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早期乳腺癌保乳术后三维适形加速部分乳腺照射的疗效
蔡钢, 梅欣, 胡伟刚, 陈兰飞, 谢耩, 俞晓立, 杨昭志, 潘自强, 郭小毛, 陈佳艺,
200032 上海,复旦大学上海医学院肿瘤学系 复旦大学附属肿瘤医院放疗科
Clinical effects of accelerated partial breast irradiation using three-dimensional conformal radiotherapy in patients with early breast cancer after breast-conserving therapy
CAI Gang, MEI Xin, HU Wei-gang, CHEN Lan-fei, XIE Jiang, YU Xiao-li, YANG Zhao-zhi, PAN Zhi-qiang, GUO Xiao-mao, CHEN Jia-yi
Department of Radiation Oncology, Cancer Hospital, Fudan University;Department of Oncology, Shanghai Medical College, Fudan University;Shanghai 200032, ChinaCorresponding author:CHEN Jia-yi, Email:chenjiayi0188@yahoo.com.cn;GUO Xiao-mao, Email:guoxm1800@126.com
Abstract：Objective To assess the clinical effects of accelerated partial breast irradiation (APBI) using three-dimensional conformal radiotherapy (3DCRT) in patients with low-risk early breast cancer after breast-conserving therapy (BCT) with respect to dosimetric parameters, local control, toxicities, and cosmetic outcome. Methods Thirty-nine patients with early breast cancer (stage 0—1) were enrolled in a prospective phase Ⅱ trial of APBI using 3DCRT in 2008—2010. Of all the patients, 28 had invasive ductal carcinoma, 5 had ductal carcinoma in situ, and 6 had other types of invasive carcinoma. The prescribed dose was 38.5 Gy/10 fractions twice daily, with an inter-fraction interval greater than 6 h. The toxicities were assessed according to the National Cancer Institute Common Toxicity Criteria, version 3.0. The cosmetic outcome was assessed according to the Harris breast cosmesis scale. Results The planning target volume coverage and normal-tissue dosimetry were appropriate in the APBI using 3DCRT. Dose homogeneity without deviation was achieved in 33 patients (85%). Of the total 39 patients, 46% met ASTRO′s "cautionary" criteria, and 18% met"unsuitable" criteria;also, 31% met GEC-ESTRO′s"intermediate-risk" criteria, and 3% met"high-risk" criteria. The follow-up rate was 100%. No patient experienced local recurrence, and no grade 3—4 toxicities were found. Cosmesis was good to excellent in 35 patients (90%) at 6 months after APBI. Conclusions The patients with early breast cancer after BCT are properly selected for APBI using 3DCRT, with satisfactory preliminary assessment results for local control, toxicities, and cosmetic outcome.
CAI Gang,MEI Xin,HU Wei-gang et al. Clinical effects of accelerated partial breast irradiation using three-dimensional conformal radiotherapy in patients with early breast cancer after breast-conserving therapy[J]. Chinese Journal of Radiation Oncology, 2013, 22(2): 94-98.
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