International comparison of cosmetic outcomes of breast conserving surgery and radiation therapy for women with ductal carcinoma in situ of the breast

被引：11

作者：

Olivotto, Ivo A. ^{[1
]}

Link, Emma ^{[2
,3
]}

Phillips, Claire ^{[3
]}

Whelan, Timothy J. ^{[4
]}

Bryant, Guy ^{[5
]}

Kunkler, Ian H. ^{[6
]}

Westenberg, A. Helen ^{[7
]}

Purohit, Kash ^{[8
]}

Ahern, Verity ^{[9
]}

Graham, Peter H. ^{[10
]}

Akra, Mohamed ^{[11
]}

McArdle, Orla ^{[12
]}

Ludbrook, Joanna J. ^{[13
]}

Harvey, Jennifer A. ^{[5
]}

Maduro, John H. ^{[14
]}

Kirkove, Carine ^{[15
]}

Gruber, Guenther ^{[16
]}

Martin, Joseph D. ^{[17
]}

Campbell, Ian D. ^{[18
]}

Delaney, Geoff P. ^{[10
,19
]}

Chua, Boon H. ^{[10
]}

机构：

[1] Univ Calgary, Calgary, AB, Canada

[2] Univ Melbourne, Melbourne, Vic, Australia

[3] Peter MacCallum Canc Ctr, Melbourne, Vic, Australia

[4] McMaster Univ, Hamilton, ON, Canada

[5] Univ Queensland, Brisbane, Qld, Australia

[6] Univ Edinburgh, Edinburgh, Midlothian, Scotland

[7] Radiotherapiegrp, Arnhem, Netherlands

[8] Univ Sheffield, Sheffield, S Yorkshire, England

[9] Univ Sydney, Westmead, NSW, Australia

[10] Univ New South Wales NSW, Sydney, NSW, Australia

[11] Univ Manitoba, Winnipeg, MB, Canada

[12] Royal Coll Surgeons Ireland, Dublin, Ireland

[13] Univ Newcastle, Callaghan, NSW, Australia

[14] Univ Med Ctr Groningen, Groningen, Netherlands

[15] Catholic Univ Louvain, Brussels, Belgium

[16] Univ Bern, Bern, Switzerland

[17] Canc Trials Ireland & Univ Hosp, Galway, Ireland

[18] Univ Auckland, Auckland, New Zealand

[19] Ingham Inst Appl Med Res, Liverpool, NSW, Australia

来源：

RADIOTHERAPY AND ONCOLOGY | 2020年 / 142卷

基金：

英国医学研究理事会;

关键词：

Breast cancer; Radiotherapy; Cosmetic outcomes; Fractionation; Boost; Breast conservation; RADIOTHERAPY START TRIALS; QUALITY-OF-LIFE; CONSERVATIVE SURGERY; SURGICAL-PROCEDURES; EORTC BOOST; FOLLOW-UP; CANCER; PATIENT; STANDARDIZATION; IRRADIATION;

D O I：

10.1016/j.radonc.2019.07.024

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

Purpose: To assess the cosmetic impact of breast conserving surgery (BCS), whole breast irradiation (WBI) fractionation and tumour bed boost (TBB) use in a phase III trial for women with ductal carcinoma in situ (DCIS) of the breast. Materials and methods: Baseline and 3-year cosmesis were assessed using the European Organization for Research and Treatment of Cancer (EORTC) Cosmetic Rating System and digital images in a randomised trial of non-low risk DCIS treated with postoperative WBI +/- TBB. Baseline cosmesis was assessed for four geographic clusters of treating centres. Cosmetic failure was a global score of fair or poor. Cosmetic deterioration was a score change from excellent or good at baseline to fair or poor at three years. Odds ratios for cosmetic deterioration by WBI dose-fractionation and TBB use were calculated for both scoring systems. Results: 1608 women were enrolled from 11 countries between 2007 and 2014. 85-90% had excellent or good baseline cosmesis independent of geography or assessment method. TBB (16 Gy in 8 fractions) was associated with a >2-fold risk of cosmetic deterioration (p < 0.001). Hypofractionated WBI (42.5 Gy in 16 fractions) achieved statistically similar 3-year cosmesis compared to conventional WBI (50 Gy in 25 fractions) (p >= 0.18). The adverse impact of a TBB was not significantly associated with WBI fractionation (interaction p >= 0.30). Conclusions: Cosmetic failure from BCS was similar across international jurisdictions. A TBB of 16 Gy increased the rate of cosmetic deterioration. Hypofractionated WBI achieved similar 3-year cosmesis as conventional WBI in women treated with BCS for DCIS. (C) 2019 Elsevier B.V. All rights reserved.

引用

页码：180 / 185

页数：6

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