Background:Intensity modulated radiotherapy with helical tomotherapy (IMRT-HT) is used in the breast cancer (BC) treatment for years now to obtain homogeneous dose distribution in the treated volumes and reduce the doses to organs at risk. The purpose of this study was to evaluate our experience in terms of local control, overall survival, progression free survival and adverse events in BC patients treated with IMRT-HT with long term follow-up.Methods:This study is a retrospective data analysis of patients irradiated with IMRT-HT. Overall survival (OS) and progression free survival (PFS) curves were plotted with Kaplan-Meier method. We also analyzed the OS and PFS data by molecular subgroups of the population. Long-term toxicities including skin, cardiac and pulmonary complications were also evaluated. Multivariant logistic regression analysis was performed to determine the independent predictors of the side effects.Results:Between 2009 and 2015, a total of 194 breasts in 179 women with nonmetastatic breast cancer were treated. Most of the tumors were grade III and N+. With a median follow-up of 10 years, we observed 9 local recurrences, 2 loco-regional recurrences, and 29 patients experienced metastatic disease. Only 18 patients are dear, of them 7 cases with breast cancer death. At 10 years, the Local recurrence free survival was 95.3% [95%CI: 92.1–98.5], the loco-regional relapse free survival was 94.5% [91.1–98.1]. The metastases free survival was 82.9% [76.9–89.3]. The progression free survival was 79.9 [73.6–86.7]. The cancer specific survival was 94.3%, and the overall survival 88% [82.8–93.5]. At long term, there were no cardiac, lung, thyroid, digestive radio induced toxicities. A small number of patients experienced grade I or II fibrosis.Conclusions:IMRT-HT could be safely used for adjuvant breast cancer irradiation in patients with complex anatomy. IMRT-HT provides favourable long-term prognosis, while late toxicity is acceptable.
背景：螺旋断层调强放疗（IMRT-HT）应用于乳腺癌治疗已有多年，其目的是在靶区内获得均匀的剂量分布，同时降低危及器官的受照剂量。本研究旨在通过长期随访，评估采用IMRT-HT治疗的乳腺癌患者的局部控制率、总生存期、无进展生存期及不良事件发生情况。 方法：本研究对接受IMRT-HT治疗的患者进行回顾性数据分析。采用Kaplan-Meier法绘制总生存期（OS）和无进展生存期（PFS）曲线，并依据患者分子亚型对OS和PFS数据进行分析。同时评估包括皮肤、心脏及肺部并发症在内的长期毒性反应，并通过多变量逻辑回归分析确定不良反应的独立预测因素。 结果：2009年至2015年间，共对179例非转移性乳腺癌患者的194个乳房进行了治疗。多数肿瘤为III级且淋巴结阳性。中位随访10年后，观察到9例局部复发、2例局部区域复发，29例患者发生转移性疾病。仅18例患者死亡，其中7例死于乳腺癌。10年局部无复发生存率为95.3% [95%CI: 92.1–98.5]，局部区域无复发生存率为94.5% [91.1–98.1]，无转移生存率为82.9% [76.9–89.3]，无进展生存率为79.9% [73.6–86.7]，癌症特异性生存率为94.3%，总生存率为88% [82.8–93.5]。长期随访中未出现心脏、肺、甲状腺或消化系统放射性损伤毒性反应，仅少数患者出现I级或II级纤维化。 结论：对于解剖结构复杂的患者，IMRT-HT可安全用于乳腺癌辅助放疗。该技术能提供良好的长期预后，且晚期毒性反应可接受。
肿瘤(癌症)患者之家