S504
5Institut Curie, Department of Radiation Oncology, Paris,
France
Purpose or Objective
In patients undergoing implant-based reconstruction,
PMRT could increase rates of infections, capsular
contracture, implant loss, and overall reconstructive
failure requiring revisional surgery. The association
between PMRT and poor reconstructive outcomes is well
documented. Immediate prosthetic breast reconstruction
produces a satisfactory aesthetic result, with high levels
of patient satisfaction. However, many patients are
advised against immediate breast reconstruction because
of concerns of implant loss and infection, particularly
those requiring chemotherapy.
Our study aimed to evaluate the patient's outcome
according to two radiotherapy PMRT regimens, standard
vs. hypofractionation, and two different types of
reconstruction: tissue expander (TE) vs. immediate breast
reconstruction(IBR).
Material and Methods
This study was conducted on 102 pts treated at 1 French
and 1 Italian institute from April 2012 to June 2016. PMRT
was delivered in two different regimes. The prescription
dose to the PTV was 50 Gy/25 fr. 5 times per week and 46
Gy/20 fr., 4 times per week. Two-stage expander-implant
reconstruction was performed in 53 patients, and the
exchange is within 6 months since PMRT; IBR was perfomed
in 49 pts.
Results
Outcomes data were recorded retrospectively. We
compared the complication rate after PMRT with either TE
or IBR. Outcome measures included a) occurrence of
capsular contraction, evaluated by using the four-grade
Baker scale, b) reconstructive failure (implant loss), and
C) aesthetic results. We recorded minor complications in 5
(9.26%) TE patients and 3 (6.12%) in IBR patients. Among
TE, 3 (5.66%) were capsular contractures, Baker grade 1-
2, one(1.88%) minor skin infection and one(1.88%) skin
dehiscence, without implant exposure. Among IBR, we
observed 3(6.12%) grade 1-2 capsular contracture. With
regards to major complication, we observed one case
(1.8%) of major wound dehiscence with implant exposure
and 6 (11.32%) capsular contracture Baker grade 3-4
among TE patients. In the IBR group, there were 7 (14.28%)
capsular contracture Baker grade 3-4 and one (2.04%)
severe infection. These were classified as major
complications requiring implant or prosthesis removal.
Conclusion
we did not observe any significant difference in minor and
major complication rate according to the type of
reconstruction. Hypofractionated PMRT confirmed its
safety.
PO-0943 Long-term results of hypofractionation with
simultaneous integrated boost in early breast cancer.
K.S. Athigakunagorn1, C. Nantavithya2, K. Shotelersuk1, P.
Rojpornpradit2
1Chulalongkorn University, Division of Therapeutic
Radiology and Oncology- Faculty of Medicine, Bangkok,
Thailand ; 2King Chulalongkorn Memorial Hospital- Thai
Red Cross Society, Division of Therapeutic Radiology and
Oncology- Department of Radiology, Bangkok, Thailand
Purpose or Objective
To report long-term results of hypofractionated whole
breast irradiation with simultaneous integrated boost (SIB)
in early breast cancer.
Material and Methods
Between October 2009 and June 2010, 73 patients with
early breast cancer (T1-3N0-1M0) who underwent breast
conserving surgery were accrued in the study. Thirty-six of
these patients received conventional irradiation as 50 Gy
in 25 fractions to the whole breast with a sequential boost
to the tumor bed of 10–16 Gy in 5–8 fractions over 5 weeks
(conventional group), while the other 37 patients received
ESTRO 2020
a hypofractionated dose of 43.2 Gy in 16 fractions with an
additional daily boost of 0.7 Gy over 3 weeks (hypofraction
group).
Results
At a median follow-up of 114 months, ipsilateral local
recurrence (ILR) was found in three patients, two of which
were in the hypofraction group. All of three ILR cases were
found to be a true local recurrence. There was no
significant difference in the 9-year disease free survival or
9-year overall survival rates between the conventional and
hypofraction groups (91.7% vs. 83.3%, p = 0.319 and
94.4% vs. 91.9%, p = 0.664, respectively).
Conclusion
This study revealed that the effectiveness of
hypofractionated whole breast irradiation with a SIB is
comparable to conventional irradiation with a sequential
boost in terms of disease free survival and overall survival.
PO-0944 Molecular subtypes in patients with breast
cancer that received neoadjuvant chemotherapy
G. Marta1, M. Mano2, L. Oliveira2, A. Pereira3
1Hospital Sirio Libanes, Radiation Oncology, Sao Paulo,
Brazil ; 2Hospital Sírio-Libanês, Department of Clinical
Oncology, Sao Paulo, Brazil ; 3Hospital Sírio-Libanês,
Department of Clinical Oncology, Brasilia, Brazil
Purpose or Objective
To evaluate the survival outcomes based on molecular
subtypes of patients with breast cancer that received
neoadjuvant chemotherapy (NAC).
Material and Methods
We performed a retrospective analysis of all non-
metastatic breast cancer patients treated between 2008
and 2014 at two institutions who had received NAC
followed by surgery and post-operative radiation therapy.
Patients were divided into four groups based on the tumor
molecular subtype: luminal (estrogen receptor [ER] /
progesterone receptor [PR] positive, human epithelial
growth factor receptor-2 [HER2] negative), HER2 (HER2
positive), and triple negative (TNBC; HER2, ER and PR
negative). Multivariate analyses for disease-free survival
(DFS) and overall survival (OS) were also performed
adjusting for unbalanced variables: pathologic complete
response (pCR), histologic type and grade tumor.
Results
A total of 653 women were included. Most (589;91.1%) of
the patients had locally advanced disease (clinical stage
IIB to IIIC). Patients were distributed as following (N;%):
luminal (300;45.9%), HER2 (173; 26.5%), TNBC (180;27.6%).
The groups differ regarding pathologic complete response
rate (pCR), histologic type and grade, where pCR were
more frequent in HER2 (64;37.0%) and TNBC (52;28.9%) vs.
Luminal (18;6%). The median follow-up time for surviving
patients was 33 months. The disease-free survival (DFS)
and overall survival (OS) rates for all patients at 3 years
were 71% and 86%, respectively. The DFS and OS rates for
all patients at 3 years were 71% and 86%, respectively.
Patients with TNBC had worse DFS and OS rates at 3 years:
(3year-DFS: 72%, 76%, and 64%; 3year-OS: 88%, 88% and
78%, for Luminal, HER2 and TNBC, respectively).
Comparing to TNBC, Luminal had better DFS (HR 0.67;
95%CI 0.46-0.97) and OS (HR 0.54; 95%CI 0.32-0.90), in
multivariate analysis, while no statically difference was
seen between HER2 vs. TNBC (DFS HR 0.73; 95%CI 0.49-
1.10; OS HR 0.63; 95%CI 0.36-1.09).
Conclusion
In locally advanced breast cancer patients who underwent
NAC, survival rates were different based on the molecular
subtype, with TNBC having the poorest prognosis.
PO-0945 The impact of surgery type in breast cancer
patients that received neoadjuvant chemotherapy
G. Marta1, A. Pereira2, J. Oliveira3, F. José Roberto4, M.
Max3
1Hospital Sirio Libanes, Radiation Oncology, Sao Paulo,