방사선종양학

  • [Front Oncol.] First Experience in Korea of Stereotactic Partial Breast Irradiation for Low-Risk Early-Stage Breast Cancer

    연세의대 / 이원희, 김용배*

  • 출처
    Front Oncol.
  • 등재일
    2020 Apr 29
  • 저널이슈번호
    10:672. doi: 10.3389/fonc.2020.00672. eCollection 2020.
  • 내용

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    Abstract
    Purpose: Accelerated partial breast irradiation (A-PBI) in Korean women has been considered impracticable, owing to small breast volume and lack of high-precision radiotherapy experience. We present the first experience of stereotactic-PBI (S-PBI) with CyberKnife M6 to investigate feasibility of use and early toxicities in Korean women with early breast cancers. Materials and Methods: A total of 104 breasts receiving S-PBI at our institution between September 2017 and October 2018 were reviewed. Patients were selected based on the American Society for Radiation Oncology (ASTRO), American Brachytherapy Society, American Society of Breast Surgeons, and Groupe Européen de Curiethérapie-European Society for Therapeutic Radiology and Oncology guidelines. A dose of 30 Gy in 5 fractions (NCT01162200) was used. Gold fiducials were routinely inserted near the tumor bed for tracking. Constraints regarding organs-at-risk followed the NSABP-B39/RTOG 0413 protocol. Results: Median follow-up was for 13 months. Patients were categorized as "suitable" (71.2%) or "cautionary" (28.8%) according to 2017 the ASTRO guidelines. No tracking failure of inserted gold fiducials occurred. Median planning target volume (PTV) and PTV-to-whole breast volume ratio was 73.6 mL (interquartile range, 58.8-103.9 mL) and 17.0% (13.3-19.1%), respectively. Median PTV V95%, PTV Dmax, and ipsilateral breast V50% were 97.8% (96.2-98.8%), 105.3% (104.2-106.4%), and 35.5% (28.3-39.8%), respectively. No immediate post-S-PBI toxicity ≥ grade 2 was reported, except grade 2 induration in three breasts. All patients remain disease-free to date. Conclusion: The first use of S-PBI in Korean women was feasible and safe for selected early breast cancer. Based on these results, we have initiated a prospective study (NCT03568981) to test S-PBI in whole-breast irradiation for low-risk early breast cancer.

     

     

    Affiliations

    Won Hee Lee  1 , Jee Suk Chang  1 , Min Jung Kim  2 , Vivian Youngjean Park  2 , Jung Hyun Yoon  2 , Se Young Kim  1 , Jee Ye Kim  3 , Hyung Seok Park  3 , Seung Il Kim  3 , Young Up Cho  3 , Byeong Woo Park  3 , Yong Bae Kim  1
    1 Department of Radiation Oncology, Breast Cancer Center, Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, South Korea.
    2 Department of Radiology, Breast Cancer Center, Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, South Korea.
    3 Department of Surgery, Breast Cancer Center, Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, South Korea.

  • 키워드
    Korean; accelerated partial breast irradiation; breast cancer; dosimetric outcomes; early toxicity; feasibility studies; stereotactic partial breast irradiation.
  • 편집위원

    부분유방방사선치료 기법으로 SBRT(30 Gy/5fx)를 적용한 국내최초보고.

    2020-07-02 14:17:33

  • 편집위원

    경과관찰기간이 짧긴 하지만, 한국인 여성을 대상으로 S-PBI의 유용성을 보여준 좋은 연구입니다.

    2020-07-02 14:21:00

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