Radiation Oncology Department, Sacro Cuore-Don Calabria Hospital, Via Don Sempreboni 5, Negrar, 37024, Verona, Italy.
Statistic Science Faculty, University of Palermo, Palermo, Italy.
Aging Clin Exp Res. 2018 May;30(5):533-538. doi: 10.1007/s40520-017-0802-z. Epub 2017 Jul 28.
To evaluate the impact of comorbidity assessment on compliance to intensity modulated radiotherapy with simultaneous integrated boost (SIB-IMRT) in elderly patients affected by early stage breast cancer (BC).
40 consecutive patients were treated with SIB-IMRT (50 Gy in 25 fractions to the whole breast, and simultaneously 60 Gy to the surgical bed) for invasive BC after conserving surgery. Inclusion criteria were: age ≥ 70 years, pT1-2 disease, pN0-1, no neoadjuvant chemotherapy, non-metastatic disease. Charlson comorbidity index was used for comorbidity evaluation.
Median follow-up was 44 months. At the time of the analysis, OS and LC rates were 100%. All patients completed the SIB-IMRT without interruptions. Acute skin toxicity was recorded as follows: grade 0 in 5 patients (12.5%), grade 1 in 25 cases (62.5%), and grade 2 in 10 patients (25%). Regarding late adverse events, skin toxicity was registered as follows: grade 0 in 27 patients (67.5%) and grade 1 in 13 cases (32.5%). No toxicity ≥grade 2 was registered. At statistical analysis, the presence of comorbidities and the breast volume >700 cc were related to skin grade 2 acute toxicity (p = 0.01, p = 0.04). In terms of cosmetic results, 98 and 2% of patients considered the result as good/excellent and as fair after RT, respectively. No patients had a poor cosmetic outcome.
The present study showed the feasibility of SIB-IMRT in early stage BC elderly patients and that the absence of comorbidity reduced the risk of acute radiation toxicity.
评估合并症评估对接受早期乳腺癌（BC）保乳手术后行同步整合推量调强放疗（SIB-IMRT）的老年患者依从性的影响。
40 例连续接受 SIB-IMRT（全乳 50Gy/25 次，手术床同时给予 60Gy）治疗的浸润性 BC 患者符合以下条件：年龄≥70 岁，pT1-2 期疾病，pN0-1，无新辅助化疗，无远处转移。采用 Charlson 合并症指数评估合并症。
中位随访时间为 44 个月。在分析时，OS 和 LC 率均为 100%。所有患者均完成 SIB-IMRT 治疗，无中断。急性皮肤毒性分级如下：0 级 5 例（12.5%），1 级 25 例（62.5%），2 级 10 例（25%）。关于晚期不良反应，皮肤毒性分级如下：0 级 27 例（67.5%），1 级 13 例（32.5%）。无≥2 级毒性。统计分析显示，合并症的存在和乳腺体积>700cc 与 2 级急性皮肤毒性相关（p=0.01，p=0.04）。在美容效果方面，98%和 2%的患者在放疗后分别认为结果为好/优秀和一般。无患者美容效果差。
本研究表明 SIB-IMRT 治疗早期 BC 老年患者是可行的，且无合并症可降低急性放射毒性的风险。
