期刊
ADVANCES IN RADIATION ONCOLOGY
卷 5, 期 5, 页码 824-833出版社
ELSEVIER INC
DOI: 10.1016/j.adro.2020.04.035
关键词
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资金
- Conquer Cancer Foundation (American Society for Clinical Oncology) - Breast Cancer Research Foundation
- Andrew Sabin Family Fellowship
- Cancer Prevention and Research Institute of Texas [RP 160670]
- National Cancer Institute [R01CA207216, R01CA225646]
- MD Anderson Cancer Center for Radiation Oncology Research
- [R01CA203984]
- [R01CA143190]
- [P30CA016672]
Purpose: Our purpose was to use 3-dimensional (3D) surface photography to quantitatively measure breast cosmesis within the framework of a randomized clinical trial of conventionally fractionated (CF) and hypofractionated (HF) whole breast irradiation (WBI); to identify how 3D measurements are associated with patient- and physician-reported cosmesis; and to determine whether objective measures of breast symmetry varied by WBI treatment arm or transforming growth factor beta 1 (TGF beta 1) status. Methods and Materials: From 2011 to 2014, 287 women age >= 40 with ductal carcinoma in situ or early-stage invasive breast cancer were enrolled in a multicenter trial and randomized to HF-WBI or CF-WBI with a boost. Three-dimensional surface photography was performed at 3 years posttreatment. Patient-reported cosmetic outcomes were recorded with the Breast Cancer Treatment Outcome Scale. Physician-reported cosmetic outcomes were assessed by the Radiation Therapy Oncology Group scale. Volume ratios and 6 quantitative measures of breast symmetry, termed F1-6C, were calculated using the breast contour and fiducial points assessed on 3D surface images. Associations between all metrics, patient- and physician-reported cosmesis, treatment arm, and TGF beta 1 genotype were performed using the Kruskal-Wallis test and multivariable logistic regression models. Results: Among 77 (39 CF-WBI and 38 HF-WBI) evaluable patients, both patient- and physician-reported cosmetic outcomes were significantly associated with the F1C vertical symmetry measure (both P <. 05). Higher dichotomized F1C and volumetric symmetry measures were associated with improved patient- and physician-reported cosmesis on multivariable logistic regression (both P <= .05). There were no statistically significant differences in vertical symmetry or volume measures between treatment arms. Increased F6C horizontal symmetry was observed in the CF-WBI arm (P = .05). Patients with the TGF beta 1 C-509T variant allele had lower F2C vertical symmetry measures (P = .02). Conclusions: Quantitative 3D image-derived measures revealed comparable cosmetic outcomes with HF-WBI compared with CF-WBI. Our findings suggest that 3D surface imaging may be a more sensitive method for measuring subtle cosmetic changes than global patient- or physician-reported assessments. (C) 2020 The Authors. Published by Elsevier Inc. on behalf of American Society for Radiation Oncology.
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