS) for early breast cancer patients.@*Methods@#A total of 76 patients with stage TisT1-2N0M0 breast cancer treated with BCS were enrolled in the analysis. The patients who underwent breast radiotherapy without regional lymph node irridiation and hypo fractionated IMRT/VMAT were used. All patients received whole breast IMRT/VMAT with tumor bed SIB. The doses delivered to the whole breast was 42.4 Gy in 16 fractions, and the dose delivered to tumor bed for SIB was 49.6 Gy in 16 fractions. Cosmetic evaluation was based on the Harvard system. Acute and late toxicities were scored according to CACAT version 3.0. Survival and recurrence rates were calculated by Kaplan-Meier method. The univariate and multivariate analysis were conducted with logistic regression.@*Results@#The median follow-up was 29 months (range 16-40 months). The follow-up rate was 100%. The 1-, 2-and 3-year overall survival rates were 100%. No recurrence or metastasis was observed in this study. The incidence of grade 1 acute skin toxicity was 68.4%, grade 2 was 7.9%. The late skin toxicity of grade 1 was 13.1%, grade 2 was 2.6%.In all, 82.4% of patients had excellent and good cosmetic outcome. The Mean dose of the tumor bed was predictive factor for grade 2 dermatitis.@*Conclusion@#The efficacy, cosmetic effect, the acute and late treatment-related toxicity of hypofractionated IMRT/VMAT-SIB in patients with early breast cancer following BCS might be acceptable. A longer follow-up is needed to define the efficacy on outcomes.@*Trial registration@#Chinese clinical trial registry, ChiCTR1800016287