- 作者：Frank A. Vicini ; M.D.&lowast ; ; fvicini@beaumont.edu ; Martin Keisch ; M.D.&dagger ; ; Chirag Shah ; M.D.&lowast ; ; Sharad Goyal ; M.D.&Dagger ; ; Atif J. Khan ; M.D.&Dagger ; ; Peter D. Beitsch ; M.D.§ ; ; Maureen Lyden ; M.S.鈥?/sup> ; Bruce G. Haffty ; M.D.&Dagger ;
- 关键词：Accelerated partial breast irradiation ; MammoSite ; Cosmesis ; Brachytherapy ; Breast cancer
- 刊名：International Journal of Radiation Oncology*Biology*Physics
- 出版年：2012
- 期刊代码：136_03603016
- 类别：med
- 出版时间：1 June, 2012
- 卷：83
- 期：2
- 页码：512-518
- 文件大小：176 K
Purpose
To evaluate factors associated with optimal cosmetic results at 72 months for early-stage breast cancer patients treated with Mammosite balloon-based accelerated partial breast irradiation (APBI).Methods and Materials
A total of 1,440 patients (1,449 cases) with early-stage breast cancer undergoing breast-conserving therapy were treated with balloon-based brachytherapy to deliver APBI (34 Gy in 3.4-Gy fractions). Cosmetic outcome was evaluated at each follow-up visit and dichotomized as excellent/good (E/G) or fair/poor (F/P). Follow-up was evaluated at 36 and 72 months to establish long-term cosmesis, stability of cosmesis, and factors associated with optimal results.
Results
The percentage of evaluable patients with excellent/good (E/G) cosmetic results at 36 months and more than 72 months were 93.3%(n = 708/759) and 90.4%(n = 235/260). Factors associated with optimal cosmetic results at 72 months included: larger skin spacing (p = 0.04) and T1 tumors (p = 0.02). Using multiple regression analysis, the only factors predictive of worse cosmetic outcome at 72 months were smaller skin spacing (odds ratio [OR], 0.89; confidence interval [CI], 0.80-0.99) and tumors greater than 2 cm (OR, 4.96, CI, 1.53-16.07). In all, 227 patients had both a 36-month and a 72-month cosmetic evaluation. The number of patients with E/G cosmetic results decreased only slightly from 93.4%at 3 years to 90.8%(p = 0.13) at 6 years, respectively.
Conclusions
APBI delivered with balloon-based brachytherapy produced E/G cosmetic results in 90.4%of cases at 6 years. Larger tumors (T2) and smaller skin spacing were found to be the two most important independent predictors of cosmesis.