接受多导管间质内高剂量率近距离放射治疗（MIB）单次分割治疗的老年患者的生活质量和综合老年评估（CGA）。SiFEBI Ⅰ/Ⅱ期试验。
Quality of life and Comprehensive Geriatric Assessment (CGA) in older adults receiving Accelerated Partial Breast Irradiation (APBI) using a single fraction of Multi-Catheter Interstitial High-Dose Rate Brachytherapy (MIB). The SiFEBI phase I/II trial.
机构信息
Geriatric Coordination Unit for Geriatric Oncology (UCOG), PACA Est CHU de NICE, France; FHU ONCOAGE, Nice, France; University of Nice-Sophia Antipolis, France.
Department of Radiotherapy, Lacassagne Center, Nice, France.
出版信息
J Geriatr Oncol. 2021 Sep;12(7):1085-1091. doi: 10.1016/j.jgo.2021.04.009. Epub 2021 May 11.
OBJECTIVES
The SiFEBI trial demonstrated that a post-operative Multicatheter Interstitial Brachytherapy (MIB) appears feasible and with acceptable toxicity in older adults aged 70 years and older presenting with low-risk breast cancer. The aim of the present ancillary study was to analyze the quality of life and Comprehensive Geriatric Assessment (CGA) domains within 6 months in older adults receiving Accelerated Partial Breast Irradiation (APBI) using a single fraction of MIB.
MATERIALS AND METHODS
From 11/2012 to 09/2014, 37 patients were included and 26 were evaluable. Patients (pts) aged 70 years and older with a Balducci score of 1 or 2 and presenting with low-risk breast cancer were prospectively enrolled in this phase I/II trial (NCT01727011). After lumpectomy, intra-operative catheter implantation was performed for post-operative APBI after pathological findings. Quality of life (QoL) evaluation and CGA were scheduled at baseline and 1, 3, and 6 months after APBI. Autonomy decline was defined as a 1-point decrease in Activities of Daily Living (ADL).
RESULTS
Mean age was 77 years. Within the first 6 months of follow-up, no autonomy decline was observed in ADL, 3 patients had an autonomy decline in Instrumental Activities of Daily Living (IADL) and 2 patients had a slower gait speed but no changes in cognitive function, nutritional status, and depression screening. Global QoL was quite similar at baseline compared to 1, 3, and 6 months. No differences were observed for functional items.
CONCLUSION
APBI based on a single fraction of MIB in older adults with low-risk breast cancer appears to be feasible with a minimal loss of autonomy regarding IADL, no loss of autonomy in ADL, an acceptable decrease in other CGA domains, and with no impact on global quality of life.
目的
SiFEBI 试验表明，对于 70 岁及以上患有低危乳腺癌的老年人，术后多导管间质近距离放疗（MIB）具有可行性，且毒性可接受。本辅助研究的目的是分析在接受单次 MIB 分割的加速部分乳腺照射（APBI）的老年患者中，6 个月内的生活质量和综合老年评估（CGA）领域。
材料和方法
2012 年 11 月至 2014 年 9 月，共纳入 37 例患者，其中 26 例可评估。本前瞻性 I/II 期试验（NCT01727011）纳入年龄 70 岁及以上、巴度奇评分 1 或 2 分、患有低危乳腺癌的患者。在保乳手术后，根据病理结果进行术中导管植入，以进行术后 APBI。在 APBI 前、后 1、3 和 6 个月安排生活质量（QoL）评估和 CGA。日常生活活动（ADL）自理能力下降定义为 ADL 下降 1 分。
结果
平均年龄为 77 岁。在随访的前 6 个月内，ADL 自理能力无下降，3 例患者 IADL 自理能力下降，2 例患者步态速度较慢，但认知功能、营养状况和抑郁筛查无变化。与 1、3 和 6 个月相比，基线时的总体 QoL 相当相似。功能项目无差异。
结论
在患有低危乳腺癌的老年患者中，单次 MIB 分割的 APBI 似乎可行，IADL 方面的自理能力轻度下降，ADL 自理能力无下降，其他 CGA 领域可接受下降，对总体生活质量无影响。
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