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每周一次的老年乳腺癌Hypofractionated 放疗同步整合增敏:初步证据。

Simultaneous Integrated Boost in Once-weekly Hypofractionated Radiotherapy for Breast Cancer in the Elderly: Preliminary Evidence.

机构信息

Department of Radiation Oncology, IRCCS Policlinico San Martino, Genoa, Italy

Department of Radiation Oncology, IRCCS Policlinico San Martino, Genoa, Italy.

出版信息

In Vivo. 2019 Nov-Dec;33(6):1985-1992. doi: 10.21873/invivo.11694.

DOI:10.21873/invivo.11694
PMID:31662528
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6899087/
Abstract

AIM

To evaluate once-weekly hypofractionated radiotherapy in elderly patients affected by early breast cancer, reporting acute and late toxicity profiles, and treatment feasibility.

PATIENTS AND METHODS

Fifty patients were treated with a hypofractionated regimen: 28.5±2.5 Gy in five fractions at one fraction weekly. Simultaneous integrated boost (SIB) to the tumor bed in high-risk cases.

INCLUSION CRITERIA

patients over 70 years old, pT1-2, N0-1a. Acute and late toxicities were assessed based on Radiation Therapy Oncology Group.

RESULTS

The median follow-up was 20 months and the median patient age was 79 years. SIB was added for 22 patients (44%). Grade 3-4 acute cutaneous toxicities were not observed; grade 2 toxicity occurred only in four patients (8%). Late subcutaneous tissue toxicity consisted of grade 2 fibrosis in two patients (4%), grade 1 in five (10%) and grade 0 in 41(85%).

CONCLUSION

Limiting fraction numbers with a safer profile may improve the management of breast cancer for the elderly.

摘要

目的

评估每周一次的超分割放疗在老年早期乳腺癌患者中的应用,报告急性和晚期毒性概况以及治疗可行性。

患者和方法

50 例患者接受超分割方案治疗:28.5±2.5Gy,每周一次,共 5 次。高危病例采用肿瘤床同步整合 boost(SIB)。

纳入标准

年龄>70 岁,pT1-2,N0-1a。根据放射治疗肿瘤学组评估急性和晚期毒性。

结果

中位随访时间为 20 个月,中位患者年龄为 79 岁。22 例(44%)患者加用 SIB。未观察到 3-4 级急性皮肤毒性;仅 4 例(8%)患者出现 2 级毒性。晚期皮下组织毒性包括 2 例(4%)2 级纤维化,5 例(10%)1 级和 41 例(85%)0 级。

结论

限制分次次数可改善老年乳腺癌的管理,且安全性更佳。

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本文引用的文献

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Cancer Radiother. 2018 Oct;22(6-7):635-639. doi: 10.1016/j.canrad.2018.07.127. Epub 2018 Aug 22.
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Radiation therapy for the whole breast: Executive summary of an American Society for Radiation Oncology (ASTRO) evidence-based guideline.全乳放射治疗:美国放射肿瘤学会(ASTRO)基于证据的指南执行摘要。
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Breast cancer data analysis for survivability studies and prediction.乳腺癌数据分析用于生存研究和预测。
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Radiation Therapy in Elderly Persons: An Old Issue With New Approaches.老年人的放射治疗:一个有新方法的老问题。
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First Results of a Phase 2 Trial of Once-Weekly Hypofractionated Breast Irradiation (WHBI) for Early-Stage Breast Cancer.早期乳腺癌每周一次大分割乳房照射(WHBI)2期试验的初步结果。
Int J Radiat Oncol Biol Phys. 2017 Jul 1;98(3):595-602. doi: 10.1016/j.ijrobp.2017.01.212.
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Hypofractionated Regional Nodal Irradiation for Women With Node-Positive Breast Cancer.局部区域淋巴结低分割照射治疗淋巴结阳性乳腺癌女性患者。
Int J Radiat Oncol Biol Phys. 2017 Mar 1;97(3):563-570. doi: 10.1016/j.ijrobp.2016.11.010. Epub 2016 Nov 15.
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External radiotherapy for breast cancer in the elderly.
Aging Clin Exp Res. 2017 Feb;29(Suppl 1):149-157. doi: 10.1007/s40520-016-0655-x. Epub 2016 Nov 11.
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Acute skin toxicity associated with a 1-week schedule of whole breast radiotherapy compared with a standard 3-week regimen delivered in the UK FAST-Forward Trial.与英国FAST-Forward试验中采用的标准3周方案相比,全乳放疗1周方案相关的急性皮肤毒性。
Radiother Oncol. 2016 Jul;120(1):114-8. doi: 10.1016/j.radonc.2016.02.027. Epub 2016 Apr 1.
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Once-Weekly Hypofractionated Whole-Breast Radiotherapy After Breast-Conserving Surgery in Older Patients: A Potential Alternative Treatment Schedule to Daily 3-Week Hypofractionation.老年患者保乳手术后每周一次的大分割全乳放疗:一种可替代每日一次三周大分割放疗的潜在治疗方案。
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