Wang Juan, Chang Xiaojing, Xu Ke, Liang Yansong, Zhao Jinxin, Liu Zezhou, Zhang Hongtao
Department of Oncology, Hebei General Hospital, Shijiazhuang, Hebei, China.
Department of Radiotherapy, The Second Hospital of Hebei Medical University, Shijiazhuang, Hebei, China.
Front Oncol. 2023 Aug 18;13:1171813. doi: 10.3389/fonc.2023.1171813. eCollection 2023.
The treatment of local-regional recurrent breast cancer (BC) after external beam radiotherapy is challenging. We aim to evaluate the effectiveness and safety of computed tomography (CT)-guided percutaneous iodine-125 brachytherapy for local recurrent BC.
We retrospectively analyzed 15 patients with local recurrent BC treated with CT-guided interstitial implantation of iodine-125 seeds. Regular contrast-enhanced CT was conducted to evaluate the tumor response. Follow-up survival, quality of life, and adverse events were analyzed.
Among the 15 patients, five were elderly patients (older than 80 years) and six were complicated with chronic underlying diseases. The median number of I seeds implantation was 33 (range: 20-130) with median dose 90 (D90, the minimum dose covering 90% of the target volume) of 108 Gy (range: 60-120 Gy). There was no significant difference in D90, V100 (the volume of the target receiving 100% of the prescription dose), and V150 (the volume of the target receiving 150% of the prescription dose) before and after operation ( > 0.05). The median follow-up was 14 months (range: 6-18 months). Six months after operation, the ORR was 66.7% (10/15) and the LCR was 93.3% (14/15). The 6- and 12-month survival rates were 100 and 41.6%, respectively, and the median survival time was 12.5 months. PS score decreased from 1.53 ± 0.81 to 0.53 ± 0.49. The pain score decreased from 2.87 ± 1.67 before operation to 1.07 ± 1.18 after operation, and the differences were statistically significant (< 0.05). No severe complications occurred.
CT-guided iodine-125 brachytherapy provided a safe and effective choice for recurrent BC with significant local therapeutic effects and minor complications, especially for elderly patients with chronic underlying disease and those who were not eligible for surgical resection and had failed to benefit from systemic therapy.
外照射放疗后局部区域复发性乳腺癌（BC）的治疗具有挑战性。我们旨在评估计算机断层扫描（CT）引导下经皮碘-125近距离放疗对局部复发性BC的有效性和安全性。
我们回顾性分析了15例接受CT引导下碘-125粒子间质植入治疗的局部复发性BC患者。定期进行增强CT以评估肿瘤反应。分析随访生存情况、生活质量和不良事件。
15例患者中，5例为老年患者（年龄大于80岁），6例合并慢性基础疾病。碘粒子植入中位数为33枚（范围：20 - 130枚），中位剂量90（D90，覆盖90%靶体积的最小剂量）为108 Gy（范围：60 - 120 Gy）。手术前后D90、V100（接受100%处方剂量的靶体积）和V150（接受150%处方剂量的靶体积）差异无统计学意义（>0.05）。中位随访时间为14个月（范围：6 - 18个月）。术后6个月，客观缓解率（ORR）为66.7%（10/15），局部控制率（LCR）为93.3%（14/15）。6个月和12个月生存率分别为100%和41.6%，中位生存时间为12.5个月。体能状态（PS）评分从1.53±0.81降至0.53±0.49。疼痛评分从术前的2.87±1.67降至术后的1.07±1.18，差异有统计学意义（<0.05）。未发生严重并发症。
CT引导下碘-125近距离放疗为复发性BC提供了一种安全有效的选择，局部治疗效果显著且并发症轻微，尤其适用于合并慢性基础疾病的老年患者以及那些不适合手术切除且未从全身治疗中获益的患者。
