Radiotherapy Breast Boost With Reduced Whole-Breast Dose Is Associated With Improved Cosmesis: The Results of a Comprehensive Assessment From the St. George and Wollongong Randomized Breast Boost Trial
| Autor: | Stacy Cail, Stephanie Inder, Catherine Clark, Peter Graham, Alison Szwajcer, Lois Browne, Grad Cert, Yaw Chin, Eric Hau, Sam Khanna |
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| Rok vydání: | 2012 |
| Předmět: |
Cancer Research
medicine.medical_specialty Contracture Esthetics Breast boost medicine.medical_treatment Breast Neoplasms Mastectomy Segmental Diagnostic Self Evaluation Breast cancer Photography Carcinoma Humans Medicine Radiology Nuclear Medicine and imaging In patient Breast Whole breast Radiotherapy breast Observer Variation Radiation business.industry Cosmesis Radiotherapy Dosage Middle Aged medicine.disease Surgery Radiation therapy Oncology Retreatment Female Dose Fractionation Radiation New South Wales business Algorithms Software |
| Zdroj: | International Journal of Radiation Oncology*Biology*Physics. 82:682-689 |
| ISSN: | 0360-3016 |
| DOI: | 10.1016/j.ijrobp.2010.11.025 |
| Popis: | Purpose To evaluate comprehensively the effect of a radiotherapy boost on breast cosmetic outcomes after 5 years in patients treated with breast-conserving surgery. Methods The St. George and Wollongong trial (NCT00138814) randomized 688 patients with histologically proven Tis-2, N 0–1, M0 carcinoma to the control arm of 50 Gy in 25 fractions (342 patients) and the boost arm of 45 Gy in 25 fractions to the whole breast followed by a 16 Gy in 8 fraction electron boost (346 patients). Five-year cosmetic outcomes were assessed by a panel subjectively in 385 patients and objectively using pBRA (relative breast retraction assessment). A subset of patients also had absolute BRA measurements. Clinician assessment and patient self-assessment of overall cosmetic and specific items as well as computer BCCT.core analysis were also performed. Results The boost arm had improved cosmetic overall outcomes as scored by the panel and BCCT.core software with 79% ( p = 0.016) and 81% ( p = 0.004) excellent/good cosmesis respectively compared with 68% in no-boost arm. The boost arm also had lower pBRA and BRA values with a mean difference of 0.60 and 1.82 mm, respectively, but was not statistically significant. There was a very high proportion of overall excellent/good cosmetic outcome in 95% and 93% in the boost and no–boost arms using patient self-assessment. However, no difference in overall and specific items scored by clinician assessment and patient self-assessment was found. Conclusion The results show the negative cosmetic effect of a 16-Gy boost is offset by a lower whole-breast dose of 45 Gy. |
| Databáze: | OpenAIRE |
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