Gunster Jetske L B, Jacobs Daphne H M, Mast Mirjam E, Verbeek-de Kanter Antoinette, Fisscher Ursula J, Petoukhova Anna L, Speijer Gabrielle, Straver Marieke, Merkus Jos, Marijnen Corrie A M, Scholten Astrid N
Department of Radiation Oncology, Netherlands Cancer Institute-Antoni van Leeuwenhoek, Amsterdam, the Netherlands.
Department of Radiation Oncology, Leiden University Medical Center, Leiden, the Netherlands.
Clin Transl Radiat Oncol. 2024 Aug 18;49:100844. doi: 10.1016/j.ctro.2024.100844. eCollection 2024 Nov.
The aim of this study is to evaluate the cosmetic outcome among early stage breast cancer patients who underwent accelerated partial breast irradiation with either intraoperative electron radiotherapy (IOERT) or photon external beam radiotherapy (EB-APBI).
This prospective multicenter cohort study enrolled women aged 60 years and older who underwent breast-conserving therapy. Following breast-conserving surgery, patients were treated with either IOERT or EB-APBI. Cosmetic outcome was evaluated over a 5 year follow-up period using both subjective scoring by patients and physicians, as well as objective scoring using BCCT.core software. Differences between treatments over time were described with mixed model analyses.
A total of 241 patients treated with IOERT and 164 patients treated with EB-APBI were eligible for cosmetic analysis. In both groups, the majority of patients reported a satisfactory cosmetic outcome, with no significant differences between treatments over time (p = 0.538). This was also observed by physicians, with satisfactory outcomes ranging from 94 % (170/181) to 91 % (69/76) over time in the IOERT group and from 93 % (124/133) to 95 % (54/57) in the EB-APBI group (p = 0.579). BCCT.core analysis returned satisfactory cosmetic outcomes in 75 % (54/72) of the IOERT patients at 3 years and in 77 % (20/26) at 5 years. These numbers were 86 % (72/84) and 90 % (36/40) for the EB-APBI patients, with no significant differences between treatment over time (p = 0.834).
Regarding the cosmetic results, IOERT and EB-APBI yield comparable and satisfactory outcomes over 5 years follow-up in the treatment of early stage breast cancer.
本研究旨在评估接受术中电子放疗（IOERT）或光子外照射加速部分乳腺放疗（EB-APBI）的早期乳腺癌患者的美容效果。
这项前瞻性多中心队列研究纳入了60岁及以上接受保乳治疗的女性。保乳手术后，患者接受IOERT或EB-APBI治疗。在5年的随访期内，使用患者和医生的主观评分以及使用BCCT.core软件的客观评分来评估美容效果。采用混合模型分析描述不同治疗随时间的差异。
共有241例接受IOERT治疗的患者和164例接受EB-APBI治疗的患者符合美容分析条件。在两组中，大多数患者报告美容效果满意，不同治疗随时间无显著差异（p = 0.538）。医生也观察到了这一点，IOERT组随时间的满意结果从94%（170/181）到91%（69/76），EB-APBI组从93%（124/133）到95%（54/57）（p = 0.579）。BCCT.core分析显示，IOERT患者3年时75%（54/72）、5年时77%（20/26）的美容效果满意。EB-APBI患者的这些数字分别为86%（72/84）和90%（36/40），不同治疗随时间无显著差异（p = 0.834）。
就美容效果而言，在早期乳腺癌治疗的5年随访中，IOERT和EB-APBI产生了可比且令人满意的结果。
