Department of Radiation Oncology, William Beaumont Hospital, MI, USA.
Radiother Oncol. 2011 Aug;100(2):210-4. doi: 10.1016/j.radonc.2011.03.011. Epub 2011 Apr 15.
To compare 12-year outcomes of accelerated partial breast irradiation (APBI) versus whole-breast irradiation (WBI) in patients treated with breast conservation.
A matched-pair analysis was performed using 199 patients receiving WBI and 199 patients receiving interstitial APBI. Match criteria included tumor size, age, nodal status, ER status, and the use of adjuvant hormonal therapy. Patterns of failure and efficacy of salvage treatments were examined.
No differences were seen in the 12-year rates of local recurrence (3.8% vs. 5.0%, p=0.40), regional recurrence (0% vs. 1.1%, p=0.15), disease free survival (DFS) (87% vs. 91%, p=0.30), cause-specific survival (CSS) (93% vs. 95%, p=0.28), or overall survival (OS) (78% vs. 71%, p=0.06) between the WBI and APBI groups, respectively. The rate of distant metastases was lower in the APBI group (10.1% vs. 4.5%, p=.05). Following LR, no difference in outcome was seen between the two groups with 5year post-LR rates of DFS (80% vs. 86%, p=0.55), CSS (88% vs. 75%, p=0.77), and OS (88% vs. 75%, p=0.77), respectively.
With 12-year follow-up, APBI produced outcomes equivalent to WBI. Following LR, patients treated with APBI also had similar failure patterns to those managed with WBI.
本研究旨在比较保乳术后接受加速部分乳腺照射（APBI）与全乳照射（WBI）的 12 年疗效。
采用配对分析，比较了 199 例接受 WBI 治疗和 199 例接受间质 APBI 治疗的患者。匹配标准包括肿瘤大小、年龄、淋巴结状态、ER 状态以及辅助激素治疗的应用。分析了失败模式和挽救治疗的疗效。
两组患者在 12 年局部复发率（3.8% vs. 5.0%，p=0.40）、区域复发率（0% vs. 1.1%，p=0.15）、无病生存率（DFS）（87% vs. 91%，p=0.30）、无病生存率（CSS）（93% vs. 95%，p=0.28）和总生存率（OS）（78% vs. 71%，p=0.06）方面均无差异。APBI 组远处转移率较低（10.1% vs. 4.5%，p=.05）。局部复发后，两组患者的结局无差异，5 年局部复发后 DFS 率（80% vs. 86%，p=0.55）、CSS 率（88% vs. 75%，p=0.77）和 OS 率（88% vs. 75%，p=0.77）分别相似。
12 年随访时，APBI 治疗的结果与 WBI 相当。局部复发后，APBI 治疗的患者与 WBI 治疗的患者失败模式相似。
