Re-irradiation for locally recurrent refractory breast cancer
Re-irradiation for locally recurrent refractory breast cancer
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DOI：
10.18632/oncotarget.6036
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发表时间：
2015-10-27
期刊：
影响因子：
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通讯作者：
Czarnota, Gregory J.
中科院分区：
文献类型：
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作者：
Merino, Tomas;Tran, William T.;Czarnota, Gregory J.
目的：报告一组局部复发难治性乳腺癌(LRRBC)再次放疗患者的治疗结果分析。方法：2008-2013年间，47名女性(平均年龄60岁)再次接受LRBC放疗。用Kaplan-Meier对数列进行曲线比较，用Cox回归进行多因素分析。结果：共完成并分析了56例再次放射治疗的病例。全乳腺和肿瘤腔(α/β=3)的平均累积2Gy当量剂量(EQD2)分别为99.8Gy和109.1 Gy.由于局部复发，大多数患者在放疗前有明显的症状。再次治疗和全身衰竭的中位时间分别为41个月和50个月。OS的中位随访期为17个月，1年OS为0.73(SE=0.07)，2年为0.67(SE=0.07)。1年和2年局部控制率分别为0.62(SE=0.07)和0.5(0.08)。急性放射性皮炎G12型45例，G3型4例，G4型1例。1例患者出现坏死。最常见的长期毒性是G3纤维化(n=4)和毛细血管扩张改变(n=3)。多因素分析显示皮肤受累(危险比=6.6(1.4~31)，p=0.016)和局部复发时间
Purpose: To report an analysis of treatment outcomes of a cohort of patients re-irradiated for locally recurrent refractory breast cancer (LRRBC)Patients and Methods: Between 2008 and 2013, 47 women (mean age = 60 years) were re-irradiated for LRRBC. Outcomes were measured using Kaplan-Meier log rank to compare curves and Cox regression for multivariate analysis. Outcomes included overall survival (OS), time to re-treatment, survival without systemic progression, and survival without local recurrence.Results: Fifty-six instances of re-irradiation were completed and analyzed. The mean cumulative 2 Gy equivalent dose (EQD2) to the whole breast and tumour cavity (alpha/beta = 3) was 99.8 Gy and 109.1 Gy, respectively. Most patients initially had significant symptoms before RT due to local recurrence. The median time to re-treatment and to systemic failure was 41 and 50 months, respectively. Median follow-up for OS was 17 months and OS was 0.73 (SE = 0.07) at 1 year and 0.67 (SE = 0.07) at 2 years. Local control was 0.62 (SE = 0.07) and 0.5 (0.08) at 1 and 2 years, respectively. Acute radiation dermatitis was G1-2, G3 and G4 in 45, 4 and 1 cases, respectively. One patient presented with necrosis. The most common long term toxicity was G3 fibrosis (n = 4) and telangiectatic changes (n = 3). Multivariable analysis indicated that skin involvement (Hazard Ratio = 6.6 (1.4-31), p = 0.016) and time to local recurrence