A Hypofractionated Radiotherapy Schedule with a Simultaneous Integrated Boost for Breast Cancer: Outcomes including Late Toxicity and Health Quality
Abstract
:1. Introduction
2. Materials and Methods
2.1. Radiotherapy
2.2. Patient Evaluation
2.3. Statistical Methods
3. Results
4. Discussion
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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No. of Patients | 125 | |
Age (range) | mean 63 (58–84) | |
BMI | mean 29.1(18–33) | |
Diabetes Mellitus | 25 (20%) | |
Hypertension | 59 (47.2%) | |
Tumor location | Right | 60 (48%) |
Left | 65 (52%) | |
Tumor quadrant | Upper outer | 62 (49.6%) |
Upper inner | 23 (28.75%) | |
Lower outer | 12 (9.6%) | |
Lower inner | 3 (2.4%) | |
Histology | IDC | 90 (72%) |
ILC | 19 (15.2%) | |
Intraductal | 16 (12.8%) | |
T stage | Tis | 16 (12.8%) |
T1 | 67 (53.6%) | |
T2 | 42 (33.6%) | |
Grade | G1 | 29 (23.2%) |
G2 | 66 (52.8%) | |
G3 | 30 (24%) | |
ER status | + | 98 (78.4%) |
− | 27 (21.6%) | |
Systemic therapy | Chemotherapy | 59 (47.2%) |
Hormonotherapy | 98 (78.4%) | |
Trastuzumab | 24 (19.2%) | |
Radiotherapy technique | ||
IMRT alone | 91 (72.8%) | |
VMAT alone | 12 (9.6%) | |
IMRT + VMAT hybrid | 22 (17.6%) |
Structure/Target volumes/Dosimetric characteristics | Results |
Breast Volume | |
Mean (range) cc | 810 (500–1800) |
Tumor bed volume | |
Mean (range) cc | 132 (54–210) |
PTV whole breast | |
Mean dose (Gy) | 49.1 |
Mean Maximum dose (Gy) | 49.5 |
D98 (Gy) | 45.1 |
V95 (%) | 92.5 |
V105 (%) | 28.7 |
PTV boost | |
Mean dose (Gy) | 53.2 |
Mean Maximum dose (Gy) | 55.1 |
D98 | 51.7 |
V95 (%) | 92.7 |
V105 (%) | 0.4 |
Toxicity | RTOG Toxicity Score | Therapy (n) Acute | 3 Months (n) Acute | 5 Years (n) Late |
---|---|---|---|---|
Skin | ||||
G1 | 23 | 13 | 6 | |
G2 | 13 | 6 | - | |
G3 | - | - | - | |
Pain | ||||
G1 | 10 | 17 | 5 | |
Edema | ||||
G1 | 15 | 14 | 3 |
Cosmetic Outcome | Before Radiotherapy n (%) | 3 Months n (%) | 5 Years n (%) |
---|---|---|---|
Excellent/good | 112 (89.6) | 110 (88) | 113 (90.4) |
Fair/poor | 13 (10.4) | 15 (12) | 12 (9.6) |
Item | Mean +/− SD | p | ||
---|---|---|---|---|
Baseline | 3 Months | 5 Years | ||
PHYSICAL WELL-BEING | 20.3 +/− 5.2 | 20.7 +/− 3.5 | 22.4 +/− 3.6 | 0.04 |
SOCIAL/FAMILY WELL-BEING | 14.0 +/− 5.3 | 14.1 +/− 5.0 | 16.2 +/− 3.8 | 0.03 |
EMOTIONAL WELL-BEING | 18.3 +/− 3.5 | 19.1 +/− 3.6 | 19.9 +/− 3.2 | 0.04 |
FUNCTIONAL WELL-BEING | 17.0 +/− 4.7 | 17.4 +/− 3.6 | 18.3 +/− 3.1 | 0.04 |
ADDITIONAL CONCERNS | 22.9 +/− 4.4 | 19.1 +/− 4.4 | 17.1 +/− 3.8 | 0.04 |
FACT-G Score | 69.6 +/− 11.3 | 70.6 +/− 10.1 | 75.0 +/− 10.3 | 0.02 |
FACT-B Score | 136.2 +/− 3.6 | 137.1 +/− 3.7 | 137.7 +/− 3.1 | 0.04 |
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Akgun, Z.; Cakir, A.; Sağlam, E.; Demirel, S.; Igci, A.; Keskin, S. A Hypofractionated Radiotherapy Schedule with a Simultaneous Integrated Boost for Breast Cancer: Outcomes including Late Toxicity and Health Quality. Medicina 2023, 59, 675. https://doi.org/10.3390/medicina59040675
Akgun Z, Cakir A, Sağlam E, Demirel S, Igci A, Keskin S. A Hypofractionated Radiotherapy Schedule with a Simultaneous Integrated Boost for Breast Cancer: Outcomes including Late Toxicity and Health Quality. Medicina. 2023; 59(4):675. https://doi.org/10.3390/medicina59040675
Chicago/Turabian StyleAkgun, Zuleyha, Aydin Cakir, Esra Sağlam, Sertac Demirel, Abdullah Igci, and Serkan Keskin. 2023. "A Hypofractionated Radiotherapy Schedule with a Simultaneous Integrated Boost for Breast Cancer: Outcomes including Late Toxicity and Health Quality" Medicina 59, no. 4: 675. https://doi.org/10.3390/medicina59040675