METHODS: A descriptive observational study was conducted on 160 patients diagnosed with breast cancer. Between July 2020 and December 2021, patients underwent conservative surgery followed by a regimen of 26 Gy administered in five daily fractions.
RESULTS: The median age was 64 years (range: 43-83), with 82 patients (51.3%) treated for left-sided breast cancer, 77 patients (48.1%) for right-sided breast cancer, and 1 instance (0.6%) of bilateral breast cancer. Of these, 66 patients had pT1c (41.3%), 70.6% were infiltrative ductal carcinomas, and 11.3% were ductal carcinoma in situ. Most tumours exhibited intermediate grade (41.9%), were hormone receptor positive (81.3%), had low Ki-67 (Ki-67 < 20%; 51.9%) and were Her 2 negative (85%). The majority of surgical margins were negative (99.4%). Among the patients, 72.5% received hormonotherapy, and 23.8% received chemotherapy. Additionally, 26 patients (16.3%) received an additional tumour boost following whole breast irradiation (WHBI) of 10 Gy administered in five sessions of 2 Gy over a week. The median planning target volume (PTV) was 899 cm3 (range: 110-2509 cm3). Early toxicity was primarily grade I radiodermatitis, affecting 117 patients (73.1%). During a median follow-up of 15 months (range: 3.9-28.77), only one patient experienced a local relapse, which required mastectomy.
CONCLUSIONS: The implementation of this highly hypofractionated regimen in early-stage breast cancer appears feasible and demonstrates minimal early toxicity. However, a more extended follow-up duration would be required to evaluate long-term toxicity and efficacy accurately.
方法:对160例诊断为乳腺癌的患者进行了一项描述性观察研究。在2020年7月至2021年12月之间,患者接受了保守手术,然后每天分五次进行26Gy的方案。
结果:中位年龄为64岁(范围:43-83),82例患者(51.3%)接受左侧乳腺癌治疗,77例(48.1%)右侧乳腺癌患者,双侧乳腺癌1例(0.6%)。其中,66例患者pT1c(41.3%),70.6%为浸润性导管癌,11.3%为导管原位癌。大多数肿瘤表现为中级(41.9%),激素受体阳性(81.3%),Ki-67较低(Ki-67<20%;51.9%),Her2阴性(85%)。大多数手术切缘为阴性(99.4%)。在患者中,72.5%接受激素治疗,23.8%接受化疗。此外,26名患者(16.3%)在一周内进行5次2Gy的全胸照射(WHBI)后,接受了10Gy的额外肿瘤增强治疗。中位计划目标体积(PTV)为899cm3(范围:110-2509cm3)。早期毒性主要是I级放射性皮炎,影响117例患者(73.1%)。在15个月的中位随访期间(范围:3.9-28.77),只有一名患者出现局部复发,需要乳房切除术.
结论:在早期乳腺癌中实施这种高分割方案似乎是可行的,并且显示出最小的早期毒性。然而,为了准确评估长期毒性和疗效,需要延长随访时间.