Radiation Oncology, Rocky Mountain Cancer Centers , Littleton, CO , USA ; Radiation Oncology, Rocky Mountain Cancer Centers , Aurora, CO , USA.
Radiation Oncology, Rocky Mountain Cancer Centers , Littleton, CO , USA.
Front Oncol. 2014 Jun 19;4:154. doi: 10.3389/fonc.2014.00154. eCollection 2014.
To report outcomes in breast cancer patients with prior breast augmentation treated with external beam accelerated partial breast irradiation (EB-APBI) utilizing intensity-modulated radiotherapy or 3-dimensional conformal radiotherapy, both with IGRT.
Sixteen stage 0/1 breast cancer patients with previous elective bilateral augmentation were treated post-lumpectomy on institutional EB-APBI trials (01185132 and 01185145 on clinicaltrials.gov). Patients received 38.5 Gy in 10 fractions over five consecutive days. Breast/chest wall pain and cosmesis were rated by patient; cosmesis was additionally evaluated by physician per RTOG criteria.
The median follow-up from accelerated partial breast irradiation (APBI) completion was 23.9 months (range, 1.2-58.6). Little to no change in cosmesis or pain from baseline was reported. Cosmetic outcomes at last follow-up were judged by patients as excellent/good in 81.2% (13/16), and by physicians as excellent/good in 93.8% (15/16). Ten patients (62.5%) reported no breast/chest wall pain, five (31.2%) reported mild pain, and one (6.2%) reported moderate pain. All patients remain disease free at last follow-up. The median ipsilateral breast, planning target volume (PTV), and implant volumes were 614, 57, and 333 cm(3). The median ratios of PTV/ipsilateral breast volume (implant excluded) and PTV/total volume (implant included) were 9 and 6%.
These 16 breast cancer cases with prior bilateral augmentation treated with EB-APBI demonstrate favorable clinical outcomes. Further exploration of EB-APBI as a treatment option for this patient population is warranted.
报告接受调强放疗或三维适形放疗的既往行双侧乳房假体置入的乳腺癌患者接受外照射加速部分乳房照射（EB-APBI）的治疗结果，两种方法均采用图像引导放疗（IGRT）。
在机构性 EB-APBI 试验（clinicaltrials.gov 上的 01185132 和 01185145）中，16 例既往行择期双侧假体置入的 0/1 期乳腺癌患者在乳房切除术之后接受了术后 EB-APBI 治疗。患者接受 38.5Gy/10 次/5 天的分割照射。乳房/胸壁疼痛和美容效果由患者进行评分；根据 RTOG 标准，美容效果另外由医生进行评估。
从加速部分乳房照射（APBI）完成到随访的中位时间为 23.9 个月（范围，1.2-58.6）。从基线开始，美容效果或疼痛几乎没有变化。在最后一次随访时，16 例患者中有 81.2%（13/16）的患者认为美容效果为优秀/良好，16 例患者中有 93.8%（15/16）的医生认为美容效果为优秀/良好。10 例（62.5%）患者报告无乳房/胸壁疼痛，5 例（31.2%）患者报告轻度疼痛，1 例（6.2%）患者报告中度疼痛。所有患者在最后一次随访时均无疾病。同侧乳房、计划靶区（PTV）和假体体积的中位数分别为 614cm3、57cm3 和 333cm3。PTV/同侧乳房体积（不包括假体）和 PTV/总体积（包括假体）的中位数比值分别为 9 和 6%。
这 16 例既往行双侧假体置入的乳腺癌患者接受 EB-APBI 治疗后获得了良好的临床结果。进一步探索 EB-APBI 作为该患者群体的一种治疗选择是合理的。
