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非转移性乳腺癌螺旋断层放疗的长期随访结果:单中心经验。

Long-term follow-up results of intensity-modulated radiotherapy with helicoïdal tomotherapy for non-metastatic breast cancers: Single centre experience.

机构信息

Department of Radiation Oncology, institut Curie, 26, rue d'Ulm, 75005 Paris, France.

Department of Radiation Oncology, institut Curie, 26, rue d'Ulm, 75005 Paris, France; Université Versailles-Saint-Quentin-en Yvelines, 55, avenue de Paris, 78035 Versailles cedex, France.

出版信息

Cancer Radiother. 2022 Sep;26(5):654-662. doi: 10.1016/j.canrad.2021.12.002. Epub 2022 Feb 25.

Abstract

PURPOSE

Intensity-modulated radiotherapy with helical Tomotherapy is a novel radiation therapy technique, which may be beneficial in several features compared to traditional methods. Our aim was to evaluate the local control, overall survival, progression free survival and adverse events in breast cancer patients treated with this new technique.

MATERIAL AND METHODS

This is retrospective analysis of patients irradiated with intensity-modulated radiotherapy with helical Tomotherapy. Overall survival and progression free survival curves were plotted with Kaplan-Meier method. We also analysed the overall survival and progression-free survival data by molecular subgroups. Long-term toxicity including skin, cardiac and pulmonary complications were also evaluated. Multivariant logistic regression analysis was performed to determine the predictors of the side effects.

RESULTS

Between 2009-2015, 179 consecutive patients with 194 treated breasts were irradiated with intensity-modulated radiotherapy with helical Tomotherapy. The median follow-up were 65 months. The overall survival rate was 89.2% (95% confidence interval [95CI]: 83.5-95.4%), while disease-free survival rate was 85.4% (95CI: 80.2-91%). The Human epidermal growth factor receptor 2-positive patients had the best 5-year overall survival data of 95% (95CI: 85.9-100%). Long-term skin toxicity was the most common, seen in a total of 20.7% of the patients.

CONCLUSION

Intensity-modulated radiotherapy with helical Tomotherapy could be safely used for adjuvant breast cancer irradiation in patients with complex anatomy and provides favourable long-term prognosis with acceptable late toxicity.

摘要

目的

螺旋断层放疗调强放疗是一种新的放射治疗技术,与传统方法相比,它可能具有多个优势。我们的目的是评估采用这种新技术治疗的乳腺癌患者的局部控制、总生存率、无进展生存率和不良事件。

材料与方法

这是对接受螺旋断层放疗调强放疗的患者进行的回顾性分析。使用 Kaplan-Meier 法绘制总生存率和无进展生存率曲线。我们还按分子亚组分析了总生存率和无进展生存率数据。此外,还评估了长期毒性(包括皮肤、心脏和肺部并发症)。多变量逻辑回归分析用于确定不良反应的预测因素。

结果

2009 年至 2015 年间,共 179 例连续患者的 194 个治疗乳房接受了螺旋断层放疗调强放疗。中位随访时间为 65 个月。总生存率为 89.2%(95%置信区间[95CI]:83.5-95.4%),而无病生存率为 85.4%(95CI:80.2-91%)。人表皮生长因子受体 2 阳性患者的 5 年总生存率数据最佳,为 95%(95CI:85.9-100%)。长期皮肤毒性是最常见的,总共有 20.7%的患者出现。

结论

螺旋断层放疗调强放疗可安全用于复杂解剖结构的乳腺癌辅助放疗,提供有利的长期预后,且晚期毒性可接受。

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