{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,25]],"date-time":"2026-07-25T13:01:53Z","timestamp":1784984513759,"version":"3.55.0"},"reference-count":25,"publisher":"Elsevier BV","issue":"3","license":[{"start":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T00:00:00Z","timestamp":1782864000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T00:00:00Z","timestamp":1782864000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"},{"start":{"date-parts":[[2026,1,13]],"date-time":"2026-01-13T00:00:00Z","timestamp":1768262400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/100001502","name":"Blue Cross Blue Shield of Michigan Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100001502","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["clinicalkey.com","clinicalkey.com.au","clinicalkey.es","clinicalkey.fr","clinicalkey.jp","redjournal.org","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["International Journal of Radiation Oncology*Biology*Physics"],"published-print":{"date-parts":[[2026,7]]},"DOI":"10.1016\/j.ijrobp.2025.12.047","type":"journal-article","created":{"date-parts":[[2026,1,13]],"date-time":"2026-01-13T17:08:42Z","timestamp":1768324122000},"page":"763-771","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":0,"title":["Acute Toxicity and Cosmesis Following a Tumor Bed Boost After Whole Breast Moderate Dose Hypofractionation"],"prefix":"10.1016","volume":"125","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0834-7669","authenticated-orcid":false,"given":"Michael","family":"Dykstra","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kent","family":"Griffith","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander","family":"Moncion","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maggie","family":"Grubb","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robin","family":"Marsh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Melissa","family":"Mietzel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frank","family":"Vicini","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lori","family":"Pierce","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"78","reference":[{"key":"10.1016\/j.ijrobp.2025.12.047_bib0001","doi-asserted-by":"crossref","first-page":"3259","DOI":"10.1200\/JCO.2007.11.4991","article-title":"Impact of a higher radiation dose on local control and survival in breast-conserving therapy of early breast cancer: 10-year results of the randomized boost versus no boost EORTC 22881-10882 trial","volume":"25","author":"Bartelink","year":"2007","journal-title":"J Clin Oncol"},{"key":"10.1016\/j.ijrobp.2025.12.047_bib0002","doi-asserted-by":"crossref","first-page":"47","DOI":"10.1016\/S1470-2045(14)71156-8","article-title":"Whole-breast irradiation with or without a boost for patients treated with breast-conserving surgery for early breast cancer: 20-year follow-up of a randomised phase 3 trial","volume":"16","author":"Bartelink","year":"2015","journal-title":"Lancet Oncol"},{"key":"10.1016\/j.ijrobp.2025.12.047_bib0003","doi-asserted-by":"crossref","first-page":"80","DOI":"10.1016\/j.radonc.2008.07.011","article-title":"Impact of the boost dose of 10 Gy versus 26 Gy in patients with early stage breast cancer after a microscopically incomplete lumpectomy: 10-year results of the randomised EORTC boost trial","volume":"90","author":"Poortmans","year":"2009","journal-title":"Radiother Oncol"},{"key":"10.1016\/j.ijrobp.2025.12.047_bib0004","doi-asserted-by":"crossref","first-page":"963","DOI":"10.1200\/JCO.1997.15.3.963","article-title":"Role of a 10-Gy boost in the conservative treatment of early breast cancer: Results of a randomized clinical trial in Lyon, France","volume":"15","author":"Romestaing","year":"1997","journal-title":"J Clin Oncol"},{"key":"10.1016\/j.ijrobp.2025.12.047_bib0005","doi-asserted-by":"crossref","first-page":"431","DOI":"10.1016\/S0140-6736(22)01246-6","article-title":"Radiation doses and fractionation schedules in non-low-risk ductal carcinoma in situ in the breast (BIG 3-07\/TROG 07.01): A randomised, factorial, multicentre, open-label, phase 3 