Clinical Cooperation Unit Molecular Radiation Oncology, German Cancer Research Center (DKFZ), Heidelberg, Germany;
Clinic and Practice of Radiation Oncology/Practice of Radiology, Konstanz, Germany.
Anticancer Res. 2023 May;43(5):2041-2053. doi: 10.21873/anticanres.16365.
BACKGROUND/AIM: Adjuvant radiotherapy is an integral part of the interdisciplinary curative treatment of breast cancer. We aimed to examine the long-term clinical results of helical tomotherapy in female patients with local restricted, lymph node negative breast cancer after breast-conserving surgery.
In this single-centre analysis, 219 female patients with early-stage breast cancer (T1/2) and no lymph node metastasis (N0) following breast-conserving surgery and sentinel-node biopsy were treated with adjuvant fractionated whole breast radiation therapy using helical tomotherapy. When boost irradiation was indicated, it was administered sequentially or using the simultaneous-integrated boost technique. Local control (LC), metastasis and survival rates, acute toxicity, late toxicity, and secondary malignancy rates were analysed retrospectively.
The mean follow-up time was 71 months. The 5- and 8-year overall survival (OS) rates were 97.7% and 92.1%, respectively. The 5- and 8-year LC rates were 99.5% and 98.2%, while the 5- and 8-year metastasis-free survival (MFS) rates of 97.4% and 94.3%, respectively. Patients with G3 grading or negative hormone receptor status did not show significantly different results. Acute erythema occurred in 79% (grade 0-2) and 21% (grade 3) of the patients. Lymphedema of the ipsilateral arm and pneumonitis occurred in 6.4% and 1.8% of the treated patients. None of the patients developed >grade 3 toxicities during follow-up, while 1.8% developed a secondary malignancy during follow-up.
Helical tomotherapy showed excellent long-term results and low toxicity rates. The incidence rates of secondary malignancy were relatively low and correlated with pre-existing data on radiotherapy, suggesting wider implementation of helical tomotherapy in adjuvant radiotherapy for breast cancer patients.
背景/目的：辅助放疗是乳腺癌多学科治疗的一个组成部分。我们旨在研究保乳手术后局部局限、无淋巴结转移的女性乳腺癌患者接受螺旋断层放疗的长期临床结果。
在这项单中心分析中，219 名接受保乳手术和前哨淋巴结活检的早期乳腺癌（T1/2）和无淋巴结转移（N0）的女性患者采用螺旋断层放疗进行辅助分次全乳房放射治疗。当需要进行肿瘤局部加量照射时，采用序贯或同步整合加量技术。回顾性分析局部控制（LC）、转移和生存率、急性毒性、晚期毒性和继发性恶性肿瘤发生率。
平均随访时间为 71 个月。5 年和 8 年总生存率（OS）分别为 97.7%和 92.1%。5 年和 8 年 LC 率分别为 99.5%和 98.2%，5 年和 8 年无转移生存率（MFS）分别为 97.4%和 94.3%。G3 分级或阴性激素受体状态的患者未显示出明显不同的结果。79%（0-2 级）和 21%（3 级）的患者出现急性红斑。同侧手臂淋巴水肿和肺炎的发生率分别为 6.4%和 1.8%。在随访期间，没有患者发生>3 级毒性反应，而 1.8%的患者在随访期间发生了继发性恶性肿瘤。
螺旋断层放疗显示出良好的长期疗效和低毒性反应。继发性恶性肿瘤的发生率相对较低，与放疗的现有数据相关，这表明螺旋断层放疗在乳腺癌辅助放疗中的应用更加广泛。
