Five Year Outcome of 145 Patients With Ductal Carcinoma In Situ (DCIS) After Accelerated Breast Radiotherapy

Ciérvide, R.; Dhage, Shubhada; Guth, Amber; Shapiro, Richard L.; Axelrod, Deborah; Roses, Daniel F.; Formenti, Silvia C.

doi:10.1016/j.ijrobp.2011.11.025

Cited by 41 publications

(18 citation statements)

References 18 publications

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“…Similar to our study, there are few data published on the treatment of DCIS with HF radiation and CB [8][9][10]. Cante et al [10] reported on 104 patients with DCIS treated with 45 Gy × 20 fractions with a daily CB of 0.25 Gy per fraction.…”

Section: Discussionsupporting

confidence: 87%

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Ductal carcinoma in situ (DCIS) breast cancer treated with 3-week accelerated hypofractionated whole-breast radiation therapy and concomitant boost

et al. 2019

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Introduction In patients with ductal carcinoma in situ (DCIS), the clinical outcomes with hypofractionated (HF) whole-breast radiation (WBRT), as well as the role of lumpectomy boost, continue to be evaluated. In this paper, we report our experience on DCIS patients treated with HF WBRT with concomitant boost (CB). Methods Early-stage (DCIS, stages I and II) breast cancer patients were treated on an IRB-approved prospective single-arm study with HF WBRT and CB. This study includes only the DCIS subset of patients prescribed a dose of 40.5 Gy × 2.7 Gy per fraction to WB with CB of 4.5 Gy × 0.3G y per fraction over 15 fractions. A total of 107 breasts in 104 patients met the study criteria. Results All patients underwent lumpectomy with negative margins. Median age was 59 years. DCIS nuclear grade distribution was 9.3% grade 1, 50.5% grade 2, and 37.4% grade 3. Majority (86%) were ER positive. 41.1% received endocrine therapy. With median follow-up of 74 months (range, 12-158), 5-year actuarial overall survival was 97.2%. At the time of this report, no patient has experienced local relapse. The CTCAE grades 1 and 2 acute skin toxicity was 66.4% and 3.7%, respectively. No patients experienced grade 3 or higher skin toxicity, breast pain, and fatigue. Conclusion The HF schedule with CB in DCIS patients is well tolerated and associated with excellent clinical outcomes. This schedule affords the benefit of delivering higher dose to the lumpectomy site without protracting overall treatment time.

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Section: Discussionsupporting

confidence: 87%

“…Reported outcomes note that both HF and CF schedules have comparable therapeutic efficacy and are well tolerated. The inclusion of DCIS patients in these studies was limited, and clinical experience with HF schedules in the treatment of DCIS continues to be evaluated [8][9][10].…”

Section: Introductionmentioning

confidence: 99%

Ductal carcinoma in situ (DCIS) breast cancer treated with 3-week accelerated hypofractionated whole-breast radiation therapy and concomitant boost

et al. 2019

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“…35.9% of those surveyed felt that age <40 was an absolute contraindication for hypofractionation, whereas 30% found this a relative contraindication. 16.2% of participants felt that breast size (chest separation >25 cm) was an absolute contraindication, while 60.8% found this a relative contraindication. Most respondents did not consider laterality or type of systemic therapy to be absolute or relative contraindications in the delivery of hypofractionated radiotherapy ( Table 2).…”

Section: Hypofractionationmentioning

confidence: 99%

“…There have been a number of retrospective studies that report the risk of local recurrence among individuals treated with hypofractionated regimes after BCS for DCIS was similar to individuals treated with conventional regimes. [16][17][18] A meta-analysis of observational studies reviewing the role of boost and hypofractionation in adjuvant radiotherapy in DCIS supported hypofractionation and the addition of boost to reduce the risk of local recurrence in the presence of positive margins. 18 The meta-analysis warned, however, that the level of evidence ranged from very low and low and that ongoing randomized trials are necessary to confirm the results with higher level of evidence.…”

Section: Ductal Carcinoma In Situmentioning

confidence: 99%

Breast interest group faculty of radiation oncology: Australian and New Zealand patterns of practice survey on breast radiotherapy

et al. 2016

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“…Ciervide et al [32] performed a subgroup analysis of 2 prospective trials on hypofractionation, including 145 patients with DCIS. Patients were treated with either 42 Gy in 15 fractions or 40.5 Gy in 15 fractions with a concomitant daily boost of 0.5 Gy to the resection cavity up to a total dose of 48 Gy.…”

Section: Hypofractionationmentioning

confidence: 99%

Radiotherapy of Ductal Carcinoma In Situ

Krug

Souchon

2015

Breast Care

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Ductal carcinoma in situ (DCIS) is a heterogeneous disease in both its biology and clinical course. In the past, recurrence rates after breast-conserving surgery have been as high as 30% after 10 years. The introduction of mammography screening and advances in imaging have led to an increase in the detection of DCIS. The focus of this review is on the role of radiotherapy in the multidisciplinary treatment, including current developments in hypofractionation and boost delivery, and attempts to define low-risk subsets of DCIS for which the need for adjuvant radiation is repeatedly questioned.

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Five Year Outcome of 145 Patients With Ductal Carcinoma In Situ (DCIS) After Accelerated Breast Radiotherapy

Cited by 41 publications

References 18 publications

Ductal carcinoma in situ (DCIS) breast cancer treated with 3-week accelerated hypofractionated whole-breast radiation therapy and concomitant boost

Ductal carcinoma in situ (DCIS) breast cancer treated with 3-week accelerated hypofractionated whole-breast radiation therapy and concomitant boost

Breast interest group faculty of radiation oncology: Australian and New Zealand patterns of practice survey on breast radiotherapy

Radiotherapy of Ductal Carcinoma In Situ

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