study","volume":"400","author":"Chua","year":"2022","journal-title":"Lancet"},{"key":"10.1016\/j.ijrobp.2025.12.047_bib0006","doi-asserted-by":"crossref","first-page":"254","DOI":"10.1016\/j.radonc.2006.12.008","article-title":"Randomised trial of standard 2D radiotherapy (RT) versus intensity modulated radiotherapy (IMRT) in patients prescribed breast radiotherapy","volume":"82","author":"Donovan","year":"2007","journal-title":"Radiother Oncol"},{"key":"10.1016\/j.ijrobp.2025.12.047_bib0007","doi-asserted-by":"crossref","first-page":"513","DOI":"10.1056\/NEJMoa0906260","article-title":"Long-term results of hypofractionated radiation therapy for breast cancer","volume":"362","author":"Whelan","year":"2010","journal-title":"N Engl J Med"},{"key":"10.1016\/j.ijrobp.2025.12.047_bib0008","doi-asserted-by":"crossref","first-page":"1098","DOI":"10.1016\/S0140-6736(08)60348-7","article-title":"The UK Standardisation of Breast Radiotherapy (START) Trial B of radiotherapy hypofractionation for treatment of early breast cancer: A randomised trial","volume":"371","author":"Bentzen","year":"2008","journal-title":"Lancet"},{"key":"10.1016\/j.ijrobp.2025.12.047_bib0009","doi-asserted-by":"crossref","first-page":"145","DOI":"10.1016\/j.prro.2018.01.012","article-title":"Radiation therapy for the whole breast: Executive summary of an American Society for Radiation Oncology (ASTRO) evidence-based guideline","volume":"8","author":"Smith","year":"2018","journal-title":"Pract Radiat Oncol"},{"key":"10.1016\/j.ijrobp.2025.12.047_bib0010","first-page":"129","article-title":"Pain assessment: Global use of the brief pain inventory","volume":"23","author":"Cleeland","year":"1994","journal-title":"Ann Acad Med Singap"},{"key":"10.1016\/j.ijrobp.2025.12.047_bib0011","doi-asserted-by":"crossref","first-page":"707","DOI":"10.1111\/1523-1747.ep12365600","article-title":"Skindex, a quality-of-life measure for patients with skin disease: Reliability, validity, and responsiveness","volume":"107","author":"Chren","year":"1996","journal-title":"J Invest Dermatol"},{"key":"10.1016\/j.ijrobp.2025.12.047_bib0012","doi-asserted-by":"crossref","first-page":"887","DOI":"10.1001\/jamaoncol.2022.0114","article-title":"Identifying patients whose symptoms are underrecognized during treatment with breast radiotherapy","volume":"8","author":"Jagsi","year":"2022","journal-title":"JAMA Oncol"},{"key":"10.1016\/j.ijrobp.2025.12.047_bib0013","doi-asserted-by":"crossref","first-page":"257","DOI":"10.1016\/0360-3016(79)90729-6","article-title":"Analysis of cosmetic results following primary radiation therapy for stages I and II carcinoma of the breast","volume":"5","author":"Harris","year":"1979","journal-title":"Int J Radiat Oncol Biol Phys"},{"key":"10.1016\/j.ijrobp.2025.12.047_bib0014","doi-asserted-by":"crossref","first-page":"e306","DOI":"10.1016\/j.ijrobp.2024.07.679","article-title":"Prospective evaluation of acute toxicity from tumor bed boost following whole breast radiotherapy","volume":"120","author":"Dykstra","year":"2024","journal-title":"Int J Radiat Oncol Biol Phys"},{"key":"10.1016\/j.ijrobp.2025.12.047_bib0015","doi-asserted-by":"crossref","first-page":"918","DOI":"10.1001\/jamaoncol.2015.2590","article-title":"Differences in the acute toxic effects of breast radiotherapy by fractionation schedule: Comparative analysis of physician-assessed and patient-reported outcomes in a large multicenter cohort","volume":"1","author":"Jagsi","year":"2015","journal-title":"JAMA Oncol"},{"key":"10.1016\/j.ijrobp.2025.12.047_bib0016","doi-asserted-by":"crossref","first-page":"236","DOI":"10.1159\/000509410","article-title":"Radiotherapy-induced fatigue in breast cancer patients","volume":"16","author":"Kowalczyk","year":"2021","journal-title":"Breast Care"},{"key":"10.1016\/j.ijrobp.2025.12.047_bib0017","doi-asserted-by":"crossref","first-page":"4019","DOI":"10.1200\/JCO.20.01703","article-title":"Toward improving patients\u2019 experiences of acute toxicity from breast radiotherapy: Insights from the analysis of patient-reported outcomes in a large multicenter cohort","volume":"38","author":"Jagsi","year":"2020","journal-title":"J Clin Oncol"},{"key":"10.1016\/j.ijrobp.2025.12.047_bib0018","doi-asserted-by":"crossref","first-page":"E51","DOI":"10.1016\/j.ijrobp.2019.06.2380","article-title":"Are