Yoshida Ken, Kotsuma Tadayuki, Takaoka Yuji, Tamenaga Setsuo, Yamazaki Hideya, Nose Takayuki, Murakami Naoya, Inaba Koji, Akiyama Hironori, Masui Koji, Takenaka Tadashi, Kubota Hikaru, Tselis Nikolaos, Masuda Norikazu, Yasojima Hiroyuki, Takeda Masashi, Mano Masayuki, Nakamura Satoaki, Utsunomiya Keita, Tanigawa Noboru, Tanaka Eiichi
Department of Radiology, Kansai Medical University Medical Center, Osaka, Japan.
Department of Radiation Oncology, National Hospital Organization Osaka National Hospital, Osaka, Japan.
J Contemp Brachytherapy. 2023 Feb;15(1):1-8. doi: 10.5114/jcb.2023.125579. Epub 2023 Feb 28.
We investigated the long-term oncological outcome of high-dose-rate (HDR) multicatheter interstitial brachytherapy (MIB) for adjuvant accelerated partial breast irradiation (APBI) after breast conserving surgery in Japanese patients.
Between June 2002 and October 2011, 86 breast cancer patients were treated at National Hospital Organization Osaka National Hospital (trial number of the local institutional review board, 0329). Median age was 48 years (range, 26-73 years). Eighty patients had invasive and 6 patients non-invasive ductal carcinoma. Tumor stage distribution was pT0 in 2, pTis in 6, pT1 in 55, pT2 in 22, and pT3 in one patient, respectively. Twenty-seven patients had close/positive resection margins. Total physical HDR dose was 36-42 Gy in 6-7 fractions.
At a median follow-up of 119 months (range, 13-189 months), the 10-year local control (LC) and overall survival rate was 93% and 88%, respectively. Concerning the 2009 Groupe Européen de Curiethérapie-European Society for Therapeutic Radiology and Oncology risk stratification scheme, the 10-year LC rate was 100%, 100%, and 91% for patients considered as low-risk, intermediate-risk, and high-risk, respectively. According to the 2018 American Brachytherapy Society risk stratification scheme, the 10-year LC rate was 100% and 90% for patients 'acceptable' and 'unacceptable' for APBI, respectively. Wound complications were observed in 7 patients (8%). Risk factors for wound complications were the omission of prophylactic antibiotics during MIB, open cavity implantation, and V ≥ 190 cc. No grade ≥ 3 late complications (CTCVE version 4.0) were observed.
Adjuvant APBI using MIB is associated with favorable long-term oncological outcomes in Japanese patients for low-risk, intermediate-risk, and acceptable groups of patients.
我们研究了高剂量率（HDR）多导管组织间近距离放疗（MIB）用于日本患者保乳手术后辅助性加速部分乳腺照射（APBI）的长期肿瘤学结局。
2002年6月至2011年10月期间，86例乳腺癌患者在国立医院机构大阪国立医院接受治疗（当地机构审查委员会试验编号，0329）。中位年龄为48岁（范围26 - 73岁）。80例患者为浸润性导管癌，6例为非浸润性导管癌。肿瘤分期分布分别为pT0 2例，pTis 6例，pT1 55例，pT2 22例，pT3 1例。27例患者切缘接近/阳性。物理HDR总剂量为36 - 42 Gy，分6 - 7次给予。
中位随访119个月（范围13 - 189个月）时，10年局部控制（LC）率和总生存率分别为93%和88%。根据2009年欧洲放射肿瘤学会（Groupe Européen de Curiethérapie - European Society for Therapeutic Radiology and Oncology）风险分层方案，低风险、中风险和高风险患者的10年LC率分别为100%、100%和91%。根据2018年美国近距离放射治疗学会风险分层方案，APBI“可接受”和“不可接受.”患者的10年LC率分别为100%和90%。7例患者（8%）出现伤口并发症。伤口并发症的风险因素为MIB期间预防性抗生素的遗漏、开放腔隙植入以及V≥190 cc。未观察到≥3级晚期并发症（CTCVE版本4.0）。
对于低风险、中风险和可接受组的日本患者，使用MIB进行辅助性APBI具有良好的长期肿瘤学结局。
