Whole breast radiotherapy in the lateral isocentric lateral decubitus position: Long-term efficacy and toxicity results
Whole breast radiotherapy in the lateral isocentric lateral decubitus position: Long-term efficacy and toxicity results
复制标题
DOI：
10.1016/j.radonc.2017.07.001
复制
发表时间：
2017-08-01
影响因子：
5.7
通讯作者：
Kirova, Youlia M.
中科院分区：
文献类型：
--
作者：
Bronsart, Estelle;Dureau, Sylvain;Kirova, Youlia M.
目的：评价已发表的ILD(等中心侧卧位)技术全乳房放疗(WBRT)的毒副反应和疗效。材料与方法：2006-2010年间，832例女性早期乳腺癌患者接受了居里研究所的3D-适形WBRT-ILD治疗。每周评估一次治疗的急性毒性，每6个月评估一次晚期毒性(治疗后6个月及以后)，直到放射治疗结束后第5年使用NCI CTC v3.0量表进行评估。剂量学研究分析平均心脏剂量和平均同侧和对侧肺剂量。结果：中位随访时间为6.4年。中位年龄为61.5岁(范围29-90)，中位体重指数(BMI)为26.3。左侧BC占51%，右侧BC占49%。采用不同的分割方式：46.5%的PTS：50(乳房)+16Gy33次，17.9%~50Gy25Fr，26.1%~4015Fr或41.6Go 3Fr，9.5%：30Gy5Fr。急性皮炎的发生率为93%，出现时间的中位数为4周，3级的发生率仅为2.8%。在多因素分析中，杯子大小有显著影响(p=0.0004)，分级有显著影响(p=0.0001)。在所有患者中，94.1%的患者在1年内没有皮肤毒性。没有心脏或肺部毒性的报道。在随访结束时，总体存活率的中位数尚未达到。我们观察到36例(3.6%)复发，其中30例局部(乳房)复发，4例淋巴结(LN)复发，2例同时复发。结论：侧卧位全乳放疗在局部控制和生存率方面具有良好的效果。ILD耐受性良好，具有非常好的急性毒性。在本研究中未观察到心脏或肺毒性。需要更长时间的随访才能证实这些结果。(C)2017爱思唯尔B.V.保留所有权利。
Purpose: To evaluate previously published whole breast radiotherapy (WBRT) using ILD (isocentring lateral decubitus) technique in terms of toxicity and efficacy.Materials and methods: From 2006 to 2010, 832 female patients with early-stage breast cancer (BC) treated by conservative surgery underwent 3D-conformal WBRT-ILD at Institut Curie. The acute toxicity of treatment was evaluated weekly and the late toxicity (6 months and later after the treatment) was evaluated every 6 months till the 5th year after the end of the radiotherapy using NCI CTC v3.0 scale. Dosimetric study was performed to analyse the mean cardiac dose and the mean homolateral and contralateral lung doses.Results: The median follow up was 6.4 years. The median age was 61.5 years (range, 29-90), and median body mass index (BMI) was 26.3. Fifty one percent of the patients presented left sided BC and 49% right sided. Different type of fractions were used: 46.5% of pts.: 50 (breast) + 16 Gy (boost) in 33 fractions (fr), in 17.9%-50 Gy/25 fr, in 26.1%-40/15 fr or 41.6 GO 3 fr and in 9.5%: 30 Gy/5 fr. Acute dermatitis was present in 93% with a median of apparition of 4 weeks, and only 2,8% grade 3. In multivariate analysis, the cup size had significant influence (p = 0.0004) and the fractionation had a significative influence (p = 0.0001). In the all patients' population, 94.1% of cases had no skin toxicity at 1 year. No cardiac or pulmonary toxicity was reported. The median overall survival had not been reached at the end of follow-up. We observed 36 (3.6%) recurrences, as following: 30 local (breast) recurrences, 4 lymph node (LN), and 2 pts experiencing both.Conclusion: Whole breast radiotherapy in the lateral decubitus position provides excellent results in terms of local control and survival. ILD is well tolerated with very good acute toxicity profile. No cardiac or pulmonary toxicity were observed in this study. Longer follow-up is needed to confirm these results. (C) 2017 Elsevier B.V. All rights reserved.