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William J. Gradishar, MD, FACP, FASCO
William J. Gradishar, MD, FACP, FASCO
Posted: Monday, April 10, 2023
Concomitant boost radiation therapy may be a safe alternative to sequential boost therapy in patients with breast cancer, according to a poster presented at the NCCN 2023 Annual Conference. According to Joy Ogunmuyiwa, MD, MPH, of NewYork-Presbyterian Brooklyn Methodist Hospital, and colleagues, “dose escalation to the lumpectomy bed by way of a radiation boost improves local control, with the absolute largest benefit found in younger patients.”
The study enrolled 25 patients with early-stage, node-negative breast cancer. All patients had already undergone breast-conserving surgery and adjuvant radiation therapy. Unique sequential boost and concomitant boost therapy plans were developed for each patient. The authors used three scores to assess the results: conformity, homogeneity, and gradient. Conformity was defined as the proportion of volume isodose to target volume. Homogeneity was defined as the maximum dose of the target to the prescription dose. Gradient was defined as the volume receiving half-prescription dose to the volume receiving full-prescription dose.
The authors reported that the conformity and gradient indices were significantly better with concomitant boost therapy compared with sequential boost therapy (P < .0001 and P < .0002, respectively). However, there was no significant difference between the two therapies when comparing homogeneity scores. Further analysis revealed that lumpectomy beds located within the inner quadrants had worse conformity scores than those located in the outer quadrants, regardless of therapy. Lumpectomy bed sizes of up to 50 cm2 were found to have a higher conformity score when treated with concomitant boost therapy than sequential therapy.
“Concomitant boost is a safe alternative to sequential boost and can be implemented in clinical routine, with the advantage of shortening patient treatment time,” concluded the investigators.
Disclosure: Dr. Ogunmuyiwa reported no conflicts of interest.
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