Chun Seok-Joo, Park Sangjoon, Kim Yong Bae, Ahn Sung-Ja, Kim Kyubo, Shin Kyung Hwan
Department of Radiation Oncology, Dongguk University Ilsan Hospital, Dongguk University College of Medicine, Goyang, Korea.
Department of Radiation Oncology, Yonsei University College of Medicine, Seoul, Korea.
Pract Radiat Oncol. 2025 May-Jun;15(3):e230-e239. doi: 10.1016/j.prro.2024.11.007. Epub 2024 Dec 10.
The American Society for Radiation Oncology (ASTRO) has recently published new guidelines for the eligibility for partial breast irradiation (PBI). This study aims to evaluate the eligibility rates of PBI according to the ASTRO 2017 and 2024 guidelines.
Patients diagnosed with pTis-T2N0 breast cancer in 2019 from 3 tertiary medical centers were accrued. All patients received standard treatment consisting of breast-conserving surgery followed by radiation therapy. Subsequently, patients were classified according to the ASTRO 2017 and 2024 guidelines.
For invasive breast cancer, 785 patients were included, among whom 192 received PBI. Classification according to the ASTRO guidelines showed a substantial increase in the proportion of patients eligible for PBI: 19.2% were classified as "suitable" under the ASTRO 2017 guidelines, while 42.4% were classified as "strongly recommended" under the ASTRO 2024 guidelines. Among 286 patients diagnosed with ductal carcinoma in situ (DCIS), 50 (17.5%) received PBI. The proportion of PBI-eligible patients nearly doubled, from 27.3% under the ASTRO 2017 guidelines to 51.7% under the ASTRO 2024 guidelines. The expanded age criterion from 50 to 40 years and the removal of the clear resection margin requirement were key factors contributing to this substantial increase in both invasive breast cancer and DCIS.
The eligibility for PBI has dramatically increased for both invasive breast cancer and DCIS under the ASTRO 2024 guidelines. These findings suggest a potential for increased use of PBI, offering individualized and optimized treatment options in early breast cancer.
美国放射肿瘤学会（ASTRO）最近发布了关于部分乳腺照射（PBI）适应证的新指南。本研究旨在根据ASTRO 2017年和2024年指南评估PBI的适应证率。
纳入了2019年来自3家三级医疗中心诊断为pTis-T2N0乳腺癌的患者。所有患者均接受了保乳手术加放疗的标准治疗。随后，根据ASTRO 2017年和2024年指南对患者进行分类。
对于浸润性乳腺癌，纳入了785例患者，其中192例接受了PBI。根据ASTRO指南进行分类显示，符合PBI适应证的患者比例大幅增加：在ASTRO 2017年指南下，19.2%被分类为“合适”，而在ASTRO 2024年指南下，42.4%被分类为“强烈推荐”。在286例诊断为导管原位癌（DCIS）的患者中，50例（17.5%）接受了PBI。符合PBI适应证的患者比例几乎翻了一番，从ASTRO 2017年指南下的27.3%增至ASTRO 2024年指南下的51.7%。年龄标准从50岁扩大到40岁以及取消切缘阴性要求是浸润性乳腺癌和DCIS患者比例大幅增加的关键因素。
根据ASTRO 2024年指南，浸润性乳腺癌和DCIS患者接受PBI的适应证均显著增加。这些发现表明PBI的使用可能增加，为早期乳腺癌提供个体化和优化的治疗选择。
