Breast induration and irradiated volume in the DBCG HYPO trial: The impact of age, smoking, and boost.

Autor: Thomsen MS; Department of Medical Physics, Aarhus University Hospital, Aarhus, Denmark. Electronic address: mettthom@rm.dk., Alsner J; Department of Experimental Clinical Oncology, Aarhus University Hospital, Aarhus, Denmark., Lutz CM; Department of Medical Physics, Aarhus University Hospital, Aarhus, Denmark., Berg M; Department of Medical Physics, University Hospital of Southern Denmark, Vejle, Denmark., Jensen I; Department of Medical Physics, Aalborg University Hospital, Aalborg, Denmark., Lorenzen EL; Laboratory of Radiation Physics, Odense University Hospital, Odense, Denmark; Department of Clinical Research, University of Southern Denmark, Odense, Denmark., Nielsen HM; Department of Oncology, Aarhus University Hospital, Aarhus, Denmark., Jakobsen EH; Department of Oncology, University Hospital of Southern Denmark, Vejle, Denmark., Stenbygaard L; Department of Oncology, Aalborg University Hospital, Aalborg, Denmark., Nielsen MH; Department of Oncology, Odense University Hospital, Odense, Denmark., Jensen MB; Danish Breast Cancer Group, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark., Overgaard J; Department of Experimental Clinical Oncology, Aarhus University Hospital, Aarhus, Denmark., Offersen BV; Department of Experimental Clinical Oncology, Aarhus University Hospital, Aarhus, Denmark; Department of Oncology, Aarhus University Hospital, Aarhus, Denmark.
Jazyk: angličtina
Zdroj: Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology [Radiother Oncol] 2024 Dec; Vol. 201, pp. 110574. Date of Electronic Publication: 2024 Oct 10.
DOI: 10.1016/j.radonc.2024.110574
Abstrakt: Purpose: To investigate the association between irradiated breast volume and grade 2-3 breast induration three years after radiotherapy in the phase III Danish Breast Cancer Group HYPO trial randomizing patients ≥ 41 years to whole breast irradiation (WBI) with 40 Gy/15fr versus 50 Gy/25fr.
Methods: Treatment plans were available for all Danish patients. Associations between frequency of induration and irradiated volume, age, smoking status, and boost were assessed by logistic regression. A sequential boost was given to patients < 50 years or in case of a narrow (<2 mm) resection margin.
Results: RT plans from 1,333 patients were analyzed with 178 (13 %) having grade 2-3 induration. 1135 patients had only WBI. For this group, induration was correlated with irradiated breast volume for patients ≥ 65 years (n = 343, 10 %/22 % for small/large irradiated volumes, p = 0.005) but not for patients aged 50-64 years (n = 792, 11 % for both small and large volumes, p = 0.82). Smoking doubled the frequency irrespective of irradiated volume and age. All patients < 50 years (n = 156) had a boost. A volume effect was found for this group (5 %/21 % induration for small/large volume, p = 0.002). 42 patients ≥ 50 years had a boost and 14 (33 %) had grade 2-3 induration, however, with a p-value > 0.05 due to the few numbers of patients.
Conclusion: A relationship between irradiated breast volume and 3-year frequency of breast induration was found for patients ≥ 65 years, whilst not for patients aged 50-64 years. Smoking doubled the risk of induration irrespective of volume and age. A dose-induration relationship was seen for boost patients < 50 years.
Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
(Copyright © 2024 The Author(s). Published by Elsevier B.V. All rights reserved.)
Databáze: MEDLINE
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