Table 2 Summary of the studies on preoperative breast cancer radiotherapy
Author and year | Inclusion criteria | n of pts | Treatment | Systemic therapy | Time to surgery | Postoperative RT | Outcomes | Toxicity | Follow-up (months) |
|---|---|---|---|---|---|---|---|---|---|
Bondiau et al., 2013 [21] | Unifocal BC not suitable for BCS, HER2 negative | 26 | Robotic SBRT (Cyberknife)/19,5–31.5 Gy/3 fr (5 dose levels) | CHT | 4–8 weeks after last CHT | Yes, 3D-CRT | pCR 36% (NS) 92% BCS rate 96% ORR | none | 30 |
Horton et al., 2015 [22] | Age > 55 years, T1 BC or low- intermediate DCIS ≤2 cm, cN0, ER + and/or PR+, HER2- | 32 | IMRT/15–21 Gy (3 dose levels)/1 fr | none | within 10 days after RT | Yes (Only to patients not satisfying eligibility criteria after BCS) | Significant increase in MRI post- radiation vascular permeability and decreased cellular density | 13 Grade2; 2 Grade 3 | 23 |
van der Leij et al., 2015 [23] | Age > 60 years, invasive, unifocal BC ≤ 3 cm on MRI, non-lobular, negative SNB | 70 | 3D-CRT or IMRT or VMAT/40 Gy/10 fr | none | 6 weeks after RT | No | 2 local recurrences | 11% mild-moderate 23 induration at 12 months; 2% mild-moderate fibrosis at 24 months | 23 |
Nichols et al., 2017 [24] | Unifocal invasive BC < 3 cm at mammography or MRI, cN0 | 27 | 3D-CRT /38.5 Gy/10 fr (twice daily) | none | > 21 days after RT | No | pCR 15% (NS) ORR 88.9%; Ki-67 reduction after RT in 70.4% | PRCO fair and poor in 17 and 5% at 1 year, respectively | 43 |
Tiberi et al., 2020 [27] | postmenopausal status, age > 65 years, stage I (cT1N0) invasive BC, unifocal luminal A, ER+, her2-negative, G1–2 | 10 | SBRT 20 Gy/1fr | none | 11–13 weeks after RT | Yes if: Grade 3, lymphovascular invasion, pT4, triple neg, extensive DCIS, tumor size > 3 cm, lobular histology | pCR: 0 (median residual cellularity was 3% in 8 patients; for the other 2 patients no response at all was observed) | none | < 12 |
DOSIMETRIC STUDIES | |||||||||
Charaghvandi et al., 2015 | Tumor size up to 30 mm, scheduled for BCS and WBI | 20 | IMB and VMAT 15 Gy/1 fr + integrated ablative boost of 20 Gy | none | – | – | Dosimetrically feasible with IMB and VMAT | – | – |
Yoo et al., 2015 [44] | Patients enrolled on a preoperative, dose escalation, single fraction PBI clinical protocol | 16 (8 + 8) | 3D-CRT, non-coplanar IMRT, coplanar IMRT, VMAT 15 Gy/1fr and 18 Gy/1 fr | none | – | – | IMRT plans provided homogeneous and conformal target coverage, skin sparing, and short delivery time | – | – |