Wadasadawala Tabassum, Anup Akanksha, Carlton Johnny, Sarin Rajiv, Gupta Sudeep, Parmar Vani, Pathak Rima, Ghosh Jaya, Bajpai Jyoti, Gulia Seema, Krishnamurthy Revathy
Department of Radiation Oncology, Tata Memorial Hospital, Homi Bhabha National Institute, Mumbai 400012, India.
Department of Medical Oncology, Tata Memorial Hospital, Homi Bhabha National Institute, Mumbai 400012, India.
Ecancermedicalscience. 2023 Feb 23;17:1510. doi: 10.3332/ecancer.2023.1510. eCollection 2023.
This phase 2 study evaluated the safety of adjuvant chemoradiation (CTRT) for breast cancer.
From April 2019 to 2020, 60 patients with stage II-III invasive breast cancer planned for adjuvant taxane-based chemotherapy and radiotherapy (RT) were accrued. Local ± regional (excluding the internal mammary nodal region) RT (40 Gy in 15 fractions ± boost) was started with the third cycle of an adjuvant taxane in a 3-weekly schedule or with the eighth cycle in a weekly schedule.
Thirty-six patients received 3-weekly paclitaxel regimen and 24 received weekly paclitaxel regimen. The commonly used technique was three-dimensional conformal RT which was employed in 58% of patients. Regional RT, including the medial supraclavicular region, was done in 42 patients (70%). No dose-limiting (grade 3 or 4) toxicity was documented and all patients completed CTRT without any treatment interruption. The median ejection fraction pre and post CTRT 6 months was 60% ( = 0.177). The median value of cardiac enzyme (Troponin T ng/L) decreased from 37 to 20 ( = 0.009) post CTRT 6 months. Of the 54 patients who underwent the pulmonary function tests, there was no significant difference in various parameters like functional vital capacity (FVC) (2.29 versus 2.2 L, = 0.375), forced expiratory volume at 1 second (FEV1) (1.86; 1.82; = 0.365), FEV1/FVC (81.5; 81.43; = 0.9) and diffusion lung capacity for carbon monoxide (88.3; 87.6; = 0.62). At a median follow-up of 34 months, the 3-year actuarial rate of disease-free survival and overall survival was 75% and 98.3%, respectively. Quality of life scores (QOL) improved after treatment for most of the domains comparable to the pre-RT scores.
Taxane-based adjuvant CTRT is a safe option and results in minimal toxicity and excellent compliance. It has favourable impact on cardio-pulmonary profile and QOL scores.
本2期研究评估了乳腺癌辅助放化疗（CTRT）的安全性。
2019年4月至2020年，纳入60例计划接受基于紫杉烷的辅助化疗和放疗（RT）的II - III期浸润性乳腺癌患者。局部±区域（不包括内乳淋巴结区域）放疗（15次分割给予40 Gy±加量）在辅助紫杉烷化疗的第3周期开始，采用3周方案，或在每周方案的第8周期开始。
36例患者接受3周紫杉醇方案，24例接受每周紫杉醇方案。常用技术为三维适形放疗，58%的患者采用该技术。42例患者（70%）进行了包括锁骨上内侧区域在内的区域放疗。未记录到剂量限制性（3级或4级）毒性，所有患者均完成CTRT，无任何治疗中断。CTRT 6个月前后的中位射血分数为60%（ = 0.177）。CTRT 6个月后心脏酶（肌钙蛋白T ng/L）的中位值从37降至20（ = 0.009）。在接受肺功能测试的54例患者中，各项参数如功能肺活量（FVC）（2.29对2.2 L， = 0.375）、第1秒用力呼气量（FEV1）（1.86；1.82； = 0.365）、FEV1/FVC（81.5；81.43； = 0.9）和一氧化碳弥散肺容量（88.3；87.6； = 0.62）均无显著差异。中位随访34个月时，3年无病生存率和总生存率的精算率分别为75%和98.3%。大多数领域的生活质量评分（QOL）在治疗后有所改善，与放疗前评分相当。
基于紫杉烷的辅助CTRT是一种安全的选择，毒性极小，依从性良好。它对心肺状况和QOL评分有有利影响。
