Latorre Javier Anchuelo, Galdós Piedad, Buznego Lucía Alonso, Blanco Ana García, Cardenal Juan, Ferri María, de Cerio Iván Díaz, Arrojo Elisabet, Sierrasesúmaga Nicolás, Noriega Mónica González, Ferré Ana De Juan, Fabregat Rosa, Ruíz Samuel, Prada Pedro J
Department of Radiation Oncology.
Department of Medical Oncology.
J Contemp Brachytherapy. 2018 Feb;10(1):58-63. doi: 10.5114/jcb.2018.73994. Epub 2018 Feb 28.
To evaluate the feasibility of acute and chronic toxicity in patients suitable for accelerated partial breast irradiation (APBI) in a single 18 Gy fraction with multicatheter high-dose-rate (HDR) brachytherapy, as well as cosmetic and oncological outcomes.
Between September 2014 and March 2016, twenty consecutive patients with low-risk invasive and ductal carcinoma in situ were treated with interstitial multicatheter HDR brachytherapy in a single 18 Gy fraction.
Median age was 63.5 years (range, 51-79). Acute toxicity was observed in seven patients, while the pain during following days and hematoma were seen in four patients. With a median follow-up of 24 months, late toxicity was found in one patient with fat necrosis g2 and fibrosis g2 in another patient. The overall survival (OS) and locoregional control (LC) was 100%. Disease-free survival (DFS) and distant control was 95%. Good to excellent cosmetic outcomes were noted in 80% of patients and fair in 4 patients (20%).
This is the first report in the medical literature that focuses on feasibility and acute and chronic toxicity, with a median follow-up of 24 months (range, 20-40). The protocol is viable and convenient. However, a longer follow-up is needed to know chronic toxicity and oncologic outcomes.
评估采用多导管高剂量率（HDR）近距离放射疗法单次给予18 Gy剂量对适合加速部分乳腺照射（APBI）的患者进行急慢性毒性反应的可行性，以及美容效果和肿瘤学结局。
2014年9月至2016年3月期间，连续20例低风险浸润性和原位导管癌患者接受了间质多导管HDR近距离放射疗法，单次给予18 Gy剂量。
中位年龄为63.5岁（范围51 - 79岁）。7例患者出现急性毒性反应，4例患者在随后几天出现疼痛和血肿。中位随访24个月时，1例患者出现脂肪坏死2级，另1例患者出现纤维化2级的晚期毒性反应。总生存率（OS）和局部区域控制率（LC）均为100%。无病生存率（DFS）和远处控制率为95%。80%的患者美容效果良好至优秀，4例患者（20%）为中等。
这是医学文献中首篇关注可行性以及急慢性毒性反应的报告，中位随访时间为24个月（范围20 - 40个月）。该方案可行且便捷。然而，需要更长时间的随访以了解慢性毒性反应和肿瘤学结局。
