Results: Study Explores Pre-Operative Radiation Boost for Breast Cancer Patients

New Brunswick, N.J., October 3, 2023 – For breast cancer patients undergoing a lumpectomy, a type of breast cancer surgery in which the tumor and a small amount of surrounding tissue called the margin is removed, the standard mode of treatment has been radiation to the whole breast followed by a boost of radiation to the lumpectomy site post-surgery. 

Researchers at Rutgers Cancer Institute of New Jersey and RWJBarnabas Health explored the outcome of patients being given the radiation boost before surgery, followed by surgery, then whole breast radiation. A radiation boost targeted at the tumor bed is an important component of breast-conserving therapy and has been shown to improve outcomes in patients with early stage breast cancer. Results of the study were shared in an oral presentation at the 2023 American Society for Therapeutic Radiology and Oncology (ASTRO) Annual Meeting 

Radiation machine

Key Details: 
•    The study design was a prospective phase II with a planned accrual of 55 patients. 
•    Patients were treated with pre-operative radiation boost of 1332 cGy in four fractions, followed by lumpectomy and adjuvant hypofractionated whole breast radiation to 3663 cGy in 11 fractions. 
•    The primary outcome of the study was to demonstrate that the incidence of grade 3 or more wound complications is not inferior to the current standard of care with conventional lumpectomy, postoperative whole breast radiation and a postoperative boost (6 to 20 percent). 

The use of a pre-operative radiation boost prior to lumpectomy followed by whole breast radiation as administered in this prospective trial resulted in an acceptable primary outcome with a similar rate of post-operative wound complications as standard of care.  The researchers are currently enrolling patients on an expansion cohort to assess longer term cosmetic outcomes and performing a panel of immunologic markers to assess immune response to the preoperative boost.  

Zeinab Abou Yehia, MD, is first author of the study. Bruce Haffty, MD, MS, chair of Radiation Oncology at Rutgers Cancer Institute of New Jersey, Rutgers Robert Wood Johnson Medical School and Rutgers New Jersey Medical School; associate vice chancellor for Cancer Programs at Rutgers Biomedical and Health Sciences; and system director of Radiation Oncology at RWJBarnabas Health, is senior author of the study and available for comment. 

Other authors include Nisha Ohri, MD, Allison Grann, MD, Firas Eladoumikdachi MD, FACS, Maria Kowzun MD, FACS, Shicha Kumar MD, FACS, Lindsay Potdevin MD, M. Michele Blackwood, MD and Deborah Toppmeyer, MD

Rutgers Cancer Institute of New Jersey and RWJBarnabas Health is the state’s leading cancer program and only National Cancer Institute-designated Comprehensive Cancer Center. 

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