Efficacy and Safety of Hypofractionated Radiotherapy With a Simultaneous Integrated Boost and With a Sequential Boost After Breast‐Conserving Surgery

ABSTRACT Purpose The objective of this study was retrospectively to compare the efficacy and safety of hypofractionated radiotherapy (HFRT) with a simultaneous integrated boost (SIB) or with a sequential boost (SB) after breast‐conserving surgery in patients diagnosed with early breast cancer. Metho...

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Main Authors: Na Li, Yang Zhou, Jianting Wang, Yuwei Wang, Ruiyu Shao, Haifang Yang, Wei Xiong, Xuan Zheng, Xiaohong Wang
Format: Article
Language:English
Published: Wiley 2025-03-01
Series:Cancer Medicine
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Online Access:https://doi.org/10.1002/cam4.70630
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author Na Li
Yang Zhou
Jianting Wang
Yuwei Wang
Ruiyu Shao
Haifang Yang
Wei Xiong
Xuan Zheng
Xiaohong Wang
author_facet Na Li
Yang Zhou
Jianting Wang
Yuwei Wang
Ruiyu Shao
Haifang Yang
Wei Xiong
Xuan Zheng
Xiaohong Wang
author_sort Na Li
collection DOAJ
description ABSTRACT Purpose The objective of this study was retrospectively to compare the efficacy and safety of hypofractionated radiotherapy (HFRT) with a simultaneous integrated boost (SIB) or with a sequential boost (SB) after breast‐conserving surgery in patients diagnosed with early breast cancer. Methods This study enrolled a total of 343 patients diagnosed with T1‐2N0‐1 breast cancer who had undergone breast‐conserving surgery followed by whole‐breast irradiation (WBI) without nodal irradiation, between March 2018 and April 2021. Out of 343 patients, 176 (51.3%) received HFRT‐SIB treatment, totaling 15 sessions, while the remaining 167 (48.7%) received HFRT‐SB treatment, totaling 18 sessions. Demographic characteristics, skin toxicity, radiation pneumonia, and myelosuppression, were compared in the two groups. Three‐year local progression free survival (LPFS) rates were determined using the Kaplan–Meier method and compared using the log‐rank test. Results The median follow‐up time was 39.7 months (range 24.3–61.3 months). Toxicities rates did not differ significantly in the HFRT‐SIB and HFRT‐SB groups, including rates of grade 2 skin toxicity (14.8% vs. 13.8%, p = 0.721), Grade 2 radiation pneumonia (2.8% vs. 3.6%, p = 0.355), grades 1, 2 and 3 myelosuppression (12.5%, 5.7% and 1.1%, respectively, vs. 9.6%, 7.8%, and 1.2%, respectively; p = 0.744). Three‐year cumulative LPFS rates were similar in the HFRT‐SIB and HFRT‐SB groups (99.3% vs. 98.6%, p = 0.52). Regional nodal recurrences were observed in one patient in the HFRT‐SIB group (after 27.4 months) and in two patients in the HFRT‐SB group (after 29.4 and 56.4 months), and a local recurrence was observed in one patient in the latter group after 36.0 months. One patient in the HFRT‐SIB group was diagnosed with distant metastases to bone, and one patient in the HFRT‐SB group was diagnosed with distant metastases to the liver. Conclusion Similar efficacy and safety of HFRT‐SIB and HFRT‐SB after breast‐conserving surgery in patients with early‐stage (T1‐2N0‐1) breast cancer. Longer‐term follow‐up is required to further compare their efficacy.
