Multibeam inverse intensity-modulated radiotherapy (IMRT) for whole breast irradiation: a single center experience in China.
Multibeam inverse intensity-modulated radiotherapy (IMRT) for whole breast irradiation: a single center experience in China.
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全乳腺多束逆调强放射治疗（IMRT）：中国单中心经验。
DOI：
10.18632/oncotarget.5278
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发表时间：
2015-10-27
期刊：
影响因子：
--
通讯作者：
Guo X
中科院分区：
文献类型：
--
作者：
Yang Z;Zhang L;Chen X;Ma J;Mei X;Chen J;Yu X;Guo X
目的介绍我院应用多束逆向调强放疗（IMRT）治疗早期乳腺癌（BC）患者全乳照射（WBI）的临床经验。我们回顾性分析了2008年至2011年采用广泛局部切除和WBI治疗的622例0至III期BC患者，采用逆向IMRT技术。所有患者均接受全乳房总剂量为50戈伊，分2-戈伊次，然后使用电子束分5次进行10戈伊的肿瘤床增强。132例（21.2%）接受全乳加区域淋巴结（RLN）照射。根据不良事件通用术语标准（CTC），622例患者中有438例有急性皮肤毒性记录。280例（64%）患者发生0/1级毒性，153例（35%）发生2级毒性，仅4例患者发生3级毒性。70例患者（16%）出现湿性脱皮。单因素分析显示，乳房计划目标体积是≥2级急性皮炎的唯一预测因素（P = 0.002）。4年后，170例患者通过自我评估报告了美容结果，其中151例（89%）患者报告了良好/极好的美容结果，17例（11%）患者报告了一般评估。对于浸润性癌，4年无局部复发生存率为98.3%。关于原位癌，没有患者发生复发。接受保守手术后接受反向IMRT计划的BC患者表现出可接受的急性毒性和临床结局。需要更长时间的随访。
To present the clinical experience in our cancer center with multibeam inverse intensity-modulated radiotherapy (IMRT) for early stage breast cancer (BC) patients with whole breast irradiation (WBI). We retrospectively analyzed 622 patients with Stage 0 to III BC treated from 2008 to 2011 with wide local excision and WBI, using an inverse IMRT technique. All of the patients were prescribed a total dose of 50 Gy to the whole breast in 2-Gy fractions, followed by a tumor bed boost of 10 Gy in 5 fractions using an electron beam. Of all of the patients, 132 (21.2%) received whole breast plus regional lymph node (RLN) irradiation. 438 of 622 patients had records of acute skin toxicity based on common terminology criteria (CTC) for adverse events. Two hundred eighty (64%) patients had Grade 0/1 toxicity, 153 (35%) had Grade 2 and only 4 patients experienced grade 3 toxicity. Seventy patients (16%) had moist desquamation. Univariate analysis revealed that breast planning target volume was the only predictive factor for Grade ≥2 acute dermatitis (P = 0.002). After 4 years, 170 patients reported cosmetic results by self-assessment, of whom 151 (89%) patients reported good/excellent cosmetic results, and 17 (11%) patients reported fair assessments. For invasive cancer, the four-year rate of freedom from locoregional recurrence survival was 98.3%. Regarding carcinoma in situ, no patients experienced recurrence. BC patients who underwent conservative surgery followed by inverse IMRT plan exhibited acceptable acute toxicities and clinical outcomes. Longer follow-up is needed.