Title
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The influence of the boost in breast-conserving therapy on cosmetic outcome in the EORTC "boost versus no boost" trial
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Author
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Institution/Organisation
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EORTC Radiotherapy Breast Canc Cooperative Group
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Abstract
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Purpose: To evaluate the influence of a radiotherapy boost on the cosmetic outcome after 3 years of follow-up in patients treated with breast-conserving therapy (BCT). Methods and Materials: In EORTC trial 22881/10882, 5569 Stage I and II breast cancer patients were treated with tumorectomy and axillary dissection, followed by tangential irradiation of the breast to a dose of 50 Gy in 5 weeks, at 2 Gy per fraction. Patients having a microscopically complete tumor excision were randomized between no boost and a boost of 16 Gy. The cosmetic outcome was evaluated by a panel, scoring photographs of 731 patients taken soon after surgery and 3 years later, and by digitizer measurements, measuring the displacement of the nipple of 3000 patients postoperatively and of 1141 patients 3 years later. Results: There was no difference in the cosmetic outcome between the two treatment arms after surgery, before the start of radiotherapy. At 3-year follow-up, both the panel evaluation and the digitizer measurements showed that the boost had a significant adverse effect on the cosmetic result. The panel evaluation at 3 years showed that 86% of patients in the no-boost group had an excellent or good global result, compared to 71% of patients in the boost group (p = 0.0001). The digitizer measurements at 3 years showed a relative breast retraction assessment (pBRA) of 7.6 pBRA in the no-boost group, compared to 8.3 pBRA in the boost group, indicating a worse cosmetic result in the boost group at follow-up (p = 0.04). Conclusions: These results showed that a boost dose of 16 Gy had a negative, but limited, impact on the cosmetic outcome after 3 years. (C) 1999 Elsevier Science Inc. |
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Language
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English
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Source (journal)
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International journal of radiation oncology, biology, physics. - Bedford
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Publication
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Bedford
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1999
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ISSN
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0360-3016
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DOI
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10.1016/S0360-3016(99)00211-4
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Volume/pages
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45
:3
(1999)
, p. 677-685
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ISI
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000082983000023
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Pubmed ID
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10524422
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Full text (Publisher's DOI)
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Full text (publisher's version - intranet only)
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