Efficacy and Safety of Hypofractionated Radiotherapy With a Simultaneous Integrated Boost and With a Sequential Boost After Breast‐Conserving Surgery
ABSTRACT Purpose The objective of this study was retrospectively to compare the efficacy and safety of hypofractionated radiotherapy (HFRT) with a simultaneous integrated boost (SIB) or with a sequential boost (SB) after breast‐conserving surgery in patients diagnosed with early breast cancer. Metho...
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| Main Authors: | , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Wiley
2025-03-01
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| Series: | Cancer Medicine |
| Subjects: | |
| Online Access: | https://doi.org/10.1002/cam4.70630 |
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| Summary: | ABSTRACT Purpose The objective of this study was retrospectively to compare the efficacy and safety of hypofractionated radiotherapy (HFRT) with a simultaneous integrated boost (SIB) or with a sequential boost (SB) after breast‐conserving surgery in patients diagnosed with early breast cancer. Methods This study enrolled a total of 343 patients diagnosed with T1‐2N0‐1 breast cancer who had undergone breast‐conserving surgery followed by whole‐breast irradiation (WBI) without nodal irradiation, between March 2018 and April 2021. Out of 343 patients, 176 (51.3%) received HFRT‐SIB treatment, totaling 15 sessions, while the remaining 167 (48.7%) received HFRT‐SB treatment, totaling 18 sessions. Demographic characteristics, skin toxicity, radiation pneumonia, and myelosuppression, were compared in the two groups. Three‐year local progression free survival (LPFS) rates were determined using the Kaplan–Meier method and compared using the log‐rank test. Results The median follow‐up time was 39.7 months (range 24.3–61.3 months). Toxicities rates did not differ significantly in the HFRT‐SIB and HFRT‐SB groups, including rates of grade 2 skin toxicity (14.8% vs. 13.8%, p = 0.721), Grade 2 radiation pneumonia (2.8% vs. 3.6%, p = 0.355), grades 1, 2 and 3 myelosuppression (12.5%, 5.7% and 1.1%, respectively, vs. 9.6%, 7.8%, and 1.2%, respectively; p = 0.744). Three‐year cumulative LPFS rates were similar in the HFRT‐SIB and HFRT‐SB groups (99.3% vs. 98.6%, p = 0.52). Regional nodal recurrences were observed in one patient in the HFRT‐SIB group (after 27.4 months) and in two patients in the HFRT‐SB group (after 29.4 and 56.4 months), and a local recurrence was observed in one patient in the latter group after 36.0 months. One patient in the HFRT‐SIB group was diagnosed with distant metastases to bone, and one patient in the HFRT‐SB group was diagnosed with distant metastases to the liver. Conclusion Similar efficacy and safety of HFRT‐SIB and HFRT‐SB after breast‐conserving surgery in patients with early‐stage (T1‐2N0‐1) breast cancer. Longer‐term follow‐up is required to further compare their efficacy. |
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| ISSN: | 2045-7634 |