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患者提出的早期乳腺癌射频消融治疗作为局部治疗(PO-RAFAELO)研究——患者提议的医疗服务项目

Patients Offer Radiofrequency Ablation Therapy for Early Breast Cancer as Local Therapy (PO-RAFAELO) Study under the Patient-proposed Health Services.

作者信息

Takayama Shin, Kinoshita Takayuki, Shiino Sho, Jimbo Kenjiro, Watanabe Ken-Ichi, Fujisawa Tomomi, Yamamoto Naohito, Onishi Tatsuya, Shien Tadahiko, Ito Mitsuya, Takahashi Mina, Futamura Manabu, Aruga Tomoyuki, Kaneko Koji, Suto Akihiko

机构信息

Department of Breast Surgery, National Cancer Center Hospital, Tokyo, Japan.

Department of Breast Surgery, National Hospital Organization Tokyo Medical Center, Tokyo, Japan.

出版信息

JMA J. 2023 Oct 16;6(4):505-512. doi: 10.31662/jmaj.2023-0047. Epub 2023 Oct 2.

Abstract

INTRODUCTION

Due to the increase in the number of early-stage breast cancer patients, there is growing interest in minimally invasive local therapies for breast cancer. Radiofrequency ablation (RFA) therapy is one of the most promising minimally invasive treatments. The Radiofrequency Ablation Therapy for Early Breast Cancer as Local Therapy (RAFAELO) study, a multicenter collaborative study that aims to validate the efficacy and safety of RFA and to standardize its use for early-stage breast cancer, was conducted under the Advanced Medical Care B system in 2013. This study enrolled the expected number of patients in November 2017; moreover, it is currently in the follow-up period. Some patients with early-stage breast cancer who are eligible for RFA could not receive the RFA treatment, as it is still not covered by insurance. Therefore, the Patients Offer Radiofrequency Ablation Therapy for Early Breast Cancer as Local Therapy (PO-RAFAELO) study under the Patient-proposed Health Services (PPHS) was proposed and approved in March 2019.

METHODS

The PPHS is a system that allows patients to receive prompt access to advanced medical care at a medical facility close to them, starting with their request. This system is considered a part of the specific and special medical coverage. The PO-RAFAELO study is the only study in the surgical field utilizing the PPHS, aiming to help in achieving regulatory approval and insurance coverage of RFA for breast cancer.

RESULTS

As of January 2023, 120 patients have undergone RFA using the PPHS and no grade 3 or higher early adverse events have occurred.

CONCLUSIONS

A certain number of patients with early-stage breast cancer prefer nonsurgical treatment, and it is important to provide information regarding the availability of RFA for early-stage breast cancer under the PPHS.Trial registration: registered with Japan Registry of Clinical Trial on March 06, 2019 (Trial ID: jRCTs032180187).

摘要

引言

由于早期乳腺癌患者数量的增加,对乳腺癌微创局部治疗的兴趣日益浓厚。射频消融(RFA)治疗是最有前景的微创治疗方法之一。早期乳腺癌射频消融局部治疗(RAFAELO)研究是一项多中心合作研究,旨在验证RFA的有效性和安全性,并规范其在早期乳腺癌中的应用,该研究于2013年在先进医疗保健B系统下开展。本研究于2017年11月纳入了预期数量的患者;此外,目前正处于随访期。一些符合RFA条件的早期乳腺癌患者无法接受RFA治疗,因为其仍未纳入医保。因此,在患者建议的医疗服务(PPHS)下开展了早期乳腺癌患者射频消融局部治疗(PO-RAFAELO)研究,并于2019年3月获得批准。

方法

PPHS是一种系统,允许患者从提出请求开始,在其附近的医疗机构迅速获得先进医疗服务。该系统被视为特定和特殊医疗覆盖的一部分。PO-RAFAELO研究是外科领域利用PPHS的唯一研究,旨在帮助实现RFA用于乳腺癌的监管批准和医保覆盖。

结果

截至2023年1月,已有120例患者使用PPHS接受了RFA治疗,未发生3级或更高等级的早期不良事件。

结论

一定数量的早期乳腺癌患者倾向于非手术治疗,在PPHS下提供有关早期乳腺癌RFA可用性的信息很重要。试验注册:于2019年3月6日在日本临床试验注册中心注册(试验编号:jRCTs032180187)。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b18f/10628329/0017678fd138/2433-3298-6-4-505-g001.jpg

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