글로벌 연구동향
방사선종양학
- 2024년 05월호
[Yonsei Med J .] Feasibility of Intraoperative Radiotherapy Tumor Bed Boost in Patients with Breast Cancer after Neoadjuvant Chemotherapy연세의대 / 양고운, 조연아*
- 출처
- Yonsei Med J .
- 등재일
- 2024 Mar
- 저널이슈번호
- 65(3):129-136. doi: 10.3349/ymj.2023.0229.
- 내용
Abstract
Purpose: This study aimed to assess the feasibility and safety of administering intraoperative radiotherapy (IORT) as a boost during breast-conserving surgery (BCS) following neoadjuvant chemotherapy for patients at high risk of breast cancer recurrence.Materials and methods: Patients who underwent neoadjuvant chemotherapy received a single 20-Gy dose of IORT during BCS, followed by external beam radiotherapy 4-6 weeks after surgery.
Results: The median follow-up duration was 31.0 months (range, 18.0-59.0 months). Initial tumor sizes had a median of 2.6 cm (range: 0.8-5.3 cm), reducing to 0.3 cm (range: 0-4.0 cm) after neoadjuvant chemotherapy. The most common neoadjuvant chemotherapy regimen was doxorubicin and cyclophosphamide, followed by paclitaxel (n=42, 73.7%). Among 57 patients who received neoadjuvant chemotherapy before BCS and IORT, 2 patients (3.5%) required secondary surgery to achieve negative resection margins due to initially positive margins. Regional lymph node irradiation was performed in 37 (64.9%) patients. There was no grade 3 or higher adverse events, with 4 patients (7.0%) experiencing grade 2 acute radiation dermatitis and 3 (5.3%) having less than grade 2 breast edema. Binary correlation analysis did not reveal statistically significant associations between applicator size or radiation therapy modality and the risk of treatment-related toxicity. Furthermore, chi-square analysis showed that the grade of treatment-related toxicity was not associated with the fractionated regimen (p=0.375).
Conclusion: Most patients successfully received IORT as a tumor bed boost after neoadjuvant chemotherapy. Thus, IORT may be a safe and feasible option for patients with advanced-stage breast cancer receiving neoadjuvant chemotherapy.
Affiliations
Gowoon Yang 1, Jun Won Kim 2, Ik Jae Lee 1, Joon Jeong 3, Sung Gwe Ahn 3, Soong June Bae 3, Jee Hung Kim 4, Yeona Cho 5
1Department of Radiation Oncology, Yonsei Cancer Center, Heavy Ion Therapy Research Institute, Yonsei University College of Medicine, Seoul, Korea.
2Department of Radiation Oncology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
3Department of Surgery, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
4Division of Medical Oncology, Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
5Department of Radiation Oncology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea. IAMYONA@yuhs.ac.
- 키워드
- Breast neoplasms; intraoperative; neoadjuvant therapy; radiotherapy; safety.
- 덧글달기
편집위원
유방암으로 선행항암화학요법 후 유방보존수술 시행 시 IntraBeam을 이용한 수술중 방사선치료로 tumor bed boost를 적용한 환자들의 치료독성을 분석한 논문으로, 주로 조기유방암을 대상으로 upfront surgery 시에 시행되었던 기존의 연구와 달리 선행항암화학요법을 시행한 유방암 환자에서 수술중 방사선치료가 시행된 점이 차별점이라고 할 수 있겠음.
덧글달기닫기2024-05-03 11:01:01
등록