Comparison of clinical efficacy between simultaneous integrated boost intensity-modulated radiotherapy and whole-breast intensity-modulated radiotherapy with sequential electronic boost radiotherapy for early breast cancer after breast-conserving surgery
10.3760/cma.j.cn115355-20230710-00355
- VernacularTitle:早期乳腺癌保乳术后同步加量调强放疗与全乳调强放疗序贯电子线瘤床补量放疗的临床效果比较
- Author:
Qin MA
1
;
Qian JIANG
;
Na JING
;
Xianling WANG
;
Yongqiang MA
;
Miaoli ZHENG
;
Yu WANG
Author Information
1. 山西省肿瘤医院 中国医学科学院肿瘤医院山西医院 山西医科大学附属肿瘤医院放射治疗科乳腺放疗病区，太原 030013
- Keywords:
Breast neoplasms;
Mastectomy;
Radiotherapy;
Prognosis
- From:
Cancer Research and Clinic
2023;35(11):845-849
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To compare the efficacy, adverse reactions and skin cosmetic effects between simultaneous integrated boost intensity-modulated radiotherapy and whole-breast intensity-modulated radiotherapy with sequential electronic boost radiotherapy for early breast cancer after breast-conserving surgery.Methods:The clinical data of 96 early breast cancer patients who underwent breast-conserving surgery in Shanxi Province Cancer Hospital from December 2015 to December 2017 were retrospectively analyzed, and the patients were divided into simultaneous integrated boost intensity-modulated radiotherapy group (observation group, 52 cases) and whole-breast intensity-modulated radiotherapy with sequential electronic boost radiotherapy group (control group, 44 cases) according to the postoperative radiotherapy method. In the observation group, the dose division scheme was 50 Gy/25 fractions (2 Gy/fraction) for the whole breast, while 60 Gy/25 fractions (2.4 Gy/fraction) was used in the tumor bed concomitantly, with a total treatment course of 33-35 d. In the control group, the dose division scheme was 50 Gy/25 fractions (2 Gy/ fraction) for the whole breast followed by tumor bed boost of 10 Gy/5 fractions (2 Gy/fraction), with a total treatment course of 40-42 d.Results:Median follow-up time of all patients was 70 months, the 5-year overall survival rates of the observation and control groups were 100.0% and 97.7%, the 5-year local recurrence-free survival rates were 98.1% and 95.5%, the 5-year disease-free survival rates were 98.1% and 93.2%, and the differences between the two groups in terms of overall survival, recurrence-free survival and disease-free survival were not statistically significant ( χ2 = 1.18, P = 0.277; χ2 = 0.44, P = 0.509; χ2 = 1.24, P = 0.265). The incidence of grade 1 and 2 acute radiation dermatitis was 63.5% (33/52) and 19.2% (10/52) in the observation group, and 50.0% (22/44) and 38.6% (17/44) in the control group, there was 1 case (2.3%) of grade 3 acute radiation dermatitis, and the difference between the two groups was statistically significant ( Z = -2.15, P = 0.032). The differences in the incidence of acute and late radiation lung injury between the two groups were not statistically significant (both P > 0.05). Except for 1 patient (2.3%) in the control group with poor cosmetic results, the rest of the patients in both groups achieved average or excellent cosmetic results ( P > 0.05). The radiotherapy time of the observation group was shorter than that of the control group, and the difference was statistically significant ( P = 0.001). Conclusions:Early breast cancer patients who received simultaneous integrated boost intensity-modulated radiotherapy or whole-breast intensity-modulated radiotherapy with sequential electronic boost radiotherapy after breast-conserving surgery could obtain good survival benefit, and the cosmetic results are all good without serious adverse effects. The treatment time of simultaneous integrated boost intensity-modulated radiotherapy is shorter and patient compliance is better.
