Role of Boost Radiotherapy for Local Control of Pure Ductal Carcinoma in Situ After Breast-conserving Surgery: a Multicenter, Retrospective Study of 622 Patients

Overview

Journal Clin Transl Oncol

Specialty Oncology

Date 2019 Jul 3

PMID 31264148

Citations 1

Authors

M J Cambra

F Moreno

X Sanz

L Anglada

M Molla

V Reyes

M Arenas

A Pedro

R Ballester

V Garcia

J Casals

M Cusido

C Jimenez

J M Escriba

M Macia

J M Sole

A Arcusa

M A Segui

S Gonzalez

B Farrus

A Biete

Affiliations

Soon will be listed here.

Abstract

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.

Citing Articles

Hypofractionation and Concomitant Boost in Ductal Carcinoma In Situ (DCIS): Analysis of a Prospective Case Series with Long-Term Follow-Up.

Cante D, Paolini M, Piva C, Petrucci E, Radici L, Ferrario S Life (Basel). 2022; 12(6).

PMID: 35743920 PMC: 9225308. DOI: 10.3390/life12060889.

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