Dataset related to article "Hypofractionated Whole Breast Irradiation and Simultaneous Integrated Boost in Large-breasted Patients: Long-term Toxicity and Cosmesis"s

This record contains data related to article "Hypofractionated Whole Breast Irradiation and Simultaneous Integrated Boost in Large-breasted Patients: Long-term Toxicity and Cosmesis"

Abstract

Introduction: The purpose of this study was to evaluate the impact of breast size on long-term toxicity and cosmesis in patients with breast cancer treated with hypofractionated simultaneous integrated boost (SIB) using volumetric modulated arc therapy (VMAT).

Patients and methods: Patients with early stage breast cancer were treated with 3-week hypofractionated SIB-VMAT to the whole breast (40.5 Gy) and tumor bed (48 Gy). Two cohorts were identified: small/medium- (< 1000 cm3) and large- (> 1000 cm3) breasted patients. Acute and late (at 2 and 5 years) skin toxicity and cosmetic data were analyzed. Univariate and multivariate analysis evaluated associations between toxicity and dosimetric/anatomical variables.

Results: From August 2010 to March 2017, a total of 1160 patients were treated; 831 had at least 2 years of follow-up and were analyzed. Treated skin area (TSA) receiving at least 20 Gy > 400 cm2 and V105% of Boost > 5 cm3 were significant predictors for acute skin toxicity. Multivariate analysis at 2 years was significant for boost volume > 70 cm3, TSA > 400 cm2, and breast size > 1500 cm3. At 5 year analysis (352 patients), none of the analyzed variables was significant. For cosmetic outcome, only the breast size (> 1000 cm3) and the boost size > 70 cm3 at 2 and 5 years, respectively, confirmed significance.

Conclusions: The TSA > 400 cm2 resulted as a significant predictor of both acute and late skin toxicity at 2 years; however, at 5 years, no breast size or dosimetric parameter suggested indications for increased toxicity. A worse cosmetic outcome was recorded at the 2-year follow up for large breasts, but was not confirmed at the 5-year follow-up. These long-term data suggest that hypofractionated SIB-VMAT is a viable modality also in large-breasted patients.

本数据集包含与论文《大乳房患者大分割全乳放疗联合同步加量容积调强弧形治疗：远期毒性与美容外观》相关的研究数据。

摘要

引言：本研究旨在评估接受大分割同步加量（Simultaneous Integrated Boost, SIB）联合容积调强弧形治疗（volumetric modulated arc therapy, VMAT）的乳腺癌患者中，乳房体积对远期毒性反应与美容外观的影响。

患者与方法：本研究纳入早期乳腺癌患者，采用3周疗程的大分割SIB-VMAT方案，对全乳给予40.5 Gy照射，瘤床给予48 Gy照射。根据乳房体积将患者分为两个队列：中小体积乳房组（<1000 cm³）与大体积乳房组（>1000 cm³）。分析患者急性与远期（随访2年、5年时）皮肤毒性反应及美容外观数据。采用单因素与多因素分析评估毒性反应与剂量学/解剖学变量之间的关联。

结果：2010年8月至2017年3月期间，共计1160例患者接受治疗；其中831例获得至少2年随访数据并纳入分析。接受至少20 Gy照射的皮肤受照面积（treated skin area, TSA）>400 cm²以及加量靶区V105%>5 cm³是急性皮肤毒性反应的显著预测因子。2年随访的多因素分析显示，加量靶区体积>70 cm³、皮肤受照面积>400 cm²以及乳房体积>1500 cm³为显著相关变量。5年随访队列（352例患者）中，所有分析变量均无统计学显著性。对于美容结局而言，仅乳房体积（>1000 cm³，2年随访时）与加量靶区体积（>70 cm³，5年随访时）被证实具有统计学意义。

结论：皮肤受照面积>400 cm²是2年随访时急性与远期皮肤毒性反应的显著预测因子；但在5年随访时，未发现乳房体积或剂量学参数与毒性反应增加存在关联。大体积乳房患者在2年随访时的美容结局更差，但该差异在5年随访时未得到证实。本长期研究数据表明，大分割SIB-VMAT方案同样适用于大体积乳房的乳腺癌患者。