The addition of a boost dose on the primary tumour bed after lumpectomy in breast conserving treatment for breast cancer : a summary of the results of EORTC 22881-10882 "boost versus no boost" trial = Le complément d’irradiation du lit tumoral après tumorectomie dans le traitement conservateur du cancer du sein : un résumé des résultats de l’essai boost versus no boost EORTC 22881-10882

Poortmans, P.M.; Collette, L.; Bartelink, H.; Struikmans, H.; Van den Bogaert, W.F.; Fourquet, A.; Jager, J.J.; Hoogenraad, W.; Mueller, R.-P.; Dubois, J.-B.; Bolla, M.; Van Der Hulst, M.; Warlam-Rodenhuis, C.C.; Pierart, M.; Horiot, J.-C.

doi:10.1016/J.CANRAD.2008.07.014

Title

The addition of a boost dose on the primary tumour bed after lumpectomy in breast conserving treatment for breast cancer : a summary of the results of EORTC 22881-10882 "boost versus no boost" trial = Le complément d’irradiation du lit tumoral après tumorectomie dans le traitement conservateur du cancer du sein : un résumé des résultats de l’essai boost versus no boost EORTC 22881-10882

Author

Poortmans, P.M.

Collette, L.

Bartelink, H.

Struikmans, H.

Van den Bogaert, W.F.

Fourquet, A.

Jager, J.J.

Hoogenraad, W.

Mueller, R.-P.

Dubois, J.-B.

Bolla, M.

Van Der Hulst, M.

Warlam-Rodenhuis, C.C.

Pierart, M.

Horiot, J.-C.

Institution/Organisation

EORTC Radiation Oncology and Breast Cancer Groups

Abstract

Purpose. - To investigate the impact of the boost close to the primary tumour bed in the framework of breast conserving therapy on local control, cosmetic results, fibrosis and overall survival for patients with early stage breast cancer. Patients and methods. - Five thousand five hundred and sixty-nine patients after lumpectomy followed by whole breast irradiation of 50 Gy were randomised. After a microscopically complete lumpectomy (5318 patients), the boost closes were either 0 or 16 Gy, while after a microscopically incomplete (251 patients) lumpectomy randomisation was between 10 and 26 Gy. The results at a median follow-up of 10 years are presented. Results. - At 10 years, the cumulative incidence of local recurrence was 10.2% versus 6.2% for the 0 Gy and the 16 Gy boost groups (p < 0.0001) and 17.5% versus 10.8% for the 10 and 26 Gy boost groups, respectively (p > 0.1). There was no statistically significant interaction per age group but recurrences tended to occur earlier in younger patients. As Younger patients had a higher cumulative risk of local relapse by year 10, the magnitude of the absolute 10-year risk reduction achieved with the boost decreased with increasing age. Development of fibrosis was significantly dependent oil the boost dose with a 10-year rate for severe fibrosis of 1.6% after 0 Gy, 3.3% after 10 Gy, 4.4% after 16 Gy and 14.4% after 26 Gy, respectively. Conclusion. - An increase of the dose with 16 Gy improved local control for patients after a complete lumpectomy only. The development of fibrosis was clearly dose dependent. With 10 years median follow-up, no impact of survival was observed. (C) 2008 Elsevier Masson SAS. All rights reserved.

Language

English

Source (journal)

Cancer radiothérapie / Société française de radiothérapie oncologique. - Paris, 1997, currens

Publication

Paris : Elsevier , 2008

ISSN

1278-3218 [print]

1769-6658 [online]

DOI

10.1016/J.CANRAD.2008.07.014

Volume/pages