Radiation Oncology Department, National Cancer Institute, Cairo University, Cairo, Egypt.
Radiation Oncology Department, National Cancer Institute, Cairo University, Cairo, Egypt.
Int J Radiat Oncol Biol Phys. 2021 Apr 1;109(5):1296-1300. doi: 10.1016/j.ijrobp.2020.11.044.
The aim of the current study was to compare toxicity, cosmesis, and local control between the once daily and the twice daily fractionation schemes for external beam accelerated partial breast irradiation.
From December 2012 to June 2018, we enrolled 113 patients with ductal carcinoma in situ or invasive breast cancer, node negative disease, and tumors less than 3 cm in size to receive accelerated partial breast irradiation (APBI) to a total dose of 38.5 Gy over 10 fractions given either once (oAPBI) or twice daily (tAPBI). Sixty patients were included in the tAPBI arm and 53 patients were included in the oAPBI arm.
Median follow-up was 74 months (range, 24-105). The median pain score during treatment was 3 out of 10 in the oAPBI and 5 in the tAPBI (P = .001). No differences were observed in GIII early skin toxicity (P = .4) or GI early pulmonary toxicity (P = 1.0) between the 2 treatment arms. GIII late skin toxicity developed in 3.8% and 11.7% of patients in the oAPBI and tAPBI arms, respectively (P = .001). GIII subcutaneous fibrosis developed in 1.9% and 8.3% of patients in the oAPBI and tAPBI, respectively (P = .001). The rate of patients with adverse cosmesis (poor/fair) was 7.5% at 12 months and at 24 months in the oAPBI arm compared with 21.7% and 26.7% in the tAPBI arm (P = .03 and .008, respectively).
oAPBI is a safe, well-tolerated schedule with more favorable outcomes than the tAPBI schedule with regards to late toxicity and cosmesis.
本研究旨在比较外照射加速部分乳腺照射（APBI）中每日一次和每日两次分割方案的毒性、美容效果和局部控制。
从 2012 年 12 月至 2018 年 6 月，我们招募了 113 例导管原位癌或浸润性乳腺癌、淋巴结阴性疾病和肿瘤小于 3cm 的患者，接受 38.5Gy 的加速部分乳腺照射（APBI），共 10 个剂量，每日一次（oAPBI）或每日两次（tAPBI）。60 例患者入组 tAPBI 组，53 例患者入组 oAPBI 组。
中位随访时间为 74 个月（范围 24-105）。oAPBI 组治疗期间的中位疼痛评分为 3 分（10 分制），tAPBI 组为 5 分（P =.001）。两组治疗中，GIII 早期皮肤毒性（P =.4）或 GI 早期肺毒性（P = 1.0）无差异。oAPBI 和 tAPBI 组分别有 3.8%和 11.7%的患者发生 GIII 晚期皮肤毒性（P =.001）。oAPBI 和 tAPBI 组分别有 1.9%和 8.3%的患者发生 GIII 皮下纤维化（P =.001）。oAPBI 组在 12 个月和 24 个月时，不良美容效果（差/差）的患者比例分别为 7.5%和 24 个月时为 21.7%和 26.7%（P =.03 和.008）。
oAPBI 是一种安全、耐受良好的方案，与 tAPBI 方案相比，在晚期毒性和美容效果方面具有更好的结果。
