评估使用次分量同步综合增强技术进行乳腺保守治疗的患者中由放射诱发的气管炎和心包炎的情况

Q3 Medicine
The gulf journal of oncology Pub Date : 2024-05-01
Senthamizhan Sundaramoorthy, Gunaseelan Karunanidhi, Pravati Pal, Sunitha V C, Hanumitha Radhakrishnan
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引用次数: 0

摘要

简介通过在一家三级医院进行的前瞻性观察研究,确定在乳腺癌保守手术后接受低分次放射治疗和同步综合增强技术的患者中,放射性诱导的肺炎和心包炎的比例:对所有接受保乳手术后接受低剂量分次放射和同步综合增强技术的经活检证实的早期单侧乳腺癌成年患者进行了放射诱发性气胸和心包炎发病率评估。基线评估包括六分钟步行测试、高分辨率计算机断层扫描(HRCT)、肺功能测试(PFT)、心电图(ECG)和超声心动图(ECHO)。放射治疗后三个月,患者接受了六分钟步行测试、心电图和超声心动图的随访评估。放射治疗后六个月,患者接受进一步的评估,包括六分钟步行测试、心电图、心动图、肺功能检查和胸部 HRCT。数据分析采用 SPSS 19 版本:我们的研究调查了在 20 名符合条件的早期乳腺癌患者中采用低分量 VMAT-SIB 技术治疗的患者中急性放射诱发性气胸和心包炎的发生率。研究发现,该技术是可行的,并获得了令人鼓舞的剂量学参数,包括同侧肺部和心脏剂量。研究还发现,在资源有限的情况下,治疗时间缩短为3-4周,而采用顺序增强疗法则需要6-7周。急性放射性肺炎和心包炎的发生率可以接受,与现有数据相当,根据CTCAE v5.0,90%的患者出现1级放射性肺炎。治疗后的肺功能测试显示出显著的变化,尤其是接受过新辅助化疗和结节照射的患者。六分钟步行测试和博格量表也与肺功能测试呈显著正相关。随访期间没有发现明显的心包炎。研究认为,使用VMAT-SIB进行低分次放疗是传统分次放疗的合适替代方案,急性毒性可以接受,但需要更长时间的随访来评估其对晚期毒性的影响:我们的研究表明,对早期乳腺癌患者来说,SIB低分次辅助放疗是一种安全可行的治疗方法。这种治疗方法不会对肺部或心脏造成任何明显的短期风险,而且 SIB 技术的覆盖面更广,更符合要求,并能保留有风险的器官。此外,据患者报告,这种治疗方法还具有积极的美容效果。不过,为了得出更准确的结论,我们还需要进行样本量更大、随访时间更长的进一步研究,以评估在全乳腺放射治疗中使用 VMAT 这种治疗方法可能产生的长期副作用。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Assessment of Radiation Induced Pneumonitis and Pericarditis in Patients Undergoing Breast Conservative Treatment Using Hypofractionated Simultaneous Integrated Boost Technique.

Introduction: To determine the proportion of radiationinduced pneumonitis and pericarditis in patients who have received Hypo-fractionated Radiation along with simultaneous integrated boost technique after breast conservative surgery using a prospective observational study from a tertiary hospital.

Materials & methods: The incidence of radiationinduced pneumonitis and pericarditis was evaluated in all adult patients with biopsy-proven early-stage unilateral breast cancer who underwent breast-conserving surgery followed by hypo-fractionated radiation with a simultaneous integrated boost technique. Baseline assessments including a six-minute walk test, highresolution computed tomography (HRCT), pulmonary function tests (PFTs), electrocardiography (ECG) and echocardiography (ECHO) were performed. At three months post-radiation treatment, patients underwent follow-up assessments with a six-minute walk test, ECG and ECHO. At six months post-radiation treatment, patients underwent further assessments with a six-minute walk test, ECG, ECHO, PFTs, and HRCT of the thorax. Data analysis was performed using SPSS version 19.

Results: Our study investigated the incidence of acute radiation-induced pneumonitis and pericarditis in patients treated with hypofractionated VMAT-SIB technique in 20 eligible early breast cancer patients. The study found that the technique is feasible and achieves encouraging dosimetric parameters, including well achieved ipsilateral lung and heart doses. The reduced treatment time of 3-4 weeks compared to the previous 6-7 weeks with sequential boost was also found to be desirable in resource-constrained settings. The incidence of acute radiation pneumonitis and pericarditis was acceptable and comparable to existing data, with 90% of patients experiencing grade 1 radiation pneumonitis according to CTCAE v5.0. Post-treatment pulmonary function tests showed significant changes, particularly in patients who had received neoadjuvant chemotherapy and nodal irradiation. The six-minute walk test and Borg scale also showed a significant positive correlation with pulmonary function tests. There was no significant pericarditis during the follow-up. The study proposes that the hypofractionated radiotherapy using VMAT-SIB is a suitable alternative to conventional fractionation, with acceptable acute toxicities, but longer follow-up is required to assess the impact on late toxicities.

Conclusion: Our research has shown that hypofractionated adjuvant radiotherapy with SIB is a safe and feasible treatment for patients with early breast cancer. This treatment method doesn't pose any significant short-term risks to the lungs or heart, and the SIB technique provides better coverage, conformity and sparing of organs at risk. Additionally, patients have reported positive cosmetic outcomes with this treatment. However, to make more accurate conclusions, we need to conduct further studies with larger sample sizes and longer follow-up periods to evaluate the potential longterm side effects of this treatment using VMAT in whole breast radiation.

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来源期刊
The gulf journal of oncology
The gulf journal of oncology Medicine-Medicine (all)
CiteScore
0.90
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37
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