Radiotherapy & Oncology
Volume 90, Issue 1 , Pages 80-85 , January 2009

Impact of the boost dose of 10Gy versus 26Gy in patients with early stage breast cancer after a microscopically incomplete lumpectomy: 10-year results of the randomised EORTC boost trial

  • Philip M. Poortmans

      Affiliations

    • Department of Radiation Oncology, Dr. Bernard Verbeeten Instituut, Tilburg, The Netherlands
    • Corresponding Author InformationCorresponding author. Department of Radiation Oncology, Dr. Bernard Verbeeten Instituut, P.O. Box 90120, 5000 LA Tilburg, The Netherlands.
    web address
    • ,
  • Laurence Collette

      Affiliations

    • EORTC Head Quarters, Brussels, Belgium
    • ,
  • Jean-Claude Horiot

      Affiliations

    • Department of Radiation Oncology, Centre Georges-François Leclerc, Dijon, France
    • ,
  • Walter F. Van den Bogaert

      Affiliations

    • Department of Radiation Oncology, University Hospital Gasthuisberg, Leuven, Belgium
    • ,
  • Alain Fourquet

      Affiliations

    • Department of Radiation Oncology, Institute Curie, Paris, France
    • ,
  • Abraham Kuten

      Affiliations

    • Department of Radiation Oncology, Rambam Medical Centre, Haifa, Israel
    • ,
  • Evert M. Noordijk

      Affiliations

    • Department of Radiation Oncology, University Medical Centre, Leiden, The Netherlands
    • ,
  • Willem Hoogenraad

      Affiliations

    • Department of Radiation Oncology, University Medical Centre, Nijmegen, The Netherlands
    • ,
  • René-Olivier Mirimanoff

      Affiliations

    • Department of Radiation Oncology, University Medical Centre, Lausanne, Switzerland
    • ,
  • Marianne Pierart

      Affiliations

    • EORTC Head Quarters, Brussels, Belgium
    • ,
  • Erik Van Limbergen

      Affiliations

    • Department of Radiation Oncology, University Hospital Gasthuisberg, Leuven, Belgium
    • ,
  • Harry Bartelink

      Affiliations

    • Department of Radiation Oncology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
    • ,
  • On behalf of the EORTC Radiation Oncology and Breast Cancer Groups

Received 12 May 2008 ,Revised 1 July 2008 ,Accepted 16 July 2008.

