Intensity modulated radiation therapy with simultaneous integrated boost in early breast cancer irradiation. Report of feasibility and preliminary toxicity

Fiorentino, Alba; Mazzola, Rosario; Ricchetti, F.; Levra, Niccolò Giaj; Fersino, S.; Naccarato, S.; Sicignano, G.; Ruggieri, R.; Paola, Gioacchino Di; Massocco, A.; Gori, Stefania; Alongi, Filippo

doi:10.1016/j.canrad.2015.02.013

Cited by 31 publications

(24 citation statements)

References 42 publications

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“…Two prospective randomized trials comparing H‐SIB vs C‐SEQ or H‐SEQ remain unpublished 31,32 . In the current study, good/excellent cosmesis was rated by 87.7% and 73.6% of patients in H‐SIB and C‐SIB, respectively, which was consistent with 82%‐100% and 73.6%‐96.5% in other studies 11,12,15,19‐23,31,33‐35 . The variety in range of scores might be due to differences in RT techniques and cosmetic scales across studies (Supplement 4).…”

Section: Discussionsupporting

confidence: 83%

Long‐term patient‐rated cosmetic and satisfactory outcomes of early breast cancer treated with conventional versus hypofractionated breast irradiation with simultaneous integrated boost technique

et al. 2020

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To compare patient‐rated cosmetic and satisfactory outcomes between conventional fractionation with simultaneously integrated boost (C‐SIB) vs hypofractionation with SIB (H‐SIB) in early breast cancer. Patients with stage I and II breast cancer who received breast‐conserving surgery followed by radiation with SIB to tumor bed and completed questionnaire were included in this study. Radiotherapy was as follows: C‐SIB arm = 50 Gy and 65 Gy in 25 fractions and H‐SIB arm = 43.2 Gy and 52.8 Gy in 16 fractions to the whole breast and tumor bed, respectively. Single cross‐sectional assessment of the breast cosmesis was done by patients and radiation oncologist at a follow‐up visit. Breast cosmetic and satisfaction scores were collected using a four‐point Harvard/NSABP/RTOG cosmesis criteria scale and a four‐point Likert‐type scale, respectively. Of a total of 114 patients (C‐SIB = 57) and (H‐SIB = 57) arms, a median time from radiotherapy completion to questionnaire response was 7.2 years. Patient‐rated cosmetic outcome in C‐SIB vs H‐SIB was “excellent” in 40.3% vs 45.6%, “good” in 33.3% vs 42.1%, “fair” in 21.1% vs 10.5%, and “poor” in 5.3% vs 1.8% (P = .288). Corresponding satisfaction was “very satisfied” in 52.6% vs 57.9%, “satisfied” in 40.4% vs 35.1%, “neutral” in 7.0% vs 5.2%, and “unsatisfied” in 0% vs 1.8% (P = .683). Stage I and older age at radiotherapy were predictors for favorable (good or excellent) cosmesis and satisfaction, respectively. In early‐stage breast cancer, H‐SIB provided a trend for better cosmesis than C‐SIB while maintaining satisfaction. The reduction in treatment duration and cost as well as favorable cosmesis outcomes encourages the use of H‐SIB.

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Section: Discussionsupporting

confidence: 83%

Long‐term patient‐rated cosmetic and satisfactory outcomes of early breast cancer treated with conventional versus hypofractionated breast irradiation with simultaneous integrated boost technique

et al. 2020

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“…An alternative method to SBT, is the simultaneous integrated boost technique (SIB) 7 – 9 , in which 60–66 Gy is prescribed to the tumor bed and to be delivered simultaneously with the standard treatment to the whole breast. The overall treatment time by SIB is reduced.…”

Section: Introductionmentioning

confidence: 99%

Advantages of a technique using two 50 degree arcs in simultaneous integrated boost radiotherapy for left-sidebreast cancer

Ding

et al. 2017

Sci Rep

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This study evaluated radiotherapy techniques with 15 cases for simultaneous integrated boost to treat whole left breast and tumor bed following breast conserving surgery. Treatment plans were generated using three techniques: volumetric modulated arc therapy (VMAT) with a partial arc of 190° (1ARC), VMAT with two tangential mini-arcs of 50° each (2TARC) and intensity modulated radiation therapy with four fixed angle fields (4IMRT). Dosimetric parameters for the whole breast (Target), the boost tumor bed (Boost), and surrounding normal organs were compared. Chair Index (CHI) was introduced to evaluate the dose homogeneity in Target given the two levels of prescription dose. The dose coverage in Target was better in 1ARC and 2TARC than that in 4IMRT. The mean CHI in 1ARC (2.47) and 2TARC (2.62) were higher than that in 4IMRT (1.71, p < 0.05), and this indicated the dose homogeneity of Target was better in 1ARC and 2TARC than that in 4IMRT. The mean doses to right lung, and contralateral breast in 4IMRT were lower than those in 2TARC but the differences between them were small. 2TARC was better than 4IMRT with respect to the dose to ipsilateral lung and heart. Overall, 2TARC was optimal among three techniques.

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“…This technique has achieved sparing of adjacent critical organs hitherto considered unachievable, while ensuring significantly better target coverage, reducing moist dermatitis and overall better quality of life [7]. Other recent comparative studies using three dimensional conformal therapy, IMRT or VMAT have established SIB-VMAT as a feasible modality and better than IMRT in terms of reduced monitor units (MU), reduced treatment time, better conformity and better normal OAR sparing [34][35][36]. Simultaneous integrated boost was found to be superior in dosimetric comparison with sequential boost [37].…”

Section: Introductionmentioning

confidence: 99%

Accelerated hypofractionated adjuvant whole breast radiation with simultaneous integrated boost using volumetric modulated arc therapy for early breast cancer: A phase I/II dosimetric and clinical feasibility study from a tertiary cancer care centre of India

Mondal

Julka

Sharma

et al. 2017

Journal of the Egyptian National Cancer Institute

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Intensity modulated radiation therapy with simultaneous integrated boost in early breast cancer irradiation. Report of feasibility and preliminary toxicity

Cited by 31 publications

References 42 publications

Long‐term patient‐rated cosmetic and satisfactory outcomes of early breast cancer treated with conventional versus hypofractionated breast irradiation with simultaneous integrated boost technique

Long‐term patient‐rated cosmetic and satisfactory outcomes of early breast cancer treated with conventional versus hypofractionated breast irradiation with simultaneous integrated boost technique

Advantages of a technique using two 50 degree arcs in simultaneous integrated boost radiotherapy for left-sidebreast cancer

Accelerated hypofractionated adjuvant whole breast radiation with simultaneous integrated boost using volumetric modulated arc therapy for early breast cancer: A phase I/II dosimetric and clinical feasibility study from a tertiary cancer care centre of India

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