Simmons Ambrosia, Sher David, Kim Dr Dong Wook Nathan, Leitch Marilyn, Wooldridge Rachel, Goudreau Sally, Seiler Stephen, Neufeld Sarah, Stein Maggie, Albuquerque Kevin, Spangler Ann, Heinzerling John, Garwood Dan, Stevenson Stella, Ahn Chul, Ding Chuxiong, Timmerman Robert D, Rahimi Asal
Department of Radiation Oncology, University Texas Southwestern Medical Center, Dallas.
Department of Radiation Oncology, Vanderbilt University Medical Center, Nashville, Tennessee.
Pract Radiat Oncol. 2025 Mar-Apr;15(2):e115-e123. doi: 10.1016/j.prro.2024.08.012. Epub 2024 Nov 16.
We report the financial toxicity and quality-of-life outcomes of our prospective phase 1 dose-escalation study of 5-fraction stereotactic partial breast irradiation (S-PBI) for early-stage breast cancer.
Women with unifocal in situ or invasive epithelial histologies, clinical stages 0, I, or II with tumor size < 3 cm treated with lumpectomy were enrolled in our phase 1 5-fraction S-PBI dose-escalation trial. Our institutionally generated questionnaire on the "Patient Perspective Cost and Convenience of Care" and the EuroQol 5-Dimension 5-level questionnaire were administered to patients treated at follow-up.
Between 2010 and 2015, 68 of the 75 patients who enrolled and completed treatment on trial completed at least some component of either the EuroQol 5-Dimension 5-level questionnaire or the "Patient Perspective Cost and Convenience of Care" questionnaire. Nearly all patients reported very high satisfaction with their treatment overall, particularly the shortened length of treatment. Over half of the patients reported some level of financial toxicity (FT) despite a significantly shortened treatment time. Patients who reported any FT were significantly younger than patients with no financial burden of treatment (means 59.2 and 63.7, respectively, P = .03). There was no difference in those who reported any level of FT based on patient race, ethnicity, marital, or employment status. This S-PBI regimen did not significantly affect quality of life over a 4-year follow-up.
These patient-reported outcomes suggest that the use of accelerated partial breast irradiation may offer low FT rates in breast cancer care, particularly for disadvantaged patient groups.
我们报告了针对早期乳腺癌的5分割立体定向部分乳腺照射（S-PBI）前瞻性1期剂量递增研究的经济毒性和生活质量结果。
对接受保乳手术治疗的原位或浸润性上皮组织学单灶性患者，临床分期为0、I或II期且肿瘤大小<3 cm的患者，纳入我们的1期5分割S-PBI剂量递增试验。在随访时，对接受治疗的患者发放我们机构编制的关于“患者对医疗成本和便利性的看法”的问卷以及欧洲五维健康量表5级问卷。
2010年至2015年期间，75名入组并完成试验治疗的患者中有68名至少完成了欧洲五维健康量表5级问卷或“患者对医疗成本和便利性的看法”问卷的某些部分。几乎所有患者对其总体治疗都非常满意，尤其是治疗时间缩短。尽管治疗时间显著缩短，但超过一半的患者报告有一定程度的经济毒性（FT）。报告有任何FT的患者明显比没有治疗经济负担的患者年轻（平均年龄分别为59.2岁和63.7岁，P = 0.03）。根据患者的种族、民族、婚姻或就业状况，报告有任何程度FT的患者之间没有差异。在4年的随访中，这种S-PBI方案对生活质量没有显著影响。
这些患者报告的结果表明，在乳腺癌治疗中使用加速部分乳腺照射可能具有较低的FT发生率，特别是对于弱势患者群体。
