The role of boost and hypofractionation as adjuvant radiotherapy in patients with DCIS: A meta-analysis of observational studies

Nilsson, Cecilia; Valachis, Antonis

doi:10.1016/j.radonc.2015.01.001

Cited by 61 publications

(43 citation statements)

References 37 publications

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“…(58) A meta-analysis of observational series including 2,534 patients from 4 retrospective studies found no significant difference in the LR rate between conventional and HF-RT for DCIS; however, a trend for lower recurrence with HF was observed (odds rate 0.78, p=0.88). (59) There is no inherent reason that normal tissue side effects should be different following WBRT for patients with excised DCIS as compared to excised invasive cancer. Therefore, a short RT schedule of 40 Gy in 15 daily fractions on 42.5 Gy in 16 daily fractions should be offered as an option to patients with DCIS.…”

Section: Particular Aspects Of Rt In Dcismentioning

confidence: 99%

See 1 more Smart Citation

Radiation Therapy Following Breast Conserving Surgery for Ductal Carcinoma in situ: Yes or No?

Stoleru¹,

Stoleru²

2017

chr

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RezumatCarcinomul ductal in situ al sânului este un precursor non-invaziv al cancerului mamar şi este reprezentat de un grup de leziuni cu potenţial malign variabil. Tratamentul local optim pentru pacientele cu carcinom ductal in situ rãmane un subiect controversat, în ciuda rezultatelor provenite din mai multe trialuri randomizate. Radioterapia care urmeazã intervenţiei chirurgicale conservatoare reduce aproximativ la jumãtate riscul de recidivã localã, dar nu are impact în ceea ce priveşte supravieţuirea pe termen lung. Studiile clinice desfãşurate pânã în prezent nu au putut identifica un subgrup de paciente cu carcinom ductal in situ cu risc scãzut, la care sã se poata renunţa în siguranţã la radioterapie, dupã intervenţia chirurgicala conservatoare. În lucrare sunt prezentate rezultate ale studiilor clinice în care s-a utilizat chirurgia conservatoare a sânului urmatã sau nu de radioterapie. Alte subiecte abordate se referã la stabilirea indicaţiei terapeutice în cazul carcinomului ductal in situ cu risc scãzut şi la noi tendinţe în radioterapia pentru carcinomul ductal in situ. Review Articlebreast cancerand represents a heterogenous group of lesions with different malignant potential. Despite several randomized trials, there is still controversy regarding the optimal local treatment for DCIS patients. The addition of radiotherapy after breast conserving surgery approximately halves the local recurrence risk but has no impact on long-term survival. Clinical studies failed to identify a low risk subgroup of DCIS patients treated with breast conserving surgery in whom radiotherapy can be safely omitted. Results of clinical trials of breast conserving surgery ± radiotherapy are summarized. Treatment decision making in low risk DCIS and current tendencies in the radiotherapy for DCIS are other issues addressed in this paper.

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Section: Particular Aspects Of Rt In Dcismentioning

confidence: 99%

“…However, if only patients with positive margins were included, there was a significant benefit (odds ratio 0.56, p=0.01). (59) Data from 4,131 cases of DCIS treated in ten academic institutions from the United States, Canada and France were recently reported. (64) Eligible patients included those with pure DCIS (i.e.…”

Section: Role Of a Tumor Bed Boost In Dcismentioning

confidence: 99%

Radiation Therapy Following Breast Conserving Surgery for Ductal Carcinoma in situ: Yes or No?

Stoleru¹,

Stoleru²

2017

chr

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“…Nilsson et al [29] summarized the available studies in a recently published meta-analysis of 12 retrospective studies with a total of 6,943 patients. The overall quality of the included studies was rated as very low.…”

Section: Application Of a Tumor Bed Boost In Dcismentioning

confidence: 99%

“…A recent meta-analysis of Nilsson et al [29] included 2,534 patients from 4 retrospective studies, and concluded that there was no significant difference between conventional and hypofractionated RT for DCIS; however, a trend for lower recurrence with hypofractionation was observed (odds rate 0.78, p = 0.08). The quality of evidence from the included trials was rated as low.…”

Section: Hypofractionationmentioning

confidence: 99%

Radiotherapy of Ductal Carcinoma In Situ

Krug

Souchon

2015

Breast Care

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Ductal carcinoma in situ (DCIS) is a heterogeneous disease in both its biology and clinical course. In the past, recurrence rates after breast-conserving surgery have been as high as 30% after 10 years. The introduction of mammography screening and advances in imaging have led to an increase in the detection of DCIS. The focus of this review is on the role of radiotherapy in the multidisciplinary treatment, including current developments in hypofractionation and boost delivery, and attempts to define low-risk subsets of DCIS for which the need for adjuvant radiation is repeatedly questioned.

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“…Avec un taux de récidive locale de 3 % à 5 ans, nos résultats sont comparables à ceux des essais randomisés qui ont utilisé une radiothérapie classique [4,[24][25][26]. Une récente méta-analyse qui regroupait quatre études comparant des radiothérapies classiques et hypofractionnées a conclu qu'il n'y avait aucune différence en termes de récidives locales (odds ratio [OR] : 0,78 ; intervalle de confiance à 95 % [IC95 %] : 0,58-1,03 ; p = 0,08) [27]. L'analyse des données actuelles semble indiquer qu'une radiothérapie mammaire hypofractionnée serait aussi sécuritaire que le régime standard en termes de récidives locales, mais le niveau de preuve est assez faible.…”

Section: Autres Indications De La Radiothérapie Mammaire Hypofractionnéeunclassified

Radiothérapie externe hypofractionnée du cancer du sein localisé : où en est-on ?

Tiberi¹,

Hijal²,

Yassa³

2015

Cancer/Radiothérapie

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The role of boost and hypofractionation as adjuvant radiotherapy in patients with DCIS: A meta-analysis of observational studies

Cited by 61 publications

References 37 publications

Radiation Therapy Following Breast Conserving Surgery for Ductal Carcinoma in situ: Yes or No?

Radiation Therapy Following Breast Conserving Surgery for Ductal Carcinoma in situ: Yes or No?

Radiotherapy of Ductal Carcinoma In Situ

Radiothérapie externe hypofractionnée du cancer du sein localisé : où en est-on ?

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