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Hypofractionated versus conventionally fractionated radiotherapy for ductal carcinoma in situ ( DCIS ) of the breast
Author(s) -
Oar Andrew J,
Boxer Miriam M,
Papadatos George,
Delaney Geoff P,
Phan Penny,
Descallar Joseph,
Duggan Kirsten,
Tran Kelvin,
Yap Mei Ling
Publication year - 2016
Publication title -
journal of medical imaging and radiation oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.31
H-Index - 43
eISSN - 1754-9485
pISSN - 1754-9477
DOI - 10.1111/1754-9485.12428
Subject(s) - medicine , ductal carcinoma , breast cancer , radiation therapy , medical record , carcinoma , radiology , cancer
Hypofractionated radiotherapy ( RT ) in the setting of early invasive breast cancer has been shown to have similar local control rates and cosmetic outcomes as conventionally fractionated RT . This study compares ipsilateral recurrence rates between hypofractionated and conventional RT , with and without a boost. The effect of hypofractionated RT and chest wall separation ( CWS ) on cosmetic outcome was also assessed. Methods All patients with ductal carcinoma in situ ( DCIS ) treated between 1998 and 2012 across two sites of a single cancer institution were retrospectively studied. Patients were analysed according to those receiving conventional RT (≤2 Gy per fraction) and those receiving hypofractionated RT (>2 Gy per fraction), as well as the presence or absence of a tumour bed boost. Data were collected through electronic medical records and local cancer registry. Cosmetic outcome was scored by physicians on a four‐point scale during clinical follow‐up appointments. Results One hundred and ninety‐seven patients were treated for DCIS during the study period. One hundred and forty‐one were treated with conventional RT , and 56 with hypofractionated RT . After a median follow up of 4.4 years, there were 12 ipsilateral recurrences, of which seven were invasive disease and five DCIS . Ten recurrences occurred in patients who received conventional RT (7.1% recurrence rate) and two in those who received hypofractionated RT (3.6% recurrence rate) ( P = 0.48). Cosmetic outcomes were not significantly different between conventional and hypofractionated RT ( P = 0.06). Conclusions Hypofractionation represents a suitable alternative for treating DCIS in the absence of randomised data.