[DG News] 초기 유방암에 대한 Accelerated Partial Breast Irradiation(APBI)는 삶의 질을 높인다.

초기 유방암의 Accelerated Partial Breast Irradiation(APBI) 치료에 대한 예후 보고서가 나오기 시작한다. 2010년인가 ASTRO annual meeting에 갔을 때 한참 논의가 진행되고 있었는데, 이제 5년이 넘었으니 슬슬 결과가 나올 때가 된 듯...

사실 외과의가 주도권을 쥐고 있는 우리나라 실정에선 좀 요원하지만, 전체 유방을 예방차원에서 치료하는데 들어가는 수고나 불편, 부작용을 고려하면 충분히 메리트가 있다고 본다. 물론 본 내용도 삶의 질이 향상되었다는 결론이다.

※출처: DG News

Quality of Life Is Superior With Accelerated Partial Breast Irradiation for Early Breast Cancer

December 8, 2016

By Jill Stein

SAN ANTONIO, Tex -- December 8, 2016 -- Women with early breast cancer who receive accelerated partial breast irradiation (APBI) report a better quality of life (QOL) than women treated with whole body irradiation (WBI), researchers reported here today at the 39th Annual San Antonio Breast Cancer Symposium (SABCS).

APBI represents a valid option for selected early breast cancer. Potential advantages include shorter treatment time, improved safety profile, and a cost reduction compared with standard fractionation.

Icro Meattini, MD, University of Florence, Florence, Italy, and colleagues reported the final analysis of QOL results from a phase 3 randomised trial comparing standard adjuvant radiotherapy (50 Gy in 25 fractions, plus 10 Gy boost) to APBI using intensely-modulated radiotherapy (IMRT; 30 Gy in 5 daily fractions). The 5-year results have been recently published showing equivalence in terms of local control.

The 520 patients were aged 40 years or older and had early breast cancer and a maximum pathological tumour size of 25 mm.

An earlier analysis showed no significant differences between the 2 treatment arms in the primary endpoint of ipsilateral breast tumour recurrences at a median follow-up of 5 years and the secondary endpoint of overall survival. APBI treatment had a significantly better acute and late toxicity profile.

In the present analysis, the investigators evaluated QOL using the European Organisation for Research and Treatment-QOL questionnaire and breast cancer specific module (EORTC QLQ-C30 and QLQ-BR23). Overall, 205 patients completed the questionnaires.

Mean values (and SD) of QLQ-C30 scores at 2 years after the completion of treatment demonstrated significant improvement favouring the APBI in terms of global health status (mean 75.5 vs 59.5, SD range 13.3-22.0; P ˂ .0001), main functional (P ˂ .01), and symptom scales (P ˂ .01).

APBI was superior on the BR23 module with respect to body image perception (mean 89 vs 72.1, SD 13.2-26.6; P ˂ .0001) and future perspective (84.8 vs 57, SD 23.1-28.5; P ˂ .0001) among functional scales; breast (6.1 vs 18.9, SD 6.6-18.2; P ˂ .0001), and arm symptoms (11.7 vs 19.6, SD 13.4-19; P = .002) among symptom scales.

According to Dr. Meattini, based on the clinical and QOL results of the study, APBI should be the treatment of choice in women with early breast cancer who are older than 40 years who are candidates for breast-conserving surgery.

[Presentation title: Accelerated Partial Breast Irradiation Versus Whole Breast Irradiation: Health-Related Quality of life Analysis From a Phase 3 Trial. Abstract P1-10-04]