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保乳术后局部短程放疗联合辅助化疗治疗安全可行。

Hypofractionated whole breast irradiation after IORT treatment is safe in patients receiving adjuvant chemotherapy.

机构信息

Breast Cancer Unit, Centro Oncológico Integral Canario (COIC), Hospital Universitario San Roque, Dolores de la Rocha 5, 35001, Las Palmas GC, Spain.

Universidad Fernando Pessoa Canarias, Dolores de La Rocha 14, 35001, Las Palmas GC, Spain.

出版信息

Clin Transl Oncol. 2021 Dec;23(12):2579-2583. doi: 10.1007/s12094-021-02648-z. Epub 2021 Jun 5.

Abstract

INTRODUCTION

Hypofractionated whole breast irradiation (hWBI) and intraoperative radiotherapy (IORT) could be associated in breast cancer patients showing high-risk factors of local recurrence after breast conserving therapy (BSC). The aim of this trial was to evaluate, for the first time, the toxicity and cosmesis of hWBI after photon-IORT in high-risk patients treated by adjuvant chemotherapy.

MATERIALS AND METHODS

Thirty-one high-risk localized breast cancer patients treated by BCS, IORT (20 Gy), and adjuvant chemotherapy were included from February 2019 to August 2020 in this prospective trial, of hWBI (40.5 Gy/2.67 Gy/15 fractions). Acute and late toxicity (CTCAEv5.0) and cosmesis (Harvard scale), were assessed after treatment.

RESULTS

All patients completed their treatment and were evaluable after treatment. No patients showed severe (G3) acute/late toxicity. Excellent/good cosmesis at least 6 months after completing the treatment, was present in 93.6% of the patients.

CONCLUSION

hWBI in high-risk localized breast cancer patients treated by chemotherapy seems to have similar toxicity and cosmetic results than conventionally fractionated WBI in combination to photon-IORT after BCS.

摘要

引言

对于保乳治疗(BCS)后局部复发风险较高的乳腺癌患者,可将分割式全乳腺照射(hWBI)和术中放疗(IORT)联合应用。本试验旨在首次评估辅助化疗后光子-IORT 后 hWBI 对高风险患者的毒性和美容效果。

材料与方法

2019 年 2 月至 2020 年 8 月,本前瞻性试验纳入了 31 例局部高危乳腺癌患者,这些患者接受了 BCS、IORT(20Gy)和辅助化疗,之后进行 hWBI(40.5Gy/2.67Gy/15 次)。治疗后评估急性和晚期毒性(CTCAEv5.0)和美容效果(哈佛量表)。

结果

所有患者均完成了治疗,且治疗后可评估。没有患者出现严重(G3)的急性/晚期毒性。93.6%的患者在完成治疗至少 6 个月后,美容效果为优秀/良好。

结论

与 BCS 后光子-IORT 联合常规分割 WBI 相比,辅助化疗后高风险局部乳腺癌患者接受 hWBI 的毒性和美容效果似乎相似。

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