we missing acute toxicities associated with hypofractionated breast irradiation? A report from a large multi-center cohort study","volume":"105","author":"Beydoun","year":"2019","journal-title":"Int J Radiat Oncol Biol Phys"},{"key":"10.1016\/j.ijrobp.2025.12.047_bib0019","doi-asserted-by":"crossref","first-page":"1378","DOI":"10.1056\/NEJMoa010874","article-title":"Recurrence rates after treatment of breast cancer with standard radiotherapy with or without additional radiation","volume":"345","author":"Bartelink","year":"2001","journal-title":"N Engl J Med"},{"key":"10.1016\/j.ijrobp.2025.12.047_bib0020","doi-asserted-by":"crossref","first-page":"2591","DOI":"10.1093\/annonc\/mds066","article-title":"Long-term cosmetic changes after breast-conserving treatment of patients with stage I\u2013II breast cancer and included in the EORTC \u2018boost versus no boost\u2019 trial","volume":"23","author":"Immink","year":"2012","journal-title":"Ann Oncol"},{"key":"10.1016\/j.ijrobp.2025.12.047_bib0021","doi-asserted-by":"crossref","first-page":"54","DOI":"10.1016\/j.phro.2020.10.001","article-title":"Assessment of manual adjustment performed in clinical practice following deep learning contouring for head and neck organs at risk in radiotherapy","volume":"16","author":"Brouwer","year":"2020","journal-title":"Phys Imaging Radiat Oncol"},{"key":"10.1016\/j.ijrobp.2025.12.047_bib0022","doi-asserted-by":"crossref","first-page":"180","DOI":"10.1016\/j.radonc.2019.07.024","article-title":"International comparison of cosmetic outcomes of breast conserving surgery and radiation therapy for women with ductal carcinoma in situ of the breast","volume":"142","author":"Olivotto","year":"2020","journal-title":"Radiother Oncol"},{"key":"10.1016\/j.ijrobp.2025.12.047_bib0023","doi-asserted-by":"crossref","first-page":"69","DOI":"10.1016\/j.ijrobp.2010.04.067","article-title":"Impact of the radiation boost on outcomes after breast-conserving surgery and radiation","volume":"81","author":"Murphy","year":"2011","journal-title":"Int J Radiat Oncol Biol Phys"},{"key":"10.1016\/j.ijrobp.2025.12.047_bib0024","doi-asserted-by":"crossref","first-page":"2587","DOI":"10.1016\/j.ejca.2008.07.032","article-title":"Predictors of the risk of fibrosis at 10 years after breast conserving therapy for early breast cancer \u2013 A study based on the EORTC trial 22881\u201310882 \u2018boost versus no boost\u2019","volume":"44","author":"Collette","year":"2008","journal-title":"Eur J Cancer"},{"key":"10.1016\/j.ijrobp.2025.12.047_bib0025","doi-asserted-by":"crossref","first-page":"45","DOI":"10.1016\/j.radonc.2016.10.006","article-title":"Radiation-induced fibrosis in the boost area after three-dimensional conformal radiotherapy with a simultaneous integrated boost technique for early-stage breast cancer: A multivariable prediction model","volume":"122","author":"Hammer","year":"2017","journal-title":"Radiother Oncol"}],"container-title":["International Journal of Radiation Oncology*Biology*Physics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0360301626000131?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0360301626000131?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2026,7,25]],"date-time":"2026-07-25T12:30:41Z","timestamp":1784982641000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S0360301626000131"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7]]},"references-count":25,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2026,7]]}},"alternative-id":["S0360301626000131"],"URL":"https:\/\/doi.org\/10.1016\/j.ijrobp.2025.12.047","relation":{},"ISSN":["0360-3016"],"issn-type":[{"value":"0360-3016","type":"print"}],"subject":[],"published":{"date-parts":[[2026,7]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"Acute Toxicity and Cosmesis Following a Tumor Bed Boost After Whole Breast Moderate Dose Hypofractionation","name":"articletitle","label":"Article Title"},{"value":"International Journal of Radiation Oncology*Biology*Physics","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.ijrobp.2025.12.047","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"\u00a9 2026 The Authors. Published by Elsevier Inc.","name":"copyright","label":"Copyright"}]}}