Comparison of simultaneous integrated tumor bed boost and sequential boost during hypofractionated whole-breast irradiation after breast-conserving surgery

作者：Dan‐Qiong Wang, Yuchun Song, Hao Jing, Hui Fang, Yong-Wen Song, Yueping Liu, Jing Jin, Shu‐Nan Qi, Yuan Yan Tang, Yuan Tang, Ning-Ning Lu, Bo Chen, Ning Li, Yi-Rui Zhai, Wen‐Wen Zhang, Xin Liu, Siye Chen, Zhuanbo Yang, Guang-Yi Sun, Xu-Ran Zhao, Zi-Han Qiu, Ye-Xiong Li, Shulian Wang, Yu Tang, Shulian Wang · 发表于：Clinical and Translational Radiation Oncology · 年份：2025 · DOI：10.1016/j.ctro.2025.100967 · 被引用次数：4 · 研究领域：Breast Cancer Treatment Studies、Breast Implant and Reconstruction、Lymphatic System and Diseases

Background and purpose This study aimed to compare the safety and efficacy of simultaneous integrated boost (SIB) and sequential boost (SeB) during hypofractionated WBI. Materials and methods This study analyzed data from two prospective studies, including 1,132 patients with pT1-3 N0-3 M0 breast cancer, of whom 775 received SIB and 357 received SeB. The prescribed dose was 43.5 Gy in 15 fractions to whole breast and/or nodal region, with either 49.5 Gy in 15 fractions (SIB) or 8.7 Gy in 3 fractions (SeB) delivered to tumor bed. Outcomes analyzed included survival outcomes, treatment-related toxicities, and cosmetic outcomes. Results The 5-year outcomes were local control rates of 97.8 % vs. 98.8 % ( p = 0.12), locoregional control rates of 97.7 % vs. 97.1 % ( p = 0.72), disease-free survival of 94.1 % vs. 93.1 % ( p = 0.71), overall survival of 97.4 % vs. 97.1 % ( p = 0.88), and breast-specific survival of 98.2 % vs. 97.5 % ( p = 0.43) for SIB versus SeB, respectively. After stabilized inverse probability of treatment weighting, differences between groups remained non-significant. Rates of fair or poor cosmetic outcomes before and after radiotherapy were lower in the SIB group, but there was no difference in cosmetic deterioration (9.8 % vs. 7.6 %, p = 0.22). Grade 2 or higher toxicities, including skin toxicity, pneumonitis, breast swelling, pain, induration, lymphedema, and shoulder mobility issues, were comparable between groups. Conclusion SIB is a viable alternative to ...