| Yue Dan,Yang Yongjing,Zhao Ling,Pu Mingwei,Li Zhong,Liu Shixin,Wu Hongfen.Efficacy analysis of accelerated partial breast irradiation versus whole breast irradiation with simultaneous integrated boost after breast-conserving surgery for early-stage breast cancer[J].Chinese Journal of Radiological Medicine and Protection,2018,38(9):664-669 |
| Efficacy analysis of accelerated partial breast irradiation versus whole breast irradiation with simultaneous integrated boost after breast-conserving surgery for early-stage breast cancer |
| Received:April 16, 2018 |
| DOI：10.3760/cma.j.issn.0254-5098.2018.09.005 |
| KeyWords:Breast-conserving surgery Accelerated partial breast irradiation (APBI) Whole breast irradiation (WBI) Simultaneous integrated boost (SIB) Efficacy |
| FundProject: |
| Author Name | Affiliation | E-mail | | Yue Dan | No.1 Department of Radiation Oncology, Jilin Province Cancer Hospital, Changchun 130012, China | | | Yang Yongjing | No.1 Department of Radiation Oncology, Jilin Province Cancer Hospital, Changchun 130012, China | | | Zhao Ling | No.1 Department of Radiation Oncology, Jilin Province Cancer Hospital, Changchun 130012, China | | | Pu Mingwei | No.1 Department of Radiation Oncology, Jilin Province Cancer Hospital, Changchun 130012, China | | | Li Zhong | No.1 Department of Radiation Oncology, Jilin Province Cancer Hospital, Changchun 130012, China | | | Liu Shixin | No.1 Department of Radiation Oncology, Jilin Province Cancer Hospital, Changchun 130012, China | | | Wu Hongfen | No.1 Department of Radiation Oncology, Jilin Province Cancer Hospital, Changchun 130012, China | 2284262146@qq.com |
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| Abstract:: |
| Objective To evaluate the efficacy of accelerated partial breast irradiation (APBI) and whole breast irradiation (WBI) with simultaneous integrated boost (SIB) from the perspective of economics, and provide a reference for postoperative adjuvant therapy mode selection for early-stage breast cancer after breast-conserving surgery. Methods A total of 355 early-stage breast cancer patients who underwent APBI or WBI-SIB after breast-conserving surgery were evaluated on efficacy and cost-effectiveness, of which 177 patients received APBI, and 178 patients received WBI-SIB. Survival analysis was done according to treatment received. NCI-CTC 3.0 was used to score the toxicities. Breast aesthetic outcome were evaluated with Harris standards. Results Median follow-up was 42 months (5.8-92.7 months). The 3-year locoregional recurrence free survival(LRFS) rates in APBI group and WBI-SIB group were 98.2% and 97.6%, distant metastasis free survival(DMFS) were 94.3% and 93.7%, disease-free survival (DFS) were 93.1% and 91.6%, and overall survival 95.5% and 94.3%, respectively, without statistically significant differences(P>0.05). Compared with WBI-SIB group, the acute reaction rates in APBI group decreased from 5.6% to 3.4%(χ2=6.044, P<0.05), and late reactions from 5.6% to 2.3% (χ2=6.149, P<0.05), while the cosmetic outcome improved from 88.8% to 93.8%(χ2=5.22, P<0.05). Moreover, the processing average time was shortened by 26.5 d (χ2=40.76, P<0.05). Conclusions After breast-conserving surgery, the efficacy of APBI showed no difference from WBI-SIB with respect to 3-year local control, disease-free survival, and overall survival, but displayed a significantly better toxicity profile and cost-effectiveness ratio for early breast cancer patients. It can be used as a good radiotherapy model after breast-conserving surgery in early-stage breast cancer. |
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