Department of Radiotherapy, National Institute of Oncology, Budapest, Hungary.
Radiother Oncol. 2010 Mar;94(3):274-9. doi: 10.1016/j.radonc.2010.01.019. Epub 2010 Feb 22.
To report the 12-year updated results of accelerated partial-breast irradiation (APBI) using multicatheter interstitial high-dose-rate (HDR) brachytherapy (BT).
Forty-five prospectively selected patients with T1N0-N1mi, nonlobular breast cancer without the presence of an extensive intraductal component and with negative surgical margins were treated with APBI after breast-conserving surgery (BCS) using interstitial HDR BT. A total dose of 30.3 Gy (n=8) and 36.4 Gy (n=37) in seven fractions within 4 days was delivered to the tumour bed plus a 1-2 cm margin. The median follow-up time was 133 months for surviving patients. Local and regional control, disease-free (DFS), cancer-specific (CSS), and overall survival (OS), as well as late side effects, and cosmetic results were assessed.
Four (8.9%) ipsilateral breast tumour recurrences were observed, for a 5-, 10-, and 12-year actuarial rate of 4.4%, 9.3%, and 9.3%, respectively. A total of two regional nodal failures were observed for a 12-year actuarial rate of 4.4%. The 12-year DFS, CSS, and OS was 75.3%, 91.1%, and 88.9%, respectively. Grade 3 fibrosis was observed in one patient (2.2%). No patient developed grade 3 teleangiectasia. Fat necrosis requiring surgical intervention occurred in one woman (2.2%). Cosmetic results were rated excellent or good in 35 patients (77.8%).
Twelve-year results with APBI using HDR multicatheter interstitial implants continue to demonstrate excellent long-term local tumour control, survival, and cosmetic results with a low-rate of late side effects.
报告应用多导管间质高剂量率（HDR）近距离放疗（BT）行加速部分乳房照射（APBI）的 12 年更新结果。
45 例 T1N0-N1mi、非小叶性乳腺癌患者，无广泛的导管内成分且切缘阴性，在保乳手术后（BCS）采用间质 HDR BT 行 APBI 治疗。肿瘤床加 1-2cm 边缘给予 30.3Gy（n=8）和 36.4Gy（n=37）共 7 次分割，总剂量为 30.3Gy 和 36.4Gy。存活患者中位随访时间为 133 个月。评估局部和区域控制、无病生存（DFS）、癌症特异性生存（CSS）和总生存（OS）以及晚期副作用和美容效果。
4 例（8.9%）同侧乳房肿瘤复发，5 年、10 年和 12 年累积发生率分别为 4.4%、9.3%和 9.3%。共发生 2 例区域淋巴结失败，12 年累积发生率为 4.4%。12 年 DFS、CSS 和 OS 分别为 75.3%、91.1%和 88.9%。1 例（2.2%）患者出现 3 级纤维化。无患者发生 3 级皮肤毛细血管扩张症。1 例（2.2%）患者发生脂肪坏死需要手术干预。35 例（77.8%）患者美容效果评为优秀或良好。
应用 HDR 多导管间质植入物行 APBI 的 12 年结果继续显示出优异的长期局部肿瘤控制、生存和美容效果，且晚期副作用发生率低。
