Department of Radiation Oncology, Nizam's Institute of Medical Sciences, Hyderabad, Telangana, India.
Indian J Cancer. 2020 Oct-Dec;57(4):423-427. doi: 10.4103/ijc.IJC_670_18.
Hypofractionation is now becoming the standard of care in breast irradiation. The aim of this study was to assess the toxicities and outcomes in patients with breast cancer treated with hypofractionated radiotherapy (HFRT).
Patients with localized breast cancer who received adjuvant HFRT between 2013 and 2015 with a minimum follow-up of 6 months following radiation were included in this prospective study. Late toxicities were assessed using CTCAE v 4 and included chest/breast pain, limb pain, limb edema, skin pigmentation, skin fibrosis, and shoulder movement restriction. Outcomes assessed included locoregional control, disease-free survival, and overall survival. Statistical analysis was done using Microsoft Excel and SPSS v22.
A total of 81 patients fulfilled the inclusion criteria, of which 19 patients had died during follow-up. Regional nodal irradiation was done in 63 (77.8%) patients using the same hypofractionated schedule of 40 Gy in 15 fractions. Late toxicities were assessed for 62 patients. The median follow-up following the course of hypofractionated radiation was 45 months (range 14 - 65 months). Late toxicities were assessed for 62 patients. Grade 1/2 chest/breast pain, limb pain, limb edema, skin pigmentation, skin fibrosis, and shoulder movement restriction were seen in 11%, 12%, 7%, 6%, 8%, and 11% of cases, respectively. Distant recurrences were seen in 8% of cases, and there were no locoregional recurrences. Five-year overall survival was 76.5%.
HFRT to whole breast or chest wall and the regional nodal areas was well-tolerated with acceptable rates of late toxicities on follow-up.
现在，在乳房照射中，分割剂量越来越成为标准治疗方法。本研究旨在评估接受分割剂量放射治疗（HFRT）的乳腺癌患者的毒性和结局。
本前瞻性研究纳入了 2013 年至 2015 年期间接受辅助 HFRT 治疗且放射治疗后随访至少 6 个月的局限性乳腺癌患者。使用 CTCAE v 4 评估迟发性毒性，包括胸痛/乳房痛、肢体痛、肢体水肿、皮肤色素沉着、皮肤纤维化和肩部运动受限。评估的结局包括局部区域控制、无病生存率和总生存率。使用 Microsoft Excel 和 SPSS v22 进行统计分析。
共有 81 例患者符合纳入标准，其中 19 例在随访期间死亡。63 例（77.8%）患者采用相同的分割剂量方案（40 Gy 分 15 次）进行区域淋巴结照射。对 62 例患者进行了迟发性毒性评估。在接受 HFRT 治疗后的中位随访时间为 45 个月（范围 14-65 个月）。对 62 例患者进行了迟发性毒性评估。11%、12%、7%、6%、8%和 11%的患者分别出现 1/2 级胸痛/乳房痛、肢体痛、肢体水肿、皮肤色素沉着、皮肤纤维化和肩部运动受限。8%的患者出现远处复发，无局部区域复发。5 年总生存率为 76.5%。
全乳房或胸壁和区域淋巴结区域的 HFRT 耐受性良好，随访期间迟发性毒性发生率可接受。
