CBCT-Guided Online Adaptive Radiation Therapy for Accelerated Partial Breast Irradiation: A Single-Institution Experience.

IF 2.5 3区医学 Q2 ONCOLOGY

Clinical breast cancer Pub Date : 2025-08-23 DOI:10.1016/j.clbc.2025.08.018

Claudia Warden, Kayla Steed, Whitney Hotsinpiller, Joel Pogue, Joseph Harms, Michael Soike, Kimberly Keene, Michael Dobelbower, Markus Bredel, Dennis Stanley, D Hunter Boggs

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引用次数: 0

Abstract

Purpose/objectives: Accelerated partial breast irradiation (APBI) using stereotactic body radiation therapy (SBRT) offers shorter treatment, comparable local control, and improved cosmesis for early-stage breast cancer (ESBC). Cone beam CT (CBCT)-guided online adaptive radiation therapy (OART) enhances target coverage and minimizes normal tissue exposure. This retrospective study evaluates clinical characteristics and outcomes in patients treated with APBI using OART.

Materials/methods: From January 2022 to May 2024, 40 patients (including 2 with bilateral disease) received SBRT with OART. Targets included the lumpectomy cavity (GTV), a 1 cm CTV margin, and a 3 mm PTV margin. Patients received 30 Gy in 5 fractions. Daily CBCT guided alignment and adaption of targets and organs-at-risk was performed. Either the scheduled or adapted plan was selected each day. Outcomes were assessed at 1 month and most recent follow-up using CTCAE criteria.

Results: Patients (ages 50-83) had predominantly right-sided (59.5%) and upper outer quadrant tumors (61.9%), with a median size of 0.9 cm. The median interval from lumpectomy to radiation was 62 days; treatment lasted a median of 9 days. The adapted plan was used in 90% of fractions. At 1 month, 48% had no toxicity; all reported events were grade 1. At a median 14.3-month follow-up, most toxicities remained grade 1; 3 patients had grade 2 effects. No recurrences were observed.

Conclusions: This study, the largest APBI with OART cohort to date, demonstrates excellent cosmesis, minimal toxicity, and promising early oncologic outcomes for ESBC patients.

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cbct引导的在线适应性放射治疗加速部分乳房照射：单一机构的经验。

目的/目的：使用立体定向体放射治疗（SBRT）的加速部分乳房照射（APBI）为早期乳腺癌（ESBC）提供了更短的治疗时间，可比较的局部控制和改善的美容。锥形束CT （CBCT）引导的在线适应性放射治疗（OART）提高了靶覆盖范围，最大限度地减少了正常组织暴露。本回顾性研究评估了使用OART治疗APBI患者的临床特征和结果。材料/方法：2022年1月至2024年5月，40例患者（包括2例双侧疾病）接受SBRT联合OART治疗。目标包括乳房肿瘤切除腔（GTV）， 1厘米CTV边缘和3毫米PTV边缘。患者接受5次30 Gy的治疗。每天进行CBCT引导的靶和高危器官对齐和适应。每天要么选择预定的计划，要么选择调整后的计划。使用CTCAE标准在1个月和最近随访时评估结果。结果：患者年龄50 ~ 83岁，以右侧肿瘤为主（59.5%），上外象限肿瘤为主（61.9%），中位尺寸0.9 cm。从乳房肿瘤切除术到放疗的中位间隔为62天；治疗时间平均为9天。90%的分数采用了调整后的方案。1个月时，48%无毒性；所有报告的事件均为1级。在中位14.3个月的随访中，大多数毒性仍为1级；3例患者出现2级效应。未见复发。结论：该研究是迄今为止最大的OART队列APBI，对ESBC患者具有良好的美容效果、最小的毒性和有希望的早期肿瘤预后。

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 breast cancer 医学-肿瘤学

CiteScore

5.40

自引率

3.20%

发文量

174

审稿时长

48 days

期刊介绍： Clinical Breast Cancer is a peer-reviewed bimonthly journal that publishes original articles describing various aspects of clinical and translational research of breast cancer. Clinical Breast Cancer is devoted to articles on detection, diagnosis, prevention, and treatment of breast cancer. The main emphasis is on recent scientific developments in all areas related to breast cancer. Specific areas of interest include clinical research reports from various therapeutic modalities, cancer genetics, drug sensitivity and resistance, novel imaging, tumor genomics, biomarkers, and chemoprevention strategies.