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Hypofractionation and concomitant boost to deliver adjuvant whole-breast radiation in ductal carcinoma in situ (DCIS): a subgroup analysis of a prospective case series

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Abstract

To report the four-year outcomes of accelerated hypofractionated whole-breast radiotherapy (WBRT) with a concomitant boost (CB) to the tumor bed in ductal carcinoma in situ (DCIS), we performed a subgroup analysis of 103 patients affected with DCIS within a cohort of 960 early breast cancer patients treated with breast conservation and hypofractionated WBRT. Prescription dose to the whole breast was 45 Gy (2.25 Gy/20 fractions) with an additional daily CB of 0.25 Gy to the surgical cavity (2.5 Gy/20 fractions up to 50 Gy). With a median follow-up of 48 months (range 12–91), no local recurrence was observed. Maximum detected acute skin toxicity was as follows: G0 in 35 % of patients, G1 in 54 %, G2 in 9 % and G3 in 2 %. Late skin and subcutaneous toxicity were generally mild with only 1 % of patients experiencing ≥G3 events (telangiectasia). No major lung and heart toxicity were detected. Cosmetic results were excellent in 50 % of patients, good in 37 %, fair in 9 % and poor in 4 %. Quality of life had a generally favorable profile both within the functioning and symptoms domains. The present result supports the hypothesis that DCIS patients could be safely treated with a hypofractionated schedule employing a CB to the lumpectomy cavity.

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Authors and Affiliations

  1. Radiotherapy Department, ASL TO4, Ivrea Community Hospital, Ivrea, Italy

    Domenico Cante, Piera Sciacero, Giuseppe Girelli, Anna Maria Marra & Maria Rosa La Porta

  2. Breast Surgery Department, ASL TO4, Ivrea Community Hospital, Ivrea, Italy

    Guido Mondini & Ovidio Paino

  3. Medical Physics Department, ASL TO4, Ivrea Community Hospital, Ivrea, Italy

    Massimo Pasquino, Giuliana Russo, Valeria Casanova Borca & Santi Tofani

  4. Tomotherapy Unit, Radiation Oncology Department, Ospedale Regionale ‘U. Parini’, AUSL Valle d’Aosta, Viale Ginevra 3, 11100, Aosta, Italy

    Pierfrancesco Franco

  5. Medical Oncology Department, Ospedale Regionale ‘U. Parini’, AUSL Valle d’Aosta, Aosta, Italy

    Gianmauro Numico

  6. Department of Oncology, Radiation Oncology, University of Torino, Turin, Italy

    Umberto Ricardi

Authors
  1. Domenico Cante
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  2. Pierfrancesco Franco
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  3. Piera Sciacero
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  4. Giuseppe Girelli
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  5. Anna Maria Marra
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  6. Massimo Pasquino
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  7. Giuliana Russo
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  8. Valeria Casanova Borca
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  9. Guido Mondini
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  10. Ovidio Paino
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  11. Gianmauro Numico
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  12. Santi Tofani
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  13. Maria Rosa La Porta
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  14. Umberto Ricardi
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Corresponding author

Correspondence to Pierfrancesco Franco.

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Cante, D., Franco, P., Sciacero, P. et al. Hypofractionation and concomitant boost to deliver adjuvant whole-breast radiation in ductal carcinoma in situ (DCIS): a subgroup analysis of a prospective case series. Med Oncol 31, 838 (2014). https://doi.org/10.1007/s12032-014-0838-2

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  • DOI: https://doi.org/10.1007/s12032-014-0838-2

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