Abstract：
OBJECTIVE: To critically review available literature on hypofractionated (≥ 3 Gy/fraction) proton therapy (PT) for breast cancer (BCa).
METHODS: A systematic screening of the literature was performed in April 2021 in compliance with the preferred reporting items for systematic reviews and meta-analyses recommendations. All full-text publication written in English were considered eligible. Acute and late toxicities, oncological outcomes and dosimetric features were considered for the analysis.
RESULTS: Twelve publications met the inclusion criteria; all studies but one focused on accelerated partial breast irradiation (APBI). Eleven works considered post-operative patients, one referred to ABPI as a curative-intent modality. The dosimetric profile of PT compared favorably with both photon-based 3D conformal and intensity-modulated techniques, while a more extended follow-up is warranted to fully assess both the long-term toxicities and the non-inferiority of oncological outcomes.
CONCLUSIONS: Our work shows that results on PT for BCa are currently only available for APBI applications, with dosimetric analyses demonstrating a clear advantage over both 3D conformal and intensity modulated X-rays techniques, especially when ≥ 2 treatment fields were used. However, further evidence is needed to define whether such theoretical benefit translates into clinical improvements, especially in the long-term.
METHODS: A systematic screening of the literature was performed in April 2021 in compliance with the preferred reporting items for systematic reviews and meta-analyses recommendations. All full-text publication written in English were considered eligible. Acute and late toxicities, oncological outcomes and dosimetric features were considered for the analysis.
RESULTS: Twelve publications met the inclusion criteria; all studies but one focused on accelerated partial breast irradiation (APBI). Eleven works considered post-operative patients, one referred to ABPI as a curative-intent modality. The dosimetric profile of PT compared favorably with both photon-based 3D conformal and intensity-modulated techniques, while a more extended follow-up is warranted to fully assess both the long-term toxicities and the non-inferiority of oncological outcomes.
CONCLUSIONS: Our work shows that results on PT for BCa are currently only available for APBI applications, with dosimetric analyses demonstrating a clear advantage over both 3D conformal and intensity modulated X-rays techniques, especially when ≥ 2 treatment fields were used. However, further evidence is needed to define whether such theoretical benefit translates into clinical improvements, especially in the long-term.
摘要：
目的：严格回顾关于乳腺癌（BCa）的大分割（≥3Gy/分数）质子治疗（PT）的现有文献。
方法：根据系统评价和荟萃分析建议的首选报告项目，于2021年4月对文献进行系统筛选。所有以英文撰写的全文出版物都被认为是合格的。急性和晚期毒性，分析考虑了肿瘤结局和剂量学特征.
结果：12篇出版物符合纳入标准；除一项外，所有研究都集中在加速部分乳房照射（APBI）上。11个作品考虑手术后的病人，一个人将ABPI称为治愈意向模式。PT的剂量学轮廓与基于光子的3D共形和强度调制技术相比都是有利的，虽然有必要进行更长时间的随访,以全面评估肿瘤结局的长期毒性和非劣效性.
结论：我们的工作表明，BCa的PT结果目前仅适用于APBI应用，剂量学分析证明了与3D共形和强度调制X射线技术相比的明显优势，特别是当使用≥2个治疗场时。然而,需要进一步的证据来确定这种理论上的益处是否转化为临床改善，尤其是长期的。
方法：根据系统评价和荟萃分析建议的首选报告项目，于2021年4月对文献进行系统筛选。所有以英文撰写的全文出版物都被认为是合格的。急性和晚期毒性，分析考虑了肿瘤结局和剂量学特征.
结果：12篇出版物符合纳入标准；除一项外，所有研究都集中在加速部分乳房照射（APBI）上。11个作品考虑手术后的病人，一个人将ABPI称为治愈意向模式。PT的剂量学轮廓与基于光子的3D共形和强度调制技术相比都是有利的，虽然有必要进行更长时间的随访,以全面评估肿瘤结局的长期毒性和非劣效性.
结论：我们的工作表明，BCa的PT结果目前仅适用于APBI应用，剂量学分析证明了与3D共形和强度调制X射线技术相比的明显优势，特别是当使用≥2个治疗场时。然而,需要进一步的证据来确定这种理论上的益处是否转化为临床改善，尤其是长期的。
