早期乳腺癌保乳手术联合术中放疗临床分析

Combined early breast-conserving surgery and intra-operative radiotherapy for breast carcinoma

目的探讨保乳手术加术中放疗在早期乳腺癌治疗中的美容效果及临床安全性。方法2008年12月-2009年10月对40例早期乳腺癌患者行保乳手术联合电子线术中放疗。采用Mobetron1000移动式电子束术中放疗系统,靶区为可见的肿瘤及其周边2cm、下方1cm范围内的正常组织,中位剂量15Gy。观察术后近期治疗效果、美容效果及不良反应。结果全组中位随访190d,未见局部复发,美容效果优或良占95%,I级放射性肺损伤发生率12.5%,局部乳腺轻微纤维化发生率5%,1例患者术后出现切口感染。结论术中放疗未明显增加保乳术的并发症及手术时间;保乳手术联合术中放疗近期疗效及美容效果良好,不良反应较轻。

Objective To study the beautifying effects and safety of combined early breast-conserving surgery and intra-operative radiotherapy for breast carcinoma.Methods Forty patients with breast cancer received combined early breast-conserving surgery and intra-operative radiotherapy with a Mobetron mobile electron accelerator at a median dose of 15Gy in our hospital from December 2008 to October 2009.The target area involved tumor with a 2cm margin lateral and 1cm margin posterior.Short-term therapeutic and beautifying effect as well as advertise effect of the treatment modality were observed.Results The patients were followed up for a median period of 190 days,during which no recurrence was observed.Excellent or good beautifying effect was achieved in 39 patients（95%）.Grade I radiation-induced lung injury was found in 5 patients（12.5%）,mild local breast fibrosis in 2 patients（5%）,and post-operative incision infection in 1 patient.Conclusion Intra-operative radiotherapy does not significantly increase complications and time of breast-conserving surgery.The short-term therapeutic and beautifying effects of combined breast-conserving surgery and intra-operative radiotherapy are good with only mild advertise effects.