{"entity":{"id":"eortc-22881-boost","kind":"trial","name":"EORTC 22881-10882 (boost against no boost)","aka":["EORTC boost trial","EORTC 22881","boost versus no boost trial"],"tldr":"An extra dose of radiotherapy aimed at the place the lump came from cuts the chance of the cancer returning in that breast by about a third, but it does not help anyone live longer and it triples the chance of the breast becoming hard and scarred. That trade is the reason the extra dose is offered by risk rather than to everybody.","summary":"Between 1989 and 1996, EORTC 22881-10882 randomised 5,318 patients with stage I or II breast cancer, all of whom had a microscopically complete excision and 50 Gy of whole-breast irradiation over five weeks, to a further 16 Gy to the tumour bed or to nothing further. Overall survival was the primary endpoint. The twenty-year report is the one to read.\n\nAt a median 17.2 years, twenty-year overall survival was 59.7 percent with the boost and 61.1 percent without it (hazard ratio 1.05, 99 percent confidence interval 0.92 to 1.19, p=0.323): the boost does not change how long people live. What it changes is local control. Ipsilateral breast tumour recurrence was the first failure in 354 patients (13 percent) without the boost and 237 (9 percent) with it (hazard ratio 0.65, 99 percent confidence interval 0.52 to 0.81, p<0.0001), a twenty-year cumulative incidence of 16.4 against 12.0 percent. About three-quarters of those recurrences led to a mastectomy in both arms.\n\nThe cost is measurable and permanent: the twenty-year cumulative incidence of severe fibrosis was 1.8 percent without the boost and 5.2 percent with it (p<0.0001). The trial's own conclusion is that the absolute benefit is largest in young patients and that the extra dose can be avoided in most patients over 60. NICE NG101 recommendation 1.13.17 offers a boost to women at high risk of local recurrence, and 1.13.18 requires that the side effects be explained.","status":"positive","asOf":"2026-09-25","links":[{"label":"ClinicalTrials.gov NCT02295033","url":"https://clinicaltrials.gov/study/NCT02295033"},{"label":"EORTC boost trial twenty-year follow-up (Lancet Oncology 2015)","url":"https://doi.org/10.1016/S1470-2045(14)71156-8"}],"tags":[],"related":[],"cancers":["breast-cancer","breast-hr-positive","breast-her2-positive","tnbc"],"sections":[],"technologies":["imrt-igrt","hypofractionated-radiotherapy"],"targets":[],"drugs":[],"companies":["curie-nki-eortc"],"institutions":[],"pathways":[],"terms":["tumour-bed-boost","resection-margins","lumpectomy"],"trials":["eortc-10801","import-low"],"people":[],"bottlenecks":[],"keyPapers":[],"journals":[],"dependsOn":[],"notes":[],"nct":"NCT02295033","phase":"3","setting":"Stage I and II breast cancer after microscopically complete excision and whole-breast irradiation of 50 Gy in five weeks: an extra 16 Gy to the tumour bed against no extra dose, with overall survival as the primary endpoint and twenty-year follow-up","sponsor":"European Organisation for Research and Treatment of Cancer","result":"Twenty-year ipsilateral breast recurrence 12.0 percent with a 16 Gy boost against 16.4 percent without (hazard ratio 0.65), no difference in overall survival, and severe fibrosis 5.2 against 1.8 percent.","yearReported":2015,"enrolled":5318,"enrolledBasis":"randomised","enrolledNote":"2,657 patients were randomised to no boost and 2,661 to a boost, 5,318 in all; the ClinicalTrials.gov record NCT02295033 was created retrospectively and states no enrolment figure.","outcomes":[{"endpoint":"Overall survival at 20 years","primary":true,"unit":"%","arms":[{"name":"16 Gy tumour-bed boost","n":2661,"value":59.7,"note":"99 percent confidence interval 56.3 to 63.0"},{"name":"No boost","n":2657,"value":61.1,"note":"99 percent confidence interval 57.6 to 64.3"}],"hr":1.05,"p":"0.323","source":"https://doi.org/10.1016/S1470-2045(14)71156-8"},{"endpoint":"Cumulative incidence of ipsilateral breast tumour recurrence at 20 years","unit":"%","arms":[{"name":"16 Gy tumour-bed boost","n":2661,"value":12,"note":"99 percent confidence interval 9.8 to 14.4"},{"name":"No boost","n":2657,"value":16.4,"note":"99 percent confidence interval 14.1 to 18.8"}],"hr":0.65,"p":"<0.0001","source":"https://doi.org/10.1016/S1470-2045(14)71156-8"},{"endpoint":"Cumulative incidence of severe fibrosis at 20 years","unit":"%","arms":[{"name":"16 Gy tumour-bed boost","n":2661,"value":5.2,"note":"99 percent confidence interval 3.9 to 6.4"},{"name":"No boost","n":2657,"value":1.8,"note":"99 percent confidence interval 1.1 to 2.5"}],"p":"<0.0001","source":"https://doi.org/10.1016/S1470-2045(14)71156-8"}]},"route":"/trials/eortc-22881-boost/","neighbours":{"cancer":[{"id":"breast-cancer","kind":"cancer","name":"Breast cancer (all types)","route":"/cancers/breast-cancer/"},{"id":"breast-her2-positive","kind":"cancer","name":"HER2-positive breast cancer","route":"/cancers/breast-her2-positive/"},{"id":"breast-hr-positive","kind":"cancer","name":"HR-positive / HER2-negative breast cancer","route":"/cancers/breast-hr-positive/"},{"id":"tnbc","kind":"cancer","name":"Triple-negative breast cancer (TNBC)","route":"/cancers/tnbc/"}],"technology":[{"id":"hypofractionated-radiotherapy","kind":"technology","name":"Hypofractionated radiotherapy","route":"/technologies/hypofractionated-radiotherapy/"},{"id":"imrt-igrt","kind":"technology","name":"IMRT / IGRT (modern external beam)","route":"/technologies/imrt-igrt/"}],"company":[{"id":"curie-nki-eortc","kind":"company","name":"EORTC","route":"/companies/curie-nki-eortc/"}],"term":[{"id":"lumpectomy","kind":"term","name":"Lumpectomy (breast-conserving surgery)","route":"/terms/lumpectomy/"},{"id":"resection-margins","kind":"term","name":"Resection margins (R0 / R1 / R2)","route":"/terms/resection-margins/"},{"id":"tumour-bed-boost","kind":"term","name":"Tumour bed boost","route":"/terms/tumour-bed-boost/"}],"trial":[{"id":"eortc-10801","kind":"trial","name":"EORTC 10801","route":"/trials/eortc-10801/"},{"id":"import-low","kind":"trial","name":"IMPORT LOW","route":"/trials/import-low/"}]}}