Abstract
Purpose
To assess the impact of the boost dose in patients with involved surgical margins.
Patients and methods
In the EORTC “boost versus no boost” trial, 251 patients with a microscopically incomplete
tumour excision were randomised to receive either a low boost dose of 10 Gy (126 patients) or a high boost dose of 26 Gy (125 patients). Overall survival and the cumulative incidence of local recurrence
as first event were compared by Logrank and Gray test, respectively (2-sided α = 0.05), with a median follow-up of 11.3 years. The planned sample size was 660 patients,
but only 251 were recruited.
Results
The median age at randomisation was 54 years. Thirty-seven patient initially relapsed
locally. At 10 years, the cumulative incidence of local recurrence was 17.5% (95%
CI: 10.4–24.6%) versus 10.8% (95% CI: 5.2–16.4%) for the low and high boost dose groups,
respectively (HR = 0.83, 95% CI: 0.43–1.57, Gray p > 0.1). Overall, 64 patients have died (25.5%), 47 of them of breast cancer, without
a difference in duration of survival between the two groups (HR = 0.97, 95% CI = 0.59–1.5, p > 0.1). Severe fibrosis was palpated in the breast in 1% versus 5% and in the boost
area in 3% versus 13% in the low and high boost dose groups, respectively.
Conclusions
There was no statistically significant difference in local control or survival between
the high boost dose of 26 Gy and the low boost dose of 10 Gy in patients with microscopically incomplete excision of early breast cancer. Fibrosis,
however, was noted significantly more frequently in cases treated with the high boost
dose.
Keywords
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Article info
Publication history
Published online: August 19, 2008
Accepted:
July 16,
2008
Received in revised form:
July 1,
2008
Received:
May 12,
2008
Identification
Copyright
© 2008 Elsevier Ireland Ltd. Published by Elsevier Inc. All rights reserved.
