Role of boost radiotherapy for local control of pure ductal carcinoma in situ after breast-conserving surgery:

• M. J. Cambra ^[8] ; F. Moreno ^[1] ; X. Sanz ^[2] ; L. Anglada ^[9] ; M. Mollà ^[3] ; V. Reyes ^[3] ; M. Arenas ^[10] ; A. Pedro ^[4] ; R. Ballester ^[11] ; V. García ^[5] ; J. Casals ^[12] ; M. Cusidó ^[13] ; C. Jimenez ^[14] ; J. M. Escribà ^[15] ; M. Macià ^[1] ; J. M. Solé ^[16] ; A. Arcusa ^[17] ; M. A. Seguí ^[6] ; S. Gonzalez ^[18] ; B. Farrús ^[7] ; A. Biete ^[7]
  1. [1] Institute Catalá Oncología

     Institute Catalá Oncología

     Barcelona, España

     
  2. [2] Parc de Salut MAR

     Parc de Salut MAR

     Barcelona, España

     
  3. [3] Hospital Vall d'Hebron

     Hospital Vall d'Hebron

     Barcelona, España

     
  4. [4] Hospital Plató

     Hospital Plató

     Barcelona, España

     
  5. [5] Hospital Arnau de Vilanova

     Hospital Arnau de Vilanova

     Valencia, España

     
  6. [6] Corporació Sanitària Parc Taulí

     Corporació Sanitària Parc Taulí

     Barcelona, España

     
  7. [7] Universitat de Barcelona

     Universitat de Barcelona

     Barcelona, España

     
  8. [8] Hospital Universitari General de Catalunya-Grupo Quirónsalud (IOV-HGC-Quironsalud),
  9. [9] Department of Radiation Oncology, ICO Girona, Avda de França, s/n, 17007, Girona, Spain
  10. [10] Department of Radiation Oncology, Hospital Universitari Sant Joan Reus
  11. [11] Department of Radiation Oncology, Institut Català D’Oncologia-Badalona, Carretera del Canyet, s/n, 08916, Badalona, Barcelona, Spain
  12. [12] Department of Radiation Oncology, Hospital Quirón, Plaça Alfonso Comín, 5, 08023, Barcelona, Spain
  13. [13] Department of Gynecology and Obstetrics, Hospital Universitari Dexeus-Grupo Quirónsalud, c/Sabino Arana, 5-19, 08028, Barcelona, Spain
  14. [14] Biostatistics and Bioinformatic Expert, Olesa de Montserrat, c/Urgell 55 A, 08640, Barcelona, Spain
  15. [15] Catalan Cancer Registry, Cancer Planning Directorate, L’Hospitalet de Llobregat, Avda de La Granvia, s/n, 08908, Barcelona, Spain
  16. [16] Department of Radiation Oncology, Consorci Sanitari de Terrassa, Ctra. Torrebonica s/n, 08227, Terrassa, Barcelona, Spain
  17. [17] Department of Medical Oncology, Ctra. Torrebonica s/n, Consorci Sanitari de Terrassa, 08227, Terrassa, Barcelona, Spain
  18. [18] Department of Medical Oncology, Hospital Universitari Mútua de Terrassa, Plaça del Doctor Robert, 5, 08221, Terrassa, Barcelona, Spain

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• Localización: Clinical & translational oncology, ISSN 1699-048X, Vol. 22, Nº. 5, 2020, págs. 670-680
• Idioma: inglés
• Texto completo no disponible (Saber más ...)
• Resumen

  • Purpose To evaluate the effect of boost radiotherapy on ipsilateral breast tumor recurrence (IBTR) for ductal carcinoma in situ (DCIS) after breast-conserving surgery and whole breast radiotherapy (WBRT) with or without boost.

    Methods and materials Retrospective, multicentre study of 622 patients (624 tumors) diagnosed with pure DCIS from 1993–2011.

    Results Most tumors (377/624; 60.4%) received a boost. At a median follow-up of 8.8 years, IBTR occurred in 64 cases (10.3%). A higher percentage of patients with risk factors for IBTR received a boost (p < 0.05). Boost was not associated with lower rates of IBTR than WBRT alone (HR 0.75, 95% CI 0.42–1.35). On the univariate analyses, IBTR was significantly associated with tumor size (11–20 mm, HR 2.32, 95% CI 1.27–4.24; and > 20 mm, HR 2.10, 95% CI 1.14–3.88), re-excision (HR 1.76, 95% CI 1.04–2.96), and tamoxifen (HR 2.03, 95% CI 1.12–3.70). Boost dose > 16 Gy had a protective effect (HR 0.39, 95% CI 0.187–0.824). Multivariate analyses confirmed the independent associations between IBTR and 11–20 mm (p = 0.02) and > 20 mm (p = 0.009) tumours, and re-excision (p = 0.006). On the margin-stratified multivariate analysis, tamoxifen was a poor prognostic factor in the close/positive margin subgroup (HR 4.28 95% CI 1.23–14.88), while the highest boost dose ( > 16 Gy) had a significant positive effect (HR 0.34, 95% CI 0.13–0.86) in the negative margin subgroup.

    Conclusions Radiotherapy boost did not improve the risk of IBTR. Boost radiotherapy was more common in patients with high-risk disease. Tumor size and re-excision were significant independent prognostic factors.