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Accelerated IMRT with concurrent boost resulted in good local control, OS in breast cancer

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2011 ASTRO Annual Meeting

MIAMI - In patients with breast cancer who were treated with a regimen of accelerated intensity modulated radiation therapy with a concurrent boost to the tumor bed, the local control rate was 98.6% and the OS was 97.6%.

From 2003 to 2006, researchers, including Etin-Osa O. Osa, MD, from the New York University Clinical Cancer Center, evaluated 490 patients with stage 0, I or II breast cancer who were prospectively enrolled in two consecutive protocols. The patients had received radiotherapy after a segmental mastectomy and had negative margins of tumor excisions.

Accelerated intensity modulated radiation included a total dose of 40.5 Gy, delivered in 15 fractions at 2.7 Gy per fraction. The patients received treatment Monday to Friday for 3 weeks, and received a concomitant daily boost of 0.5 Gy to the tumor site. The majority of women, 93%, were treated in the prone position, and the remaining 7% were treated in the supine position.

Most of the patients, 82%, had stage I or II invasive breast cancer and 18% had ductal carcinoma in situ. After a median follow-up of 3 years, seven patients had a local recurrence, resulting in 98.6% local control. Five additional patients developed distant recurrence and four others developed contralateral breast cancer.

There were 12 total deaths, five of which were breast cancer-related, resulting in a 97.6% OS. An evaluation of late radiation toxicity showed that 57% of the patients experience grade-1 toxicity, 18% experienced grade-2 toxicity, 3% experienced grade-3 toxicity and 22% had no toxicity. A self evaluation of cosmesis showed that 83% of the patients reported a good-excellent result, 16% a fair result and 1% a poor result.

Earn CME this spring at the HemOnc Today Breast Cancer Review & Perspective meeting to be held March 23-24, 2012 at the Hilton San Diego Bayfront. See details at HemOncTodayBreastCancer.com.

For more information:

• Osa EO. #17. Presented at: the 53rd ASTRO Annual Meeting; Oct. 2-6, 2011; Miami Beach, Fla.

Disclosure: Dr. Osa reports no relevant financial disclosures.

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