Dept. of Radiation Oncology, Ghent University Hospital, Belgium.
Dept. of Radiation Oncology, Liège University Hospital, Belgium.
Radiother Oncol. 2017 Jan;122(1):30-36. doi: 10.1016/j.radonc.2016.12.023. Epub 2017 Jan 3.
The safety of a simultaneous integrated boost (SIB) in combination with prone hypofractionated whole-breast irradiation (WBI) was investigated.
167 patients were randomized between WBI with a sequential boost (SeB) or SIB. All patients were treated in prone position to 40.05Gy in 15 fractions to the whole breast. In the control arm, a SeB of 10Gy in 4 fractions (negative surgical margins) or 14.88Gy in 6 fractions (transsection) was prescribed. In the experimental arm a SIB of 46.8 or 49.95Gy (negative and positive surgical margins, respectively) was prescribed.
Patient age was the only significantly different parameter between treatment arms with patients in the SIB arm being slightly older. In both arms, 6/83 patients developed moist desquamation. Grade 2/3 dermatitis was significantly more frequent in the SeB arm (38/83vs 24/83 patients, p=0.037). In the SIB and SeB arm, respectively, 36 patients (43%) and 51 patients (61%) developed pruritus (p=0.015). The incidence of oedema was lower in the SIB arm (59vs 68 patients), but not statistically significant (p=0.071).
The primary endpoint, moist desquamation, was not significantly different between treatment arms.
本研究旨在评估同步整合推量（SIB）联合俯卧位短分割全乳放疗（WBI）的安全性。
167 例患者被随机分为 WBI 序贯推量（SeB）组或 SIB 组。所有患者均采用俯卧位接受 40.05Gy/15f 的全乳照射。在对照组中，行 10Gy/4f（阴性切缘）或 14.88Gy/6f（横断）的 SeB。实验组则行 46.8Gy 或 49.95Gy 的 SIB（阴性和阳性切缘）。
患者年龄是治疗组之间唯一具有显著差异的参数，SIB 组的患者年龄稍大。在两个治疗组中，6/83 例患者出现湿性脱皮。SIB 组（38/83）较 SeB 组（24/83）更易发生 2/3 级皮炎（p=0.037）。SIB 组和 SeB 组分别有 36 例（43%）和 51 例（61%）患者出现瘙痒（p=0.015）。SIB 组水肿的发生率较低（59 例 vs 68 例），但无统计学意义（p=0.071）。
主要终点，湿性脱皮，两组间无显著差异。
