Clinical Study Of Accelerated Partial Breast Irradiation Compared With Conventional Whole Breast Irradiation After Breast Conserving Surgery For Early Stage Breast Cancer

Objective: To explore the differences in the short-term clinical efficacy and adverse reactions of two radiotherapy modes of partial accelerated breast irradiation and conventional whole breast irradiation in the treatment of early breast cancer after breast-conserving surgery,so as to provide clinical basis for the selection of the optimal radiotherapy mode for patients with early breast cancer after breast-conserving surgery.Methods: In this study,80 patients with early breast cancer after breast-conserving surgery admitted to the Radiotherapy Department of Jilin Cancer Hospital from January2018 to December 2020 were included,including 40 patients in the partial accelerated breast irradiation group(APBI group)and 40 patients in the conventional whole breast irradiation group(WBI group).All enrolled patients completed postoperative radiotherapy for early breast cancer.NCI-CTCAE 5.0 and RTOG/ESTRO radiotherapy injury grading criteria were used to compare the adverse reactions of the two groups,evaluate quality of life according to FACT-B evaluation criteria,cosmetic effects according to the Harris Beauty Standard,and the local recurrence rate,the survival rate without distant metastasis.Results:1、 In the accelerated partial breast irradiation group median follow-up times was 24.5months and 25 months in the conventional whole breast irradiation group.2、At the end of the follow-up,the follow-up rate of the whole group was 100%,and no death in both groups.3、During the follow-up period the survival rate was 100% in the two groups.In APBI group,there was 1 case(2.5%)of ipsilateral breast tumor recurrence and 1 case(2.5%)of ipsilateral supraclavicular lymph node recurrence,and 1 case(2.5%)occurred ipsilateral supraclavicular lymph node recurrence in WBI group.There was no distant metastasis in the APBI group,and 1 case(2.5%)occurred bone metastasis in the WBI group.There was no differences between the two groups(P>0.05).4、Compared with WBI group,the rate of grade 2 acute radiotherapy reactions in the APBI group decreased from 7.5% to 5.0%(P=0.034),and the rate of grade 2 late radiotherapy reactions was also slightly better than that in the WBI group(P=0.048),and there was no grade 3 or above acute and late radiotherapy reactions occurred in both groups.5 、 The breast cosmetic effect of APBI group was improved from 85% to 90%compared with WBI group,and the breast cosmetic effect after radiotherapy of APBI group was slightly better than WBI group(P=0.048).6、The patient’s quality of life was improved who was enrolled in the APBI group(P=0.003).7、The incidence of myelosuppression was similar in both groups(P>0.05).8 、 The APBI group significantly reduced the total time required for radiotherapy(P<0.001).Conclusion: The short-term clinical effect of Accelerated partial breast irradiation after breast-conserving surgery is similar to that of conventional whole breast irradiation.Accelerated partial breast irradiation was slightly better than conventional whole breast irradiation in acute adverse reactions to radiotherapy,late adverse reactions to radiotherapy,cosmetic effect and quality of life.In the meantime,shorten the time of radiotherapy and reduce financial burden.Therefore,accelerated partial breast irradiation can be used as one of the options of radiotherapy after breast conserving surgery for early breast cancer.