Randomized clinical trial of tissue equivalent bolus prescription in postmastectomy radiotherapy stratified by skin involvement status

•Alternate-days bolus may be the most appropriated regimen to increase the absorbed dose in the superficial regions of the CW.•Due to the excess of G3 radiodermatitis events (70 %), the daily 5 mm-bolus should be avoided in PMRT for NIBC.•Toxicity-related treatment interruptions are avoided if the bolus is promptly discontinued when a G3 toxicity occurs.•The proposed rads-TI was able to capture the toxicity burden during the entire course of radiotherapy.