Phase I-II studies on accelerated IMRT in breast carcinoma: technical comparison and acute toxicity in 332 patients.

Vincenzo Valentini, Francesco Deodato, Giorgia Garganese, Luigi Sofo, Giovanni Scambia, Alessio Giuseppe Morganti, Savino Cilla, Gabriella Macchia, Simona Panunzi, Andrea De Gaetano, Giuseppina Sallustio, Numa Cellini, Angelo Piermattei, Cinzia Digesù, Gabriella Ferrandina, Maria Grazia Cece, Massimo Cirocco, Liberato Di Lullo, Divina Traficante, Francesca Scarabeo

Risultato della ricerca: Contributo in rivistaArticolo in rivista

55 Citazioni (Scopus)


BACKGROUND AND PURPOSE: To evaluate the results in terms of dosimetric parameters and acute toxicity of two clinical studies (MARA-1 and MARA-2) on accelerated IMRT-based postoperative radiotherapy. These results are compared with historical control group (CG) of patients treated with "standard" 3D postoperative radiotherapy. MATERIALS AND METHODS: Prescribed dose to the breast was 50.4Gy in the CG, 40Gy in MARA-1 (low risk of local recurrence), and 50Gy in MARA-2 (medium-high risk of recurrence). The tumor bed total dose was 60.4Gy (sequential 10Gy electron boost), 44Gy (concomitant 4Gy boost), and 60Gy (concomitant 10Gy boost) in CG, MARA-1 and MARA-2 studies, respectively. Overall treatment time was of 32 fractions for CG (6.4weeks); 16 fractions for MARA-1 study (3.2weeks) and 25 fractions for MARA-2 study (5weeks). RESULTS: Three hundred and thirty two patients were included in the analysis. Dosimetric analysis showed D(max) and V(107%) reduction (p<0.001) and D(min) improvement (p<0.001) in the PTV in patients treated with IMRT. Grade 2 acute skin toxicity was 33.6%, 13.1%, and 45.1% in the CG, MARA-1, and MARA-2, respectively (p<0.001), and grade 3 acute skin toxicity was 3.1%, 1.0%, and 2.0%, respectively. Similarly, larger PTV and use of chemotherapy with anthracyclines and taxanes were associated with a greater acute toxicity. With a median follow-up of 31 months, no patients showed local or nodal relapse. CONCLUSIONS: A simplified step and shoot IMRT technique allowed better PTV coverage and reduced overall treatment time (CG, 6.6weeks; MARA-1, 3.2weeks; MARA-2, 5weeks) with acceptable short-term toxicity.
Lingua originaleEnglish
pagine (da-a)86-92
Numero di pagine7
RivistaRadiotherapy and Oncology
Stato di pubblicazionePubblicato - 2009


  • IMRT
  • accelerated treatment
  • acute toxicity
  • breast
  • radiotherapy


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