文章：

局部复发性乳腺癌的野内再放疗耐受性与肿瘤学结果：一项长期单中心经验

Tolerance and Oncological Outcomes of In-Field Reirradiation for Locally Recurrent Breast Cancer: A Long-Term Single-Center Experience

原文发布日期：12 September 2023

DOI: 10.3390/cancers15184515

类型: Article

开放获取: 是

英文摘要：

Background: The management of cancer relapse in previously irradiated tissues is a challenging therapeutic issue. The aim of this work was to report our experience with breast reirradiation for locoregionally recurrent breast cancer. Methods: All patients who underwent breast or chest wall in-field reirradiation at the Institut Curie, Paris, France, between 2003 and 2019, were identified. Efficacy outcomes and physician-reported toxicities were retrospectively assessed. Results: A total of 21,372 patients underwent breast irradiation in our institution. Of these, 28 received a second course of radiotherapy to the homolateral breast/chest wall. A total of 18 (64%) patients were treated with a curative intent, and 10 (36%) were treated for palliative purposes. Only one acute and one late grade 3 adverse events were reported. One patient with major cardiovascular risk factors died of myocardial infarction 13 months after left breast reirradiation. The 2-year LRFS, OS, DSS, PFS and MFS were 59%, 79%, 82%, 46% and 75%, respectively, in the whole cohort. The 2-year LRFS (72% vs. 31%,p= 0.02), OS (94% vs. 50%,p< 0.01), DSS (94% vs. 56%,p< 0.01) and PFS (61% vs. 20%,p= 0.02) differed significantly between patients treated with curative or palliative intent but not the MFS (78% vs. 69%,p= 0.77). Among the patients, eight (29%) remained relapse-free 5 years after reirradiation. Conclusion: Breast/chest wall reirradiation appears to be feasible with good disease control, especially in patients treated with a curative intent, and presents acceptable toxicity rates.

摘要翻译： 

背景：在既往接受过放疗的组织中处理癌症复发是一个具有挑战性的治疗问题。本研究旨在报告我们对局部复发性乳腺癌进行乳腺再程放疗的经验。方法：我们回顾性分析了2003年至2019年间在法国巴黎居里研究所接受乳腺或胸壁靶区内再程放疗的所有患者，评估其疗效结局及医生报告的不良反应。结果：本机构共有21,372例患者接受了乳腺放疗，其中28例对同侧乳腺/胸壁进行了第二疗程放疗。18例（64%）患者以根治为目的进行治疗，10例（36%）以姑息为目的进行治疗。仅报告了1例急性3级和1例晚期3级不良事件。1例具有主要心血管危险因素的患者在左乳再程放疗后13个月死于心肌梗死。整个队列的2年局部无复发生存率、总生存率、疾病特异性生存率、无进展生存率和无远处转移生存率分别为59%、79%、82%、46%和75%。以根治为目的与以姑息为目的治疗的患者相比，其2年局部无复发生存率（72% vs. 31%，p=0.02）、总生存率（94% vs. 50%，p<0.01）、疾病特异性生存率（94% vs. 56%，p<0.01）和无进展生存率（61% vs. 20%，p=0.02）存在显著差异，但无远处转移生存率无显著差异（78% vs. 69%，p=0.77）。在患者中，有8例（29%）在再程放疗后5年保持无复发状态。结论：乳腺/胸壁再程放疗似乎是可行的，具有良好的疾病控制效果，尤其是在以根治为目的治疗的患者中，并且呈现出可接受的毒性发生率。

原文链接：

Tolerance and Oncological Outcomes of In-Field Reirradiation for Locally Recurrent Breast Cancer: A Long-Term Single-Center Experience