Patient preference study comparing hypofractionated versus conventionally fractionated whole-breast irradiation after breast-conserving surgery
Patient preference study comparing hypofractionated versus conventionally fractionated whole-breast irradiation after breast-conserving surgery
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DOI：
10.1093/jjco/hyz003
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发表时间：
2019-06-01
影响因子：
2.4
通讯作者：
Sasaki, Ryohei
中科院分区：
文献类型：
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作者：
Kawaguchi, Hiroki;Tsujino, Kayoko;Sasaki, Ryohei
目的比较保乳手术后大分割（HF）和常规分割（CF）全乳照射（WBI）的患者偏好和急性不良事件。方法我们进行了一项患者偏好研究，比较了保乳手术后CF-WBI（50戈伊/25次）和HF-WBI（41.6戈伊/16次）。符合条件的患者在放射肿瘤科医生解释后选择任一类型的分割。结果2009年6月至2013年12月，共有348例患者（349个乳房）入选本研究。其中，259例患者（260个乳房[74.5%]）选择了CF-WBI，89例患者（89个乳房[25.5%]）选择了HF-WBI。与选择HF-WBI显著相关的因素是年龄较大（P = 0.028）和未接受辅助化疗（P = 0.041）。关于急性不良事件，HF-WBI中观察到的2级（G2）或更高级别放射性皮炎的频率低于CF-WBI（13. 8% vs. 29. 4%; P = 0. 004）。此外，仅在CF-WBI组中观察到G2或更高级别的乳房疼痛（6.9%; P = 0.012）。有没有显着差异的存在疲劳，伤口疼痛或放射性肺炎G2或更高的groups.Conclusions在这项研究中，在患者自己选择的照射方法，更多的患者倾向于选择CF-WBI。HF-WBI组中G2或更高级别皮炎和乳房疼痛的频率显著低于CF-WBI组。我们的研究结果支持在保乳手术后推荐HF-WBI的证据，同时提出患者偏好的方面。
Objective To compare patient preferences and acute adverse events of hypofractionated (HF) and conventionally fractionated (CF) whole-breast irradiation (WBI) after breast-conserving surgery in our institution.Methods We conducted a patient preference study comparing CF-WBI (50 Gy/25 fractions) and HF-WBI (41.6 Gy/16 fractions) after breast-conserving surgery. Eligible patients selected either type of fractionation following an explanation from the radiation oncologist. In this report, we analyzed the selection rate and acute toxicities.Results Between June 2009 and December 2013, 348 patients (349 breasts) were identified as eligible for the study. Among them, 259 patients (260 breasts [74.5%]) selected CF-WBI and 89 patients (89 breasts [25.5%]) selected HF-WBI. Factors significantly associated with the selection of HF-WBI were older age (P = 0.028) and no adjuvant chemotherapy (P = 0.041). Regarding acute adverse events, Grade 2 (G2) or higher radiation dermatitis was less frequently observed in HF-WBI than in CF-WBI (13.8% vs. 29.4%; P = 0.004). In addition, G2 or higher breast pain was only observed in the CF-WBI group (6.9%; P = 0.012). There were no significant differences in the presence of fatigue, wound pain or radiation pneumonitis of G2 or higher between the groups.Conclusions In this study, in which patients themselves selected the irradiation method, more patients tended to select CF-WBI. The frequency of G2 or higher dermatitis and breast pain was significantly lower in the HF-WBI group than in the CF-WBI group. Our results support the evidence for recommending HF-WBI after breast-conserving surgery while presenting aspects of patient preferences.