Quality of life after simultaneously integrated boost with intensity-modulated versus conventional radiotherapy with sequential boost for adjuvant treatment of breast cancer: 2-year results of the multicenter randomized IMRT-MC2 trial

Background - We recently published 2-year results of the prospective, randomized IMRT-MC2 trial, showing non-inferior local control and cosmesis in breast cancer patients after conventionally fractionated intensity-modulated radiotherapy with simultaneously integrated boost (IMRT-SIB), compared to 3...

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Main Authors: Forster, Tobias (Author) , Hommertgen, Adriane (Author) , Häfner, Matthias (Author) , Arians, Nathalie (Author) , König, Laila (Author) , Harrabi, Semi B. (Author) , Schlampp, Ingmar (Author) , Köhler, Clara (Author) , Meixner, Eva (Author) , Heinrich, Vanessa (Author) , Weidner, Nicola (Author) , Hüsing, Johannes (Author) , Sohn, Christof (Author) , Heil, Jörg (Author) , Golatta, Michael (Author) , Hof, Holger (Author) , Krug, David (Author) , Debus, Jürgen (Author) , Hörner-Rieber, Juliane (Author)
Format: Article (Journal)
Language:English
Published: 1 September 2021
In: Radiotherapy and oncology
Year: 2021, Volume: 163, Pages: 165-176
ISSN:1879-0887
DOI:10.1016/j.radonc.2021.08.019
Online Access:Verlag, lizenzpflichtig, Volltext: https://doi.org/10.1016/j.radonc.2021.08.019
Verlag, lizenzpflichtig, Volltext: https://www.sciencedirect.com/science/article/pii/S016781402106713X
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Author Notes:Tobias Forster, Adriane Hommertgen, Matthias Felix Häfner, Nathalie Arians, Laila König, Semi Ben Harrabi, Ingmar Schlampp, Clara Köhler, Eva Meixner, Vanessa Heinrich, Nicola Weidner, Johannes Hüsing, Christof Sohn, Jörg Heil, Michael Golatta, Holger Hof, David Krug, Jürgen Debus, Juliane Hörner-Rieber

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520 |a Background - We recently published 2-year results of the prospective, randomized IMRT-MC2 trial, showing non-inferior local control and cosmesis in breast cancer patients after conventionally fractionated intensity-modulated radiotherapy with simultaneously integrated boost (IMRT-SIB), compared to 3D-conformal radiotherapy with sequential boost (3D-CRT-seqB). Here, we report on 2-year quality of life results. - Patients and Methods - 502 patients were enrolled and randomized to IMRT-SIB (50.4 Gy in 1.8 Gy fractions with a 64.4 Gy SIB to the tumor bed) or to 3D-CRT-seqB (50.4 Gy in 1.8 Gy fractions, followed by a sequential boost of 16 Gy in 2 Gy fractions). For quality of life (QoL) assessment, patients completed the QLQ-C30 and QLQ-BR23 questionnaires at baseline, 6 weeks and 2 years after radiotherapy. - Results - Significant differences between treatment arms were seen 6 weeks after radiotherapy for pain (22.3 points for IMRT vs. 27.0 points for 3D-CRT-seqB; p = 0.033) and arm symptoms (18.1 points for IMRT vs. 23.6 points for 3D-CRT-seqB; p = 0.013), both favoring IMRT-SIB. Compared to baseline values, both arms showed significant improvement in global score (IMRT: p = 0.009; 3D-CRT: p = 0.001) after 2 years, with slight deterioration on the role (IMRT: p = 0.008; 3-D-CRT: p = 0.001) and social functioning (IMRT: p = 0.013, 3D-CRT: p = 0.001) as well as the future perspectives scale (IMRT: p = 0.003; 3D-CRT: p = 0.0034). - Conclusion - This is the first randomized phase III trial demonstrating that IMRT-SIB was associated with slightly superior QoL compared to 3-D-CRT-seqB. These findings further support the clinical implementation of SIB in adjuvant breast cancer treatment. 
650 4 |a 3-D-conformal radiotherapy 
650 4 |a Breast cancer 
650 4 |a Intensity-modulated radiotherapy (IMRT) 
650 4 |a Quality of life 
650 4 |a Sequential boost irradiation 
650 4 |a Simultaneously integrated boost (SIB) 
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