【摘 要】
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Objective:To assess the efficacy and cosmetic outcomes for two different hypofractionated schedules with integrated boost intensity-modulated radiotherapy(IMRT)after breast conservative surgery for ea
【机 构】
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Department of Radiation Oncology,Sichuan Cancer Hospital,Chengdu 610041
【出 处】
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第十一届中国西部地区放射肿瘤学学术会议暨内蒙古自治区放射肿瘤学2016年学术会议
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Objective:To assess the efficacy and cosmetic outcomes for two different hypofractionated schedules with integrated boost intensity-modulated radiotherapy(IMRT)after breast conservative surgery for early breast cancer.Methods:From June 2012 to June 2014,132 patients with stage TisT1-2N0-1M0 breast cancer treated with breast conservative surgery were retrospectively analyzed.The patients undergone breast radiotherapy without regional lymph node irridiation and hypofractionated radiotherapy were used.All patients received whole breast IMRT with integrated tumor bed boost.We divided the patients to two groups.Group A: 56 Patients were treated to the whole breast with doses of 40.5Gy in 15 fractions of 2.7Gy,the tumor bed were simultaneously boosted with doses of 51.2Gy in 15 fractions of 3.2Gy.Group B: the other 76 patients were treated to the whole breast with doses of 50Gy in 25 fractions of 2.0Gy,the tumor bed were simultaneously boosted with doses of 60Gy in 25 fractions of 2.4Gy.Cosmetic evaluation is based on the Harvard system.Acute and late toxicities were scored according to CACAT version 3.Survival and recurrence rates were calculated by Kaplan-Meier method and the differences were compared by Logrank test.Chi-square test was used to compared toxicity and cosmetic outcome between the two groups.Results:Two groups of patients with a median follow-up of 25 months.The follow-up rate was 100%.the 1-,2-and 3-year overall survival rates were 100%.One patient experienced an axillary nodal relapse.For group A and group B,the incidence of grade 1 acute skin toxicity was 44.6%and 42.1%(P > 0.05),grade 2 was 14.2%and 18.4%(P > 0.05).One year after irradiation,in group A and group B,the late skin toxicity of grade 1 was 12.5%and 15.7%(P > 0.05),grade 2 was 1.8%and 13.1%(x2=4.07,P = 0.02).In A and B group,80.3%and 73.6%of patients had excellent and good cosmetic outcome(P > 0.05).Conclusion:The two different hypofractionated radiotherapy schedules provides similar results in local control,toxicity and cosmetic outcome.Long-term follow up is warranted to confirm this finding.
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