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One Week, One Boost, One Goal: Feasibility, Safety and Local Control in Breast Ductal Carcinoma In Situ With
A Montero1, R Ciervide2, B Alvarez2
1Department of Radiation Oncology, HM Hospitales, Madrid, Spain; Facultad de Ciencias de la Salud, Universidad Camilo José Cela, Madrid, Spain.
Clinical Oncology (Royal College of Radiologists (Great Britain))
|November 22, 2025
Summary
Ultra-hypofractionated radiotherapy with a simultaneous integrated boost is safe and effective for ductal carcinoma in situ. This treatment shows high local control rates and minimal toxicity in DCIS patients, including those post-mastectomy.
Area of Science:
- Oncology
- Radiation Oncology
- Breast Cancer Research
Background:
- Limited data exists on ultra-hypofractionated radiotherapy (UHF-RT) for ductal carcinoma in situ (DCIS).
- The use of simultaneous integrated boost (SIB) with UHF-RT for DCIS requires further investigation regarding feasibility and safety.
Purpose of the Study:
- To evaluate the feasibility and safety of UHF-RT with SIB in patients with DCIS.
- To assess acute and late toxicities and recurrence-free survival in DCIS patients treated with UHF-RT and SIB.
Main Methods:
- Prospective cohort study of 100 women with DCIS treated with UHF-RT (26 Gy/5 fractions) and SIB (29-32 Gy).
- Included patients undergoing breast-conserving surgery or postmastectomy radiotherapy.
- Toxicity assessed using Common Terminology Criteria for Adverse Events v5.0; recurrence-free survival analyzed using Kaplan-Meier estimates.
Main Results:
- High local control rate of 98.8% at 48 months with one in situ recurrence successfully salvaged.
- Predominantly grade 1 acute toxicity (dermatitis, edema); no grade ≥3 toxicity observed.
- Low rates of asymptomatic fat necrosis (11%) and manageable late effects (hyperpigmentation, fibrosis, mild pain).
Conclusions:
- UHF-RT with SIB is a feasible, safe, and well-tolerated treatment for DCIS, including high-risk postmastectomy cases.
- These findings support the use of UHF-RT with SIB for DCIS, pending results from ongoing randomized trials.