References 

  1. Fisher B, Anderson S, Bryant J, et al. Twenty-year follow-up of a randomized trial comparing total mastectomy, lumpectomy, and lumpectomy plus irradiation for the treatment of invasive breast cancer. N Engl J Med. 2002;347:1233–1241
  2. Veronesi U, Cascinelli N, Mariani L, et al. Twenty-year follow-up of a randomized study comparing breast-conserving surgery with radical mastectomy for early breast cancer. N Engl J Med. 2002;347:1227–1232
  3. Voogd AC, Nielsen M, Peterse JL, et al. Differences in risk factors for local and distant recurrence after breast-conserving therapy or mastectomy for stage I and II breast cancer: pooled results of two large European randomized trials. J Clin Oncol. 2001;19:1688–1697
  4. Early Breast Cancer Trialists Collaborative Group (EBCTCG). Effects of radiotherapy and differences in the extent of surgery for early breast cancer on local recurrence and 15-year survival: an overview of the randomized trial. Lancet 2005;366:17–25.
  5. Curran D, Van Dongen JP, Aaronson NK, et al. Quality of life of early-stage breast cancer patients treated with radical mastectomy or breast-conserving procedures: results of EORTC trial 10801. Eur J Cancer. 1998;34:307–314
  6. Van Dongen JA, Voogd AC, Fentiman IS, et al. Long-term results of a randomized trial comparing breast-conserving therapy with mastectomy: European Organization for Research and Treatment of Cancer 10801 trial. J Natl Cancer Inst. 2000;92:1143–1145
  7. Van Limbergen E, Van den Bogaert W, vander Schueren E, Rijnders A. Tumor excision and radiotherapy as primary treatment of breast cancer. Analysis of patient and treatment parameters and local control. Radiother Oncol. 1987;8:1–9
  8. Bartelink H, Horiot JC, Poortmans PM, et al. Impact of a higher radiation dose on local control and survival in breast-conserving therapy of early breast cancer: 10-year results of the randomized boost versus no boost EORTC 22881-10882 trial. J Clin Oncol. 2007;25:3259–3265
  9. Bartelink H, Borger JH, van Dongen JA, Peterse JL. The Impact of tumor size and histology on local control after breast-conserving therapy. Radiother Oncol. 1988;11:297–303
  10. Newman LA, Kuerer HM. Advances in breast conservation therapy. J Clin Oncol. 2005;23:1685–1697
  11. Van den Broek N, Van der Sangen MJ, Van de Poll-Franse LV, van Beek MW, Nieuwenhuijzen GA, Voogd AC. Margin status and the risk of local recurrence after breast-conserving treatment of lobular breast cancer. Breast Cancer Res Treat. 2007;105:63–68
  12. TNM – classification of malignant tumours. 4th ed. Fully Revised Edition; 1987. p. 95–6.
  13. International commission of radiation units and measurements: dose specification for reporting external beam therapy with photons and electrons. Report 50. ICRU Publication: Bethesda, MD, USA, 1992.
  14. Harry Bartelink, Jean-Claude Horiot, Philip Poortmans, et al. Recurrence rates after treatment of breast cancer with standard radiotherapy with or without additional radiation. N Engl J Med. 2001;345:1378–1387
  15. Poortmans PM, Ataman F, Davis JB, et al. Quality assurance in the EORTC phase III randomised ‘boost vs. no boost’ trial for breast conserving therapy: comparison of the results of two individual case reviews performed early and late during the accrual period. Radiother Oncol. 2005;76:278–284
  16. Pocock SJ, Simon R. Sequential treatment assignment with balancing for prognostic factors in the controlled clinical trial. Biometrics. 1975;31:103–115
  17. Kaplan EL, Meier P. Nonparametric estimation from incomplete observations. J Am Stat Assoc. 1958;53:457–481
  18. Gray RJ. A class of K-sample tests for comparing the cumulative incidence of a competing risk. Ann Stat. 1988;16:1141–1154
  19. Schuck A, Ko ¨nemann S, Heinen K, et al. Strahlenther Onkol. 2002;178:307–313
  20. Van Limbergen E, van der Schueren E, Van den Bogaert W, Van Wing J. Local control of operable breast cancer with radiotherapy only. Eur J Cancer. 1990;26:674–679
  21. DiBiase SJ, Komarnicky LT, Schwartz GF, et al. The number of positive margins influences the outcome of women treated with breast preservation for early stage breast carcinoma. Cancer. 1998;82:2212–2220
  22. Park CC, Mitsumori M, Nixon A, et al. Outcome at 8 years after breast-conserving surgery and radiation therapy for invasive breast cancer: influence of margin status and systemic therapy on local recurrence. J Clin Oncol. 2000;18:1668–1675
  23. Solin LJ, Fowble BL, Schultz DJ, et al. The significance of the pathology margins of the tumor excision on the outcome of patients treated with definitive irradiation for early stage breast cancer. Int J Radiat Oncol Biol Phys. 1991;21:279–287
  24. Santiago RJ, Wu L, Harris E, et al. Fifteen-year results of breast-conserving surgery and definitive irradiation for stage 1 and II breast carcinoma: The University of Pennsylvania Experience. Int J Radiat Oncol Biol Phys. 2004;58:233–240
  25. Jones H, Antonini N, Colette L, et al. The impact of boost dose and margins on the local recurrence rate in breast conserving therapy: results from the EORTC Boost–No Boost Trial. Plenary oral presentation, 49th ASTRO-meeting. 28 October 2007–01 November 2007, Los Angeles. Int J Radiat Oncol Biol Phys 2007;69:abstract 2981.
  26. Van Limbergen E, Rijnders A, Van der Schueren E, Lerut T, Christiaens R. Cosmetic evaluation of breast conserving treatment for mammary cancer. 2. A quantitative analysis of the influence of radiation dose, fractionation schedules and surgical treatment techniques on cosmetic results. Radiother Oncol. 1989;16:253–267
  27. Donovan E, Bleakley N, Denholm E, et al. Randomised trial of standard 2D radiotherapy (RT) versus intensity modulated radiotherapy (IMRT) in patients prescribed breast radiotherapy. Radiother Oncol. 2007;82:254–264
  28. Antonini N, Jones H, Horiot JC, et al. Effect of age and radiation dose on local control after breast conserving treatment: EORTC Trial 22881-10882. Radiother Oncol. 2007;82:265–271
  29. Vrieling C, Collette L, Fourquet A, et al. Can patient-, treatment- and pathology-related characteristics explain the high local recurrence rate following breast-conserving therapy in young patients?. Eur J Cancer. 2003;39:932–944
  30. Poortmans P, Bartelink H, Horiot JC, et al. The influence of the boost technique on local control in breast conserving treatment in the EORTC “boost versus no boost” randomised trial. Radiother Oncol. 2004;72:25–33
  31. Hurkmans CW, Meijer GJ, Van Vliet-Vroegindeweij C, Van der Sangen MJ, Cassee J. High-dose simultaneously integrated breast boost using intensity-modulated radiotherapy and inverse optimization. Int J Radiat Oncol Biol Phys. 2006;66:923–930
  32. Van der Laan HP, Dolsma WV, Maduro JH, Korevaar EW, Hollander M, Langendijk JA. Three-dimensional conformal simultaneously integrated boost technique for breast-conserving radiotherapy. Int J Radiat Oncol Biol Phys. 2007;68:1018–1023

PII: S0167-8140(08)00376-9

doi: 10.1016/j.radonc.2008.07.011

Radiotherapy & Oncology
Volume 90, Issue 1 , Pages 80-85 , January 2009

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