Radiation Oncology Department, Hospital Central de la Defensa Gómez-Ulla, Madrid, Spain.
Clin Transl Oncol. 2012 May;14(5):362-8. doi: 10.1007/s12094-012-0809-z.
Conservative treatment represents the current therapy for early-stage breast cancer. When risk factors for local relapse exist, a tumour bed boost is required. Retrospectively, we evaluated the prognostic factors influencing local recurrence (LR), overall survival (OS) and disease-free survival (DFS).
After conservative treatment, 210 patients received a single-dose HDR brachytherapy (HDRBT) boost between June 1996 and December 2005. Mean age was 57 years; 75% had invasive ductal carcinoma. The most frequent surgery was lumpectomy (55.7%); 39.4% were G3, 18.6% intraductal component >25% and only 22% had negative margins.
With a mean follow-up of 85 months, at 5 and 10 years the OS was 93% and 88%, DFS 92% and 89%, and LR 3.6% and 5.3%, respectively. For LR, the risk factors were carcinoma in situ, N+ and involved margins, whereas for metastasis, the risk factors were T2 tumours, stage III, N+ and the presence of local recurrence.
HDR-BT boost in one fraction is an effective, simple and safe method for reducing LR. The outpatient setting and shorter treatment duration represent undeniable advantages.
保守治疗是早期乳腺癌的当前治疗方法。当存在局部复发的危险因素时，需要进行肿瘤床加量放疗。回顾性评估了影响局部复发（LR）、总生存（OS）和无病生存（DFS）的预后因素。
在保守治疗后，210 例患者于 1996 年 6 月至 2005 年 12 月期间接受了单次 HDR 近距离放疗（HDRBT）加量放疗。平均年龄为 57 岁；75%为浸润性导管癌。最常见的手术是保乳术（55.7%）；39.4%为 G3 级，18.6%的管内成分>25%，仅有 22%的切缘阴性。
平均随访 85 个月，5 年和 10 年的 OS 分别为 93%和 88%，DFS 分别为 92%和 89%，LR 分别为 3.6%和 5.3%。对于 LR，危险因素是原位癌、N+和阳性切缘，而对于转移，危险因素是 T2 肿瘤、III 期、N+和局部复发。
单次分割 HDR-BT 加量放疗是一种有效、简单、安全的降低 LR 的方法。门诊治疗和较短的治疗时间是不可否认的优势。
