Hypofractionated whole-breast radiotherapy and concomitant boost after breast conservation in elderly patients



To report the 5- and 10-year results of accelerated hypofractionated whole-breast radiotherapy (WBRT) with concomitant boost to the tumor bed in 83 consecutive patients with early breast cancer aged >70 years.


All patients were treated with breast conservation and hypofractionated WBRT. The prescription dose to the whole breast was 45 Gy (2.25 Gy/20 fractions) with an additional daily concomitant boost of 0.25 Gy to the surgical cavity (2.5 Gy/20 fractions up to 50 Gy). The maximum detected toxicity was scored according to the Common Terminology Criteria for Adverse Events, version 3.0. We considered as skin toxicity: erythema, edema, desquamation, ulceration, hemorrhage, necrosis, telangiectasia, fibrosis-induration, hyperpigmentation, retraction and atrophy. Cosmetic results were assessed as set by the Harvard criteria.


With a median follow-up of 60 months (range 36-88), no local recurrence was observed. The maximum detected acute skin toxicity was G0 in 57% of patients, G1 in 40% and G2 in 3%. Late skin and subcutaneous toxicity was generally mild with no ≥G3 events. The cosmetic results were excellent in 69% of patients, good in 22%, fair in 5%, and poor in 4%.


The present results support the use of hypofractionation employing a concomitant boost to the lumpectomy cavity in women aged >70 years. This is a convenient treatment option for both this type of population and health-care providers.

Tumori 2016; 102(2): 196 - 202




Domenico Cante, Pierfrancesco Franco, Piera Sciacero, Giuseppe Girelli, Massimo Pasquino, Valeria Casanova Borca, Santi Tofani, Maria Rosa La Porta, Umberto Ricardi

Article History


Financial support: None to declare.
Conflict of interest: The authors declare they do not have any conflict of interest.

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  • Radiotherapy Department, Ivrea Community Hospital, ASL TO4, Ivrea - Italy
  • Department of Oncology – Radiation Oncology, University of Turin, Turin - Italy
  • Medical Physics Department, Ivrea Community Hospital, ASL TO4, Ivrea - Italy

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