在乳腺癌的乳腺保护疗法后,术内放射治疗作为增强剂与同时整合增强剂的比较
Raluca Stoian1,2,3, Jan-Philipp Harald Exner1,2,3, Mark Gainey1,2,3
1Department of Radiation Oncology, University Hospital of Freiburg, Robert-Koch-Strasse, Freiburg, Germany.
Frontiers in oncology
|July 6, 2023
概括
术内放射治疗 (IORT) 和同时整合增强 (SIB) 提供了乳房保护手术 (BCS) 后的优秀局部控制. 虽然IORT的急性毒性较高,但这两种方法的晚期毒性和生存结果相似.
科学领域:
- 在瘤学瘤学.
- 辐射瘤学 辐射瘤学
- 乳腺癌治疗方法 乳腺癌治疗方法
背景情况:
- 有限的随机试验数据存在于术内放射治疗 (IORT) 作为高风险乳腺癌患者的瘤床增强.
- 这一回顾性分析比较了IORT和同时整合增强 (SIB) 与传统全乳房放射治疗 (WBI) 乳房保护手术 (BCS) 后的毒性和瘤结果.
研究的目的:
- 评估和比较IORT和SIB技术的毒性概况,当用于BCS后的瘤床增强时.
- 在高风险乳腺癌患者中,评估和比较IORT和SIB之间的瘤结果,包括局部控制和生存率.
主要方法:
- 在2009-2019年期间接受IORT (20 Gy单剂量) 跟随WBI或WBI与SIB增强治疗的患者的回顾性分析.
- 倾向性得分匹配用于创建IORT + WBI和SIB + WBI的可比队列.
- 分析了毒性 (急性和晚期),总生存率 (OS) 和无进展生存率 (PFS);用卡普兰-梅尔法计算了局部控制 (LC) 率.
主要成果:
- 倾向性得分匹配创建了由60名患者组成的队列. 随访时间中位数为43.5个月 (IORT+WBI) 和32个月 (SIB+WBI).
- 急性毒性,主要是放射性皮炎,没有显著差异. 然而,疲劳和乳腺内淋巴胀在IORT时更频繁.
- 两组均表现出优异的3年和5年局部控制率 (SIB分别为98%,IORT分别为98%和93%),晚期毒性可比.
结论:
- 在BCS后的IORT和SIB瘤床增强技术都显示出出色的局部控制和可比的晚期毒性.
- IORT的应用与急性毒性中适度增加有关,包括更高的疲劳率和乳腺内淋巴.
- 这些发现需要通过前性随机研究进行验证,例如TARGIT-B试验.
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