Karasawa Kumiko, Kunogi Hiroaki, Hirai Takahisa, Hojo Hidehiro, Hirowatari Hisako, Izawa Hiromi, Ito Kana, Sasai Keisuke, Kawashima Motohiro, Furuya Tomohisa, Sugimoto Satoru, Kurokawa Chie, Ozawa Shuichi, Saito Mitsue
Department of Radiology, Faculty of Medicine, Juntendo University, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan,
Breast Cancer. 2014 Jul;21(4):402-8. doi: 10.1007/s12282-012-0406-6. Epub 2012 Sep 12.
To evaluate the efficacy and safety of hypofractionated whole-breast irradiation (HF-WBI) compared with conventionally fractionated (CF) WBI.
Patients with early breast cancer (stages 0-II and <3 positive lymph nodes) who had undergone breast-conserving surgery were eligible for the HF-WBI study. HF-WBI was administered at 43.2 Gy in 16 fractions over 3.2 weeks to the whole breast with an additional tumor-bed boost of 8.1 Gy in 3 fractions over 3 days for positive surgical margins or those <5 mm. CF-WBI was administered at 50 Gy in 25 fractions over 5 weeks to the whole breast with an additional tumor-bed boost of 16 Gy in 8 fractions over 1.4 weeks to 6 Gy in 3 fractions over 3 days, depending on margin status.
From April 1, 2006, to December 31, 2010, 717 patients were registered and 734 breasts were treated by HF-WBI. In the same period, 381 patients and 393 breasts who matched the study criteria chose CF-WBI, so the total number of patients in this comparison was 1,098. Grade 2 acute skin reactions were observed for 24 patients (3 %) in the HF-WBI group and 53 patients (14 %) in the CF-WBI (p < 0.001) group. The median follow-up period was 27 months. Two cases of intrabreast tumor recurrence were observed in each treatment group. Regional lymph node recurrence was observed in 1 HF-WBI patient and 2 CF-WBI patients.
HF-WBI is superior to CF-WBI in terms of acute skin reaction and has the same short-term efficacy.
评估大分割全乳照射（HF-WBI）与常规分割（CF）全乳照射的疗效和安全性。
接受保乳手术的早期乳腺癌（0-II期且腋窝淋巴结转移＜3枚）的早期乳腺癌患者符合HF-WBI研究标准。HF-WBI组全乳给予43.2 Gy，分16次，在3.2周内完成，对于手术切缘阳性或切缘宽度＜5 mm的患者，瘤床再追加8.1 Gy，分3次，在3天内完成。CF-WBI组全乳给予50 Gy，分25次，在5周内完成，根据切缘情况，瘤床再追加16 Gy，分8次，在1.4周内完成至6 Gy，分3次，在3天内完成。
2006年4月1日至2010年12月31日，717例患者登记入组，734侧乳房接受HF-WBI治疗。同期，381例患者、393侧乳房符合研究标准并选择CF-WBI，因此本比较研究中患者总数为1098例。HF-WBI组24例患者（3%）出现2级急性皮肤反应，CF-WBI组53例患者（14%）出现2级急性皮肤反应（p＜0.001）。中位随访时间为27个月。每个治疗组均观察到2例乳腺内肿瘤复发。HF-WBI组1例患者、CF-WBI组2例患者出现区域淋巴结复发。
HF-WBI在急性皮肤反应方面优于CF-WBI，且短期疗效相同。
