晶格放疗治疗大型、外突或溃疡性乳腺癌的疗效：一项前瞻性单中心研究。
The Promising Effects of Lattice Radiotherapy for Large, Fungating, or Ulcerating Breast Cancers: A Prospective Single-center Study.
机构信息
REM Radioterapia srl, Viagrande, Italy;
Department of Medicine and Surgery, Kore University of Enna, Enna, Italy.
出版信息
In Vivo. 2024 Sep-Oct;38(5):2484-2493. doi: 10.21873/invivo.13719.
BACKGROUND/AIM: To evaluate the safety and efficacy of lattice radiotherapy (LRT) for large, inoperable breast cancers.
PATIENTS AND METHODS
In this prospective study, patients who underwent LRT for breast tumors that were ulcerating/fungating/extensively eroding the chest wall, and were ineligible/unwilling for surgery, were enrolled from May 2021 to Nov 2023. Baseline Eastern Cooperative Oncology Group (ECOG) status, pre- and post-LRT numerical rating scale (NRS), and post-LRT changes in quality of life (QoL) were recorded. Survival outcomes were reported at 6 months and 1-year. Median rates of survival and dosimetric parameters were calculated. Kaplan-Meier curves for overall survival (OS), cancer-specific survival (CSS), and failure of local control (LC) were constructed.
RESULTS
Ten patients (8 females) underwent LRT. The median age was 76 years (range=57-99 years) and the median ECOG performance status was 2.5 (range=1-4). The planned schedule was completed by 9/10 patients, accounting for a 90% compliance rate. Among patients with pain (n=7), NRS rapidly reduced from 7 (range=5-10) to 3 (range=1-6). The median equivalent uniform dose was 0.71 Gy (0.09-1.59 Gy). The actuarial rates of 6-month LC, CSS, and OS were 75%, 89%, and 61%, respectively, with only LC rate changing to 50% at 1 year. Two patients had local relapse at the six-month and 1-year follow-up, respectively, after having achieved a complete response at three months, and two others died of COVID-19 infection and ischemic stroke.
CONCLUSION
LRT was found to be effective and safe in palliating symptoms among patients with large inoperable breast tumors.
背景/目的：评估网格放疗（LRT）治疗无法手术的大型乳腺癌的安全性和有效性。
方法
在这项前瞻性研究中，从 2021 年 5 月至 2023 年 11 月，招募了因胸壁溃疡/糜烂/广泛侵蚀而无法手术且不适合/不愿意手术的患者，进行 LRT 治疗。记录了基线东部合作肿瘤学组（ECOG）状态、LRT 前后数字评分量表（NRS）以及 LRT 后生活质量（QoL）的变化。报告了 6 个月和 1 年的生存结果。计算了中位生存率和剂量学参数。绘制了总生存（OS）、癌症特异性生存（CSS）和局部控制失败（LC）的 Kaplan-Meier 曲线。
结果
10 名患者（8 名女性）接受了 LRT。中位年龄为 76 岁（范围=57-99 岁），中位 ECOG 表现状态为 2.5（范围=1-4）。9/10 名患者完成了计划的治疗方案，依从率为 90%。在有疼痛的患者中（n=7），NRS 迅速从 7（范围=5-10）降至 3（范围=1-6）。中位等效均匀剂量为 0.71Gy（0.09-1.59Gy）。6 个月 LC、CSS 和 OS 的累积生存率分别为 75%、89%和 61%，仅 LC 率在 1 年后降至 50%。两名患者在 3 个月时获得完全缓解后，分别在 6 个月和 1 年随访时局部复发，另外两名患者因 COVID-19 感染和缺血性中风而死亡。
结论
LRT 对无法手术的大型乳腺癌患者缓解症状有效且安全。
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