Department of Radiation Oncology, William Beaumont Hospital, Royal Oak, MI 48072, USA.
Int J Radiat Oncol Biol Phys. 2012 Jun 1;83(2):512-8. doi: 10.1016/j.ijrobp.2011.07.011. Epub 2011 Nov 11.
To evaluate factors associated with optimal cosmetic results at 72 months for early-stage breast cancer patients treated with Mammosite balloon-based accelerated partial breast irradiation (APBI).
A total of 1,440 patients (1,449 cases) with early-stage breast cancer undergoing breast-conserving therapy were treated with balloon-based brachytherapy to deliver APBI (34 Gy in 3.4-Gy fractions). Cosmetic outcome was evaluated at each follow-up visit and dichotomized as excellent/good (E/G) or fair/poor (F/P). Follow-up was evaluated at 36 and 72 months to establish long-term cosmesis, stability of cosmesis, and factors associated with optimal results.
The percentage of evaluable patients with excellent/good (E/G) cosmetic results at 36 months and more than 72 months were 93.3% (n = 708/759) and 90.4% (n = 235/260). Factors associated with optimal cosmetic results at 72 months included: larger skin spacing (p = 0.04) and T1 tumors (p = 0.02). Using multiple regression analysis, the only factors predictive of worse cosmetic outcome at 72 months were smaller skin spacing (odds ratio [OR], 0.89; confidence interval [CI], 0.80-0.99) and tumors greater than 2 cm (OR, 4.96, CI, 1.53-16.07). In all, 227 patients had both a 36-month and a 72-month cosmetic evaluation. The number of patients with E/G cosmetic results decreased only slightly from 93.4% at 3 years to 90.8% (p = 0.13) at 6 years, respectively.
APBI delivered with balloon-based brachytherapy produced E/G cosmetic results in 90.4% of cases at 6 years. Larger tumors (T2) and smaller skin spacing were found to be the two most important independent predictors of cosmesis.
评估接受 Mammosite 球囊式加速部分乳房照射（APBI）治疗的早期乳腺癌患者在 72 个月时获得最佳美容效果的相关因素。
共有 1440 名（1449 例）接受保乳治疗的早期乳腺癌患者接受球囊式近距离放射治疗以提供 APBI（34 Gy 分 3.4-Gy 剂量）。在每次随访时评估美容效果，并将其分为优秀/良好（E/G）或一般/差（F/P）。通过 36 个月和 72 个月的随访评估来建立长期美容效果、美容效果的稳定性以及与最佳结果相关的因素。
36 个月和 72 个月时，有 93.3%（n=708/759）和 90.4%（n=235/260）的可评估患者获得优秀/良好（E/G）的美容效果。72 个月时与最佳美容效果相关的因素包括：更大的皮肤间距（p=0.04）和 T1 肿瘤（p=0.02）。通过多元回归分析，仅预测 72 个月时美容效果较差的因素为皮肤间距较小（比值比[OR]，0.89；置信区间[CI]，0.80-0.99）和肿瘤大于 2 cm（OR，4.96，CI，1.53-16.07）。共有 227 名患者在 36 个月和 72 个月时均进行了美容评估。E/G 美容效果的患者数量从 3 年时的 93.4%仅略有下降，分别为 6 年时的 90.8%（p=0.13）。
接受球囊式近距离放射治疗的 APBI 在 6 年内使 90.4%的病例获得 E/G 美容效果。较大的肿瘤（T2）和较小的皮肤间距被认为是美容效果的两个最重要的独立预测因素。
