S326
Clinical - Breast
ESTRO 2026
Purpose/Objective: The CONCERT trial (CTRI/2023/06/054280) randomises breast cancer patients requiring adjuvant radiotherapy (RT) into RT alone versus concurrent chemo-RT with disease-free survival as the primary endpoint. We herein report the acute toxicity profile and treatment compliance among the initial cohort of patients who have completed the assigned trial intervention. Material/Methods: Data of initial 105 patients (N=51 RT alone and N=54 Chemo-RT arm) who were treated between May 2024 to October 2025 was analyzed. The RT-related acute toxicity was scored according to the RTOG grading system. Pain was also analyzed using the visual analog scale. Results: The median age was 50 years, BMI was 28.7 and ECOG PS was 0. Fifty per cent of patients were premenopausal, and 31% had comorbidities. Laterality was equally distributed, while high-risk molecular subtype was present in 47.5% with tumor located in the outer quadrant in 68%. The majority (62%) of patients had locally advanced (stage III) disease and high grade (93%). The type of surgery was equally distributed, and in half of the patients, surgery was done after anthracycline-based neoadjuvant CT. The dose prescribed was 40 Gy in 15 fractions and concurrent RT was delivered along with taxane-based chemotherapy. Patients with breast conservation also received tumor bed boost to a dose of 12.5 Gy in 5 fractions. Table 1 shows the incidence of various acute toxicities in the two arms of treatment. All patients completed the assigned treatment without any gap or interruptions. Only three patients from the Chemo-RT arm had grade 3 toxicity (one each of dermatitis, fatigue and pruritus). There was no grade 3 toxicity in the standard arm.Table 1: Grades of various acute toxicities in the two arms at the time of RT conclusion.
Multiple prognostic factors like BMI, age, menopausal status, type of surgery, stage and presence of comorbidities were studied to find a correlation with the incidence of RT-related acute toxicity. However, none of these factors were found to be correlative. Conclusion: The initial data suggest that concurrent chemo- radiotherapy is well tolerated and does not result in any treatment breaks. The RT-related toxicities are minimal. The toxicities and pain were numerically higher in the test arm but not statistically significant. Keywords: concurrent, chemo-radiotherapy, breast cancer Comparison of Radiation Dose to Cardiac Substructures in VMAT and 3DCRT for Post- Mastectomy Breast Cancer Patients Kaniz Fatima, Shraddha Raj, Richa Madhawi Radiation Oncology, Indira Gandhi Institute of Medical Sciences, Patna, India Purpose/Objective: Radiation therapy remains a cornerstone in the multidisciplinary management of breast cancer. Even in the modern era of cutting-edge radiotherapy, limiting the dose to organs at risk (OARs), particularly the heart, remains a significant challenge. A well- established correlation exists between the mean cardiac dose and the risk of radiation-induced cardiac toxicities (1). The complex anatomical structure of the heart may contribute to differential radiosensitivity within the organ, influencing the pattern and severity Poster Discussion 4469
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