Clinical impact of IMPORT HIGH trial (CRUK/06/003) on breast radiotherapy practices in the United Kingdom

Abstract

We investigated the impact of the IMPORT HIGH trial on the adoption of advanced breast RT techniques in the UK and the trial has influenced non-trial breast RT techniques in terms of volume delineation, dosimetry, treatment delivery and verification.

Hypofractionation with concomitant boost using intensity-modulated radiation therapy in early-stage breast cancer in Mexico

“…In 26 centres, this study evaluated the usage of IMRT with an inverse technique or direct technique for concomitant boost to the tumour bed that was marked with surgical clips and concluded that the IMPORT HIGH provides a guide and the necessary support for a safe integration of the appropriate RT techniques. 22 In our study, 74% of the patients had invasive cancer, and 26% had in situ cancer. The cut-off age to receive HF with concomitant boost was >50 years old as utilized in phase I and II studies.…”

“…4,[18][19][20] There is not much phase III evidence regarding HF with concomitant boost to the tumour bed. [21][22][23][24] Few phase I II studies have been published, and the available studies have heterogeneous numbers of patients and involve doses to the breast ranging from 2.5 to 2.7 Gy/Fx with totals of 15-20 Fx and doses to the tumour bed of 2.75-3.5 Gy/Fx. [25][26][27][28][29][30] Regarding patients over 70 years of age who have been treated with this schedule, the evidence is scarce, but the results have proven this approach to be an option for this population group.…”

Intensity modulated radiation therapy for breast cancer: current perspectives

“…The primary end point of all these studies was the reduction of adverse events, and other reported end points were cosmesis, Patients Reported Outcomes Measures (PROMs), and QoL. One randomized trial was excluded because the authors reported only planning results,22 impact of image guidance,23 and impact of the trial on clinical practice 24…”

The IMPORT LOW Trial: Collaborative Research Accelerates Practice Change in Breast Radiotherapy

“…First, the radiotherapy quality assurance aspects of IMPORT LOW and its partner trial for high-risk patients, IMPORT HIGH, meant that centres needed to implement threedimensional field-in-field intensity-modulated radiotherapy in order to participate. This had a beneficial impact outside of the trials, accelerating the implementation of three-dimensional field-in-field intensity-modulated radiotherapy [12,13] and thus reducing the incidence of early moist desquamation and late firmness and shrinkage across the population of patients undergoing breast radiotherapy. A second legacy of the trial is the practice of marking the margins of the resection cavity with titanium clips.…”