Department of Radiotherapy, Centro Hospitalar Universitário de São João, Porto, Portugal.
Department of Brachytherapy, Instituto Português de Oncologia do Porto Francisco Gentil E.P.E., Porto, Portugal.
Brachytherapy. 2021 Mar-Apr;20(2):315-325. doi: 10.1016/j.brachy.2020.10.005. Epub 2020 Nov 14.
This study aims to review the outcome of an institution in multicatheter/interstitial accelerated partial breast irradiation (MC-APBI) for treatment of patients with breast cancer, either with strong criteria for APBI or unable to be treated with whole-breast irradiation. The outcomes were also stratified by the American Society for Radiation Oncology, American Brachytherapy Society, and Groupe Européen de Curiethérapie-European Society for Therapeutic Radiology and Oncology patient selection criteria.
The study includes 118 patients and 120 MC-APBI treatments, treated in a single tertiary center, between November 2003 and August 2016. The analysis is focused on the clinical baseline characteristics, local control, relapse-free survival, disease-specific survival (DSS), and overall survival.
In accordance to the American Society for Radiation Oncology, American Brachytherapy Society, and Groupe Européen de Curiethérapie-European Society for Therapeutic Radiology and Oncology, 17.1% were "unsuitable," 19.2% were "unacceptable," and 19.5% were "high risk," respectively. The main reasons why high-risk patients were submitted to MC-APBI were as follows: cardiopathy (n = 7), social difficulties (n = 4), and mobility limitations (n = 4). At the median followup period of 86.5 months, ipsilateral breast tumor recurrence was observed in one (0.8%) patient. The 3-year and 5-year relapse-free survival were 100% and 99.1%, respectively. DSS was 100%.
This study demonstrated excellent control rates, DFS, and DSS of MC-APBI, rendering APBI as an excellent treatment for patients with breast cancer, even those who are not necessarily eligible for this treatment approach. The selection criteria for ABPI diverge according to different guidelines and are based on studies with discrepancies, making extremely possible that these recommendations could be changed.
本研究旨在回顾本机构在多导管/间质加速部分乳房照射（MC-APBI）治疗乳腺癌患者方面的结果，这些患者要么符合 APBI 的强烈标准，要么无法接受全乳房照射。根据美国放射肿瘤学会、美国近距离放射治疗学会和欧洲放射治疗与肿瘤学会的患者选择标准，结果也进行了分层。
本研究纳入了 2003 年 11 月至 2016 年 8 月期间在一家三级中心接受治疗的 118 例患者和 120 例 MC-APBI 治疗。分析重点是临床基线特征、局部控制、无复发生存率、疾病特异性生存率（DSS）和总生存率。
根据美国放射肿瘤学会、美国近距离放射治疗学会和欧洲放射治疗与肿瘤学会的标准，17.1%的患者为“不适合”，19.2%的患者为“不可接受”，19.5%的患者为“高危”。高危患者接受 MC-APBI 的主要原因如下：心脏病（n=7）、社会困难（n=4）和行动不便（n=4）。在中位随访 86.5 个月时，1 例（0.8%）患者出现同侧乳腺肿瘤复发。3 年和 5 年无复发生存率分别为 100%和 99.1%，DSS 为 100%。
本研究表明 MC-APBI 的控制率、DFS 和 DSS 非常优异，使得 APBI 成为乳腺癌患者的一种极好的治疗方法，即使是那些不一定符合该治疗方法的患者。ABPI 的选择标准因不同的指南而有所不同，并且基于存在差异的研究，这些建议极有可能发生改变。
