IORT-photon boost plus hypofractionated whole breast irradiation in patients with breast cancer after primary systemic treatment: feasibility, safety and clinical results.

IF 2.8 3区医学 Q2 ONCOLOGY

Clinical & Translational Oncology Pub Date : 2024-10-28 DOI:10.1007/s12094-024-03759-z

J Burgos-Burgos, V Vega, D Macias-Verde, E Vicente, C Murias, C Santana, P C Lara

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引用次数: 0

Abstract

Aim: To assess for the first time the safety and feasibility of combining photon-intraoperative radiotherapy (ph-IORT) with hypofractionated whole breast irradiation (h-WBI) in patients referred to primary systemic therapy (PST).

Methods: From March 2019 to December 2020, patients referred for breast conservative surgery (BCS) after PST in our institution were prospectively included in the present trial. PST was prescribed to all patients according the ESMO-SEOM guidelines. Once the PST was completed, BCS was discussed in the multidisciplinary tumor board (MTB). 20 Gy were prescribed to the surface of the applicator of an Intrabeam®photon-IORT during BCS. h-WBI (40.5 Gy/2.67 Gy/15frx) was planned to be administered 3-5w after BCS. All patients were treated with hWBI VMAT-Rapid-Arc&Daily Exac-Trac-IGRT. The primary end points of the study were feasibility and safety (grade 3 toxicity rate CTCAE.5.0-scale) of the proposed treatment protocol. The secondary end points included cosmetic results (Harvard Scale), local relapse rate and overall survival.

Results: Thirty-five patients were included in the trial. The median age was 54 years. Tumor size was > 2 cm in all cases. Eighteen patients were N + (51.4%). There was no disease progression during PST. All patients received the planned 20 Gy-ph-IORT boost at the time of BCS and the proposed h-WBI. 31/35 (88,6%) patients started h-WBI within the predefined time period (3-5w after BCS). No patient showed ≥ G3 acute toxicity 3 months after the end of h-WBI. No ≥ G3 late toxicity was observed at 12 months of follow-up and thereafter. Cosmetic results were scored excellent/good in 26 patients (74.2%). After a median follow-up of 52 months, a TNBC patient locally relapsed at 13 months of follow-up.

Conclusion: We demonstrated for the first time that ph-IORT + hWBI is feasible and safe in patients referred to BCS after PST.

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在乳腺癌患者中进行IORT-光子增量加低分量全乳腺照射：可行性、安全性和临床结果。

目的：首次评估光子术中放疗（ph-IORT）与低分次全乳腺照射（h-WBI）在转诊至原发性系统治疗（PST）患者中的安全性和可行性：方法：2019年3月至2020年12月，我院将PST后转诊接受乳腺保守手术（BCS）的患者纳入本试验的前瞻性研究。所有患者均根据ESMO-SEOM指南接受PST治疗。PST 结束后，多学科肿瘤委员会（MTB）讨论 BCS。计划在 BCS 结束后 3-5w 施用 h-WBI（40.5 Gy/2.67 Gy/15frx）。所有患者都接受了 hWBI VMAT-Rapid-Arc&Daily Exac-Trac-IGRT 治疗。研究的主要终点是拟议治疗方案的可行性和安全性（3 级毒性率 CTCAE.5.0 级）。次要终点包括美容效果（哈佛量表）、局部复发率和总生存率：试验共纳入 35 名患者。中位年龄为 54 岁。所有病例的肿瘤大小均大于 2 厘米。18例患者为N +（51.4%）。PST期间没有出现疾病进展。所有患者在进行 BCS 和拟议的 h-WBI 时都接受了计划的 20 Gy-ph-IORT 增强治疗。31/35（88.6%）名患者在预定时间内（BCS 后 3-5w ）开始了 h-WBI。h-WBI 结束 3 个月后，没有患者出现≥ G3 急性毒性。在 12 个月的随访及其后，未观察到≥ G3 的后期毒性。26名患者（74.2%）的美容效果被评为优/良。中位随访52个月后，一名TNBC患者在随访13个月时局部复发：我们首次证明了 ph-IORT + hWBI 在 PST 后转诊至 BCS 的患者中是可行且安全的。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical & Translational Oncology 医学-肿瘤学

CiteScore

6.20

自引率

2.90%

发文量

240

审稿时长

1 months

期刊介绍： Clinical and Translational Oncology is an international journal devoted to fostering interaction between experimental and clinical oncology. It covers all aspects of research on cancer, from the more basic discoveries dealing with both cell and molecular biology of tumour cells, to the most advanced clinical assays of conventional and new drugs. In addition, the journal has a strong commitment to facilitating the transfer of knowledge from the basic laboratory to the clinical practice, with the publication of educational series devoted to closing the gap between molecular and clinical oncologists. Molecular biology of tumours, identification of new targets for cancer therapy, and new technologies for research and treatment of cancer are the major themes covered by the educational series. Full research articles on a broad spectrum of subjects, including the molecular and cellular bases of disease, aetiology, pathophysiology, pathology, epidemiology, clinical features, and the diagnosis, prognosis and treatment of cancer, will be considered for publication.