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spelling doaj-art-36f54b2d8be643e4beb74e19e8875ee42025-08-20T02:12:19ZengWileyCancer Medicine2045-76342025-03-01146n/an/a10.1002/cam4.70630Efficacy and Safety of Hypofractionated Radiotherapy With a Simultaneous Integrated Boost and With a Sequential Boost After Breast‐Conserving SurgeryNa Li0Yang Zhou1Jianting Wang2Yuwei Wang3Ruiyu Shao4Haifang Yang5Wei Xiong6Xuan Zheng7Xiaohong Wang8Tangshan People's Hospital Tangshan Hebei ChinaTangshan People's Hospital Tangshan Hebei ChinaTangshan People's Hospital Tangshan Hebei ChinaTangshan People's Hospital Tangshan Hebei ChinaTangshan People's Hospital Tangshan Hebei ChinaTangshan People's Hospital Tangshan Hebei ChinaTangshan People's Hospital Tangshan Hebei ChinaTangshan People's Hospital Tangshan Hebei ChinaDepartment of Radiochemotherapy Tangshan People's Hospital Tangshan Hebei ChinaABSTRACT Purpose The objective of this study was retrospectively to compare the efficacy and safety of hypofractionated radiotherapy (HFRT) with a simultaneous integrated boost (SIB) or with a sequential boost (SB) after breast‐conserving surgery in patients diagnosed with early breast cancer. Methods This study enrolled a total of 343 patients diagnosed with T1‐2N0‐1 breast cancer who had undergone breast‐conserving surgery followed by whole‐breast irradiation (WBI) without nodal irradiation, between March 2018 and April 2021. Out of 343 patients, 176 (51.3%) received HFRT‐SIB treatment, totaling 15 sessions, while the remaining 167 (48.7%) received HFRT‐SB treatment, totaling 18 sessions. Demographic characteristics, skin toxicity, radiation pneumonia, and myelosuppression, were compared in the two groups. Three‐year local progression free survival (LPFS) rates were determined using the Kaplan–Meier method and compared using the log‐rank test. Results The median follow‐up time was 39.7 months (range 24.3–61.3 months). Toxicities rates did not differ significantly in the HFRT‐SIB and HFRT‐SB groups, including rates of grade 2 skin toxicity (14.8% vs. 13.8%, p = 0.721), Grade 2 radiation pneumonia (2.8% vs. 3.6%, p = 0.355), grades 1, 2 and 3 myelosuppression (12.5%, 5.7% and 1.1%, respectively, vs. 9.6%, 7.8%, and 1.2%, respectively; p = 0.744). Three‐year cumulative LPFS rates were similar in the HFRT‐SIB and HFRT‐SB groups (99.3% vs. 98.6%, p = 0.52). Regional nodal recurrences were observed in one patient in the HFRT‐SIB group (after 27.4 months) and in two patients in the HFRT‐SB group (after 29.4 and 56.4 months), and a local recurrence was observed in one patient in the latter group after 36.0 months. One patient in the HFRT‐SIB group was diagnosed with distant metastases to bone, and one patient in the HFRT‐SB group was diagnosed with distant metastases to the liver. Conclusion Similar efficacy and safety of HFRT‐SIB and HFRT‐SB after breast‐conserving surgery in patients with early‐stage (T1‐2N0‐1) breast cancer. Longer‐term follow‐up is required to further compare their efficacy.https://doi.org/10.1002/cam4.70630breast‐conserving surgeryhypofractionatedradiotherapysequentialsimultaneous
spellingShingle Na Li
Yang Zhou
Jianting Wang
Yuwei Wang
Ruiyu Shao
Haifang Yang
Wei Xiong
Xuan Zheng
Xiaohong Wang
Efficacy and Safety of Hypofractionated Radiotherapy With a Simultaneous Integrated Boost and With a Sequential Boost After Breast‐Conserving Surgery
Cancer Medicine
breast‐conserving surgery
hypofractionated
radiotherapy
sequential
simultaneous
title Efficacy and Safety of Hypofractionated Radiotherapy With a Simultaneous Integrated Boost and With a Sequential Boost After Breast‐Conserving Surgery
title_full Efficacy and Safety of Hypofractionated Radiotherapy With a Simultaneous Integrated Boost and With a Sequential Boost After Breast‐Conserving Surgery
title_fullStr Efficacy and Safety of Hypofractionated Radiotherapy With a Simultaneous Integrated Boost and With a Sequential Boost After Breast‐Conserving Surgery
title_full_unstemmed Efficacy and Safety of Hypofractionated Radiotherapy With a Simultaneous Integrated Boost and With a Sequential Boost After Breast‐Conserving Surgery
title_short Efficacy and Safety of Hypofractionated Radiotherapy With a Simultaneous Integrated Boost and With a Sequential Boost After Breast‐Conserving Surgery
title_sort efficacy and safety of hypofractionated radiotherapy with a simultaneous integrated boost and with a sequential boost after breast conserving surgery
topic breast‐conserving surgery
hypofractionated
radiotherapy
sequential
simultaneous
url https://doi.org/10.1002/cam4.70630
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