Department of Radiation Oncology, Puerta del Mar University Hospital, Ana de Viya 21 Avenue, 11009, Cadiz, Spain.
Biomedical Research and Innovation Institute of Cádiz (INiBICA) Research Unit, Puerta del Mar University Hospital, Cadiz, Spain.
Clin Transl Oncol. 2022 Jan;24(1):24-33. doi: 10.1007/s12094-021-02664-z. Epub 2021 Jul 2.
The aim of this study was to compare accelerated partial breast irradiation (APBI) with multicatheter interstitial brachytherapy (BT) and whole breast irradiation (WBI), in terms of toxicity, aesthetic result, quality of life and survival, in clinical practice.
A comparative study of two prospectively recorded cohorts of 76 breast cancer patients who complied with the recommendations of GEC-ESTRO for APBI was conducted. The main objective was toxicity, quality of life measured through validated questionnaires and the aesthetic results. Secondary objectives were overall survival and disease-free survival.
Seventy-six stage I/II breast cancer patients, with a mean age of 66 years entered the study. APBI group showed less acute G1-2 dermatitis (51.4 vs 94.9%, p < 0.001) and late hyperpigmentation (0 vs 17.9%, p = 0.04). There were no differences in aesthetic results, both assessed by the patient herself and by the doctor. Statistically significant differences in measures of quality of life were observed in favour of the APBI, both in EORTC QLQ-BR23 and body image scale questionnaires. With a median follow-up of 72 months (6 years), the estimated overall survival at 5 and 10 years was 96.8 and 77.7%, respectively, and disease-free survival at 5 and 10 years was 91.1 and 69.4%, respectively, without statistically significant differences between groups.
APBI is an attractive alternative in candidate patients with initial breast cancer, with benefits in acute toxicity and quality of life and fewer visits to the hospital, without compromising tumor control or survival.
本研究旨在比较加速部分乳房照射（APBI）与多导管间质近距离放疗（BT）和全乳房照射（WBI）在临床实践中的毒性、美容效果、生活质量和生存方面的差异。
对 76 例符合 GEC-ESTRO 推荐的 APBI 适应证的乳腺癌患者进行了两项前瞻性记录队列的比较研究。主要目标是毒性、通过验证问卷测量的生活质量和美容效果。次要目标是总生存和无病生存。
76 例 I/II 期乳腺癌患者，平均年龄 66 岁，入组本研究。APBI 组急性 G1-2 皮炎发生率较低（51.4% vs 94.9%，p<0.001），晚期色素沉着发生率较低（0% vs 17.9%，p=0.04）。两组美容效果无差异，均由患者自身和医生评估。EORTC QLQ-BR23 和身体形象量表问卷的生活质量测量均显示 APBI 组具有统计学显著差异。中位随访 72 个月（6 年）后，5 年和 10 年的总生存率分别为 96.8%和 77.7%，无病生存率分别为 91.1%和 69.4%，两组间无统计学差异。
APBI 是初始乳腺癌候选患者的一种有吸引力的替代治疗方法，具有急性毒性和生活质量的优势，且减少了去医院的次数，而不会影响肿瘤控制或生存。
