Department of Radiation Oncology, William Beaumont Hospital, Royal Oak, MI 48072, USA.
Int J Radiat Oncol Biol Phys. 2011 Mar 1;79(3):808-17. doi: 10.1016/j.ijrobp.2009.11.043. Epub 2010 May 14.
To present 5-year data on treatment efficacy, cosmetic results, and toxicities for patients enrolled on the American Society of Breast Surgeons MammoSite breast brachytherapy registry trial.
A total of 1440 patients (1449 cases) with early-stage breast cancer receiving breast-conserving therapy were treated with the MammoSite device to deliver accelerated partial-breast irradiation (APBI) (34 Gy in 3.4-Gy fractions). Of 1449 cases, 1255 (87%) had invasive breast cancer (IBC) (median size, 10 mm) and 194 (13%) had ductal carcinoma in situ (DCIS) (median size, 8 mm). Median follow-up was 54 months.
Thirty-seven cases (2.6%) developed an ipsilateral breast tumor recurrence (IBTR), for a 5-year actuarial rate of 3.80% (3.86% for IBC and 3.39% for DCIS). Negative estrogen receptor status (p=0.0011) was the only clinical, pathologic, or treatment-related variable associated with IBTR for patients with IBC and young age (<50 years; p=0.0096) and positive margin status (p=0.0126) in those with DCIS. The percentage of breasts with good/excellent cosmetic results at 60 months (n=371) was 90.6%. Symptomatic breast seromas were reported in 13.0% of cases, and 2.3% developed fat necrosis. A subset analysis of the first 400 consecutive cases enrolled was performed (352 with IBC, 48 DCIS). With a median follow-up of 60.5 months, the 5-year actuarial rate of IBTR was 3.04%.
Treatment efficacy, cosmesis, and toxicity 5 years after treatment with APBI using the MammoSite device are good and similar to those reported with other forms of APBI with similar follow-up.
呈现美国乳腺外科学会 MammoSite 乳房近距离放疗注册研究中入组患者的 5 年治疗疗效、美容效果和毒性数据。
共有 1440 例（1449 例）早期乳腺癌患者接受 MammoSite 设备进行保乳治疗，以提供加速部分乳房照射（APBI）（34 Gy 分 3.4-Gy 剂量）。在 1449 例中，1255 例（87%）患有浸润性乳腺癌（IBC）（中位大小为 10 毫米），194 例（13%）患有导管原位癌（DCIS）（中位大小为 8 毫米）。中位随访时间为 54 个月。
37 例（2.6%）发生同侧乳房肿瘤复发（IBTR），5 年累计发生率为 3.80%（IBC 为 3.86%，DCIS 为 3.39%）。对于 IBC 患者，雌激素受体阴性状态（p=0.0011）和年轻（<50 岁；p=0.0096）是唯一与 IBTR 相关的临床、病理或治疗相关变量，而对于 DCIS 患者，阳性切缘状态（p=0.0126）是唯一相关的因素。60 个月时（n=371）有良好/优秀美容效果的乳房百分比为 90.6%。13.0%的病例报告有症状性乳房血清肿，2.3%发生脂肪坏死。对入组的前 400 例连续病例进行了亚组分析（352 例 IBC，48 例 DCIS）。中位随访 60.5 个月时，IBTR 的 5 年累计发生率为 3.04%。
使用 MammoSite 设备进行 APBI 治疗后 5 年的治疗疗效、美容效果和毒性良好，与其他具有相似随访的 APBI 形式相似。
